Malpractice law and health care reform: optimal liability policy in an era of managed care

• 成果类型: Article; Proceedings Paper
• 署名作者: Kessler, D; McClellan, M
• 署名单位: Stanford University; National Bureau of Economic Research
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/S0047-2727(01)00124-4
• 发表日期: 2002
• 页码: 175-197
• 关键词: managed care; liability law; defensive medicine

摘要

Because fee-for-service health insurance insulates providers from the costs of treatment decisions, it may lead to defensive medicine - precautionary treatment with minimal expected medical benefit administered out of fear of legal liability. By giving providers higher-powered incentives, managed care may affect optimal liability policy. Among elderly Medicare beneficiaries with heart disease in 1984-1994, we find that liability-reducing tort reforms reduce defensive practices in areas with high and low managed care enrollment, but that managed care and liability reform are substitutes. We consider some implications of these results for the current debate over the appropriateness of extending malpractice liability to managed care organizations. (C) 2002 Elsevier Science BV All rights reserved.