Assistant Secretary of Defense for Health Affairs

The Assistant Secretary of Defense for Health Affairs (or ASD(HA)) is chartered under United States Department of Defense Directive (DoDD) 5136.1 [1] in 1994. This DoDD states that the ASD(HA) is the principal advisor to the U.S. Secretary of Defense on all "DoD health policies, programs and activities." In addition to exercising oversight of all DoD health resources, ASD(HA) serves as director of the Tricare Management Activity.

The ASD(HA) reports to the Undersecretary of Defense (Personnel and Readiness), or USD(PR). A political appointee responsible for the United States Department of Defense's Military Health System [2], the ASD(HA) is an Executive Service Level IV official. He or she is nominated by the President of the United States, and confirmed by the United States Senate.

History

This position was originally established in 1949 as the Chairman, Armed Forces Medical Policy Council. Reorganization Plan No. 6 (1953) abolished the council and transferred its functions to a new position, the Assistant Secretary of Defense (Health Affairs). In August 1953, some functions of this position were transferred to the Assistant Secretary of Defense (Manpower), and the title was changed to Assistant Secretary of Defense (Health and Medical).^[1]

The position was abolished completely on January 31, 1961, and for the remainder of the decade, all of its functions were vested in the Assistant Secretary of Defense (Manpower). However, Congress authorized a permanent assistant secretary position for health affairs in November 1969 (P.L. 91-121). The post was then re-established as Assistant Secretary of Defense (Health and Environment) in June 1970 by Defense Directive 5136.1. In January 1976, the position was re-designated Assistant Secretary of Defense (Health Affairs), a title that has endured to the present day.^[1]

Responsibilities

The ASD(HA) is responsible for a number of organizations which directly affect the health care of service members and their dependents. These responsibilities are executed through several Senior Executive Service managers, including the Principal Deputy Assistant Secretary of Defense (Health Affairs) and the following Deputy Assistant Secretaries:

• Force Health Protection & Readiness (FHP&R)
• Clinical and Program Policy
• Health Budgets and Financial Policy.

Other special activities within Health Affairs' jurisdiction include the TRICARE Management Activity, an extensive network of private physicians and hospitals providing health maintenance to service members. With a $40 billion budget (as of 2005), the Military Health System (MHS) provides care for roughly 9.2 million (as of 2005) people through TRICARE and through more than 70 military hospitals worldwide.^[2] MHS comprises over 133,000 military and civilian doctors, nurses, medical educators, researchers, health care providers, allied health professionals, and health administration personnel worldwide, providing our nation with an unequalled integrated healthcare delivery, expeditionary medical, educational, and research capability.

The ASD (HA) oversees the Uniformed Services University of Health Sciences (USUHS), which educates uniform physicians and other health professionals for the Army, Navy, Air Force and Public Health Service. The ASD(HA) also directly tasks the International Health[3] Division of FHP&R, while FHP&R provides administrative oversight and resources.

Current leadership

Dr. Jonathan Woodson is the Assistant Secretary of Defense for Health Affairs and Director, TRICARE Management Activity. In this role, he administers the more than $50 billion Military Health System (MHS) budget and serves as principal advisor to the Secretary of Defense for health issues. The MHS comprises over 133,000 military and civilian doctors, nurses, medical educators, researchers, healthcare providers, allied health professionals, and health administration personnel worldwide, providing our nation with an unequalled integrated healthcare delivery, expeditionary medical, educational, and research capability.

Dr. Woodson ensures the effective execution of the Department of Defense (DoD) medical mission. He oversees the development of medical policies, analyses, and recommendations to the Secretary of Defense and the Undersecretary for Personnel and Readiness, and issues guidance to DoD components on medical matters. He also serves as the principal advisor to the Undersecretary for Personnel and Readiness on matters of chemical, biological, radiological, and nuclear (CBRN) medical defense programs and deployment matters pertaining to force health.

Dr. Woodson co-chairs the Armed Services Biomedical Research Evaluation and Management Committee, which facilitates oversight of DoD biomedical research. In addition, Dr. Woodson exercises authority, direction, and control over the Uniformed Services University of the Health Sciences (USUHS); the Armed Forces Radiobiology Research Institute (AFRRI); the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury (DCoE); the Armed Forces Institute of Pathology; and the Armed Services Blood Program Office.

As Director, TRICARE Management Activity, Dr. Woodson is responsible for managing all TRICARE health and medical resources, and supervising and administering TRICARE medical and dental programs, which serve more than 9.6 million beneficiaries. Dr. Woodson also oversees the TRICARE budget; information technology systems; contracting process; and directs TRICARE Regional Offices (TRO). In addition, he manages the Defense Health Program (DHP) and the DoD Unified Medical Program as TRICARE director.

Prior to his appointment by President Barack Obama, Dr. Woodson served as Associate Dean for Diversity and Multicultural Affairs and Professor of Surgery at the Boston University School of Medicine (BUSM), and senior attending vascular surgeon at Boston Medical Center (BMC). Dr. Woodson holds the rank of brigadier general in the U.S. Army Reserve, and served as Assistant Surgeon General for Reserve Affairs, Force Structure and Mobilization in the Office of the Surgeon General, and as Deputy Commander of the Army Reserve Medical Command.

Dr. Woodson is a graduate of the City College of New York and the New York University School of Medicine. He received his postgraduate medical education at the Massachusetts General Hospital, Harvard Medical School and completed residency training in internal medicine, and general and vascular surgery. He is board certified in internal medicine, general surgery, vascular surgery and critical care surgery. He also holds a Master's Degree in Strategic Studies (concentration in strategic leadership) from the U.S. Army War College.

In 1992, he was awarded a research fellowship at the Association of American Medical Colleges Health Services Research Institute. He has authored/coauthored a number of publications and book chapters on vascular trauma and outcomes in vascular limb salvage surgery.

His prior military assignments include deployments to Saudi Arabia (Operation Desert Storm), Kosovo, Operation Enduring Freedom and Operation Iraqi Freedom. He has also served as a Senior Medical Officer with the National Disaster Management System, where he responded to the September 11th attack in New York City. Dr. Woodson's military awards and decorations include the Legion of Merit, the Bronze Star Medal, and the Meritorious Service Medal (with oak leaf cluster).

In 2007, he was named one of the top Vascular Surgeons in Boston and in 2008 was listed as one of the Top Surgeons in the U.S. He is the recipient of the 2009 Gold Humanism in Medicine Award from the Association of American Medical Colleges.

Recent leadership

George Peach Taylor, Jr., M.D., MPH, recently performed the duties of the Assistant Secretary of Defense for Health Affairs; and as Acting Director, TRICARE Management Activity. Dr. Taylor also currently serves as the Deputy Assistant Secretary of Defense for Force Health Protection and Readiness. In that capacity, he directs Department-wide efforts to develop and implement policies and programs relating to DoD deployment medicine, force health protection, national disaster support, international health agreements and missions, and medical readiness for 2.3 million Service members.

Previously, Charles L. Rice, M.D., performed the duties of the Assistant Secretary of Defense for Health Affairs, was the Acting Director, TRICARE Management Activity, and President of the USUHS. Before assuming his role at USUHS, Dr. Rice, a Navy-trained surgeon and researcher, served as the vice chancellor for health affairs at the University of Illinois, Chicago, from 1999-2004. Prior to that, he was vice dean of the UIC College of Medicine, as well as a professor of surgery and professor of physiology and biophysics. Originally from Atlanta, Ga., Dr. Rice graduated with an A.B. from the University of Georgia in 1964 and earned his medical degree from the Medical College of Georgia in 1968. He interned at Bowman Gray School of Medicine at Wake Forest University, Winston-Salem, N.C. He completed his general surgery residency at the National Naval Medical Center in Bethesda, Md., followed by a research fellowship at the Naval Medical Research Institute in Bethesda. Dr. Rice's full biography can be found at [4].

The previous ASD(HA) was Dr. S. Ward Casscells. Dr. Casscells' term expired on 28 April 2009. The Obama Administration asked him to remain after the transition, but he has chosen to leave to be with family and continue his medical career. His interim replacement is Acting ASD(HA) Ellen Embrey [5], a merit Senior Executive Service employee (not political), who is permanent Deputy Assistant Secretary of Defense for Force Health Protection and Readiness, a 3-star equivalent position. Embrey has a reputation for both breadth and depth of knowledge in defense matters, strong ethical standards, and an ability to form partnerships working for common goals. Ms. Embrey has since stepped down from serving as the interim ASD(HA).

Past Assistant Secretaries

The table below includes both the various titles of this post over time, as well as all the holders of those offices.

Assistant Secretaries of Defense (Health Affairs)^[1][3]

Name	Tenure	SecDef(s) Served Under	President(s) Served Under
Chairman, Armed Forces Medical Policy Council
Dr. Raymond B. Allen	July 5, 1949 – September 30, 1949	Louis A. Johnson	Harry Truman
Dr. Richard L. Meiling	October 1, 1949 - January 2, 1951	Louis A. Johnson George C. Marshall	Harry Truman
Dr. William R. Lovelace	July 1, 1951 - March 31, 1952	George C. Marshall Robert A. Lovett	Harry Truman
Dr. Melvin A. Casberg	April 1, 1952 - March 31, 1953	Robert A. Lovett Charles E. Wilson	Harry Truman Dwight Eisenhower
Assistant to the Secretary of Defense (Health Affairs)
Dr. Melvin A. Casberg	April 1, 1953 - August 2, 1953	Charles E. Wilson	Dwight Eisenhower
Assistant Secretary of Defense (Health and Medical)
Dr. Melvin A. Casberg	August 3, 1953 - January 27, 1954	Charles E. Wilson	Dwight Eisenhower
Dr. Frank B. Berry	January 28, 1954 - January 31, 1961	Charles E. Wilson Neil H. McElroy Thomas S. Gates	Dwight Eisenhower John Kennedy
Assistant Secretary of Defense (Health and Environment)
Dr. Louis M. Rousselot	July 22, 1970 - July 1, 1971	Melvin R. Laird	Richard Nixon
Dr. Richard S. Wilbur	July 27, 1971 - September 1, 1973	Melvin R. Laird Elliot L. Richardson James R. Schlesinger	Richard Nixon
Dr. James R. Cowan	February 19, 1974 - March 1, 1976	James R. Schlesinger Donald H. Rumsfeld	Richard Nixon Gerald Ford
Vernon McKenzie (Acting)	March 2, 1976 - March 8, 1976	Donald H. Rumsfeld	Gerald Ford
Assistant Secretary of Defense (Health Affairs)
Dr. Robert N. Smith	August 30, 1976 - January 7, 1978	Donald H. Rumsfeld Harold Brown	Gerald Ford Jimmy Carter
Vernon McKenzie (Acting)	January 8, 1978 - August 14, 1979	Harold Brown	Jimmy Carter
Dr. John Moxley III	September 14, 1979 - August 9, 1981	Harold Brown Caspar W. Weinberger	Jimmy Carter Ronald Reagan
Dr. John Beary (Acting)	August 10, 1981 - September 24, 1983	Caspar W. Weinberger	Ronald Reagan
Vernon McKenzie (Acting)	September 25, 1983 - November 17, 1983	Caspar W. Weinberger	Ronald Reagan
Dr. William Mayer	November 18, 1983 - April 21, 1989	Caspar W. Weinberger Frank C. Carlucci III William Howard Taft IV (Acting) Richard B. Cheney	Ronald Reagan George H. W. Bush
Dr. Enrique Mendez	March 5, 1990 - January 20, 1993	Richard B. Cheney	George H. W. Bush
Dr. Edward D. Martin (Acting)	January 20, 1993 - March 23, 1994	Leslie Aspin, Jr. William J. Perry	William Clinton
Dr. Stephen C. Joseph	March 23, 1994 - March 31, 1997	William J. Perry William S. Cohen	William Clinton
Dr. Edward D. Martin (Acting)	April 1, 1997 - February 28, 1998	William S. Cohen	William Clinton
Gary Christopherson (Acting)	March 1, 1998 - May 25, 1998	William S. Cohen	William Clinton
Dr. Sue Bailey	May 26, 1998 - August 10, 2000	William S. Cohen	William Clinton
Dr. J. Jarrett Clinton	August 14, 2000 - October 29, 2001	William S. Cohen Donald H. Rumsfeld	William Clinton George W. Bush
Dr. William Winkenwerder, Jr.	October 29, 2001 - April 12, 2007	Donald H. Rumsfeld	George W. Bush
Dr. S. Ward Casscells	April 12, 2007 - April 28, 2009	Robert M. Gates	George W. Bush Barack Obama
Ellen Embrey (Acting*)	April 29, 2009 - January 31, 2010	Robert M. Gates	Barack Obama
Allen W. Middleton (Acting*)	February 1, 2010 - February 28, 2010	Robert M. Gates	Barack Obama
Dr. Charles L. Rice (Acting*)	March 1, 2010 - September 6, 2010	Robert M. Gates	Barack Obama
Dr. George P. Taylor, Jr. (Acting*)	September 7, 2010 - December 22, 2010	Robert M. Gates	Barack Obama
Dr. Jonathan Woodson [4]	December 22, 2010 -	Robert M. Gates	Barack Obama

Persons marked with a * are interim officials described in military documents as "Performing the Duties of the ASD/HA," rather than as "Acting"

References

1. ^ ^{a b c} "Department of Defense Key Officials". Historical Office, OSD. 2004. http://osdhistory.defense.gov/docs/DOD%20Key%20Officials%201947-2004.pdf. Retrieved 2011-02-01. 
2. ^ Galvin, Robert. 4 August 2005. “The Complex World of Military Medicine: A Conversation with William Winkenwerder.” Health Affairs. http://www.healthaffairs.org/
3. ^ "History of the Assistant Secretary of Defense for Health Affairs" http://www.health.mil/About_MHS/History.aspx
4. ^ http://www.govexec.com/dailyfed/1210/122810bb1.htm