Holding health care accountable : law and the new medical marketplace / E. Haavi Morreim.

Format:

Book

Author/Creator:

Morreim, E. Haavi, author.

Series:

Oxford scholarship online.

Oxford scholarship online

Language:

English

Subjects (All):

Managed care plans (Medical care)--Law and legislation--United States.

Managed care plans (Medical care).

Liability (Law)--United States.

Liability (Law).

Physicians--Malpractice--United States.

Physicians.

Physical Description:

1 online resource (337 p.)

Edition:

1st ed.

Place of Publication:

New York : Oxford University Press, 2023.

Language Note:

English

Summary:

Health care in the US and elsewhere has been rocked by economic upheaval. Cost-cuts, care-cuts, and confusion abound. Traditional tort and contract law have not kept pace. Physicians are still expected to deliver the same standard of care -- including costly resources - to everyone, regardless whether it is paid for. Health plans can now face litigation for virtually any unfortunate outcome, even those stemming from society's mandate to keep costs down while improving population health. This book cuts through the chaos and offers a clear, persuasive resolution. Part I explains why new economic realities have rendered prevailing malpractice and contract law largely anachronistic. Part II argues that pointing the legal finger of blame blindly or hastily can hinder good medical care. Instead of "whom do we want to hold liable," we should focus first on "who should be doing what, for the best delivery of health care." When things go wrong, each should be liable only for those aspects of care they could and should have controlled. Once a good division of labor is identified, what kind of liability should be imposed depends on what kind of mistake was made. Failures to exercise adequate expertise (knowledge, skill, care effort) should be addressed as torts, while failures to provide promised resources should be resolved under contract. Part III shows that this approach, though novel, fits remarkably well with basic common law doctrines, and can even enlighten ERISA issues. With extensive documentation from current case law, commentary, and empirical literature, the book will also serve as a comprehensive reference for attorneys, law professors, physicians, administrators, bioethicists, and students.

Contents:

Intro

Contents

Chapter 1. Introduction

PART I: JURISPRUDENTIAL PROBLEMS

Chapter 2. Physicians and Tort Liability

A. Economic Upheaval

B. Inadequacies of Current Malpractice Tort Law

C. Recasting Physicians' Duty of Care

D. Conclusion: The Traditional Custom-Based Approach to Setting the Medical Standard of Care Should Be Abandoned, and a New Approach to Physicians' Malpractice Liability Should Be Identified

Chapter 3. Health Plans and Tort Liability

A. Historical Overview

B. Growth of Liability for Health Plans

C. Challenges in Ascribing Tort Liability to Health Plans

Chapter 4. Health Plans and Contract Liability

A. Obstacles to Effective Contracting

B. Consequences of Ineffective Contracting

PART II: ADDRESSING THE PROBLEMS: RESHAPING LEGAL STANDARDS

Chapter 5. Pinpointing the Issues

A. Two Prospective Answers to the Jurisprudential Dilemmas

B. The Real Dispute: Who Should Control What

C. Who Should Control What: Seeking a Reasonable Balance

Chapter 6. A Basic Distinction

A. Expertise

B. Resources

C. Litigating Breaches of Duty: Expertise Versus Resources

Chapter 7. Reshaping Liability for Physicians

A. Physicians and Expertise

B. Physicians and Resources

Chapter 8. Reshaping Liability for Health Plans: Expertise and Tort

A. Duties of Expertise in Four Domains

B. Reducing Corporations' Practice of Medicine

C. Tort Litigation for Breach of Expertise Duties

Chapter 9. Reshaping Liability for Health Plans: Resources and Contract

A. Conditions for Effective Contracting

B. Guidelines-Based Contracting: Choosing and Enforcing Resource Entitlements and Resource Limits

PRAT Ill: ASSESSING THE PROPOSED APPROACH: PROSPECTS FOR JUDICIAL ACCEPTANCE

Chapter 10. Judicial Acceptability

A. Physicians' Liabilities.

B. Health Plans' Liabilities: Expertise and Tort

C. Health Plans' Liabilities: Resources and Contract

D. Implications for Litigation

E. Summary

Chapter 11. Special Issues In ERISA

A. Quality-Quantity: Paralleling The Expertise-Resource Distinction

B. Quality-Quantity: A Flawed Distinction

C. Fixing the Problems: ERISA and Resource Issues

D. ERISA's Future

Chapter 12. Reflections

Notes

References

Table of Cases

Index

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W.

Notes:

Previously issued in print: 2001.

Includes bibliographical references (pages 281-305) and index.

Derived record based on print version record and publisher information.

ISBN:

0-19-770709-2

1-280-83502-8

0-19-974894-2

OCLC:

647897681