On the History of the Military Health System

The Military Health System has a long and honored tradition. It really goes back to the days of the Revolutionary War when provisions were made for the medical care of soldiers. It’s interesting; during the early part of the history of our country, the medical forces, if you will, were always retired at the end of the conflict, and no permanent provision was really made for a medical system until later in our history. Obviously, there was an expansion of the medical system to support the military operations. This was the first time that perhaps medical records and an evacuation system were used. There were even publications about the medical care that was delivered. We can’t really talk about a system of care until we get into World War I; then we saw an expansion of the medical system to support the large number of casualties. Through World War II, the system became refined—specialties came about, the advancement of field labs and surgical units. With the advent of helicopter transport, we were clearing the battlefield much more efficiently; it allowed for the development of specific surgical techniques. My background is as a vascular surgeon. It was during the Korean War [when] many of these techniques began. The casualties were coming from the battlefield much sooner, with cleaner wounds that were not infected, so you could do surgical repairs.

We fast-forward to today’s conflicts and 10 years of war. One of the signature advancements in the Military Health System has been the rapid evacuation of casualties within 24 to 48 hours, reuniting them with their families, getting them to definitive care centers in either Germany—Landstuhl—or back here in the continental United States. We advanced not only the clearing of casualties in the battlefield, but the quality of the care given to them. Our survival rates are the
highest in recorded history, the died-of-wounds rates the lowest in history. We try and bring every bit of technology and know-how to make sure that soldiers, sailors, airmen, and Marines survive when they go in harm’s way.

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