The Role of the Courts in Shaping Health Policy

Award Year:
Peter Jacobson
Health Care Law
Dr. Jacobson looks at the role judicial decision-making plays in shaping health policy and how courts can best resolve policy and value conflicts emerging in the shift to managed care. Judicial doctrine dealing with medical necessity, utilization management, anti-trust issues, and ERISA are analyzed. This leads to increased understanding of the impact of the courts on medical practice and health policy goals such as access to health care services, cost containment, technology diffusion and innovation, quality of care, and physician and patient autonomy. The project includes: a case content analysis of trends in health care litigation, a synthesis of the legal and health services literature, and interviews with judges and health law scholars. A conceptual framework, to assist judges in appraising the health policy conflicts and trade-offs they are likely to confront, is developed. This offers a useful rationale and organizing principles for deciding individual cases and guiding the evolution of consistent judicial doctrine in resolving health care disputes.