By the end of 2016, the military health system may look completely different than it does now. Or it may resemble the current structure with tweaks hardly noticeable to military patients.
What is certain is that change is coming to military medicine and Tricare: Congress has promised a complete review of the $48 billion system and reform in the coming year, aiming to improve patient care and streamline the bureaucratic structure.
In 2015, lawmakers overhauled the military retirement system and have been promising the same for military health in 2016.
"There is a lot of appetite on the part of the big four [Sen. John McCain, R-Ariz.; Sen. Jack Reed, D-R.I.; Rep. Mac Thornberry, R-Texas; and Rep. Adam Smith, D-Wash.] as well as a lot of other members of the House Armed Services Committee and Senate Armed Services Committee, to take a systemic look at the health system," SASC Staff Director Chris Brose said in November.
Last January, the Military Compensation and Retirement Modernization Commission recommended major changes to the military health system, to include moving non-active-duty Tricare beneficiaries to civilian health insurance plans and making military hospitals and clinics competitive with civilian facilities.
The commission also argued in favor of creating a four-star Joint Readiness Command that would lead the personnel responsible for readiness, including a subordinate joint medical command.
Commission members said their changes would improve access to health care and solve problems in providing care to reserve and National Guard members who transition between military and private health care.
But the Defense Department has offered its own reform plan and wants Congress to approve its proposals, which included consolidating Tricare Standard, Prime and Extra into a single program, raising enrollment fees and co-payments for some beneficiaries and implementing fees for Tricare For Life, the program for senior retirees.
House Armed Services Committee spokesman Claude Chafin said the goal of military health care reform would not be to save money but to "create a better system to serve military personnel and military families."
The House Armed Services Committee already has held meetings and oversight hearings on military health, with promises to hold more in the first several months of 2016.
The Senate Armed Services Committee is promising the same.
McCain has called growing military personnel costs "one of our greatest challenges."
"We're going to have to make some tough decisions," he said.