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DEPARTMENT OF DEFENSE APPROPRIATIONS

FOR 1993

HEARINGS

BEFORE A

SUBCOMMITTEE OF THE

COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES

ONE HUNDRED SECOND CONGRESS
SECOND SESSION

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DONALD E. RICHBOURG, J. David Willson, JOHN G. PLAShal, Robert V. DAVIS, SANDRA A. GIL-
BERT, DAVID F. KILIAN, DELACROIX Davis III, ALICIA JONES, JULIE PACQUING, TIMOTHY L. PE-
TERSON, GREGORY J. WALTERS, DAVID W. ROBERTS, and Marcia L. MATTS, Staff Assistants;
CINDY E. WAGNER, Administrative Aide

PART 2

Page

Medical Programs...

1

Drug Interdiction and Counter-Drug Activities, Defense........
Environmental Restoration, Defense.........

267

385

Testimony of Members of Congress and Other Interested
Individuals and Organizations

457

59-855 O

Printed for the use of the Committee on Appropriations

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON: 1992

For sale by the U.S. Government Printing Office

Superintendent of Documents, Congressional Sales Office, Washington, DC 20402

·A6

1949

COMMITTEE ON APPROPRIATIONS

JAMIE L. WHITTEN, Mississippi, Chairman

WILLIAM H. NATCHER, Kentucky,

Vice Chairman

NEAL SMITH, Iowa

SIDNEY R. YATES, Illinois
DAVID R. OBEY, Wisconsin

EDWARD R. ROYBAL, California
LOUIS STOKES, Ohio
TOM BEVILL, Alabama
BILL ALEXANDER, Arkansas
JOHN P. MURTHA, Pennsylvania
BOB TRAXLER, Michigan
JOSEPH D. EARLY, Massachusetts
CHARLES WILSON, Texas
NORMAN D. DICKS, Washington
MATTHEW F. MCHUGH, New York
WILLIAM LEHMAN, Florida
MARTIN OLAV SABO, Minnesota
JULIAN C. DIXON, California
VIC FAZIO, California

W. G. (BILL) HEFNER, North Carolina

LES AUCOIN, Oregon

BERNARD J. DWYER, New Jersey

STENY H. HOYER, Maryland

BOB CARR, Michigan

ROBERT J. MRAZEK, New York

RICHARD J. DURBIN, Illinois

RONALD D. COLEMAN, Texas

ALAN B. MOLLOHAN, West Virginia

LINDSAY THOMAS, Georgia

CHESTER G. ATKINS, Massachusetts

JIM CHAPMAN, Texas

MARCY KAPTUR, Ohio

LAWRENCE J. SMITH, Florida

DAVID E. SKAGGS, Colorado

DAVID E. PRICE, North Carolina

NANCY PELOSI, California

PETER J. VISCLOSKY, Indiana

JOSEPH M. McDADE, Pennsylvania
JOHN T. MYERS, Indiana
CLARENCE E. MILLER, Ohio
LAWRENCE COUGHLIN, Pennsylvania
C. W. BILL YOUNG, Florida
RALPH REGULA, Ohio
CARL D. PURSELL, Michigan
MICKEY EDWARDS, Oklahoma
BOB LIVINGSTON, Louisiana
BILL GREEN, New York
JERRY LEWIS, California
JOHN EDWARD PORTER, Illinois
HAROLD ROGERS, Kentucky
JOE SKEEN, New Mexico
FRANK R. WOLF, Virginia
BILL LOWERY, California
VIN WEBER, Minnesota
TOM DELAY, Texas

JIM KOLBE, Arizona

DEAN A. GALLO, New Jersey BARBARA F. VUCANOVICH, Nevada JIM LIGHTFOOT, Iowa

FREDERICK G. MOHRMAN, Clerk and Staff Director

NOTES:

The Honorable Silvio O. Conte was Ranking Minority Member of the Committee until his death on February 8, 1991.

The Honorable William H. Gray III resigned from the Committee on September 11, 1991.

DEPARTMENT OF DEFENSE APPROPRIATIONS

FOR 1993

THURSDAY, MARCH 12, 1992.

MEDICAL PROGRAMS-DEPARTMENT OF DEFENSE

WITNESSES

HON. ENRIQUE MENDEZ, JR., ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS, DEPARTMENT OF DEFENSE

LT. GEN. FRANK F. LEDFORD, JR., SURGEON GENERAL, U.S. ARMY

VICE ADM. DONALD F. HAGEN, SURGEON GENERAL, U.S. NAVY

LT. GEN. ALEXANDER M. SLOAN, SURGEON GENERAL, U.S. AIR FORCE

INTRODUCTION

Mr. MURTHA. The Committee will come to order.

We want to welcome Dr. Enrique Mendez, the Assistant Secretary of Defense for Health Affairs, and the three Services' Surgeons General. I know we always have an interesting hearing, but this morning at our public witness medical hearing, a number of problems came up in talking about the CHAMPUS Reform program that was instituted in California as a demonstration project by the Department, which we feel has worked very successfully.

We are looking forward to your testimony, and then getting to questions. So we will put your full testimony in the record and if you would summarize your remarks, we will get right to the questions.

SUMMARY STATEMENT OF DR. MENDEZ

Dr. MENDEZ. Mr. Chairman, distinguished Members of the Committee, I am pleased to be here this afternoon, and I thank you for the substantial support and thoughtful guidance your Committee has provided over the years. I want to thank you also for the opportunity to discuss with you the programs and initiatives under way within the Military Health Services System.

Mr. Chairman, I will proceed with a summary of my testimony. Our efforts this year span all avenues of health care pursuit: management, structure, organization, budget, delivery, quality, and systems. In each endeavor, this Committee has maintained active

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