Hall Mark A, Agrawal Gail
Wake Forest University, Winston-Salem, North Carolina, USA.
Health Aff (Millwood). 2003 Sep-Oct;22(5):138-45. doi: 10.1377/hlthaff.22.5.138.
Since the mid-1990s ten states have enacted statutes that have created tort liability for patient harm caused by managed care organizations, and similar liability has been considered in Congress. This study is the first attempt to evaluate the impact of these state statutes on liability exposure and litigation activity. These statutes have resulted in little or no litigation and are not seen as creating any fundamentally new type of liability exposure. This muted effect is not attributable primarily to ERISA preemption but, rather, to the costs and complexities of suing a health plan, which deter lawyers from including this additional defendant in medical malpractice cases. The main drivers of increased liability concerns are the large class-action lawsuits that are pending under federal law and the few state cases with massive punitive-damage verdicts prior to these statutes. This suggests that a federal liability statute is not likely to greatly increase liability exposure unless it allows such suits.
自20世纪90年代中期以来，已有10个州颁布法规，规定管理式医疗组织对患者伤害承担侵权责任，国会也在考虑类似的责任规定。本研究首次尝试评估这些州法规对责任风险和诉讼活动的影响。这些法规导致的诉讼很少或几乎没有，而且并未被视为产生了任何全新类型的责任风险。这种微弱的影响主要并非归因于《雇员退休收入保障法》的优先适用，而是由于起诉健康计划的成本和复杂性，这使得律师们不愿在医疗事故案件中增加这一额外被告。责任担忧增加的主要推动因素是根据联邦法律悬而未决的大规模集体诉讼，以及在这些法规出台之前少数州出现的巨额惩罚性损害赔偿判决的案件。这表明，除非联邦责任法规允许此类诉讼，否则不太可能大幅增加责任风险。
