The Defense Department's decision to change contractors in its managed-care program for military dependents and retirees in California and Hawaii has gotten messier.
Aetna Government Health Plans, which last month lost the contract it has managed since February 1994, has asked beneficiaries to write Congress, the White House and the Pentagon to protest.
Meanwhile, Health Systems International's QualMed subsidiary, which won the $2.5 billion five-year deal, wants the Pentagon to overturn an automatic stay Military healthcare
placed on the contract transition when Aetna protested officially to the federal government. A decision is expected soon.
The turmoil surrounding the contract also raises questions about how quickly the Defense Department can roll out its Tricare managed-care system-scheduled to go nationwide by May 1997.
The value of the contracts and the cost that managed-care firms incur in preparing contract proposals almost ensure that losers in any bid will protest the decision, leading to delays in implementation.
"This is only contract No. 2," said Dorsey Chescavage, National Military Family Association healthcare specialist.
But Chescavage added that she believes the Pentagon will forge ahead with further contract awards on schedule because it wants to preserve the military healthcare system's peacetime mission-the day-to-day treatment of 8.3 million members of the military, their dependents and retirees.
Congress and an independent advisory commission are increasing their scrutiny of the military health service because it hasn't shrunk at the same rate as the rest of the armed forces.
Some recommend that the military medical force focus only on training to treat war casualties and send most members of the military and all dependents and retirees to private-sector providers.
But if Tricare rolls out on schedule, Chescavage said, the military health service will be able to preserve a larger role by coordinating peacetime care.