Pay bulls***

[StevenRF]

This is hilarious. My wife just got approved to commission but turned it down after the only AFSC she got wasn't on her list, or anywhere near her background.

By the same logic, since my wife has a job, I shouldn't get BAH or BAS cause she could pay for food and housing. The military has this weird 1950's mindset about family makeup.

---

Members don't see this ad.

 

[BigNavyPedsGuy]

House bill- https://www.congress.gov/114/bills/hr1735/BILLS-114hr1735pcs.pdf

Backrow- For unifying Medical command are you referencing sec 711.? Seems like a glorified position because the 3 surgeon generals can't get along with each other.

Title 37- https://www.law.cornell.edu/uscode/text/37/335

Senate bill- https://www.congress.gov/114/bills/s1376/BILLS-114s1376pcs.pdf
Sec 604- BAH dual spouse garbage and those that are roommates.

Sec 606
Sec 612- one year extension on healthcare bonuses.

Sec 632 retirement pay reform

Sec 652- privatization of the defense commissary system.

Sec 717- limitation on conversion of military medical and dental positions to civilian medical and dental positions.

sec 720- pilot program on incentive programs to improve health care provided under Tricare program

Sec 1221- Drawdown of US forces in Afghanistan

Sec 2702- prohibition on conducting additional BRAC round


Basic allowance for housing- https://www.law.cornell.edu/uscode/text/37/403
It is labeled as a general entitlement. "a member of a uniformed service who is entitled to basic pay is entitled to a basic allowance for housing at the monthly rates prescribed under this section or another provision of law with regard to the applicable component of the basic allowance for housing."
If a service member is entitled to basic pay then they are entitled to basic allowance for housing.

You keep making the same argument. You're complaining because you don't want a pay cut. That's fine. Nobody does. But in this case it people are going to disagree. Why should the Navy pay twice for the same housing allowance when people share a house?

 

[Gastrapathy]

Because it's really just a part of total compensation. If it wasn't, the rules would say that you can't pocket extra, can't have roommates that draw BAH, and aren't eligible if you've paid off a mortgage.

Instead, dual mil couples are selectively targeted. Let's say we took away specialty bonuses from anyone with a specialty starting with the letter O. I don't think Tired would like that post. It's just as capricious because it targets a small group.

Want to make a meaningful change, stop paying young marines (or everyone) more for their dependopotomi.

The real pay story for MDs is coming with the bonus changes. I'm not sure what to predict but we will see.

 

[Homunculus]

i'm dual military, and can appreciate the stance that BAH is "only meant for housing" so anything extra is bonus.

my issue is that this is a targeted to a population that has very unique stressors-- being dual military is twice the deployment exposure, twice the operational nonsense, twice the chance to get screwed over this way or that. many financial decisions stem from the expectation that has been set that certain pays aren't going to be suddenly taken away in an unprecedented fashion. i can't imagine the hornets nest that's been kicked up in the non medical community, since their BAH is an even higher percentage of their yearly income.

if they want to truly make it fair in the sense of "housing allowance" and reap the most savings they should ask for rent or mortgage payment receipts, and take back (or not pay in future months) any money left after those payments are applied. so if my BAH is $1500 and my rent is $1200, that extra $300 is not going toward housing anymore and since the "intent" of housing allowance is apparently for housing only you aren't deserving of the extra cash.

but that will never happen. instead they go after the low hanging fruit. but after that gets pruned who knows what's next. stagnant medical pays are already a back door pay cut, and it's not much of a leap to see those get trimmed.

personally it makes my spouse and my decision to ETS easier. so in a way i guess giving us some clarity could be a good thing, even if it may cost us 24k+ a year in the meantime. thankfully we may not need to PCS before then so we can potentially wait it out.

--your friendly neighborhood dual military livin' large caveman

 

[ProudMD]

If this proposal passes Congress, when will it take effect?

 

[backrow]

If this proposal passes Congress, when will it take effect?

Oct 1, 2015

 

[TurtleDO2012]

Its absurd that the paycut would be applied immediately Oct 1, 2015, it specifically targets a small community in the overall DOD that already has stressors that single military families have to deal with. People can complain about a 9 month deployment but how bout you go for 9 months and then your spouse also has to leave for 9 months shortly after you get back. For those not in the medical community or receiving other bonuses this is a random cut of about 20% or more to your direct overall pay. For most the extra BAH just goes into the pockets of the local daycare because my spouse chose to pursue a military career. Already dual couples are the cheapest overall cost compared to single families with the benefits are spread over each service member.

In terms of personal cuts needing to be made that's fine but don't apply them so directly to such a small community. If cuts need to be made then first cut the excessive worthless defense programs, hold contractors to their actual contracts they bid rather than accepting every single additional cost over-run or change order, and reduce all paychecks in the DOD. Most PAs max out at Major and have far more impressive careers than any nurse yet nurses continue to climb that latter to LT colonel and Colonel just as easy as any physician. In the long term this leads to far more excessive costs with their retirement benefits then BAH for even a 20 year career for a dual couple. Why don't we just stop being so bloated with pay grades above O-6 level?
http://www.usnews.com/opinion/blogs/world-report/2013/07/24/the-pentagon-has-too-many-troops
http://fabiusmaximus.com/2015/02/04/us-military-officer-corps-bloat-78079/
http://www.nytimes.com/roomfordebat...im-the-top-like-most-innovative-organizations
http://www.nytimes.com/roomfordebat...sts-of-having-too-many-generals-are-crippling
http://archive.armytimes.com/articl...316/Watchdog-group-Too-many-generals-admirals
http://www.truth-out.org/opinion/item/5920:the-pentagons-biggest-overrun-way-too-many-generals

I already make less then every single civilian provider in my clinic and some of the "admin staff" super secretaries make more than I do. They don't deploy, they don't move every couple of years, and they aren't at the beck and call to the whim of the military. They have special DOD contracts that make it impossible for them to be fired.

As the recent Army propaganda commercials portray us being apart of a "team" then any cuts should be felt universally across the DOD, not one of the smallest communities getting a 20% reduction in based over the semantics of "allowance" or "perceived intention."

 

[ARMYDOCWIFE]

Its absurd that the paycut would be applied immediately Oct 1, 2015, it specifically targets a small community in the overall DOD that already has stressors that single military families have to deal with. People can complain about a 9 month deployment but how bout you go for 9 months and then your spouse also has to leave for 9 months shortly after you get back. For those not in the medical community or receiving other bonuses this is a random cut of about 20% or more to your direct overall pay. For most the extra BAH just goes into the pockets of the local daycare because my spouse chose to pursue a military career. Already dual couples are the cheapest overall cost compared to single families with the benefits are spread over each service member.

In terms of personal cuts needing to be made that's fine but don't apply them so directly to such a small community. If cuts need to be made then first cut the excessive worthless defense programs, hold contractors to their actual contracts they bid rather than accepting every single additional cost over-run or change order, and reduce all paychecks in the DOD. Most PAs max out at Major and have far more impressive careers than any nurse yet nurses continue to climb that latter to LT colonel and Colonel just as easy as any physician. In the long term this leads to far more excessive costs with their retirement benefits then BAH for even a 20 year career for a dual couple. Why don't we just stop being so bloated with pay grades above O-6 level?
http://www.usnews.com/opinion/blogs/world-report/2013/07/24/the-pentagon-has-too-many-troops
http://fabiusmaximus.com/2015/02/04/us-military-officer-corps-bloat-78079/
http://www.nytimes.com/roomfordebat...im-the-top-like-most-innovative-organizations
http://www.nytimes.com/roomfordebat...sts-of-having-too-many-generals-are-crippling
http://archive.armytimes.com/articl...316/Watchdog-group-Too-many-generals-admirals
http://www.truth-out.org/opinion/item/5920:the-pentagons-biggest-overrun-way-too-many-generals

I already make less then every single civilian provider in my clinic and some of the "admin staff" super secretaries make more than I do. They don't deploy, they don't move every couple of years, and they aren't at the beck and call to the whim of the military. They have special DOD contracts that make it impossible for them to be fired.

As the recent Army propaganda commercials portray us being apart of a "team" then any cuts should be felt universally across the DOD, not one of the smallest communities getting a 20% reduction in based over the semantics of "allowance" or "perceived intention."

I agree about cutting the bloated 0-6 levels. I overheard a conversation once at a conference about how many docs specifically senior ranking Army docs receive their specialty pay but are sitting in administrative positions especially at OTSG and not seeing patients. I know 0-7 and above don't receive these special pays but I wonder how many docs are out there not seeing patients and receiving the special pays. Not sure how I feel about this. Any thoughts?

 

[TurtleDO2012]

Doing the math and staying focused on the typical O3 resident with 2 years of service- (4435.20+253.38+416.66)x12= 61,260.48 without BAH compared to 79,260.48 with BAH (assumption avg BAH of 1500/month). That is a difference of 29% or higher depending on amount of BAH!

Since numerous other people want to get hung up on semantics and terminology and "perceived intention" then when someone is in a training capacity they shouldn't receive any of their bonuses similar to how all first time residents are. So for those fellows out there and repeat GME trainees since you are required to be supervised and haven't yet completed your training that you are currently practicing in all of your bonuses should be also removed. Those are intended for those practicing unsupervised and actually completing work in their current field. Otherwise any fresh trainee would be able to receive them.

 

[backrow]

Just to clarify the start date, the law would go into effect on October 1st, 2015, but the language states it won't go into effect until the person has a new BAH (something to that effect).

So essentially you would keep your BAH until your next PCS it seems. If this becomes law you'll probably see some people try to homestead even more

 

[colbgw02]

Since numerous other people want to get hung up on semantics and terminology and "perceived intention" then when someone is in a training capacity they shouldn't receive any of their bonuses similar to how all first time residents are. So for those fellows out there and repeat GME trainees since you are required to be supervised and haven't yet completed your training that you are currently practicing in all of your bonuses should be also removed. Those are intended for those practicing unsupervised and actually completing work in their current field. Otherwise any fresh trainee would be able to receive them.

Agreed.

I've said before that every time I've signed an ISP or MASP contract I'm always a bit amazed that I'm getting to do this. I mean, the Army owns me while I'm under my initial ADSO. They're under no obligation to give me any special pay at all, in training or otherwise. That means the only reason to do so is a retention benefit. But is that benefit real or perceived? I would be interested to see the data on retention rates per specialty as compared to special pay distributed through initial ADSO.

To be clear, I would never propose this, because so many military physicians are already underpaid. It's just that this is an organization that can force its member to fight and die if necessary. The power of the State is so vast. I guess I'm just a little surprised whenever it does something that isn't definitively self-serving.

 

[chronick]

It sounds like you have a problem with your local leadership, not with the pay structure. By your logic, I should get paid orders of magnitude more than the fat-ass colonels in my department that generate fewer RVUs than I do all while holding fewer administrative roles. Those things upset me too, but I don't blame the pay tables for it. I blame the individuals who are lazy and the leadership that lets them get away with it.

I think all things being equal those that work more should get paid more, yes, that's my logic and I blame the pay tables for it.

 

[idq1i]

I've said before that every time I've signed an ISP or MASP contract I'm always a bit amazed that I'm getting to do this. I mean, the Army owns me while I'm under my initial ADSO. They're under no obligation to give me any special pay at all, in training or otherwise. That means the only reason to do so is a retention benefit. But is that benefit real or perceived? I would be interested to see the data on retention rates per specialty as compared to special pay distributed through initial ADSO.

Sorry, doesn't make sense to me. They can call it "special pay", "magic pay", or "greedy rich doctor supplement" but it is still a part of your salary. Anyone going into the service can look at the data and figure out what they would be paid for a given rank, longevity and specialty. It is true that they keep it separate from your "base salary" because they want to reserve the right to yank it, and it would be easier to not give you a "bonus" than it would be to cut your salary.

You (or at least most of us) are under the initial ADSO at least in part because of the full complete salary (including the bonuses)

I view my 36k pay cut this year (no isp) as wage theft. There is no reason that ISP contract needs to be offset 3 months in the army (besides retention)

 

[colbgw02]

Sorry, doesn't make sense to me. They can call it "special pay", "magic pay", or "greedy rich doctor supplement" but it is still a part of your salary. Anyone going into the service can look at the data and figure out what they would be paid for a given rank, longevity and specialty. It is true that they keep it separate from your "base salary" because they want to reserve the right to yank it, and it would be easier to not give you a "bonus" than it would be to cut your salary.

You (or at least most of us) are under the initial ADSO at least in part because of the full complete salary (including the bonuses)

I view my 36k pay cut this year (no isp) as wage theft. There is no reason that ISP contract needs to be offset 3 months in the army (besides retention)

This is exactly what I'm curious about. Yes, the information is out there, but how many people are aware of this when they're signing on the bottom line? And if they are, how much is it really affecting their decisions? Imagine a typical pre-med. Tell them that they're going to get Y amount of money for HPSP and Z amount of money (line officer compensation) as a physician (whether in residency or during initial ADSO). Now how many of them are even going to be able to conceptualize how little that is as compared to what their civilian classmates will make? My guess is not many. They're going to be so focused on avoiding loans and so enamored with the salary that is base pay + BAH + BAS that they won't care. I mean, you and I know better, but we're not the recruiters target population.

 

[ProudMD]

Just to clarify the start date, the law would go into effect on October 1st, 2015, but the language states it won't go into effect until the person has a new BAH (something to that effect).

So essentially you would keep your BAH until your next PCS it seems. If this becomes law you'll probably see some people try to homestead even more

This is my understanding (and a few others as well):

For USUHS students who start school this August, we'll get the current BAH rates until we graduate and get promoted/PCS, correct?

The reason I am asking is that this proposed bill will also reduce BAH for military members who have other military members as roommates. So if 3 O-1s room together, each will only get 75% of his/her BAH instead of the full amount. And if this bill passed, this proposed change will start on October 1st.

But from the language of the bill (no effect until a PCS), this hopefully won't be the case and USUHS students can get their full BAH amount regardless of their roommate or marriage situations.

 

[colbgw02]

I get that you feel like it wasn't worth it. But the pay gap between fully-trained military vs civilian physicians is only one small part of the story, and very specialty-dependent at that.

Not sure if you're using the Royal You, but if not, please know that I'm hardly debt free. My nearly $1K/month student loan payments can attest to that. My military obligaton doesn't stem from HPSP. It wasn't "worth it" for me, in part, because I took a relatively uncommon path to where I am now. That isn't to say that I would feel differently had I taken the more common HPSP path, but that's a theoretical queston at this point.

Overall though, I agree with your point. One thing that I learned to do relatively early on was not to universalize my experience. I mean, some things about the .mil are truisms, but there's also a ridiculous amount of experiential variance.

And I put "worth it" in quotations because that's such a difficult thing to judge, even in retrospect. As happy as I am to have this chapter of my life (nearly) over, I also recognize that it's been a formative experience. The best way I have to describe it is that I don't regret it, but I wouldn't choose it again. That may be the ultimate equivocation, but somehow it works.

 

[backrow]

Yes, it appears that you would likely be okay through the four years at USUHS

 

[ProudMD]

Yes, it appears that you would likely be okay through the four years at USUHS

This is definitely reassuring. However, the best outcome is that this proposal doesn't pass. When people sign up for the military, they get paid their salary/allowances that they are entitled to. That shouldn't change if they decide to marry other service members. You do the work, you get the full pay.

 

[idq1i]

I totally get that. Honestly, I would do it over again, if I were going to medical school. But if I could do everything over again, I wouldn't go to medical school at all. And I sure as hell would never want to be in the military if I weren't in the Medical Corps.

After watching your posts, I want to quit my military and join yours. Obviously, we are in different armed forces.

I am not trying to be disrespectful. I just wonder how 2 experiences could be so different, especially considering that I haven't even been GMOed or BDE surgeoned

 

[TurtleDO2012]

I am being crazy/a$$ now and wouldn't suggest this but- Another cost saver would be to stop paying USUHS students any BAH while they are paraded around the US to different bases on extended TDYs racking up $100 plus a night hotel stays. Hawaii nightly hotel rate is $177, $5310 per student per month plus they can pull down their full BAH and not actually have a a true residence they are responsible for if desired. Also take away their meals and incidentals for further savings. Place them all in barracks, eat at the hospital or the local chow hall. I present that as another area of "waste" but in reality it is a pain to have to cruise around to different MTFs living out of a hotel room if that card is dealt your way.

 

[deleted480308]

The point of specialty pay isn't how

I am being crazy/a$$ now and wouldn't suggest this but- Another cost saver would be to stop paying USUHS students any BAH while they are paraded around the US to different bases on extended TDYs racking up $100 plus a night hotel stays. Hawaii nightly hotel rate is $177, $5310 per student per month plus they can pull down their full BAH and not actually have a a true residence they are responsible for if desired. Also take away their meals and incidentals for further savings. Place them all in barracks, eat at the hospital or the local chow hall. I present that as another area of "waste" but in reality it is a pain to have to cruise around to different MTFs living out of a hotel room if that card is dealt your way.

or we could just pay people the market value of their worth and stop acting like salary is the only way to save money. If we insist on have such a huge level of military activity, it costs money to staff and we have to pay

 

[colbgw02]

I did not attend USUHS, so am I wrong in thinking that its students are limited in the number of TDY rotations they can take during MSIV?

 

[colbgw02]

Yes. Some of them will spend nearly their entire MS3 and MS4 years away from the DC area.

I understand that, but that's not the same as being on TDY. I seem to recall some intern classmates who spent most of their MS4 year away from DC, but footed the bill for it out of pocket.

 

[idq1i]

It may well be what many have suggested: I have never been an attending surgeon in an MTF, much less a small MTF. I talked to a friend who has been out for two years at a small Naval Hospital. He has a lot of frustration over getting his patients what they need. I have not had that problem yet; at a large MTF I can always find a way to get what we need, and as a GMO I just stole it or threw a fit, and one of those usually got the job done.

Or it may be a matter of expectations. With all due respect, my experience has been that the people who are most unhappy are generally those who expect that they should get what they want in nearly all instances. That their opinion on how the system should be run is always the correct one. The loss of control for these people is very psychologically destructive. Personally, I never expect anything to go correctly, or anyone to help me, or anything good to happen to me at all. I always assume I'm in the **** all by myself, and I reflexively do other people's jobs, because I assume they won't. When I do run into helpful people or good situations, I'm really pleasantly surprised and it's a big boost for my morale.

Or it may simply be that you genuinely believe that medical practice in the military should in most ways be similar to practice in the civilian world. I can see how that belief could make someone horribly unhappy. I simply don't expect or believe that ideal. I don't think that operational units need anything more than a GMO, and I think that in many cases a board certified FP or IM doc is a negative influence on a unit. I don't think that subspecialty training is necessary for most surgeons at smaller hospitals (though that's not going to stop me from trying to get it for myself). I don't think that pay parity is particularly important, and I don't think that it would contribute substantially to retention. I understand the need to protect the whole system, not just our little piece of it.

I dunno. Whatever the case is, I've met a lot of people who feel like you, and honestly I'm glad I don't share your outlook. This life is hard. Being perpetually unhappy with your circumstances, I would guess, makes things many times harder.

Very reasonable. I respect your position. I fall on the "what kind of a f'ing banana republic of a clinic are you running here," and "none of you [civ] assclowns would survive a day in the civilian world as providers." It's a self perpetuating vicious cycle. The more I see the angrier I get, the more I lash out.

Next year I'll post my compete story that may explain my bitterness

 

[ProudMD]

I understand that, but that's not the same as being on TDY. I seem to recall some intern classmates who spent most of their MS4 year away from DC, but footed the bill for it out of pocket.

MS4 year means elective rotations, and those have to be self-funded. The mandatory rotations, which take place during MS2 and MS3, are all covered, and hopefully that'll remain the case!

 

[backrow]

I am being crazy/a$$ now and wouldn't suggest this but- Another cost saver would be to stop paying USUHS students any BAH while they are paraded around the US to different bases on extended TDYs racking up $100 plus a night hotel stays. Hawaii nightly hotel rate is $177, $5310 per student per month plus they can pull down their full BAH and not actually have a a true residence they are responsible for if desired. Also take away their meals and incidentals for further savings. Place them all in barracks, eat at the hospital or the local chow hall. I present that as another area of "waste" but in reality it is a pain to have to cruise around to different MTFs living out of a hotel room if that card is dealt your way.

I get your point, but unlike HPSP students USUHS students almost never get to stay anywhere other than the BOQ which is nowhere near $100 a night. They also frequently get reduced per down based on the availability of messing on base.

They also only get required rotations covered so not every rotation is covered. Reducing BAH would also mess up the not so small percentage of USUHS folks who are married +/- children.

 

[colbgw02]

MS4 year means elective rotations, and those have to be self-funded. The mandatory rotations, which take place during MS2 and MS3, are all covered, and hopefully that'll remain the case!

Thanks, ProudMD.

I understand everyone's frustrations with this proposed change, and those frustrations stand on their own merits. It's not necessary to contort and invent reasons to be upset, e.g. USUHS away rotation policy.

 

[ProudMD]

So the entire MS4 year is self-funded? My school had a couple required MS4 rotations (ER, I think 1-2 others). Do you have those? Are those paid for? And if, for example, you go to do a Medicine Sub-I at Fort Bragg or whereever, they don't pay housing or travel? That surprises me, though maybe it shouldn't.



What you describe is perfectly consistent with the rest of the military. If you go TAD, or deploy, you get your BAH. I don't see why USUHS students should have their benefits reduced in a way that is inconsistent with the rest of the military. It would also require every USUHS student to use SCRA to break their leases early, and the military would be on the hook for housing for any overlap periods where they had to return to USUHS.

That's a great question and I honestly don't know the answer. I start USUHS this fall and all I know so far is that all the mandatory rotations are fully funded while the elective ones are out of pocket. I would think that MS4 is composed mostly of elective rotations.

And during the mandatory rotations, all costs (travel, food, and lodging) are covered.

 

[ProudMD]

Thanks, ProudMD.

I understand everyone's frustrations with this proposed change, and those frustrations stand on their own merits. It's not necessary to contort and invent reasons to be upset, e.g. USUHS away rotation policy.

Maybe you are misunderstanding what I wrote. I am not in anyway upset at any of USUHS's policies. I am merely pointing out a fact in response to another user's inquiries.

 

[colbgw02]

Maybe you are misunderstanding what I wrote. I am not in anyway upset at any of USUHS's policies. I am merely pointing out a fact in response to another user's inquiries.

I know you weren't saying that. I was referring to others who seem to be using an incorrect understanding of USUHS policy to further a point.

 

[backrow]

So the entire MS4 year is self-funded? My school had a couple required MS4 rotations (ER, I think 1-2 others). Do you have those? Are those paid for? And if, for example, you go to do a Medicine Sub-I at Fort Bragg or whereever, they don't pay housing or travel?

The curriculum at USUHS has undergone substantial change since I was there many moons ago. They are now doing rotations as 2nd years so I'm not 100% sure which 4th year rotations are now mandatory.

In the past the 4th year required a medicine sub-I, a surgical sub-I, ER, and neurology. ER and neurology were at specific locations and were selected through a lottery system. The Sub-I was set up by the student. Those 4 rotations would be funded, the remainder including any other audition rotations one wanted to do would be out of pocket. Unlike some other schools USUHS students don't get months of vacation during 4th year so they have to find something to do.

One of the reasons you see USUHS rotate around is the local hospitals cannot support all the students, they need more training locations than what is available locally.

 

[ProudMD]

I know you weren't saying that. I was referring to others who seem to be using an incorrect understanding of USUHS policy to further a point.

My apologies for misunderstanding.

 

[colbgw02]

Or it may simply be that you genuinely believe that medical practice in the military should in most ways be similar to practice in the civilian world. I can see how that belief could make someone horribly unhappy. I simply don't expect or believe that ideal.

Here's the thing though, how do we square this idea with the reality of what we see day-to-day in garrison?

Consider the following:
-our residencies are accredited according to civilian standards
-we are expected to be licensed by civilian state boards
-we are expected (eventually) to be certified by civilian specialty boards
-our hospital are credentialed by a civilian agency
-our standards of care (in garrison) are set by the community
-our potential mistakes are ajudicated in a civilian court and reported to a civilian authority (NPDB)

I'm all on board with the concept that military medicine's primary mission is support of the warfighter, but the truth is that military medicine talks out of both sides of its mouth. On one hand, we're expected to put the mission first, but on the other hand, the .mil has - at best - encouraged and - at worst - relied upon a system designed to produce physicians that can't share that same approach. The same qualifications that the .mil requires of us also tell us that what we see in our MTFs on a day-to-day basis is too often unsatisfactory.

Unless we are willing to abandon the civilian standards we have adopted, my simpleton brain sees only two solutions. On one hand, we can re-invest tremendous resources to make military medicine what it once was (pre-Tricare days), but I highly doubt that'll happen in light of increasing financial austerity. Or, we can find a way to separate military medicine's wartime and garrison missions as completely as possible. I won't pretend to understand the intricacies of the latter fully, but my guess is that it probably involves a robust reserve medical force, not unlike what the Brits use.

 

[HighPriest]

I definitely expect certain things to go the way I want them to go.
I expect to be able to take care of soldiers and their families as my primary mode of service (which is the mission of my hospital).

I expect to be treated as if I am an expert in my field of medical practice. To not do so leads to someone else trying to steer my medical decisions. I'm not talking financially, I simply mean that I expect to be able to make an educated, data-supported decisions and for my supervisors to trust those decisions so long as they have no reason not to do so.

I expect to never be threatened or pressured to make unethical decisions.

If there is ever a question about my practice, I expect to be a part of the discussion at some point.

I expect to be able to practice my field of medicine once I have separated from the military. That was a part of the sales pitch - they train me, I owe then ADSO. Of course there are different definitions as to what that entails, but suffice to say that I expect to be generally employable.

So far, the Army has done a fairly half-assed job with these things. Certainly that has a bearing on my opinion of military service. I will say that my consultant has stepped up on helping with the last part. The first three, at my current station, are constant issues. I feel like those three are key to being able to practice good medicine to the best of my ability.

There has been a lot of good as well. I liked residency, I got the one I wanted in a great area, and the training was good. The pay during residency was great. The pay during med school was not, and I had to take out loans even with the scholarship. But I honestly don't care about that. I also don't care -that much- about the pay discrepancy. I knew it was going to happen. If it bothers me now, I have no one to blame but myself. It is enough of an issue that the scales need some balancing away from the pay difference to get me to stay in the military. Obviously, most people feel that way as most people leave the service. The problem isn't the pay (for me), it's that there isn't enough good in milmed to counterbalance it.

I don't expect to live in a great area or work in a large MEDCEN, but to say living a crap-hole and watching all of the skills you've worked so hard to build wilt, with zero chance of ever getting somewhere tolerable, and zero understanding from the Army as to why that's an issue doesn't influence your outlook is either naive, mindless acceptance, or extremely Zen - like Bhudda's cat Zen. It might border on Stockholm Syndrome. But due to the way the Army handles stationing and homesteading, that is the real world.


If what the big Army needs, for some reason, is to sacrifice the skillsets and experiences of a select group of people based upon chance alone, then for me they have failed to balance those scales in favor of sticking around.

I don't think I could look back at some of the issues I've had at my MTF and chalk them up to the needs of the bigger Army. They've just all seemed like things that were handled very poorly on the local level. I also don't think I could look back on something like being explicitly told to do things I didn't think were safe and accept it based upon keeping low expectations. Maybe that makes me an dingus. So be it.
For whatever it's worth, I only started truly experiencing these issues when I took over as department chief, and I could believe that they are unique to my MTF, if I hadn't heard similar experiences from others.

It isn't that I don't see how anyone could love milmed. I get it. Some people have totally different experiences. But unless my experience after my PCS is dramatically different, I can't see my impression changing much. My answers to prospective applicants serve only to illustrate my impression.

 

[TurtleDO2012]

My USUHS example is simply another piece in the medical world along with the bonuses and specific situations like the person completing that second residency, that fellow completing their training and receiving their bonus, how these things could so easily disappear given the support or lack there is at times from command representatives.

I would be extremely amazed that those on the armed forces committee even knew that dual military were receiving dual BAH and more likely the representatives from the DOD throw that up as a means to reduce costs and they included it in their bill.

As physicians we are collectively one of the smallest groups, sometimes an after thought it seems, and I would not doubt that at some point those at our command positions would love to offer up the little things we have as a cuts. The priority continues to be excessive risk aversion training, military training to puff up CVs so we equal the line group.

In terms of military, the medical community I believe is the only one that has an opportunity at recouping money. We bill Medicare first for all those eligible and if we convinced patients/had the capabilities/proper support staff we could greatly improve our effencicy at having "income generating" patients.

 

[Onefellswoop87]

For what it's worth:
"The Obama administration on Wednesday voiced strong opposition to a controversial congressional proposal to cut back Basic Allowance for Housing for dual-military couples and for troops who share housing with other service members. The targeted cut in BAH would "impose a marriage penalty," and "have a disproportionate negative impact on women service members," according to a statement outlining the administration's views on the Senate version of the 2016 defense authorization bill, unveiled in May"

http://www.navytimes.com/story/mili...bama-opposes-cuts-bah-dual-families/28406213/

 

[ArmyTiger]

I thought this was a nice reply, despite the obvious slippery slope argument.
http://taskandpurpose.com/the-big-problem-with-senates-proposal-to-cut-housing-allowance/

 

[ProudMD]

It's also worth noting that only the senate proposal mentions this new BAH cut to married service members and roommates. The house proposal contains no such provisions. So hopefully the chance of this BAH cut passing both chambers shouldn't be very high.

 

[Ziehl-Neelsen]

i'm dual military, and can appreciate the stance that BAH is "only meant for housing" so anything extra is bonus.

my issue is that this is a targeted to a population that has very unique stressors-- being dual military is twice the deployment exposure, twice the operational nonsense, twice the chance to get screwed over this way or that. many financial decisions stem from the expectation that has been set that certain pays aren't going to be suddenly taken away in an unprecedented fashion. i can't imagine the hornets nest that's been kicked up in the non medical community, since their BAH is an even higher percentage of their yearly income.

if they want to truly make it fair in the sense of "housing allowance" and reap the most savings they should ask for rent or mortgage payment receipts, and take back (or not pay in future months) any money left after those payments are applied. so if my BAH is $1500 and my rent is $1200, that extra $300 is not going toward housing anymore and since the "intent" of housing allowance is apparently for housing only you aren't deserving of the extra cash.

but that will never happen. instead they go after the low hanging fruit. but after that gets pruned who knows what's next. stagnant medical pays are already a back door pay cut, and it's not much of a leap to see those get trimmed.

personally it makes my spouse and my decision to ETS easier. so in a way i guess giving us some clarity could be a good thing, even if it may cost us 24k+ a year in the meantime. thankfully we may not need to PCS before then so we can potentially wait it out.

--your friendly neighborhood dual military livin' large caveman

In the same boat as the caveman...

I appreciate the legality of the proposed cut as it represents a "redundant allowance" for dual military couples like me and the rib, and in a perverse way I kind of welcome the cut as it indicates that Congress is finally willing to make hard decisions that make them unpopular in pursuit of curbing spending. May they take the same knife to the big issues like medicare and SS.

I'm somewhat thankful that our 24k paycut won't come until our next PCS so we can budget with regard to housing expenses, but I have 2 main issues with the cut for us:

1. Our extra BAH goes to pay for live-in childcare which I consider a virtual necessity for a 2 doctor military couple who makes a point of shouldering an equal share of the load and refuses to dump on colleagues. I doubt changes will be made to the military childcare system to make it more affordable, more accomodating, and of higher quality to make up for the loss of a BAH.

2. I know it's not "personal" or a direct reflection on me, but it's hard to get over the visceral kick to the gut of pulling more than my weight in the hospital, doing everything the Army's asked, and spending years apart from my wife and children (as many other dual mil couples have done) and being rewarded with a paycut.

We'll see where we're at in 4 years at the end of this ADSO, but this certainly is a mark in the ETS column.

 

[j4pac]

In the same boat as the caveman...

I appreciate the legality of the proposed cut as it represents a "redundant allowance" for dual military couples like me and the rib, and in a perverse way I kind of welcome the cut as it indicates that Congress is finally willing to make hard decisions that make them unpopular in pursuit of curbing spending. May they take the same knife to the big issues like medicare and SS.

I'm somewhat thankful that our 24k paycut won't come until our next PCS so we can budget with regard to housing expenses, but I have 2 main issues with the cut for us:

1. Our extra BAH goes to pay for live-in childcare which I consider a virtual necessity for a 2 doctor military couple who makes a point of shouldering an equal share of the load and refuses to dump on colleagues. I doubt changes will be made to the military childcare system to make it more affordable, more accomodating, and of higher quality to make up for the loss of a BAH.

2. I know it's not "personal" or a direct reflection on me, but it's hard to get over the visceral kick to the gut of pulling more than my weight in the hospital, doing everything the Army's asked, and spending years apart from my wife and children (as many other dual mil couples have done) and being rewarded with a paycut.

We'll see where we're at in 4 years at the end of this ADSO, but this certainly is a mark in the ETS column.

This is so true. I know many duel military couples and the sacrifices that they have to go through and the extra expenses associated makes the double BAH just about a necessity.

 

[j4pac]

Extra expenses? With all due respect, extra child care because both parents are working isn't exactly unique to dual military couples.

Are you really comparing military personnel to average Joe and Jane working in the same town their entire lives with infinite support? You're wrong on this one.

 

[j4pac]

No, I'm comparing dual military child care expenses with single military child expenses where both adults work. I'm not saying that there aren't (many) unique stressors that come from being a dual military family. But lots of families have both adults working full-time; dual military families are not special in that respect.

In my opinion, it would be irresponsible for a duel military family to not respect the possibility of deployment. With already crap support, a very large percentage of the duel military (who can afford it) opt for au pairs and nannies. I believe that a better comparison isn't "working full-time" families...it's two medical professionals working full-time. The unpredictability of schedules is more than a stressor...it requires families to invest in safeguards that after 9-5 jobs simply do not require. Unlike two docs being compensated well...most people in the military ARE NOT. They are scraping by and the second BAH certainly helps.

 

[ProudMD]

The biggest issue I see here has to do with the way BAH is "intended" versus the way it's actually being used in real life. Even though it's called "basic allowance for housing" - implying that it's only supposed to be used for housing needs - many (if not most) service members are incorporating the BAH as part of their basic, stable, monthly income. For many members of the military, the meager basic pay is simply not enough to cover the basic expenses.

If anything, BAH's name should be changed. Call it "Tax Free Supplemental Income" or something. In my opinion, it'll more accurately align with the way the BAH is currently being viewed and used among most of the military population.

 

[Perrotfish]

I think this might be the stupidest, most myopic, and most openly discriminatory policy I have ever seen put forth for cutting military pay. It is a practical pay cut of 10-15 thousand dollars a year that would affect half of all women in the military and almost no men.

BAH is pay. Your pay is whatever your family doesn't have anymore if you quit your job. If they take it away from you because (they argue) that you are a married woman and don't need it, then they are cutting your pay. You are being paid less for the same work. You and your husband did not both lose half of your BAH, he kept his and you lost yours. Your husband is being paid the same amount that he was, and you are being paid less. This is a policy that cuts the pays of half of the women in the military and almost no men.

I am not dual military, this doesn't affect me financially. But if they cut all my medical bonuses tomorrow I would not be half as angry as I would be if this proposal passed.

 

[j4pac]

I think this might be the stupidest, most myopic, and most openly discriminatory policy I have ever seen put forth for cutting military pay. It is a practical pay cut of 10-15 thousand dollars a year that would affect half of all women in the military and almost no men.

BAH is pay. Your pay is whatever your family doesn't have anymore if you quit your job. If they take it away from you because (they argue) that you are a married woman and don't need it, then they are cutting your pay. You are being paid less for the same work. You and your husband did not both lose half of your BAH, he kept his and you lost yours. Your husband is being paid the same amount that he was, and you are being paid less. This is a policy that cuts the pays of half of the women in the military and almost no men.

I am not dual military, this doesn't affect me financially. But if they cut all my medical bonuses tomorrow I would not be half as angry as I would be if this proposal passed.

Brilliant insight. I didn't think of it as a discriminate against women...but it absolutely is.

 

[j4pac]

I have to tell you, dual field-grade physician officer couples are the people I would worry least about in this situation, given the overall income level and likelihood of deployment in the Medical Corps. I would worry more about the dual military junior enlisted, of whom there are more, and who will suffer more from this change.

Again, it's not that I'm not sympathetic to the situation that people are put in. However, if the intention is to use dual BAH to narrow the military-civilian pay gap, or hire for a nanny, I think you're pretty far off-base from what even the most strident defenders of dual BAH payments are saying.

And if we're going to consider removing an extra subsidy as a form of "discrimination against women," then we should probably ask why active duty single mothers aren't getting dual BAH. Their needs are clearly far greater than dual military couples. The odds of a dual military couple both being deployed at the same time are relatively low, but every time a single parent is deployed it is difficult.

Are their people who take advantage of the situation? Of course. The childless duel military officers are banking...no question about it. But the duel enlisted enlisted are truly struggling. The military doesn't have the time and resources to take these situations on a case to case basis.

And there is a difference between the single mother and duel military. Equal pay is a BIG DEAL. We should not be penalizing the servicemember for being married. When the individual is making less money...that's an issue. You also shouldn't be REWARDING single mothers with double BAH. They are one service member...and they should get one BAH. Would I like to see single mother's helped out? Of course...but the military is about making blanket policies...and two BAH's to one individual is something that never would be done. Keep things simple...one servicemember...one BAH.

 

[ProudMD]

Are their people who take advantage of the situation? Of course. The childless duel military officers are banking...no question about it. But the duel enlisted enlisted are truly struggling. The military doesn't have the time and resources to take these situations on a case to case basis.

And there is a difference between the single mother and duel military. Equal pay is a BIG DEAL. We should not be penalizing the servicemember for being married. When the individual is making less money...that's an issue. You also shouldn't be REWARDING single mothers with double BAH. They are one service member...and they should get one BAH. Would I like to see single mother's helped out? Of course...but the military is about making blanket policies...and two BAH's to one individual is something that never would be done. Keep things simple...one servicemember...one BAH.

I agree with most of what you said, but I have a slight issue with implying that childless dual military officers "taking advantage of the situation". Having children is entirely a personal choice, and those who choose not to have children shouldn't be stigmatized in any way. If a military officer couple want to spend all their money on themselves, then that's their decision, which should be respected. I am NOT saying that you are stigmatizing anyone, but it isn't right to say that childless officer couples are "taking advantage" of anything.

Like you said, equal pay for equal work, period - dependent or martial status should be irrelevant.

 

[Perrotfish]

And if we're going to consider removing an extra subsidy as a form of "discrimination against women," then we should probably ask why active duty single mothers aren't getting dual BAH. diffi

Its not an extra subsidy, its pay. Its discrimination not to pay people based on anything but the job that they are dong. We don't need to pay single AD moms double BAH because BAH is pay, and they deserve to get paid once for one job regardless of how much they need to get paid twice. We do need to pay married active duty couples double BAH because BAH is pay. You get paid twice for working two jobs, regardless of how little you need it. That's how work works.

 

[j4pac]

I agree with most of what you said, but I have a slight issue with implying that childless dual military officers "taking advantage of the situation". Having children is entirely a personal choice, and those who choose not to have children shouldn't be stigmatized in any way. If a military officer couple want to spend all their money on themselves, then that's their decision, which should be respected. I am NOT saying that you are stigmatizing anyone, but it isn't right to say that childless officer couples are "taking advantage" of anything.

Like you said, equal pay for equal work, period - dependent or martial status should be irrelevant.

Yeah...it was poorly worded. I didn't mean to say "take advantage".

 

[ProudMD]

Its not an extra subsidy, its pay. Its discrimination not to pay people based on anything but the job that they are dong. We don't need to pay single AD moms double BAH because BAH is pay, and they deserve to get paid once for one job regardless of how much they need to get paid twice. We do need to pay married active duty couples double BAH because BAH is pay. You get paid twice for working two jobs, regardless of how little you need it. That's how work works.

100% concur. BAH isn't some sort of special "bonus" - it's an extension/part of a service-member's basic compensation.

And from what I've read across internet forums, it seems that most people who are FOR this proposed cut are simply upset that dual-military couples are making more money than they are because of an extra BAH. It's the sad and dangerous mentality that if I can't/don't have it, then you can't either.