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Health Insurance Reform and the Physician-Patient Relationship

Scott A. Kupor
JAMA. 1993;269(19):2503-2504. doi:10.1001/jama.1993.03500190045019.
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To the Editor.  —Parmet's "physician-patient relationship"1 provides an interesting and informative glance at an often neglected issue surrounding health care reform. In the discussion of malpractice reform, Parmet makes two claims regarding malpractice suits under a national health insurance program: (1) the frequency of litigation will decline due in part to the fact that 10% of current damage awards are for medical expenses and (2) the severity of damage awards will decline due to elimination of the collateral source rule (total damages will be offset by covered medical expenses). "As a result," Parmet writes, "jurors are likely to reduce the damages awarded."The results of studies conducted on collateral source rule elimination, however, temper the optimism of Parmet's conclusion. In a study of the effect of tort reforms on the size and frequency of malpractice claims, Danzon2 reported that the elimination of the collateral source rule reduced the


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