cal capability should be enhanced through the development of a battlefield threat assessment and response system. Development of such a system should include biotechnology R&D focused on improved methods for early detection, identification, and countermeasures to prevent or neutralize the adverse effects of chemical, toxin, or biological threats; to counter nuclear and directed-energy threats; and to reduce the risks from environmental hazards. Timely and effective response to new threats depends on making the knowledge of potential threats and countermeasures available to the combat medical specialist. Finally, and most importantly, the Department of the Navy should place much more emphasis on the pursuit of combat medicine capability in its medical caregivers and should reward those who specialize in combat medicine more fully in accord with its value to our naval forces and naval operations.

Innovative military medicine, focused on serving its customer, the combatant, has the potential to become the benchmark for a responsive U.S. health care delivery system. There are important cultural enablers to achieving greater levels of survivability in 2035. They require (1) integration of combat and medical elements in planning, (2) improvements in the requirements process for field medicine, (3) better career paths for combat medical personnel and specialists, (4) dedicated funding for combat medicine, and (5) a specialty that focuses on combat medicine with its own training program.

In brief, the Department of the Navy should place additional resources and focus on combat medicine and on the technologies that enhance the effective delivery of medical care anytime and anywhere. In achieving this end, the Navy will substantially improve the care of those most deserving its attention. Moreover, by better ensuring the presence of naval force personnel when and where they are needed, investment in survivability is a major force multiplier. Such investments will be repaid directly in increased force readiness and effectiveness where they are most needed.