Expanded Managed Care Liability: What Impact On Employer Coverage?

Abstract

Studdert holds advanced degrees in law (University of Melbourne, Australia), health policy, and public health (both from Harvard University). He is a policy analyst at RAND and worked previously as an attorney and as an adviser to the health minister in Australia. William Sage, a physician and an attorney (both degrees from Stanford University), is an associate professor of law at Columbia University. Carole Gresenz holds a doctorate in economics from Brown University and works as a health and labor economist at RAND. Deborah Hensler is a professor of law at Stanford University and a senior fellow at the RAND Institute for Civil Justice.

Is It Time to Give Influenza Vaccine to Healthy Infants?

“…The right-to-sue provisions in some of these bills exclude punitive damages; others do not preclude them. 34 Similarly, a wave of proposed state laws would give health care consumers the right to proceed legally against managedcare organizations, although only Texas, Missouri, and Georgia had enacted such laws as of October 1999. 34 These judicial and legislative changes portend more frequent litigation against managed-care organizations.…”

“…34 Similarly, a wave of proposed state laws would give health care consumers the right to proceed legally against managedcare organizations, although only Texas, Missouri, and Georgia had enacted such laws as of October 1999. 34 These judicial and legislative changes portend more frequent litigation against managed-care organizations. Such suits still appear to be relatively rare, 35 although shifts in their frequency are difficult to detect.…”

“…45 In particular, the magnitude of punitive damages, the uncertainty surrounding their imposition, and the moral opprobrium attached to them all serve to compound a special sensitivity that those in the health care field, including insurers and employers, tend to have with regard to litigation. 34 Thus, in a way reminiscent of Samuel Johnson's quip that nothing focuses the mind like one's impending execution, there is at least the promise that litigation would lead to a reemphasis on quality and greater attention to responsive caregood outcomes for patients. However, the track record of litigation, at least in the domain of medical malpractice, 36 provides few reasons for optimism.…”

“…34 First, they might simply relax their standards of utilization review in an effort to minimize their exposure to litigation and attempt to pass along to employers the costs associated with the resulting higher volume of services. Second, in a slight modification of the foregoing scenario, managed-care organizations might seek to offset the higher costs associated with reduced management with a reduction in the benefits they offer.…”