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December 23, 1992, Vol 268, No. 24 >
ARTICLE | December 23, 1992

The Impact of Health Insurance Reform on the Law Governing the Physician-Patient Relationship FREE

Wendy E. Parmet, JD
[+] Author Affiliations

Reprint requests to Northeastern University School of Law, 400 Huntington Ave, Boston, MA 02115 (Ms Parmet).


JAMA. 1992;268(24):3468-3472. doi:10.1001/jama.1992.03490240076041
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Article
References

AS THE health care cost and access crises deepen,1 and with the arrival of a new administration in Washington, health insurance reform looks increasingly inevitable. However, despite widespread recognition that change is needed, many fear that reform will lead to increased regulation, a decline in the quality of care, and an erosion of physician autonomy and patient choice. This need not be the case. Although reform will undoubtedly change the legal climate in which health care is practiced, it may prove no more corrosive of the physician-patient relationship than continuation of the decentralized system we now have.

For editorial comment see p 3479.

PROPOSED REFORMS  The number and variety of reforms that have been proffered is truly staggering.2 Nevertheless, three broad categories warrant special consideration: single-payer proposals, employment-based proposals, and tax credit/insurance reform proposals.An example of the single-payer model is the proposal put forward by Rep Marty

REFERENCES

1 +
Lundberg GD.  National health care reform: the aura of inevitability intensifies. JAMA . 1992;;267:2521-2524.
2 +
Blendon RJ, Edwards J, Hyams AL.  Making the critical choices. JAMA . 1992;;267:2509-2520.
3 +
HR 1300, 102nd Cong, 1st Sess, 1991.
4 +
S 1446, 102nd Cong, 1st Sess, 1991.
5 +
S 1227, 102nd Cong, 1st Sess, 1991.
6 +
Clinton B.  The Clinton health care plan. N Engl J Med . 1992;;227:804-806.
7 +
The President's Comprehensive Health Reform Program, February 6, 1992.
8 +
White House Fact Sheet, The President's Health Care Reform Plan. Federal Information Systems Corporation, Federal News Service, Nexis; February 6, 1992.
9 +
Hurley v Eddingfield, 156 Ind 416 (1901).
10 +
Canterbury v Spence, 464 F2d 772, cert denied, 409 US 1064 (1972).
11 +
Hall v Hilbun, 466 So 2d 856 (1985).
12 +
The Emergency Medical Treatment and Active Labor Act ('COBRA'), codified as amended at 42 USC §1395dd.
13 +
42 CFR §124.601 et seq (1991) (Hill-Burton community service regulations).
14 +
42 USCA 12181 (7) (F) (1992).
15 +
42 USCA 2000a (1981) (prohibiting discrimination on basis of race, creed, or national origin in places of public accommodation).
16 +
42 USCA §2000d (1981) (prohibition of discrimination by recipients of federal funds).
17 +
Helling v Carey, 83 Wash 2d 514, 519 P2d 981 (1974).
18 +
Inglehart JK.  Health policy report: the American health care system, introduction. N Engl J Med . 1992;;326:962-967.
19 +
Rust v Sullivan, US, 111 SCt 1759 (1991).
20 +
Parmet WE.  Legal rights and communicable disease: AIDS, the police power and individual liberty. J Health Polit Policy Law . 1989;;14:741-771.
21 +
West Virginia v Dent, 129 US 114 (1889).
22 +
42 USCA §1395 cc(a) (1) (f) (1) (A) (1992).
23 +
42 USCA §12181 (7) (F) (1992).
24 +
26 USCA §106(a) (Supp 1992); §3121 (Supp 1992).
25 +
29 USC §1001 et seq (1988).
26 +
29 USC §1144(a) (1988).
27 +
Stone D.  Why the states can't solve the health care crisis. Am Prospect . (Spring) 1992;;9:51-60.
28 +
Sullivan LW.  The Bush administration's health care plan. N Engl J Med . 1992;; 327:801-804.
29 +
Bonfield AE, Asimow M. State and Federal Administrative Law . St Paul, Minn: West Publishing Co; 1989;.
30 +
Fox D, Schaffer D.  Health policy and ERISA: interest groups and semipreemption. J Health Polit Policy Law . 1989;;14:239-260.
31 +
Katz SJ, Mizgala HF, Welen HG.  British Columbia sends patients to Seattle for coronary artery surgery. JAMA . 1991;;266:1108-1111.
32 +
Fuchs VR, Hahn JHS.  How does Canada do it? a comparison of expenditures for physicians' services in the United States and Canada. N Engl J Med . 1990;;323:884-890.
33 +
Daniels N.  Is the Oregon rationing plan fair? JAMA . 1991;;265:2332-2335.
34 +
Wilson v Blue Cross, 271 Cal Rptr 876, 222 Cal App 3d 660 (1990).
35 +
Wickline v State of California, 192 Cal App 3d 1630, 239 Cal Rptr 810 (1986).
36 +
Varol v Blue Cross and Blue Shield, 708 FSupp 826 (1989).
37 +
Pilot Life Ins Co v Dedeaux, 181 US 41 (1987).
38 +
Holmes v Pacific Mutual Life Ins Co, 706 FSupp 733 (CD Cal 1989).
39 +
But see Cooney v South Central Bell Tel Co, 1992 Lexis 2402 (EDLa 1992) (ERISA does not preempt intentional tort action against health plan care managers).
40 +
Kohn v Delaware Valley HMO, Inc, 1992 Lexis 1092 (EDPa 1992) and 1991 US Dist, Lexis 18694 (EDLa 1991) (ERISA does not preempt ostensible agency claim against an HMO for negligence of the provider but does preempt action against an HMO for failure to provide benefits).
41 +
Reilly v Blue Cross and Blue Shield, 846 F2d 416 (7th Cir), cert denied, 488 US 856 (1988).
42 +
Boyd TH.  Cost containment and the physician's fidicuiary duty to the patient. DePaul Law Rev . 1989;;39:139-159.
43 +
Eg, S 1936, 102nd Cong, 1st Sess, 1991 (Chaffee tax credit bill).
44 +
Annas G, Law S, Rosenblatt R, Wing K. American Health Law . Boston, Mass: Little Brown & Co; 1990;.
45 +
Harvard Medical Practice Study. Patients, Doctors, and Lawyers: Medical Injury, Malpractice Litigation and Patients' Compensation in New York. 1990.
46 +
Danzon PM. Medical Malpractice: Theory, Evidence, and Public Policy . Cambridge, Mass: Harvard University Press; 1985;.
47 +
Annas G, Katz B, Trakimas R.  Medical malpractice under national health insurance: essential or expendable? Duke Law J . 1975;;1335-1373.
48 +
Furrow B, Johnson S, Jost T, Schwartz R. Health Law Cases, Materials and Problems . 2nd ed. St Paul, Minn: West Publishing Co; 1991;.
49 +
Sanders J, Joyce C.  Off to the races: the 1980 tort crisis and the law reform process. Houston Law Rev . 1990;;27:207-222.
50 +
Hadley J, Steinberg E, Feder J.  Comparison of uninsured and private insured hospital patients. JAMA . 1991;;265:374-379.
51 +
Bravemen PA, Egerter S, Bennett T, Showstack J.  Differences in hospital resource allocation among sick newborns according to insurance coverage. JAMA . 1991;;266:3300-3308.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Lundberg GD.  National health care reform: the aura of inevitability intensifies. JAMA . 1992;;267:2521-2524.
2 +
Blendon RJ, Edwards J, Hyams AL.  Making the critical choices. JAMA . 1992;;267:2509-2520.
3 +
HR 1300, 102nd Cong, 1st Sess, 1991.
4 +
S 1446, 102nd Cong, 1st Sess, 1991.
5 +
S 1227, 102nd Cong, 1st Sess, 1991.
6 +
Clinton B.  The Clinton health care plan. N Engl J Med . 1992;;227:804-806.
7 +
The President's Comprehensive Health Reform Program, February 6, 1992.
8 +
White House Fact Sheet, The President's Health Care Reform Plan. Federal Information Systems Corporation, Federal News Service, Nexis; February 6, 1992.
9 +
Hurley v Eddingfield, 156 Ind 416 (1901).
10 +
Canterbury v Spence, 464 F2d 772, cert denied, 409 US 1064 (1972).
11 +
Hall v Hilbun, 466 So 2d 856 (1985).
12 +
The Emergency Medical Treatment and Active Labor Act ('COBRA'), codified as amended at 42 USC §1395dd.
13 +
42 CFR §124.601 et seq (1991) (Hill-Burton community service regulations).
14 +
42 USCA 12181 (7) (F) (1992).
15 +
42 USCA 2000a (1981) (prohibiting discrimination on basis of race, creed, or national origin in places of public accommodation).
16 +
42 USCA §2000d (1981) (prohibition of discrimination by recipients of federal funds).
17 +
Helling v Carey, 83 Wash 2d 514, 519 P2d 981 (1974).
18 +
Inglehart JK.  Health policy report: the American health care system, introduction. N Engl J Med . 1992;;326:962-967.
19 +
Rust v Sullivan, US, 111 SCt 1759 (1991).
20 +
Parmet WE.  Legal rights and communicable disease: AIDS, the police power and individual liberty. J Health Polit Policy Law . 1989;;14:741-771.
21 +
West Virginia v Dent, 129 US 114 (1889).
22 +
42 USCA §1395 cc(a) (1) (f) (1) (A) (1992).
23 +
42 USCA §12181 (7) (F) (1992).
24 +
26 USCA §106(a) (Supp 1992); §3121 (Supp 1992).
25 +
29 USC §1001 et seq (1988).
26 +
29 USC §1144(a) (1988).
27 +
Stone D.  Why the states can't solve the health care crisis. Am Prospect . (Spring) 1992;;9:51-60.
28 +
Sullivan LW.  The Bush administration's health care plan. N Engl J Med . 1992;; 327:801-804.
29 +
Bonfield AE, Asimow M. State and Federal Administrative Law . St Paul, Minn: West Publishing Co; 1989;.
30 +
Fox D, Schaffer D.  Health policy and ERISA: interest groups and semipreemption. J Health Polit Policy Law . 1989;;14:239-260.
31 +
Katz SJ, Mizgala HF, Welen HG.  British Columbia sends patients to Seattle for coronary artery surgery. JAMA . 1991;;266:1108-1111.
32 +
Fuchs VR, Hahn JHS.  How does Canada do it? a comparison of expenditures for physicians' services in the United States and Canada. N Engl J Med . 1990;;323:884-890.
33 +
Daniels N.  Is the Oregon rationing plan fair? JAMA . 1991;;265:2332-2335.
34 +
Wilson v Blue Cross, 271 Cal Rptr 876, 222 Cal App 3d 660 (1990).
35 +
Wickline v State of California, 192 Cal App 3d 1630, 239 Cal Rptr 810 (1986).
36 +
Varol v Blue Cross and Blue Shield, 708 FSupp 826 (1989).
37 +
Pilot Life Ins Co v Dedeaux, 181 US 41 (1987).
38 +
Holmes v Pacific Mutual Life Ins Co, 706 FSupp 733 (CD Cal 1989).
39 +
But see Cooney v South Central Bell Tel Co, 1992 Lexis 2402 (EDLa 1992) (ERISA does not preempt intentional tort action against health plan care managers).
40 +
Kohn v Delaware Valley HMO, Inc, 1992 Lexis 1092 (EDPa 1992) and 1991 US Dist, Lexis 18694 (EDLa 1991) (ERISA does not preempt ostensible agency claim against an HMO for negligence of the provider but does preempt action against an HMO for failure to provide benefits).
41 +
Reilly v Blue Cross and Blue Shield, 846 F2d 416 (7th Cir), cert denied, 488 US 856 (1988).
42 +
Boyd TH.  Cost containment and the physician's fidicuiary duty to the patient. DePaul Law Rev . 1989;;39:139-159.
43 +
Eg, S 1936, 102nd Cong, 1st Sess, 1991 (Chaffee tax credit bill).
44 +
Annas G, Law S, Rosenblatt R, Wing K. American Health Law . Boston, Mass: Little Brown & Co; 1990;.
45 +
Harvard Medical Practice Study. Patients, Doctors, and Lawyers: Medical Injury, Malpractice Litigation and Patients' Compensation in New York. 1990.
46 +
Danzon PM. Medical Malpractice: Theory, Evidence, and Public Policy . Cambridge, Mass: Harvard University Press; 1985;.
47 +
Annas G, Katz B, Trakimas R.  Medical malpractice under national health insurance: essential or expendable? Duke Law J . 1975;;1335-1373.
48 +
Furrow B, Johnson S, Jost T, Schwartz R. Health Law Cases, Materials and Problems . 2nd ed. St Paul, Minn: West Publishing Co; 1991;.
49 +
Sanders J, Joyce C.  Off to the races: the 1980 tort crisis and the law reform process. Houston Law Rev . 1990;;27:207-222.
50 +
Hadley J, Steinberg E, Feder J.  Comparison of uninsured and private insured hospital patients. JAMA . 1991;;265:374-379.
51 +
Bravemen PA, Egerter S, Bennett T, Showstack J.  Differences in hospital resource allocation among sick newborns according to insurance coverage. JAMA . 1991;;266:3300-3308.

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