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At least 973 records · Page 54Linked to original sources
PubMed1992

Captive insurance companies in health care.

A health care system or individual hospital should consider establishing a captive insurance company if any one of the following situations exist: The organization's professional liability program is arranged with a self-insured retention of $500,000 or more, or consideration is being given to such an arrangement. A trust fund has been established for a self-insured exposure--professional liability, workers' compensation, or employee benefits. A portion of the organization's professional liability excess insurance program is arranged with an insurer that uses a fronting insurer. The organization currently sponsors, or is considering sponsoring, a physicians' liability insurance program for medical staff members. If any of those situations exist, a comprehensive feasibility study should be undertaken, preferably by an independent, objective organization that does not have a financial interest in the outcome of the study.

Costs and Cost Analysis↗
PubMed1987

Coordinated teamwork in California industrial rehabilitation.

This article describes a case study of an industrially produced hand injury that exemplifies the coordination and teamwork involved in vocational rehabilitation in the California Workers' Compensation system. This patient required multiple tendon and nerve transplant operations done with microsurgical techniques, hand therapy for functional and sensory retraining, job analysis, vocational evaluation, labor market survey, work-hardening experience, and an on-the-job training program to effect a successful outcome. An overview of the current status of the California Workers' Compensation system and current insurance perspectives are discussed.

Accidents, Occupational↗
PubMed2002

Who should pay for bad genes?

Parents have long been able to influence the genetic composition of their children through their choice of a reproductive partner, if only very approximately. They are, however, increasingly able to determine the genetic make-up of their children in other, more precise ways, such as by selecting a particular gamete or embryo or by genetically modifying an embryo prior to artificial implantation. This Article discusses parents' obligations to their children and other members of the community stemming from their children's genes. In a just state, it argues, parents would be responsible for redressing any genetic disadvantage their children suffer as a result of parents' voluntary actions. Within the context of a liberal egalitarian account of distributive justice, this responsibility might most fairly be discharged through a compulsory insurance plan that provides compensation to genetically disadvantaged children when they might have had non-disadvantaged children instead would in some circumstances incur greater liability, because they could not fairly push the cost of their choices off on other members of the insurance pool. The Article also asks whether parents wrong a child by allowing it to be born with a genetic impairment when, had they taken steps to remove the impairment, the unimpaired child they had would have been a different person from the genetically disadvantaged child because the better-off child's capacities and experiences differed considerably from those that the disadvantaged child would have had. Contrary to many people's moral intuitions, the Article argues that parents do not wrong such a child. Nevertheless, parents remain morally obligated to bear any added costs occasioned by the child's impairment. Any other approach would allow them unjustly to shift the burden of their choices to other parents. Finally, the Article takes up the much debated question of whether parents harm a child by allowing it to be born with a life not worth living when they could have prevented its birth. It suggests that the answer to this question should be irrelevant to parents' legal liability. Acting on behalf of the parental insurance pool, the state may nonetheless adopt a variety of measures to help potential parents avoid giving birth to such children, which one can assume virtually all would prefer.

Child↗
PubMed1995

Health insurance in Russia--the Kuzbass experience.

The leading pilot region for health finance reform in the Russian Federation has been adapting systems to changing economic circumstances since 1986. In 1992 a 'regulated competition' model was introduced and compulsory contributions are now routed to insurers via a central compensation fund. Hospitals are paid at standard rates (using 'clinical statistical groups') per case by diagnosis and procedure, and by outcome. Primary care is moving from fundholder polyclinics to general practitioners operating under incentives to efficient gatekeeping and provision of quality out-patient care. Private insurance co-exists for about five percent of the population, but the compulsory component is regulated through the central fund and only supplements are voluntary. The region has strong natural resources, but against a background of economic and environmental problems, a one-third increase on funding available to health over the pilot period is satisfactory, with costs of health insurance administration limited to three percent.

Consumer Behavior↗
PubMed2001

The Nordic model: Finnish experience of the patient injury act in practice.

This paper reviews experience in Finland with the operation of a Law protecting patients who have been harmed in the course of bona fide medical treatment. The current provisions of insurance, claims procedures and compensation are described. In the light of initial experience, parts of the original system were modified. Figures demonstrate the changing levels of claims since 1988 and their outcomes.

Finland↗
PubMedDate not supplied

Specialty versus community hospitals: what role for the law?

U.S. health care has long featured a struggle between regulation and markets as vehicles of reform, and the community hospital is at the center of this struggle. The key to its financial viability is cross-subsidization, whereby revenues from insured patients subsidize the care of the uninsured and underinsured, and profits from well-compensated services support those operating at a loss. Cross-subsidization has been challenged by efforts to move highly compensated services and well-insured patients to ambulatory surgical centers and specialty hospitals. We review the ongoing battle between through a legal lens and offer conjectures about the outcome. Refined certificate-of-need regulation may be the preferable policy choice.

Financial Management, Hospital↗