Updated

The Pentagon wants to close the Army's century-old hospital at Walter Reed Medical Center (search), the world-renowned facility in the nation's capital that has treated presidents and foreign leaders as well as soldiers and veterans.

The proposal is part of a broad reordering of the military's system for medical education, research and care, which the Pentagon says suffers from a mismatch of needs and resources.

Inpatient services would be curtailed at some military bases, and some facilities would be consolidated. Under the plan, the shuttering of Walter Reed would involve moving some of its staff and services to an expanded health care facility on the campus of the National Naval Medical Center in nearby Bethesda, Md. The new facility would retain the Walter Reed name, officials said.

"It will rival Mayo Clinic, Johns Hopkins and the other great medical institutions of the world," Lt. Gen. George Taylor, the Air Force surgeon general, told a Pentagon news conference, referring to the new Walter Reed.

The plan is contained in Defense Secretary Donald H. Rumsfeld's (search) recommendations for base closings and realignments, which he submitted Friday to an independent base closing commission and to Congress. Pentagon officials said they expect some elements of the medical proposals to stir controversy, particularly the closure of Walter Reed, the most famous military hospital.

Dr. William Winkenwerder (search), the assistant secretary of defense for health affairs, said Rumsfeld wants to use the base consolidation — the military's first since 1995 — as an opportunity to gain efficiencies in the medical care system and better position it for the 21st century.

"It is a plan that allows us to invest in and modernize key flagship facilities," he said in an interview.

After spending an estimated $2.4 billion to make these changes over the coming six years, the Pentagon projects that it would then yield a net savings of $400 million a year thereafter.

Walter Reed hospital first opened in 1909 and has treated presidents, members of Congress and foreign leaders, in addition to members of the armed forces and veterans. Today it admits about 16,000 patients a year. They include hundreds of the more seriously wounded soldiers from the wars in Iraq and Afghanistan. The far larger Navy hospital at Bethesda opened in 1942.

Research at Walter Reed's satellite Forest Glen facility at Silver Spring, Md., will be expanded.

Among other proposed changes:

— Build a new 165-bed hospital at Fort Belvoir, Va., just south of Washington. Creating the expanded facility in Bethesda — to be renamed the Walter Reed National Military Medical Center at Bethesda — and building the new hospital at Fort Belvoir will cost a combined $1 billion, according to Taylor, who directed a multi-service group that developed the overall plan for changing the medical care delivery system.

Taylor said Thursday that the 450,000 military beneficiaries in the Washington area who currently rely on Walter Reed and Bethesda will see no net decline in health care services. And once the changes are completed, the Pentagon will be able to run the military medical care system in the national capital region for $100 million a year less than it costs today, he said.

— Similar to the merging of Walter Reed and Bethesda services for the Washington area, the Pentagon would create a single, expanded medical center for the San Antonio area by closing Wilford Hall Medical Center at Lackland Air Force Base, Texas, and moving its resources to the 450-bed Brooke Army Medical Center at Fort Sam Houston in northeastern San Antonio.

Brooke also would expand its trauma services. The Pentagon would build a new outpatient, same-day surgical center at Lackland.

— Fort Sam Houston would get a new medical training center for enlisted personnel from all the services. Currently each service sends its enlisted people to separate sites for this training — Sheppard Air Force Base, Texas; Fort Sam Houston and Navy bases in Virginia, Illinois and California.

— Fort Sam Houston also will be the home of a new "center of excellence" in battlefield health and trauma, to be staffed by people from all the military services. Similar joint-service centers will be created elsewhere for other specialties like infectious disease research.

Fort Sam Houston overall would gain about 9,000 positions. Lackland would lose a few thousand.

— Medical centers on nine military bases in eight states will close their inpatient care facilities and become same-day surgical centers. They are at Fort Eustis, Va., Fort Knox, Ky., Marine Corps Air Station Cherry Point, N.C., the Great Lakes Naval Training Center in Illinois, Andrews Air Force Base, Md., MacDill Air Force Base, Fla., Scott Air Force Base, Ill., Keesler Air Force Base, Miss., and the Air Force Academy in Colorado Springs, Colo.

— The aerospace medicine program at Brooks City-Base — formerly Brooks Air Force Base — in San Antonio would be moved to Wright-Patterson Air Force Base in Dayton, Ohio. Wright-Patterson also would obtain the Navy's aero-medical research laboratory now located at Pensacola, Fla.

— All military functions at Brooks City-Base would cease, Taylor said. The Pentagon currently leases the space it has used there from the city of San Antonio. "We're not shutting the doors to the place. We'll simply remove the military structure at Brooks City-Base," Taylor said.