The answer is clear: Until the United States is self-sufficient in the education of its own health workers, it will continue to risk the health of the most vulnerable people in the United States and abroad. The Obama administration has made a major commitment to improving the health of the poorest people in the world through the $63 billion Global Health Initiative. But much of this effort will be wasted if the United States continues to take from developing countries the very thing health systems need most: the people needed to run them.
Finally, find a way to give today’s officers more of a voice in their assignments and in their lives. If there is one key generational difference between today’s young officers and those of my generation (and there are many), expecting a voice in their future is the one that most stands out — for the officer, for his or her spouse with a separate career, and for their family. One answer may be the creation of "yellow pages" to apply for assignments as Tim Kane suggests. Officers and their families want choices, not simply orders. Another is simply more humane one-on-one dialogue between human resources directors and individual officers. During a rapid drawdown, the human resources impetus is to "dump" officers, and no one is held accountable for the ensuing quality drain as many of the best exit. That meat-ax approach to management has to end if the military is to retain critical talent in this drawdown as a hedge against a very dangerous world.