Shelley J J
Fort Bragg, NC 28307-5000, USA.
Mil Med. 1998 Oct;163(10):682-6.
As the total force structure of the U.S. armed forces downsizes, the Military Health Services System (MHSS) is taking commensurate cuts in personnel and resources. To minimize costs and optimize readiness, the Department of Defense seeks to increase resource sharing and support provided by managed care support contracts under TRICARE as well as contracting of civilian providers to provide health care in military treatment facilities. Proponents of such arrangements claim that these options result in increased quality of, and improved access to, health services at a substantial savings for MHSS. Central to this controversy is the Feres doctrine, which prevents members of the armed services from suing the government for any death or injury that is in some way "incident to service." The purpose of this paper is to explore the liability issues posed by these new contractual arrangements as well as their potential effect on Feres doctrine reform.
随着美国武装部队总兵力结构的缩减，军事卫生服务系统（MHSS）在人员和资源方面也相应削减。为了将成本降至最低并优化战备状态，国防部寻求增加通过“军人医疗保健计划”（TRICARE）下的管理式医疗支持合同提供的资源共享和支持，以及与民用医疗服务提供者签约，以便在军事治疗设施中提供医疗服务。此类安排的支持者声称，这些选择能够提高医疗服务质量、改善医疗服务可及性，同时为军事卫生服务系统大幅节省开支。这场争议的核心是费雷斯原则，该原则禁止武装部队成员就任何以某种方式“因服役而发生”的死亡或伤害起诉政府。本文的目的是探讨这些新合同安排所带来的责任问题，以及它们对费雷斯原则改革的潜在影响。
