How often are patients seriously injured through faulty medical care? And what proportion of these people receive compensation for their injuries and suffering? This is the first book that tries to answer these questions in a careful, scholarly way. Among its important findings is that at most one in ten patients injured through medical negligence receives compensation through the malpractice system. The focus of public attention has been on the rising cost to physicians of malpractice insurance. Although Patricia Danzon analyzes this question thoroughly, her view is much broader, encompassing the malpractice system itself--the legal process, the liability insurance markets, and the feedback to health care. As an economist, she is concerned with the efficiency or cost-effectiveness of the system from the point of view of its three social purposes: deterrence of medical negligence, compensation of injured patients, and the spreading of risk. To provide evidence of the operation of the system in practice, to distinguish fact from allegation, and to evaluate proposals for reform, she has undertaken a detailed empirical analysis of malpractice claims and insurance markets. It is a major contribution to our understanding of how the system works in practice and how it might be improved.
In the 1980s and the early 1990s, America's system of workers' compensation insurance was in trouble. As medical costs grew and benefits and compensable injuries expanded, costs of this insurance skyrocketed. In response, the states imposed price controls, but those controls caused unforeseen--and negative--consequences. The authors define the problems, trace the regulatory responses, and analyze the effects of rate regulation.
Drug coverage for seniors is better addressed by private-sector plans than by forcing manufacturers to offer Federal Supply Schedule discounts to the retail sector.
Drug coverage for seniors is better addressed by private-sector plans than by forcing manufacturers to offer Federal Supply Schedule discounts to the retail sector.
The research summarized (four studies) investigated the effects of reimbursement policies on the use of, and charges for, laboratory tests. The principal findings were: (1) the percentage of the bill that the patient's insurance coverage pays does not influence the number of tests ordered during an outpatient visit; (2) laboratory use is lower in a Health Maintenance Organization than in the fee-for-service system; (3) physicians who control test billing appear to order more tests per visit than other physicians; (4) fee ceilings on inputs other than laboratory tests, such as physician time, appear to be offset, at least partially, by higher test prices; and (5) cost-based reimbursement for hospital services appears to increase cost and charges in hospital laboratories; the larger the share of laboratory services attributable to cost-paying patients, the higher are hospital laboratory costs and charges.
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