July 23, 2009- AUSA Medical Symposium

By General George W. Casey, Jr.August 3, 2009

Hello, everybody! Great to be with you. This is obviously not a good week to be sick in the Army. And I'm part of the tribute to Army medicine here. They were debating whether or not it looked "chiefly" for me to actually sit down rather than try to talk standing up. I can assure you that it looks much more "chiefly" for me to be sitting down than falling off the stage. So I'm going to sit down here for a second. And then I'd like to give you some context to inform your programs as you think about where we're going as an Army in the next several years. And with that ... have a drum roll as I attempt to sit down. Thank you.

First of all, how are we doing as an Army' I think we're doing pretty well. In fact, about two years ago this time, I started saying that we were out of balance as an Army. And I worked hard to find the right words to describe the condition of the Army ... because I was hearing "broken" ... I was hearing "hollow" ... I was hearing "not ready." And this is the most resilient, professional, combat-seasoned force that I've been associated with in thirty-nine years. So we clearly weren't any of those first three.

But that said, we were deploying at a pace that we couldn't sustain. And Soldiers and Families are stretched. We're seeing the cumulative impacts of eight years at war. And so I said, "We're out of balance." We're so weighed down by our current commitments that we can't do the things that we know we need to do to sustain the Soldiers and Families of this great all-volunteer force and to prepare ourselves to do other things.

We put ourselves on a plan two years ago centered on four imperatives to get ourselves back in balance: number one - and the most important priority - Sustain our Soldiers and Families, the heart and soul of this force; second, continue to Prepare our Soldiers for success in the current conflict ... we could not flinch to make sure that the men and women we're sending in harm's way had the best manning, training, and equipment they could possibly have to have an edge on the enemy; third, we said we had to Reset them effectively when they came back ... the units, equipment, and most especially the people; and then lastly, we had to continue to Transform for an uncertain future.

Now, let me just give you a quick status report about where we are.

The first element of getting back in balance was finishing our growth. You recall that in 2007 President Bush directed that we increase the size of the Army by about 75,000 people ... about 65,000 in the active force and the rest in the Guard and Reserves. Originally, that was not going to be completed until 2012. In May of this year, the U.S. Army Reserves met its strength target. All of our components met their growth objectives three years early. That's made a big difference.

Now, as that was happening, it became clear to us that the number of non-deployables was increasing ... the Soldiers with the bad backs that they'd put off fixing ... the bad knees ... the bad shoulders. And so, we were having increasing difficulty sending our units out the door greater than 95 percent strength. In May of this year, we actually sent a unit out at 85 percent strength, a brigade combat team. We got them up to 90 percent in about 45 days, but I felt real uncomfortable about that. And so, we had been working since last December with the Secretary of Defense to allow us to have a temporary increase in our strength to allow us to bridge these next 18 to 24 months, which will be a tough period ... because I know that we are going to have some additional forces deployed to Afghanistan before we start coming down in Iraq. I think you know that, last Monday, Secretary Gates announced that he had gotten the President's approval to allow us to further increase our in strength temporarily by 22,000 folks. That is a huge bridge for us to get us through these next 18 to 24 months. I feel quite comfortable that that is the edge that we needed to do this effectively. So the growth - the initial growth - is done. We'll continue to expand ourselves probably over the next two years.

Second - and this is probably the most important element of getting ourselves back in balance - is increasing the time that Soldiers spend at home ... dwell. It's important for a couple of reasons. One, it gives the Soldier time to recover. You know this better than anyone. The effects of these deployments are cumulative. The second one's harder than the first. The third's harder than the second. And when you're only home for 12 or 13 months in between these deployments, you don't have time to fully recover. Nobody does. Increasing dwell gives Soldiers more time to reintegrate with their Families. It gives us more time to effectively train them and equip them. And it gives them more time to prepare to do other things besides Iraq and Afghanistan. Right now our average time at home is less than 18 months ... more than 12, less than 18. When the units that are in Iraq and Afghanistan now start coming home, they're going to average around 18 months ... in fact, 18 to 24 months. And so, we will have an expanded time to reset them effectively. We have to take advantage of that time. I've sent some folks out to do some surveys. One of the things they tell us is that, during our reintegration training, it kind of stops at 90 days. We have to do better than that. We have to stay on this ... because you don't come home, take a health reassessment, go to a couple of classes, and you're off and running again. It doesn't work like that. So increasing dwell is the most important element of getting ourselves back in balance. When the drawdown in Iraq is executed by this time next year - knock on wood - we will actually be in a position where our average Soldier will get almost 24 months. That's about a year faster than I thought it would take to get there. Now, we're at war. So it's not a given. But that's the direction that we're headed. And that's a good thing for all of us.

The third element of our getting ourselves in balance here is ... you remember 2004' ... we started to transform ourselves organizationally. We began to create modular organizations. Well, we have completed the modular conversion of around 265 of the 300 brigades in the Army. Every brigade in the Army will be converted. And we've been doing that since 2004. We'll finish it by 2011. By then, we will have modularized every brigade in the Army. The other element of our organizational change is rebalancing. We've been rebalancing about 150,000 Soldiers from Cold War skills to skills that are more relevant in the 21st century. That's a tall order, but we're two-thirds of the way to doing that. To give you an example ... we probably stood down about 200 tank companies, artillery batteries, and air defense batteries. We have stood up an equivalent number of special forces companies, civil affair companies, military police companies, engineers ... those kind of things. Taken together, that's the largest organizational transformation of the Army since World War II. And we've done it while we've been deploying 150,000 Soldiers over and back to Iraq and Afghanistan. We will have done in seven years what in a peacetime environment probably would have taken us more than two decades.

The next element of balance is the base realignment and closure implementation. I'm sure more than a handful of you are affected by that. There are $65 billion going into Army installations in five years. You can't go on an Army installation right now without seeing cranes, but the upside of that are improved facilities for our Soldiers and Families. And that's a big deal.

And the last element is putting ourselves on a rotational model ... on the Army Force Generation model. I'll tell you, ARFORGEN in some places has a bad name. In good conscience, we laid out a model in 2006. It was a three-year model. It was an objective model. But because of the demand in Iraq and Afghanistan, we never were able to implement it as intended. So, we are working right now to adapt our institutions to support an Army operating on a rotational model. That is a huge institutional change for us.

And I need your help here. I need you to be thinking: "how would I do what I'm doing differently if I knew I was supporting an Army operating on a rotation model'" I run into this stuff all the time. Largely, our support systems are designed for pre-September 11. They're designed to support a garrison-based Army that lived to train. We are never going back to those days. So if you're waiting to go back there, the "good old days" are still ahead of us. And they're going to be an Army operating on a rotational model. We have to think differently about how we do our business. But I started to say that I see this stuff all the time. It's like walking around in a dark garage full of rakes. You take a step, and something new pops up and hits you in the nose. And you say, "Why are we doing this like that'" Here's an example. I don't know if you've heard the term "ice cubes." The personnel folks use it. They use it to refer to the population of a unit that doesn't have enough time left on their enlistment contract to deploy with the unit. So they sit there and melt. There's nothing else you can do with them. You can't put them anyplace for a couple of months. And why is that' Because we write our enlistment contracts that way.

In the Marines, they write contracts so a Marine gets basic training, AIT, goes to a unit, and gets two rotations. We can do that, but we haven't had to in the past. Because our systems are lined up the way they are, we're getting it done ... but it's through brute force and ignorance. We're constantly pounding that square peg into a round hole. So I need you to think about how you might do what you're doing differently to sustain a force operating on a rotational cycle.

My bottom line report to you is that we have made good progress over the last two years towards our objective of putting the Army back in balance. Especially with this temporary increase of 22,000, I feel pretty good about our ability to get where I thought we'd get by 2011. The next 12 to 18 months aren't going to be easy. We will increase in Afghanistan, I'm sure. But I don't think it's going to have a significant impact. So we'll get through the next 12 to 18 months. Then, I think we'll start steadying ourselves out. So my status report to you: we're in fairly good shape, moving in the right direction ... but the next 12 to 18 months will be tough.

Let me go out of line here and just give you a quick situation report on how we're doing on Sustain, Prepare, Reset, and Transform.

On Sustain, we will continue our efforts to provide the best medical care available. I just came from BAMC, meeting with a group of Soldiers. And they just fill you so full of such pride. I also presented a couple of Silver Stars. It was also the first time I've ever seen a guy on crutches present a Purple Heart to a guy on crutches.

I want to tell you about a major program that we're going to roll out here around the first of October. It's a program that we've been working on for over a year. It's called Comprehensive Soldier Fitness. As we looked at what we were doing with mental fitness across the Army, we had some assessment programs ... kind of pre- and post-deployment; we had some educational programs ... the Battlemind training is basically a resilience program; we had lots of assistance programs to help folks who'd been identified with problems; and we had lots of treatment programs to treat folks that were identified with problems. But as we looked at this, what we saw was that it was all heavily weighted towards treating folks or assisting folks after the fact. As we looked at things like rising suicide numbers, we said to ourselves: "We have to do something to prevent these mental health challenges." So we started looking at how you prevent that. We went to the University of Pennsylvania and found a couple of "docs" who had been working this for thirty years. We got into the science of it with them because you can teach people to be more resilient. So we've been developing tools and curricula with them for the better part of a year. We've had the best minds in the country working on these programs. Here's what you're going to get.

The first - and I think one of the most important elements - is a global assessment tool. It is an online individual survey that a Soldier can sit down at a computer and take. It will give the Soldier some assessment of his or her strengths in five areas: physical, emotional, social, family, and spiritual. It will then connect him or her - if they desire - to self-help modules, which is the second part of the program. These modules can help them build strength in particular areas. It will be absolutely confidential. One of the main elements of this is trying to reduce the stigma here. It's a personal thing that Soldiers will take. We have an additional part of this program - really one for Families. That will probably come about 90 days behind the Soldier program. So the assessment tool is the first part, and the modules are the second part. The third part has already been introduced ... incorporating resilience training into basic training. We will have resilience training at every level of Army schooling, and we will have packages much like the Battlemind training. In fact, if you think "Battlemind plus," that's the type of resilience training that will be available in the school and in units.

The last part of the program - and the one that I think has the most potential - is building Master Resilience Trainers. If you think about the notion of Master Fitness Trainers, what we're trying to do with this program is to bring the level of mental fitness up to the level that we give to physical fitness. And, you know, I was a little leery about this. So we sent some sergeants - fifty sergeants - up to the University of Pennsylvania to go through the training ... frankly, to help us "militarize" the training ... because, by and large, the University of Pennsylvania had been working with civilians. I went up and visited them, and I had them all send me an email about what they thought about the training and the potential for this type of training for our Soldiers. And they're sergeants, so they didn't pull any punches. There were some who had real concerns about whether our culture would accept this, but all of them to a person saw the value. The drill sergeants said, "We want it now. This is what we need for my Soldiers now." We have one more pilot in August, and we'll start producing Master Resilience Trainers to go down to battalion level in November. This program is not intended to be a short-term chain-teach "quick fix." This is about changing the culture of the Army. It's about building resilient Soldiers and Families for a period of persistent conflict and high operational tempo ... to allow them to thrive in that environment.

Because you know, there's a perception out there that everyone who goes to combat gets post-traumatic stress. But it's just not true. Now, you've been there. The vast majority of people that go to combat have a growth experience. They're challenged by something very, very difficult, and they succeed. Someone told me yesterday that Lance Armstrong didn't win a Tour de France until he had cancer. That's pretty telling. The whole purpose of this program is to increase the number of people across our Army who have a growth experience ... because we're going to be doing this for awhile. We will keep treating folks, but we have to do more ... and we can do more. The science is there, and it supports it. So Rhonda is going to talk to you tomorrow. Brigadier General Rhonda Cornum works for the Army G3. That's where this program is ... not that I've got anything against MEDCOM programs. But this is an Army program. We're treating it like physical fitness. So I'm happy to entertain your questions on this, but I want you to think about it and talk about it. It's something very important to sustain ourselves going forward here.

On Prepare ... we're doing very well. With this 22,000 additional folks, we'll get manning up to appropriate levels. Actually, we'll be able to slow the spin in the personnel system down a bit. We're not getting Soldiers to units on time to take part in training. When you have 20 percent of the unit change out after the mission rehearsal exercise, it makes it hard on folks. So this will help us quite a bit.

Reset ... as I said, units, people, equipment. Let's talk about the "people" part of it for a minute. If you have 15 months at home, you can do a slow, stable six-month reset. We haven't had that. We've been averaging 12 or 13 months at home, and that's too fast. I just had all of the two- and three-star commanders and their sergeants major in for a training conference. I told them that, starting in 2010, you're going to have units that are going to have 18 to 24 months at home. If you let them, they'll do that reset like they have only 12 or 13 months at home. And they'll run everybody into the ground. We have to do things to save our subordinates from themselves, and we have to take advantage of that time to rest our force. So that was the direction that I gave to them.

Something I'm leery about ... you know, when you're home for 12 to 13 months, you don't necessarily settle everything. You just get back on the treadmill and keep going. I'm concerned that, as we have Soldiers home longer, some of the things that have been suppressed with repeated deployments are going to have more time to bubble up. So I think we're going to see some challenges on the personnel side ... the "people" side ... that have been suppressed for the last couple of years. That's where I think you all come in. I think we're going to see more of what we've seen lately.

Lastly, Transform. I talked about persistent conflict. Let me tell you, we've been doing an awful lot of thinking about the future environment. The question is: what are you transforming for' In Washington, we're going through the Quadrennial Defense Review right now. You know, one of the nice things about Washington' No bad idea ever dies. I think the Quadrennial Defense Review is designed to make sure that that is indeed the case. But that said, there's an awful lot of good thinking that's going on. The thought that we're all really scratching our heads about is: what type of environment should we be designing our Army and our Armed Forces for' Well, as we look at this, a couple of things strike me. One, we've been at war for eight years. We're at war with a global extremist network that attacked us on our soil. They're not going to quit. They're not going to go away. This is a long-term ideological struggle. So if you think of what we're doing now more in terms of the Cold War than of Desert Shield and Desert Storm, you'd be correct.

Against that backdrop, you look at the trends in the international environment. The trends are more likely to exacerbate what's going on right now than they are likely to make it better. What am I talking about'

Globalization. You know up until six or eight months ago, globalization was bringing prosperity to places all around the world. But that prosperity was very unevenly distributed. So if you think about where the prosperous countries of the world are located and where the "have not" areas - like South America, Africa, the Middle East, and South Asia - are located, you see striking differences between the "haves" and "have nots." The "have nots," for example, are much more susceptible to recruitment by terrorist organizations.

Technology is another double-edged sword. The same technology that's bringing knowledge to anyone with a computer is being used by terrorists to export terror around the globe.

Demographics ... also going in the wrong direction. I've seen reports that the populations of some of these developing countries are expected to double in the next decade. Pakistan has, I think, 140 to 170 million people. Imagine that doubling in a decade ... and the problems that brings to a government. Sixty percent of the world's population is expected to live in cities by 2030. That says a lot about where we'll operate. The other thing that I think is fascinating is the middle class of China and India. The middle class in China and India are already larger than the population of the United States. That's a lot of two-car families. It means a lot of demand for resources. And the two things that worry me most: weapons of mass destruction in the hands of terrorists, and safe havens ... countries or parts of countries where governments either can't or won't deny their soil to terrorist organizations.

So those things I think tend to exacerbate the situation that we have right now. That means that for the next decade or so, we are going to be engaged ... maybe not on the level of Iraq and Afghanistan ... but we're going to be engaged. That says that we have to put ourselves on a rotational model because we have an all-volunteer force. We have to organize ourselves to generate trained and ready forces to support places like Iraq and Afghanistan and, at the same time, have forces left over to hedge against the unexpected. I fully believe that we're going to be doing something in the next three to five years that none of us are thinking about right now, and we have to have the capability to do those things. So we see a period of protracted confrontation ... persistent conflict. We'll organize ourselves for that.

As an Army, it's not enough for us to look at the environment. You also have to look at what war is going to be like in the 21st century. We've had some good glimpses. I got into this big discussion with the doctrine writers. Has the nature of war changed' Or is it just the character of war' Well, they beat me into submission. I acknowledge that the nature of war is immutable and doesn't change, but the character of conflict changes in different eras. I believe that's true.

So what's it going to be like in the 21st century' You know, you can look at Iraq and Afghanistan ... that's a part of it. But I look at Lebanon in 2006. I think that is a harder solution set. What do you have' You have a terrorist organization - Hezbollah - operating inside a state - Lebanon - supported by two other states - Syria and Iran - and fighting yet a fourth state - Israel. And you have a terrorist organization that is employing the instruments of state power. Hezbollah started the war with 13,000 rockets ... not the little ones that you dodge at the FOBs ... but big 220mm rockets. They fired those at Israeli population centers. They used improvised explosive devices to channelize attacking Israeli Army formations into kill zones where they shot at them with state-of-the-art guided missiles. They shot down an Israeli helicopter with a state-of-the-art surface-to-air missile. They hit an Israeli ship in the Mediterranean Sea with a cruise missile. They had unmanned aerial vehicles. They used secure cell phones and secure computers for command and control. And they got their message out on local television. Now, that's a different ballgame. It's certainly a different ballgame than the wars that I grew up preparing to fight on the plains of Europe or in the deserts of Saudi Arabia or over the hills of Korea. It's a different ballgame. So we have developed a doctrine of full spectrum operations. No matter where you are in the spectrum of conflict, you will simultaneously apply offense, defense, and stability operations to seize and retain the initiative and achieve decisive results. That's our doctrine.

And I will tell you - as with any doctrine - it takes a lot of discussion ... a lot of thought ... to move from where we were to where we need to go. We had a great discussion at this conference with the two- and three-star commanders and sergeants major about what that really meant. You hear a lot of discussion about how it's either conventional war or irregular war. The more I hear that, the less useful a distinction I think it is. It's full spectrum operations. That's what we do as an Army. It's not either/or. We're designing our Army to conduct full spectrum operations against hybrid threats like Hezbollah, where they take combinations of conventional, irregular, terrorist, and criminal capabilities and package them all together and use them against us asymmetrically. That's what we're going to see. People just aren't stupid enough to come at our strength. So they're going to come at us asymmetrically with everything they can. If you look at all that, the thing that really strikes you is the complexity of it all. Lots of you have been to Iraq and Afghanistan. You've seen the complexity there. When you have complexity, it all comes back to leaders ... because it's the leaders who have the vision and the courage to cut through that complexity. So as part of our doctrinal development, we've got an active program to look at how we really build leaders that can operate across the spectrum of conflict.

We're building an Army that's a versatile mix of tailorable and networked organizations operating on a rotational cycle ... so that we can provide trained and ready forces for combatant commanders and be prepared to hedge against unexpected contingencies at a tempo that would allow us to sustain this magnificent all-volunteer force. That's what we're doing. It will take us awhile to get there, but that is the direction we're headed. I believe it will give us exactly the type of Army that we need for the challenges of the 21st century. And with that, I'm going to wrap up with just one more thing.

People ask me, "Did you ever think that the Army would be able to sustain a deployment tempo of one year out, one year back for five years'" And I say, "No." If you asked me that in 2004, I would have said, "No." So I ask myself, "How do we do this' How do we attract and retain the men and women who are so committed that they're leading ... that less than 1 percent of the population of this country ... is leading the efforts for 300 million people in a war against terror'"

And as I think about it, I go back to four things. One is leadership ... particularly the noncommissioned officer leadership that you are honoring here today. It is our noncommissioned officer leaders who are there at the platoon and company level where combat is at its most brutal. They're the ones that are going back with the same units time and again. It's all about leadership. I also think we've helped ourselves with the support that we're putting out there for Families. We've doubled the money we've put toward Families, recognizing that we're asking them to do so much. I think it's about our values and our ethos. I think it's about the word "ethos." I believe every man and woman in this Army is committed to that word ... "ethos." Lastly - and probably most importantly to you - I think about every Soldier who goes into harm's way and knows that if something happens to them, they have the best medical support in the world to fix them and put them back on their feet. I cannot tell you what that means to every Soldier in this Army going out of the gate on a patrol, knowing that there might be an IED out there with their name on it.

We would not have been able to sustain that commitment were it not for your efforts in providing the best medical support in the world. You are a key element that is holding this Army together in an incredibly difficult time. And you are a key element of making us what we are today ... the best Army in the world. So thanks very much for what you do. God bless you.