If only there was a U.S. Health Force! (there is)

As the country’s health infrastructure is ravaged by COVID-19, two key U.S. Senators — both of whom ran for President in 2020 — have proposed the creation of a Health Force to respond to the crisis.

Sen. Kirsten Gillibrand (D-New York) and Sen. Michael Bennet (D-Colorado) want to create a federal service that can work on contact tracing, testing patients for COVID-19, and (hopefully) administer a future vaccine en masse. The idea is two-fold, along with addressing urgent public health needs the Health Force would also be a channel to provide jobs to the millions of displaced workers in the United States.

The Senatorial inspiration for this idea came from responses to the Great Depression, when the Feds created civil service organizations like the Works Progress Administration to give people jobs while investing in the country’s infrastructure. And before you ask: no the Health Force is not a reaction to the growing U.S. Space Force.

First, let’s point out that it’s a good idea: employ people, train them at the CDC, and send them out to fight COVID-19. It’s also a solution that pretty much happened in the 1880’s under Grover Cleveland and is already in place. The solution was the U.S. Public Health Service and its very own Commissioned Corps of officers.

You may have heard of the Surgeon General of the United States. Along with renewing their recommendations on labels of cigarettes and alcohol, their chief managerial function is to lead the U.S. Public Health Service Commissioned Corps.

Our current Surgeon General, Dr. Jerome Adams, has been a frequent guest at White House briefings in the last few months. His previous job was serving as a state health care administrator in Indiana, where he met none other than Vice President Mike Pence.

Perhaps you’ve asked yourself: why is Dr. Adams wearing the uniform of a vice admiral in the Navy? A perfectly valid question. The answer is: he is not. He’s wearing the uniform of a vice admiral in the Public Health Service Commissioned Corps! A uniformed service of the United States with the same rank structures, pay, and benefits as the other services; from Army to Coast Guard. For simplicity and, perhaps cost savings, the PHS Commissioned Corps uses Navy uniforms with their own insignia.

The PHS Commissioned Corps recruits, trains, and commissions physicians, nurses, physician assistants, medical technologists, pharmacists, engineers, and more to serve in their ranks. The legal requirements and discipline of a the service are the principal benefits to having them serve in uniform instead of as civilians. Which is to say: you can order them to duty in dangerous situations. A key feature you want when responding to an emergency.

The PHS Commissioned Corps has one draw back though: it’s commissioned. It only has officers. No enlisted personnel serve in the PHS Commissioned Corps. If you’re not familiar with the distinction, uniformed services are broadly split up into management, the officers, and labor, the enlisted personnel. The Commissioned Corps is, by design, all management and no labor. It could be time for that design to change.

Instead of creating an entirely new federal agency to work in parallel with the health service and CDC, a better solution would be to add enlisted ranks to the Public Health Service and, ideally, non-medical commissioned officer positions as well. Instead of bootcamp with your rifle, you’re off to health camp with your syringe. This would allow thousands of Americans to contribute to our struggle to contain, treat, and recover from COVID-19 while granting them the benefits and protections of uniformed service.

Once in uniform, even under significantly less stressful regimens than their military cousins, the personnel of the Public Health Service could quickly and legally be attached to national guard units in each state, onboard infected aircraft carriers, or deployed into national COVID-19 hotspots — and civilian hospital — to respond in force. All the while we would be fighting unemployment, bringing about a new option for national service, and providing job training for roles in the healthcare sector, an industry that is not declining in the United States anytime soon.

One of my favorite quotes about government comes from the 1990’s movie “Contact” starring Jodie Foster. Toward the end of the film, an eccentric billionaire informs Foster’s character that the United States, thought to have built only one costly space vehicle (which was destroyed), had in fact secretly built a second vehicle that could save the day. Says the billionaire, “The first rule of government spending: why buy one when you can have two at twice the price?”

While you should never underestimate the ability of Congress to be inefficient, it would be far better to expand the services we already have. Instead of reinventing the wheel… maybe just put some air in the tires. On the road to recovery, we don’t have time for anything else.

Coloradan, American, Democrat… in that order. Husband, father to two daughters, and policy nerd.

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