Innovations in the Organization of Health Services: Inhibiting vs. Permissive Regulation

Abstract

This Article concerns the effect of current legal rules upon the possibility of developing non-profit, consumer-sponsored, prepaid comprehensive health-service programs. Concomitantly considered are the effects of existing law upon physician sponsored plans, such as Blue Shield, and upon institutional practice under which non-profit hospitals or other institutions employ salaried physicians. The legal areas covered include: (1) Rules prohibiting the corporate practice of medicine; (2) Enabling acts permitting the operation of prepaid health-service plans; (3) Insurance codes and regulations protecting the public against fraudulent or financially unstable prepayment plans; and (4) Restraint-of-trade rules protecting prepayment plans against harassment and interference.

Keywords

Public welfare, Social welfare

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Authors

Edward H. Forgotson (U.C.L.A. School of Medicine)
Ruth Roemer (U.C.L.A. School of Medicine)
Roger W. Newman (George Washington University)

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