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PubMed1989

The role of physician-owned insurance companies in the detection and deterrence of negligence.

This study presents evidence that physician-owned insurance companies and their physician members play an important role in the detection and deterrence of negligent behavior. A survey of physician-owned companies indicates that 94% involve their physicians in one or more aspects of the underwriting process. About 60% involve their members in assessing the competence of physicians who have been sued and in advising the underwriters on decisions concerning both continued insurability and the conditions of insurance. During 1985, a total of 0.66% of the physicians in physician-owned companies had their insurance terminated or were forced to give up their coverage because of negligence-prone behavior. An additional 0.7% of active policyholders were subject to restrictions on practice or other medical sanctions and 1.8% to surcharges and deductibles. Thus, disciplinary actions were in place against 3.2% of insured physicians whose performance was viewed as in some way substandard. The findings indicate that the physician-owned companies are effective agents in identifying negligence-prone behavior, and suggest that these companies also play an important role in deterring substandard performance.

Clinical Competence↗
PubMed1985

Biased selection in the Federal Employees Health Benefits Program.

The existence of biased selection in health insurance markets has long been assumed by economic theorists as well as seen between classes of health plans. In this paper, we use a model of the premium rate that takes into consideration the effects of moral hazard to make empirical estimates of the extent of selection in the Federal Employees Health Benefits Program. We find that biased selection has raised the premium of the Blue Cross Plan high-option coverage by 21% and lowered the premium of the low-option coverage by 29%, both relative to premiums that would have been charged in the absence of selection.

Blue Cross Blue Shield Insurance Plans↗
PubMed1986

State health insurance pools: current performance, future prospects.

State health insurance pools have been suggested to help cover the uninsured. Their attraction lies in the theoretical economies of pooling and the limited public role intended for their administration and funding. Almost all existing pools have targeted high health risks, otherwise uninsurable people who can still afford high premiums for conventional, major-medical-style coverage. Enrollments have been low, even relative to the small eligible population, and medical spending high. Little risk pooling or other savings seem to have occurred. Deficits have therefore mounted, necessitating increased assessments on all private health insurers in pool states and indirectly burdening state treasuries as well. Better pools would have to attract a broader mix of risks, actively manage medical spending, or both.

Adult↗
PubMedDate not supplied

Prolonged and recurrent occupational dermatitis. Some whys and wherefores.

Most cases of occupational dermatitis are successfully diagnosed and treated effectively; with proper preventive measures, the patient can resume work. This is not always the case, however, because there are certain employees whose dermatitis defies the best diagnostic and therapeutic measures. Such cases engender disagreement between the patient and physician, the employer, the insurance carrier, and the compensation commission. Several of the causes for failure to effect a cure in cases of occupational dermatitis are explained in this article.

Chronic Disease↗
PubMed1988

The rise and decline of the early HMOs: some international experiences.

Consumer-controlled health insurance groups in northern Europe in the late nineteenth and early twentieth centuries resembled modern American HMOs in many ways. Fierceness of competition hindered European doctors' control of their own services, prompting them to organize physician-dominated insurance groups and to extend their power through means of licensure, boycott, and supportive government regulation. While patients thus gained the right to choose their own doctor, physicians were able to negotiate more favorable payment standards, including price discrimination by patients' income levels. The experience may foreshadow more ruthless operation of market principles among American HMOs, and raise questions about the HMO model's viability for Europe today.

Community Participation↗