c ccc cc cc c cc cc c c ! " c " cc# $c c & c$ c '"cc c c cc cc cc c )*c cc'$ c c c'c $c# cc cc+ c c -c c "c c cc/*c c cc c cc c 0c1 c cc! c c c c3c "c cc cc c c'ccc 5 c'c' c 1 c c cc cc c c #c*cc c cc78c "ccc9 c c " c! c c c cccc cccc#c c c:c cc #"" cc:" c#:ccc #cc cc c1 cc$ c c c*c#"" c 'c:"cc cc* $c ccccc'c cc c cccc'c/ c"c c cc $ccccc1 ; c c cccc 'c cccc ##cccc c! c cc cccccc c+cc c"c cc' c#cc 2, c<'#=c c "c/*c+c'#c+ c*cc'c c c # cccc c cc cc cc cc cc c%c c%c c%c c(c c(c c(c c(c c,c c.c c.c c.c c2c c 4c c c c c c c c c c 6c c 6c c 6c c 6c c 6c c c c c c c c %c c .c c .c c .c c .c c 2c c 2c c 4c c 4c c c c c c c c %c c %c c (c c '#c" cc'c c c / c c$ cc'#c +c $cc:"c $cc$c c cc+ ccc cc c c c cc c## c 'cc c cc" c cc)*c1 ; c'c c c / c c c& c'c cc c7 cc! 8c c (c c (c c (c c ,c c ,c c ,c c64c c6 c c6 c c6 c c6(c c6,c c6,c c6,c Introduction The Problem of Medical Error c ' cc c c c cc c c" cc c c c c c c c c"c ""$cc c>c c ?c c c" c c c c *$c cc c ccccc cc c c $c c*c @cc ""c c # c"$ cccAcc* ccc* c:" c Acc ccc c ccc cccc $c c c cc"c c ' cc c " c c* ccc c $ ccc c c ccc c "$c cc 6 c c cc--c"cc:"c c ' ; c % c c c #" ccc $ c cc3cB@c' Cc $ c ; cc'c c c cc c+c c cc cccc "Ac Acc c"cc c c@*cccc c ccccc cc" cc c$cc c ccc:" c cc c$ c ; cc c c c 6c c %c c $ c ccc c ; cc c"cc c @c c c@ ccc "$c c c@ cc"cc c c*cc c ccc c c* ccc" c c c c5 c c> c c' c$cc"c c )$c$c c $c c ccc3c @ccc c*c c"cc cc* cc c"$c c c cc> c c cc"c 6c c ccc$cccc cc c'$ ccc"cc c7$c$8c ! cccc c c c9#c " cc c> c c ccc c c" c$ c c*ccc c c c#$c$ccc c Dcc c c $c cc:"cc $cc ccc c " c c c"" cc c" cc c cc c c cc c c c" cc 6c c cc@*c @cc cc c>cc c c> c"$ ccc"c* c c " cc c c cc c c$ c* c cc c ccccc cccc cc""" c c $ c c cccc c c cc c c #c"c c:" cc cc c #c cc cc" c 6 c #cccc" c c ) c c c" cc" $cc c cc$ c % c " c ccc $cc $ c ( c c c cccc $c cc $ cc #" ccc c ccc c E c724ccc8c" c ' "" cc c ccc c cc " cc cc c" cc* c c c " c@c c ccc cc cc ccc@c" cc "$c@ c 6c Ruality Control Regulation: Licensing of Health Care Professionals Intro c c cccc$ *cc ccc" cc ccccc c ccc c c cc cc c$ c* c* c $c c" c c c c* ccc c c c* ccc c c #c+c"" c c @c c $ c c @c c"c c @c cc 6 c 'c c !c* c c"c cc*cc c"c c c c"cccc* c c c-ccc c c c c c /cc"cc.c cc ccc c" cc c c1 c3c# $c*c5c c *cc cc c c@ c c #? cc c c c cc cc"cc c c ccc c#5cc c c c c@c$ cc cc cc cc c cc@c c $c c" cc c""c cc c cc c c cc c c cc @cccc""c c ! c ccc* c c c $cc c c cc c Bc c c$ cc ccc c c c*c riscipline c In Re Williams cc c $ cc c c cc cAc* c* ccc cc"c cc c Ec c c cc ccc c :AccAc c c c ccc c c c" c c ë er The Agency f r ëealth Care Administrati nc c cc ccc* c c cc c c cc cc c ccDccc c$ c 6 c )c'cc+c cc c c c c c c c+!#c c c"*cc""$ccc cc"*c c" " cc c!#c*@c c cc" cc'cc c$@c c c cc ccc c" c cc* c ccccc c )c'c c/cc c c cccccc Acc c ccc c Ac c c"cc c Complimentary and Alternative Medicine c c c #cccccc* ccc"c ccc "cc$ c cc c* c!cc!1cc c ccc c c B c c'c c -/c c c / c/c c $ c c c c 'c ccc* c#c c*c*c c c!ccc#cc* c c cc c ccc@c c c#cc c ðtate B ard f Registrati n f r the ëealing Arts McD n ghc c ccccc ccc> cc* cc cc ""Acc c c cc> cc* c c" cccc c cc c !ccc*cc$cc* ccc cc nlicensed Providers c c c ccc cc" cc"c c" c c c" cc cc c ccc$ *c c c cc cc $c c c 'c $c"cc:" c c* c cc* c cc c cc c"cc c"c c ðtate B ard f Nrsing and ðtate B ard f ëealing Arts Rebkec c ´ccc c cc c1/cc * cc""c c c cc cc cc ccc@c cc$c c c ccc"*ccc * cc c c ccc c c c cccDcc cccccc ðcope of Practice Regulation c ðermchief G nzalesc c )c" cc$cc cc>c c c c c c c*c"cc ccc" cc c %c Ruality Control Regulation of Health Care Institutions Introduction c c> cc cc c cc?cc c c> cc cc c c@c"ccc"c c c> cc c c 6 c B c c@c cc $c c cc7--8ccc cc c c ccc" $c c c c c :cc*c %c c $cc c c$cc cc c þew Health Care ðervice Configurations c c c # cccc* c cc Ac* c@c c cc ccc c" c c c$ c c B c c$c ccc"cc c cc cc @"c"c c Mceri Chassinc c #cccccc c c"$ c cc$c c c cc"$ Acccc cc* c cc Regulatory ðystems c ! c/*c" cc) cc c ! c c c" cc'"cc'$ c c ) cc c cc $$c c cc"cc c $c c cc 6 c c c ccccccc cc c c ccc ccccc c ! c c1 ; c'c c ) cc c ccc" c c cccc c" c $c 6 c cc$ *c$ c c " c c )cc" c c c"c$ *c$ c c ! c c c"cc $c c$c> c c ) cc c c cc c" cc"$c $cc c c c* ccc'cc c c cc c c" $c cccc c cc c cc*c> c c c " c c c ccc c ) cc cc C c c (c 6c c 1c c* cc"c cc cc> ccc c c c c c ccc* cc"cc"c c cc c?ccc c c c *$c cc cc c? cc" ccc C c c cc c cccc ccc " c c /c cc*c cc c $$ccc c"$c1 ; cc "$c> c c c c 'c cc@ c c"cc"cc c> c ccc c c3c*cc c'c'c c cccc ccc cccc cc $c c c" c"*c c cc c cc" " c c $c'c c c? c c c 'c c3c c*c c 'c' c c c c cc'cc cccc cc $c c c" c"*c c cc c cc" " c c In Re The Estate f Michael Patrick ðmith ëecklerc c c cccc ccc@cc c" c c c c"$ cAccc?c c cccc c" c"*c<0cc#B=c c '$cc" c c c cc@c c c cc c c "ccc $cc$c $c ccc:c c ccc* cc c ccc c": c c c c c ' c c c c $ cc c c Äairfax Nrsing ë me In Uð Dept f ëëð c c $ c cc""" c* c c c cc c c c cc cc"c$ cc Private Accreditation of Health Care Facilities c c cccccc" c c c $c c c c$c c cc "c*c c" $c cc$c cc c$cc c" $c cc c*cc c c5 c c c c"cc c# c c c ccc" c cc *$c c ,c 6 c $c cc $cc c$c" c c #c c$ c c c $c$ c c c@cc cccc The Professional- Patient Relationship Introduction c B c!c c'c<cc "=c c 1c3c c* c c cc " c c #"c3c c c c--cc c Esqiel Watters -- ccc$c Acc cc c !c c*cAc c cc c*ccc c ccc cc c Ac c c cc cc cccc cc*c"c* c c The Contract Between the Patient and Physician c c c c "cc cc@ccccc c !cc c" Ac"cc c c cccc:"ccc* c ccccc c 1c c" -" c "cc c" c c?cc c c cc? c c ccc@ cc c" c c ccc c "c c 1c c c? c c Ec"c c cc: c c c "c c c cc ccc " ccc c ! ccc c cccccc :c* c c c ccc c c cc c"c c c" ccccc cAcc cc "Acccc ccc c !ccc" $c c ccccc c c c c c c Millard C rrad c c #ccc" c* ccc $c* ccc cc c c ccc $ cccc c Ec) c c c ccccc" c" cccc c Acc*c " c" Ac ccc" c $c* c64c cc cc c c*cccccc c Acc c c ccc c ;c c c) c c .c c c$ c*ccc * c"c c64c Ac c*c c c $ c cc cF6 c#c --c+ cc: ccc c c @cc c c 6 c '" c ccB ccc c Mills Pate c--c&c" cc c c c c* c:"c*cccc c cc $ cc c"c c c" c c""c cc c :"cc c Tnkl Regents f the Uniersity f Calif rniac c c $ ccc ccc* c $cc c?c c $c $cc cc c" c cc c " cc*c c c$c c c c c ) c cccc"$c % c c c cc cccc! c c c! $c cc"c *c"c ccc c ccc* cc $cc@ cc c c cc"$ c cc""cc c c c '#ccc$ c cc cc c c*c!c"cc@ c c cccc""c ccccccc c ccc"cc Informed Consent: The Physician͛s Obligation c c c c c*c" c c ccc cc c" c c ccccc* cc c c c cc? cc cc"c c c c c cc* cc"c" c*ccc c 1 cc ccc! c c ccc c? cc*c $ cc c c$c :c c c c $ cc c c c" cccc c c c #$ cccc $ c cccc c c c $ c +c c c@ cc c" c $ c $$c c" cc c c 6c cc+*@cccc c ) ccc/ cc$c c Canterbry ðpence ± " c Dcc c c c c cc $ccc cc cc c * c c" c*c $c c cc@cc c c c 2c c c c ccc cc cc " c ;Ac $ccc ccc c ! cc c3c'" c @c c c ± hns n K kem r ± c cc :" cc c :" c c c c@ cc c cc ccc Dcccc c cc c c": c c Canterbry ðpencec c ccccc "c*c c" c cc>c $cc ccc c" c c c c: cc* c cc c @c *c $cc cc cc cc 6c c ccc? $c cc Ac* cccc ? $cc c B ccc"c"c*c $cc c cc c c !cc c Tisdale Pritt, ±R, MD ± *c ccc" c c #cc c> cc c c" cc c c c c cccc c"c"c c c c @c c c" ccc c c"c c c"c cc cc c c: cc $c c :" cc ccc c c Canterbry ðpensec c cc*c:" ccc c c c cc * ccc cc c cc@ccc * c c cc c""cc c B c @c c"c cc cc cc c" cccc cc ccc c" cc$ *c c ! c *cc c c c ccc cc c c" c c cc c"c c cc c c1 c c cc" cc ccc c c c cc c" Acc c " c c c" c ccc c*cc c ! cc" ccc cc c :" c " c Confidentiality and riscloser in the Physician ʹPatent Relationship c / cc c c ëmphers Äirst Interstate Bank f Oreg nc3c c"c c c 4c c c cccc cc c c c c cc c*c c +c c $c'c c ëerman Kratche -- cc<c*@ c" =ccc*@cc c #c"c ccccc c"c* cc c ccc" c""Ac c c ccc c &c#c cccc ccc c c* c" cc<:"c*@c" =c c #c1$$ *c c '-cc c ' c ( 4 c c ! c* c cc c"" ccc c cc c cc c c c"$ c* c cc c c c cc c ' c ( %4 c c ! c 6 c ' c ( %4 c c / c'c c cc c c *c:"cc c cc c 'cc $cc $ c c c c c cc ccc c c c c"cc c cccc"$ c ccc c c cc c c """ ccc c c c c "$c c> cc ccc cc c cc 6 c c "$c c cc $cc cc c*@cc c" $c c ccc c cc cc c Acc c$cccccc c #c c ccc cccc""c c c" cc c"c ccc cc $ c $c cccc $Ac c> c cc $c c>ccc@cc" $c:c"c"c c c Ac sta Brym et Al c3c9c c"cc c #ccccc c cc cccc $Ac c c ccc"c" c c cccc c Liability of Health Care Professionals The ðtandard of Care c c c'ccc c ëall ëilbnc c c c c cc$ cc c cccc c !ccc" c$ c c* c c ? $c c c"c$cc"c c ccc:"cc""c $c c> cc$c c:" c c c ccc" c c ccc cccccc cccc c$ccc cc $c c cc@ccc$c c Ac$ Ac > "cc" cccc@c cAcc c ccc ccc cc c" c $ c :"c* cc $c" cc cc c cE cc c'ccc c ëinlicky Dreyfsc3ccc cc cc c c c*c $ccc $c cc c?c c c *c c*cc c*@c c c*c c $cc c" ccc:"c * ccc c cc c c 6 c 1 c cc"$ c c c : ccc:"c* c c #c cc cc c cc c*c c c c@*c c c* cc"ccc c c* c c cc:"c c c cc c ccc cc $ c c &cc7res ipsa l qit r´c c c* c cc $c ""c c*c c c ? ccc"c ±udicial ðtandard ðetting c ëelling Carey ± ccc@ccc ac cccc c> @cc cc c cc c c c*c " ccc"cccc bc ccc c ccc* c c> Dc cc" cc " $c c$c c $c c* cc:c c Other Theories c ) c ccc! c c ðtrasel ðeen ëills OB-GYN Ass ciates, Incc3c- Ac!GAcc c: cc cc$c" c cc c c cccc c" c c "cccc cc c " c c: c c cc ccc c c cc c & ; c c ccc* ccc c" cc" c c & ; c$ *c c E c"-""$ccccc c " c c ! ccc c c c c c c c c cc c c*cccc> cc c ccc"c c c c c*cccc c c cc c c c c c Wickline ðtatec3c cE$cc" c Ac! cc c c cc ?c" c c c"c c c! c c c cccc Acc c! c c $c c c c"cc-c< =c Liability of Health Care Institutions Introduction c cc c c c" cc cc c @cc c c @c c c c c cc* c c c Agency Law and the Test of ͞Control͟ c "c c Grimm ðmmit C nty Children ðerices B ardc c c " c c cccc$ cc:cccc c c ccc $cc" c c c c'cc" cE$c c ðc tt ððM ëealthcare ðt L isc3c! cc Ac " c c cc c c cccc c cc! c c"c "cc c* cc"cc c c c!c*ccc Independent Contractors and Vicarious Liability c Brless West Virginia Uniersity ë spitalc3c! c#cc c ccc " c c c c c " cc cc ccc *c@cccc"cc@ c c" ccccc c c" c cc cc "c c c cc cc c ccc c c c*c> c > ccc ccccc Hospital rirect Liability c "c) c c Darling Charlest n C mmnity Mem rial ë spital c--c@ccc c" ccc cc ;c c c " c$ c cccc* c c c" c * ccc>c cc c Th mps n Nas n ë spitalc c " c $cc c c #cccccc c c ccc c>c cc> "c c #ccccc cc"c" c c 6c 6 c #ccc$cc"c* c" c c* c c*ccc" cc c #cccAc"ccc>ccc " ccc> ccc c" c Tort Liability of Managed Care c 9 c c c Petr ich ðhare ëealth Plan f Illin is c--c! ccAcc $c ccc c" c c #""c# c c c1c3cc cc cc $c c $c cc c c"cc c*ccc c* c$ c $c c c c * c--c c @cc $c c " c c 5 c c3c c cc cc'#cc $ c cc "c* ccc ccc c ccc c*c cc c c " c# c c Pagrigan Aetna Uð ëealthcare f Calif rnia 3c cc c c cc c* c c c cc $ccc@*cc c ! c c c"c) c c ðhann n McNlty ± 1c* c c c # c$ cc cccc* c ccc ccc$cc c* c $cc c c c c c1c*c"$ ccccc* c c ccc c c c c ccc"$ c cc Health Care Cost and Access: The Policy Context The Problems c c c ccc#c c c##c* c c cccc* c$ccc # c c*c"$ c$c c c* c c$c* ccAc cc* c c c* c*c$cc cccc c c cccc##c* ccc c c ccc c c #c cc c c c c ccccc* c*c*c"cc cc cc*c*c c c*ccc" $c@c c /1c3c c" cc c ccc c c@c ccc" $c3c c ccc " c" ccc c@ccc @*c c c c@c@c cc> cc" cc c$ cc c" cc c c$ c c c 6c c@cc c c" cc c"c"c * ccc"$ c $cc > c c +c c:" c c# c ccc c ) cB c c # c" c c BAc+cc#c c cc c*cc ccc $ c @c'c c c@c cc" $c c c" c $ c # $cc c Bc"cc cc ccc $ c " c $ c c c)cc! c c c c$ cc c cc c c cc cc"cc c c $ c c7 "c8c : c c c : c c Approaches to Expanding Access to Care c c c c cc c *c'c c / @cc c c cc> c c cc c" cc c $ cc c c c c" ccc cc c cccc cc c c* c*c cc> cc" "c c c c c* c c* c c c c c $ccc"ccc$c c c c ccc" c cccc c ccc" c c ) c c'$ c c +c cc: cc"$ ccc c c c 'c@"Ac* c cEccc cEc c* c c c ##c c c c c c*ccc c:c cc c c cc:" cc c c c cc $ cccc"cc c c# c :c c' c 4 c c c cc:c cc c"cc 44Hcc c"$c$c* c " c c ccc: cc %c c c c c c c c ?c c c c ccc c" ccc c"cc c:cc c c" cc cc*cc"cc c' c cc' c 4 c c c cc: ccc"@c:" c c c cccc c$c c ccc c c c c"cc $c cc c$cc c * ccc 44cc 44Hcc"$cccc cc $cc #"" c"c' c cc %c c c" c c:c ccc c c "cccc"" cc c c: c* c* c cc c cc c$cc$ c c c c* cccc c cc c c* cc c* c* c c:cc c c "c c @cc' c 4 c c c c c$ c cc c* cc cccc(c cc $cc": c cc c ccc ccc? cc c"c c c " c ccc c' c 4 c c $ c cc"c c"cc ccc "$ c ccc cc c"c c c"c"c.4Hcccc c cc %444cc24444c 'c"c :c c' c c c c$c ccc cccc c *c" cccc c"c*c $c c c c"c ccc c 'c"c $cc c %c*@c* cc$cc c"c*cc%4A444c $ cc' c %4 Ac %4 c c $ c* c c:cccc" c c c c"cc> cc" c c c c;c $c"c cc c.c"cc c c c c cc"cccc" c c $ cc c c c*cc*c"cc c*c*c"cc c *cc* c c c c c*c*c c c + c c c cc cc c 4 ccc c c cc c c c ccc cc 6c c $ cc c c c &c ccc "c" c' c % c c % %c c c cc ccc c cc"cc c* c "c$c%4c"c* ccc"$ c c c cc c* c c"c c ccc $ccc "$ c c (c c c @ c +c c9 c' c 4 4.c c cccc $cc c"cc> c"cc ccc cccc c"c*c $c"c c c*c c"cc c c cc"c ccc c cc c c cc c c&'c cccc c c" c" c c cc cc cc c $ccc "cc c c> cc$ cc c c ccc"cc cc c c c c c cc c c c c" c c c $cc"cc c> c c c c"c c ccc"cc"c$ c @c c c cccc c c c: cc c #cc c c ccc cccc" c c "$ c c"c ccc* c ; cc c cc c c c$ ccc cc ccAcc c cccc:c c $cc c c cc" c ccccccc " ccccc c c c c c cc'$ c'#c c c ccc $c"" c* c cc*c c* cc"c cccc c c*ccccc cc" c$cc c*cc c cccc cc$ c c* cc" c$ c c ccc'c c/ cc! Ac'*c cc ccc c c'$ c c c@cc c cc c cccc c C c c#$c$"c c c ccc c c--$ c cc 6 c c" " ccc c c c* cccc c cc c c: c c cc: c:cc -c c"c 6 c c $cc c c" $c $c % c c"$ cc*c ( c c*-c c , c ' c" cc . c c> ccc" c 2 c c c$cc ,c 4 c cccc $ cc c c"c cc c c$ c " c cc 6 c ccc ; c c: c"c cc Access to Health Care: The Obligation to Provide c Introduction c # cccc c c ccc cc c Acc c c cc cc "c* c ccc c* c $c$c c c/c! " c c c c c cc c " c* c ccc> cc cc* c @c $ c c@ c ccc 6 c #c/ cc c c c cc c c ccccc c* c c c cc cAc $ c c" cc9C#!'c Common Law Approaches c Ricks Bdge -- ! cccccc* ccc c c*cc c*c ccc c" cc c cc c c cc c" cc cc c " cc $c c cc c" c c Childs Weis ± cC*cccc! Acc! c cccc! c c c c cc"cc cc c c ccccc 6 c Williams Uð -- c " c*cc "cc* cc c c c cccc c*ccccc c " c cc cccc ðtatutory Exemptions to the Common Law c c c ccc#c c c"" ccc " c c"c c"cc"c cc"cc c #c $cc c"*cc c $ c c c " " c " c c c cc c ccc c " c c> ccc c c" cc c %4c´ccc c* c c"c c $cc c cc c c cc> ccc""" c c cc c ccc ccc- c c ccc $cccc ccccc c" cc c cc c cccc c ;cccc c " c c .c c c" c cc cc ccc cc "c c c c cc*c c c " cc"$ c ccc c """ cc c""" cc ; c c c c ccc c cc" cc c Baber ë spital C rp rati n f America c--c ;ccAcc c c ##ccc "cc c c" cc"c cc" c c c> cc> cc " cc"$ cc c: c c cI""" Icc I* c c" cc c " Jcc"AIc c I c$ Ic c$ cc c cAc* c* cc cc $ ;cc c " Ac c " cc"c $c$ c" cc c c " c cccc" c cDcc cc cc c c cc c c$cc$ cc ##Jc c"$ Ac c" c c"c$ c c c c" c ccc c Dc c c " cc@*cc c c c c" c*cc ;cc cDcc $ c #c" cccccc" Ac c c " c cc c c""ccc*c c""" c ccc" c Private Healthcare Insurance and Managed Care: ðtate Regulation and Liability Insurance and Managed Care: ðome Basic Concepts c c c c"cccc c cc$c c c$$cc c c"ccc Ac" c c ccc1c c ë N t T Think Ab t Managed Carec c cc"cc cc cc ccc c $cc c$ c c c c "c c ccc @c c*c"$ cccc @c c ccc* c $c$ c c c c 6c ccc* cc cc"cc> cc $c cccc" ccc"$ c c"ccc c cc cc cc c cc c @c " c Acc c@c"c c cAc" c c1cc c C ngressi nal Research ðerice, Insring the Uninsred: Opti ns and Analysisc 2c c "cc cc c c ccc" cGc*cccc c c @c@ccc c /c c cc* ccc ccc cc ccc c c c cc"cc c @cccc c ccccccc c c cc@cc" c c cccc Acc* cc*c " c c @ c c c"cc" ccccc:"c c c cc c$ ccc c c #$cc+$c' c c #$c' c c ccc""c* c"c cc@"cc $cc c c c* c c cc c cc cc cc ccc c cc"cc c c c* c cc" c c c The ðtrggle f r the ð l f ëealth Insrance, Deb rah ðt nec c ccc cc cc Ac* c c c cccc c c Contract Liability of Private Insurers and Managed Care Organizations c Lbeznik ëealthChicag , Incc3c)*c cc$Acccc c ccc cKcccccc"$ c ccc$c c B cc c@ccc$c cccccccc Tort Liability of Managed Care c cc $c cc&c'c*c c cc c c cc $c c" c" ccc c c c:c c" c c 'cc> c c" ccc cc c #"ccc#ccc c c c 'c $c c cc"cccccc cc cccc cc c* cc" c c c c *$cc-" cc cc c* c c" $ ; cc c/cc c 'c $cccccc* c cc"c c "$cc c +c c""c cc c*cAc cc $ cc c ccccc"ccccc $ cc c #c> ccc cc c 4c ðtate Regulation of Managed Care c c cccc c c c 'c*c c1c)*@c c cc cc cc c*@cc7c cc "$ c*8c* c" c1cc c ccc c cc ccccc*@cc c 7#cB c$ 8c*cc c c1cc"cc"$ c * ccc ccc c 7 cc8c*cccc* cc"c cc $ cc c" ccccc cc@ccc c"c c ccc7""c"8c*c* c> cc"cc c cc c c" c 6 c & ; cc c & ; c$ *cccccc$ ccc Ac" cc&ccc c c cc """ cc cc c " $c3c! cc"ccc"$ cc c c3c c"cc* c c c c$ *c3cc $c " c c c # c$ *c3c cc, c ccc c 6 c cc$ *c3ccc cccc c" c c -"c3c$ *c" cc"c"c c cc c$c c c 'c $c"cc c c *c c"c $c"c c *c c* cc@c c c c c$ *c c ! cc c cc $ c cc* c ccc"$ cc $ c ccc> c $ c c c"cc c $ c $c c " c*c c c cc $ ; c ccc cAcc*cc? 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cccc" c* c$ cc"$ c c c "cc ccc c"Acc c c c c""" c> c c c cc c$ cc c ccc"$ cc c "cc c cc c"c c ' c% c3c 2c&'#c c c :"cc"$ c c c<=cc c Ac c"$ cc c "cc "ccc c "c c"cccc 'c*c cc cc*cc cccc"c c"c c < =<#=:"cc"$ c c"" c</=Ac c c c "c cccc:"cc $cc"ccc*ccc 'c* cc Ac@ Acc c c ) cc"c c"Lccc cc cc "Ac cccccc c"Lcccc c c cc cc@ cc""ccc*ccc'c c %c "" ccc c" Ac cAc@Ac c" Acc $c" c The Relationship Between Federal ERIðA Fiduciary Law and ðtate Tort Claims Against Managed Care Plans c Pegram ëerdrich -- :c c Acc* cc"" :cc c c cc c c* c c cc :c c cc ERIðA Preemption of ðtate Tort Litigation c Aetna ëealth Inc Daila 3cc" c$cccc'#c c c" c $$c ; c$ *c* ccc'#c c c" c*c c""cc$c Beneficiary Remedies Provided by ERIðA c c c '#c c"c c"cc c c cc c cc"$ ccccc c* c c ccc c ccc *$c"c"cc"$ c c"cc c Metr p litan Life Insrance C mpany Glenn ±cc''cc Acc c c cccc*@cc c c c c ccc* ccc ccc c c cc cc c c cc c c c cEcc*@c* c ''#0c c cccc c cc"cc" c"cc@cccc c c $ c 0c cc"$ cc"cc c:"c $ c c cc@c cc$ c cc "cE0c cc Federal Initiatives to Expand Private Insurance Coverage c #cc1/#c$c> c c #c c c ccc": c c> cc* c(c cc ccc c cccc c cc c c c@c c c c"c c c"c c"cc c c c $ c c c cccc c" cc c cc ccc c c > c c c cc cc c@c@c c$ ccc"" c* c .c cccc c$c* c $cc$cc: c1/#c c* c $cc cc"ccc c(6cc*c cc c c c c$cc"" cc: c $cc c (c $ c > c c" c cc cc cc "c@ccc$ cc* ccc "c* c""ccc"c$cccc "c $ c* c"cc$ccc c cc c ##cc#c c ##cc#cccc cc c c# c$cc $c#c"$ cc cc 1/#c" cc:c$cc Public Health Care Financing Programs: Medicare and Medicaid Introduction c cc" c ccc ccc cc cc c$ ccc c c" c cc $cccc" c c E* cc c"c cc$* c c c c* c""c cc c c $ c ccccc c c c c"c ccc>cc""c c ccc c ccccc> c* c ccccc c B c $c c"c c c B c c cc"$ cc c *c c c"c"$ cc"cc c c B c c"c* cc c c c"cc c *c c c"cc c Medicare c cc c c cc @cc c cc c cc c / c c $c c c#c"cc " Ac c Ac c cc " cc c c'""ccc/c$c c c c" c$ Ac" c "Ac" c$ c cc$ c c 24ccc " ; cc$cc c"cc Ac* c c c(4c ccc $c c$c cc:ccc cc "$ $cc $ c +c c* ccc$cc c""cc " c""cc $ c 'ccc* c>cc)c$c! c c c* cc ccc$c c c cc* c c c$ c!$"c $c#$ c c c ccc"cccc*c@c c ,c c $c* c""" c cc c ccc c $c* cc" " c c " c cc""$cc 6c c>ccc""cc c!"c #""c/c c cc c c *$ccc "cc cc c " c!c<c!=c c 1$c Acc c" " cc c Ac c cc cc$c" " Acc* cc*c$c c c"c cccc$c"c @cc/c c c ccc cc" $c"ccc c $c 6c cccc:c 44c c$c 4cc c c c cc"$ cc cc c"cc cc c c c c"ccc c " c!cc*c ccc c@c c cc"c cc ,%cAc*ccc" c "cc % 4c* c cc c %Hc"c*ccc c c c 4%4c c"ccc"@c c cc c"c* c c"ccc c 6 c #c c cc cc" c""c* c cc cc c c/ c c c 'cc"ccc" cc c cccc c 6c ccc $c"cc c ccc ccccc$c > ccccc $ c c c cccc $c c c c c $ c 1$c c"c cccc 6 c cc'$ c c c c c c cc c"cc c cc cc cc c " $c"c 6 c c" cc c c" $ccc! -cE"c c ! ccE"cc"c* cc $c cccc$ c c .c c cc c"cc* c" Ac c* c c c " ccc ;cccAcccc " ccc $c c c" cc cc c c" c c c?cc*Ac c:"c c c"cc " ccc c c" c c 'cc c cc " cc *$c cc cc $c ccc c"c c c c" c"c c 7!Ec"8c3c cc c"c 6 c cc" c " cc $ c c c c cc ccc $$c c c !Ec* ccc c ccc c c cc* cc"cc$ cc c c* c c * ccc c$ c c !cc cc c*c c1 c/c c#cc 2.2c* cc c cc" cc c c c ccc c"c* c c $cc$cc c c?cc" c cc c ccc c c"@c c ccc*cccc c ccc c " c % c ccc c c*c" c"ccccc c c c*@Ac cc> cc c c$c*c c c c "c*c"c c " c c $c* c " cc $c"cc " c> cc c c" c $c! c* c cc" c c $ccc6 c> cc c cc c $cc" cc c 1? cc c c c3c* c c c"c*c* cc"ccc c cc c cccc* c c> cc c c c c c cc c c"c ;c ccc cc c cccc @c?c c B c @c c*c c ' :c c c* cccc c" c c ccccc"c c"c 6c ccc c* cc " cc c c ( c ccc c 2c c c#$cc c c c c c c c c c c ccB cGc@cc cc " c 6c cccc$c c cc cc 4c "c c / cc1cc@cc c c$cc c cc"Acc ccc c * cc ccccc c c > cc c c* cc c c"ccc#cc cc cc/c Medicare and the PPACA c cc'$ c c c cc*c9c/c cc* cc"cc " c"cc cc"cc cc cc c c ccc cccc* c ccc c $c> c cccc cc" ccc cc'c c c'cc'c* c$ *cc cccc*c c ! 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c ##cc c c ccc cc c c 7)*c 8cc--c#c-Ac-"c $ cc cc c* cc 66c+Ec c cc c "cc c ! c *c c cc c 'c"ccccc @c c c* c*c cccc .c"c c (c c !c c c ccc%ccc cc c &c%cccc cc c c c 'cc " cc"cc@cc* c c / c c / c$cccccc c c c cc cc> c$0Accc c c*cc cc c$c c c c &c cc c cc*Acc:"ccc c> c c &c'! c-c- ccccc" ccc cc c cccc* ccc cc c c c"c c c*c cc cc* c ccc$cc c *cc*c* Acc cc+Ec 66c*c:"cc c c c c c $ccc @c"c* cc $Ac c" c* c cc"c* c c cc@cc c 6 c $c c ccc*cc" cc$cc c$cc$ c c ##cc/ c c c*c ccc> ccc$ c* cc @c"c c c cc c c c* c ccc c cAc c cc Ac@ c c cc ; c c c cc" c*cccc c c c c c c c c c c ccc: cc cc"cc c cccc@c c cc 6 c cc'$ c c +c+c'$ c c c c"c cc c cc ccc c c cc*cc c cc c&'Accccc cc cc $c " c" $ c c " cc c cc c cc@c cc cccc $c c*ccccc ccAcc cc $cc cccc c cc' c c c ccc 4c"cc 44cc %4c+Ecc 4cc c $c %4c+Ec c cccc ;cc c" cc c$c %4c+Ec c ccc c c ccc$c*ccccc c c "cc$ cc c c cc cc* $ccF %c* c> cc c cc" c 6c c/c/c#c*ccc> cc cccc c cc :c$ *ccc ccc "c $cc cc$c c c cc c cc c c ##cccc'$ c c cc c c c"cc c" cc c"cc c c c cc c c cc* ccc" ccc cc" c$cc@ccc c cc cc$cc c c* ccccc cc c$ cc "$c> ccc c c# cc+ c+c'c "c c c c 66c c c ccc c"c cc " ccc cc c c"cccc cAcc cc $c*c c c Acc c ccc$ cc c Westside M thers ëaeman ±c cc"$ c cccc c> c c c c#cc c"" c cccc c"$ Dc ccc*c> c" cc c #c"ccJc" c"*Ac cc Ac c"c* cc c &cBlessing Äreest nec< 22,=Accc* ccc c" $c c c< =c cc c*c cc c c" Ac< =c ccc c ccc $c Acc<6=c c cc c" ccc$ cc % c ##ccc# c c c ccc ccc ccc Acc ccc c* c* cc c c cc cc c c"c:" cc F %c c c cc ccc " ccc c c ccc$ cc*cc"cccccc$ cc c c cccccc cE#1cc* c c c c c ccccc c $c c cc:" cc c cc c ccc "ccc cc$ ccc'c ðtructure of the Health Care Enterprise Integration and þew Organizational ðtructures c c c'cc cc cc" c c c*cc$c*c c c c.4ccc ccc c 24c c*cc$c*cc cc c Physician Payment Reie C mmissi n, Annal Rep rt t C ngressc c c cccc"c cc c cc c c c c:c c #c"c" c c cc" c ;c c cc* c"cc cc cc" c c #c -" c ; cc* c"cc c c c " cc" c ccc " c"c $ c #c"c" c c c"$ cc cc$ cc cc c" c* ccc ;cccc c c * c cc c Accc"cc cc 6 c $ c E"c cB cBc cc"cc" c c " c "c c* ccc cc cc ;c c"cc c ; cc $ c #cc$ c ; c"$ c $cc " cc$ cc" cc $ c ccc " c*c c" cc $ c c! $c'cc"cc " cc" c @cc $ccc c c)*c"cc c1 ; c c c+ cc c c#c c +cc'$ cc c +cc$ ccc $c"c c cc c"c cc" c"c* ccc c$c c ccc c c cc cc cc"c* c* c c " cc c"Acc*cc @cc "cc c c c c $cc " "c c ccc"c c c"c ccc Acc cc cc cc cc c c! c c c c* cc*c ccccc c " cc cc $ccc c c'" c" c c c cc " c* cc"c" c"c* c ccc" c c c$c ccc c c"ccc " ccc c " cc c" Accc@c c c " ccc c c c " c $c c c" c " ccc" ccc $c" c c c cc@ c c" c" c*c c ccc> cccc ##c cc 6c c ccc c c* c c" @c" cc $ c cc c cc " c c*cAcc c c c"cc " c*cc $cc $c c c$c c cc c ccAcc c ccc cccc 6 c ##cc c c #cc1 ; c c #1'ccc c /c* ccccc c> Accc ccc c c cc cc c c cccc" "cc6cccc c 6%c 6 c $ccccc* c*c*cc c ; cc $cc c"cc c $ cc" " c"$ cc$ cc"" c c c c" cc" cc c c/ c cc cc % c $c c"cc "cccc c c cc $cc ( c ! c"cc"c$ cc cc " cAc"cc> cccc c cc c$ c c c , c !c c cc" -c cc Public Health c c c Barry Leey, Tenty Äirst Centry Challengesc c c c c c c c cccc" c$c c "$c c c + cc*Ac c Ac c c c*cccccc$cc c$Acc cc cc":cc c$cc*c c cc c" ccc" c c*c c $ c c*c c *cc cc" cc cc ?c 6 c *c" cc$ c c c ! cc ?cc % c $c c ( c c c , c ; cccc . c c c c c c+ cc c c*c c ±ac bs n Massachsetts ±c c> c$ c c c cc"*c $c c c"cc c cc c cc $c c cc"c $cccc c*c cc Ac* c c cc c c*c ccc 6 c +c Ac cc c c c*cccc*cc "c" c c"c ccc "c$ ccAc*c $c cc"cc c 1 c cc& c c c"c c c" cc" c" c c c"c* c c c c cc c c c* cc cc"cc cc c cc"c cccc c cc ccc cc c :"cccc" cc c $ cc cc c c $ c c c c 6(c $c c cc " ; c> c c c c c Bioethics Introduction c c $ccc> cc c c"c" cc c c$ cc c cc cc c c*c" cc c $cccc Ac c c c" c" c 6c c cc c* ccc Acc cc* c c The nited ðtates Constitution ad the ͞Right to rie͟ c Crzan Direct r, Miss ri Department f ëealth ± cc Dcc cc $ccc$ $cc c c cc cccc cAcccc"c"cc c c cc c - cccc "Ac c c c cc: Accccc c "ccc cc c 0c c c c"$ cc c cc$ c'c c c c!ccc"cc c c cc*ccc cc c -$ c c cc cc c "c cc " c c$ c> Mc c c 6,c