American Bankruptcy Institute Law Review 17 Am. Bankr. Inst. L. Rev., No. 1, Spring, 2009. Boston College Law Review 50 B.C. L. Rev., No. 3, May, 2009. Boston University Public Interest Law Journal 18 B.U. Pub. Int. L.J., No. 2, Spring, 2009. Cardozo Journal of Conflict Resolution 10 Cardozo J. Conflict Resol., No. 2, Spring, 2009. Cardozo Public Law, Policy, & Ethics Journal 7 Cardozo Pub. L. Pol’y & Ethics J., No. 3, Summer, 2009. Chicago Journal of International Law 10 Chi. J. Int’l L., No. 1, Summer, 2009. Colorado Journal of International Environmental Law and Policy 20 Colo. J. Int’l Envtl. L. & Pol’y, No. 2, Winter, 2009. Columbia Journal of Law & the Arts 32 Colum. J.L. & Arts, No. 3, Spring, 2009. Connecticut Public Interest Law Journal 8 Conn. Pub. Int. L.J., No. 2, Spring-Summer, 2009. Cornell Journal of Law and Public Policy 18 Cornell J.L. & Pub. Pol’y, No. 1, Fall, 2008. Cornell Law Review 94 Cornell L. Rev., No. 5, July, 2009. Creighton Law Review 42 Creighton L. Rev., No. 3, April, 2009. Criminal Law Forum 20 Crim. L. Forum, Nos. 2-3, Pp. 173-394, 2009. Delaware Journal of Corporate Law 34 Del. J. Corp. L., No. 2, Pp. 433-754, 2009. Environmental Law Reporter News & Analysis 39 Envtl. L. Rep. News & Analysis, No. 7, July, 2009. European Journal of International Law 20 Eur. J. Int’l L., No. 2, April, 2009. Family Law Quarterly 43 Fam. L.Q., No. 1, Spring, 2009. Georgetown Journal of International Law 40 Geo. J. Int’l L., No. 3, Spring, 2009. Georgetown Journal of Legal Ethics 22 Geo. J. Legal Ethics, No. 2, Spring, 2009. Golden Gate University Law Review 39 Golden Gate U. L. Rev., No. 2, Winter, 2009. Harvard Environmental Law Review 33 Harv. Envtl. L. Rev., No. 2, Pp. 297-608, 2009. International Review of Law and Economics 29 Int’l Rev. L. & Econ., No. 1, March, 2009. Journal of Environmental Law and Litigation 24 J. Envtl. L. & Litig., No. 1, Pp. 1-201, 2009. Journal of Legislation 34 J. Legis., No. 1, Pp. 1-98, 2008. Journal of Technology Law & Policy 14 J. Tech. L. & Pol’y, No. 1, June, 2009. Labor Lawyer 24 Lab. Law., No. 3, Winter/Spring, 2009. Michigan Journal of International Law 30 Mich. J. Int’l L., No. 3, Spring, 2009. New Criminal Law Review 12 New Crim. L. Rev., No. 2, Spring, 2009. Northern Kentucky Law Review 36 N. Ky. L. Rev., No. 4, Pp. 445-654, 2009. Ohio Northern University Law Review 35 Ohio N.U. L. Rev., No. 2, Pp. 445-886, 2009. Pace Law Review 29 Pace L. Rev., No. 3, Spring, 2009. Quinnipiac Health Law Journal 12 Quinnipiac Health L.J., No. 2, Pp. 209-332, 2008-2009. Real Property, Trust and Estate Law Journal 44 Real Prop. Tr. & Est. L.J., No. 1, Spring, 2009. Rutgers Race and the Law Review 10 Rutgers Race & L. Rev., No. 2, Pp. 441-629, 2009. San Diego Law Review 46 San Diego L. Rev., No. 2, Spring, 2009. Seton Hall Law Review 39 Seton Hall L. Rev., No. 3, Pp. 725-1102, 2009. Southern California Interdisciplinary Law Journal 18 S. Cal. Interdisc. L.J., No. 3, Spring, 2009. Stanford Environmental Law Journal 28 Stan. Envtl. L.J., No. 3, July, 2009. Tulsa Law Review 44 Tulsa L. Rev., No. 2, Winter, 2008. UMKC Law Review 77 UMKC L. Rev., No. 4, Summer, 2009. Washburn Law Journal 48 Washburn L.J., No. 3, Spring, 2009. Washington University Global Studies Law Review 8 Wash. U. Global Stud. L. Rev., No. 3, Pp.451-617, 2009. Washington University Journal of Law & Policy 29 Wash. U. J.L. & Pol’y, Pp. 1-401, 2009. Washington University Law Review 86 Wash. U. L. Rev., No. 6, Pp. 1273-1521, 2009. William Mitchell Law Review 35 Wm. Mitchell L. Rev., No. 4, Pp. 1235-1609, 2009. Yale Journal of International Law 34 Yale J. Int’l L., No. 2, Summer, 2009. Yale Journal on Regulation 26 Yale J. on Reg., No. 2, Summer, 2009.

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Current index to legal periodicals

Professor Titmuss, an eminent English social theorist, believes that man is inherently altruistic and that the duty of government is to create that social and economic climate which best channels man's drive to work together for the common good. In support of this belief, he has written a book about the procurement, distribution, and transfusion of human blood, a medical topic which he employs as an illustrative social and economic microcosm. The conclusion he reaches is foregone: "The voluntary socialized system in Britain is economically, professionally, administratively and qualitatively more efficient than the mixed, commercialized, and individualistic American system" (Titmuss, R.M: "Why Give to Strangers?" Lancet 1 :123-125, 1971). As the book was written with a bias, so will it be read with bias. My own bias is that of an American and a blood-banker. I am only too conscious of many deficiencies in the American complex of arrangements—it isn't

The Gift Relationship: From Human Blood to Social Policy

This article classifies the major approaches to the assessment of the process and outcomes of medical care. The apparent need to safeguard and enhance the quality of care has led to the institution of mechanisms that subject care to constant review so that deficiencies may be found and corrected. The article reviews the developments that led to the involvement of the federal government in this activity through its sponsorship of professional standards review organizations (PSRO's). The major features of the PSRO's are described and their possible effects discussed. It is too early to say how the PSRO's will fare, but should they fail to accomplish their objectives the pressure for more radical solutions will be difficult to resist.

https://science.sciencemag.org/content/sci/200/4344/856.full.pdf

The quality of medical care

Prologue: Health policymakers listening to presidential candidate Bill Clinton's proposals for health system reform may have felt a sense of deja vu as he returned time and again to the theme of “managed competition' in his speeches. The term was familiar to many who had been following the speaking and writing of Alain Enthoven as he refined and articulated the concept. In Enthoven's construct, managed competition relies on a sponsor to structure and adjust the market for competing health plans, to establish equitable rules, create price-elastic demand, and avoid uncompensated risk selection. That sponsor could take the form of a health insurance purchasing cooperative, or HIPC, comprising members of the employer and consumer communities. Enthoven's definition of managed competition is a blending of the competitive and regulatory strategies that have coexisted uneasily for years in the U.S. health care system. As happens with many concepts that become election-year rhetoric, managed competition has come t...

/pdf/the-history-and-principles-of-managed-competition-4qb66blkns.pdf

The History and Principles of Managed Competition

https://escholarship.org/content/qt6sz2h5qt/qt6sz2h5qt.pdf?t=o9nw56

The impact of hospital market structure on patient volume, average length of stay, and the cost of care.

How can decisions about health care in the United States - too long dominated by providers, government, and the legal system - be put back into the hands of the people? Clark C. Havighurst contends that private contracts can be sharpened to do just that and ensure universal coverage, too. Private contracts, the author states, would allow for more and genuine consumer choice, based on real differences among competing health plans in content, coverage, and cost of services. Contracts would establish the standards and obligations of all parties - instead of the courts relying on definitions of care borrowed from the medical profession that drive health plans to overspending. Voluntary economizing would replace rationing without consent. Contracts could cure a dysfunctional health care market and end a severe misuse of U.S. resources. Often with specific contract language, Mr. Havighurst offers organized health plans, employers, purchasing cooperatives, Congress, and the courts ways they can turn private contracts into effective instruments of consumer-driven health reform. He recommends explicit recognition of contracts in any health reform legislation. With changes in how health coverage is purchased, courts would respect freedom of contract. And better health care contracts could be the key to designing an appropriate and affordable form of universal coverage.

Health Care Choices: Private Contracts as Instruments of Health Reform

Practice guidelines-systematic, scientifically derived statements of appropriate measures to be taken by physicians in the diagnosis and treatment of disease-are widely viewed as a potential panacea for many of the health care industry's most pressing problems.' In addition to helping physicians obtain better medical results for their patients, practice guidelines are expected to give public and private financers of health services better tools with which to resist paying for, and thus discourage, inappropriate care. They are also being viewed hopefully as a way to ameliorate the problems associated with the law governing medical malpractice. In addition to reducing both the number of iatrogenic injuries that might become the subject of malpractice litigation2 and the pressure on physicians to practice defensive medicine,3 the availability of practice guidelines should somewhat

/pdf/practice-guidelines-as-legal-standards-governing-physician-42aufowrjt.pdf

Practice guidelines as legal standards governing physician liability.

A "no-fault" insurance system is proposed to replace the present adversary legal system for dealing with medical malpractice. Designed to obviate inquiries into providers' blameworthiness wherever possible, the system has features which would bring certain adverse medical outcomes to light, compensate for them promptly though not lavishly, and generate incentives for providers to avoid relatively bad outcomes experience. The difficulty of specifying compensable events might dictate that, at least initially, only events which are relatively avoidable and easily identified when they occur could be made compensable, the remainder being left for adjudication under traditional principles. The system would be operated primarily by providers and would stimulate peer review, self-regulation, continuing education, and increased attention to clinical outcomes rather than inputs or processes. Direct regulation of the quality of care would be unnecessary in areas where the system proved workable, and medical decision-making would be left largely free from outside interference. Costs could appear high but would be manageable.

"Medical Adversity Insurance"--a no-fault approach to medical malpractice and quality assurance.

In the 1970s, the health policy debate focused on whether government or the medical profession should control the health care system. This article asserts that that struggle between two forms of centralized control was both less promising and less consequential than the devolution of decision-making authority upon consumers and their agents that is occurring today and that seems likely to continue as competitive forces become stronger and opportunities for meaningful consumer choice increases. What we are witnessing is the simultaneous deprofessionalization and depoliticization of important decisions affecting health care, a decentralization and diversification of the system that is opening new possibilities for translating diverse consumer desires into provider performance. Although covering much familiar ground, this article links a variety of seemingly discrete issues under the sterility of the competition-versus-regulation debate and to show the historical and ethical significance of the major changes that are under way in the health care sector today.

The changing locus of decision making in the health care sector.

/pdf/coping-with-quality-cost-trade-offs-in-medical-care-the-role-4srk0pncgw.pdf

Clark C. Havighurst

Papers

Health Care Choices: Private Contracts as Instruments of Health Reform

Practice guidelines as legal standards governing physician liability.

"Medical Adversity Insurance"--a no-fault approach to medical malpractice and quality assurance.

The changing locus of decision making in the health care sector.

Coping With Quality/Cost Trade-Offs in Medical Care: The Role of PSROs