Lawyers and medical torts: medical malpractice litigation as a residual option

The relationship between the supply of lawyers and the frequency of medical malpractice claims for one state is examined. A model of the location decisions of lawyers within a state developed. These decisions depend on their forecasts of the amounts of various types of legal business which will be available. Because such forecasts are inperfect, however, at a given time an excess of lawyers in any given hypothesized, there will then be an incentive to dip deeper into the available pool of malpractice cases. This hypothesis is tested and it is found that the estimated excess of lawyers over those required to perform other tasks is a significant factor in explaining the filing of malpractice claims.     

Reverse moral hazard of liability insurers: evidence from medical malpractice claims

This study investigates putative differences in the legal defense of medical malpractice claims between liability carriers with distinct ownership forms: doctor-controlled and commercial-stock. The scope of a carrier's legal defense is determined by claim characteristics, such as injury severity and liability, and possibly the doctor's private costs from settling or losing a claim. When a carrier does not internalize the doctor's private costs from losing or settling a claim, then a conflict of interest arises as the carrier provides a lower level of legal defense than preferred by the doctor (i.e., reverse moral hazard). The perception is that doctor-sponsored carriers mitigate such conflicts of interest. If this is the case, we should expect to see differences in the amount spent by the carrier in defense of the doctor and the propensity to settle claims. To test these expectations, we use medical malpractice claims filed in Florida between 1985 and 1990. We indeed find differences in legal defense in terms of amount spent on legal defense and settlement rate between carriers with different ownership. The doctor-sponsored carrier we investigated was less likely to settle out-of-court, and did spend more on a doctor's legal defense than stock carriers.     

Unemployment,insurance and smoking

Using recent state-level data from the United States, this article examines new influences on cigarette demand. In particular, we uniquely focus on the effects of unemployment and health insurance coverage on smoking. Results show that higher cigarette prices, a lack of health insurance and restrictions on smoking at home, all lead to reduced smoking. On the other hand, literacy, income, unemployment, workplace smoking restrictions, smokeless tobacco taxes and tobacco-producing states do not seem to have an appreciable impact. The magnitude of the price elasticity of demand is greater than that found in the pre-MSA era. Policy implications are discussed.     

大学生医疗保险现状研究

随着2009年国务院颁布将大学生纳入城镇居民基本医疗保险政策,各高校陆续开始实施新的大学生医疗保险政策。从分析我国大学生医疗保险发展的历程入手,探讨了新制度中存在的问题,并提出了相应的可行性政策建设。     

统筹城乡基本医疗保险制度的路径研究

我国虽然已经建立起覆盖全民的基本医疗保险制度,但同时我们也该看到,由于制度的历史性问题,该保障制度存在非常明显的碎片化特征。具体说,就是我国基本医疗保险制度参保人群的区分是以是否就业、不同行政区以及城市与农村的差别为参照的,其能获得的保险待遇、基金管理都存在巨大差异,造成了城乡医疗保障之间的不公平现象,缺乏可持续性。为解决基本医疗保险制度的“二元”性,我国应当尽快推进统筹城乡医疗保险制度,因此,将主要探讨城乡基本医疗保障制度现状,以及统筹城乡基本医疗保障制度实施路径,并提出具体的整合框架与建议。     

试论我国医疗保险费用控制

建立有效的医疗保险费用控制机制,既是社会医疗保险系统改革的核心内容,也是商业健康保险所必须解决的一个问题.医疗保险的核心是医疗费用,医疗保险费用控制的根本性问题可以归结为医疗费用控制问题.本文基于历史分析视角,通过分析我国医疗保险费用控制的过程及效果,结合对影响医疗费用上涨因素的剖析,同时借鉴发达国家经验,对如何有效控制医疗保险费用上涨的路径选择提出对策建议.     

当前我国医疗保险制度存在的问题及解决途径探析

中国特色的医疗保险制度在我国初步建立,由于历史的和现实的原因,还存在着一些问题,不能完全满足广大人民群众的需求,需要在实践中逐步加以改进和完善。通过系统总结当前我国医疗保险制度存在的突出问题,并对其存在的原因进行深入分析,从而提出建设性的对策建议。     

Managing judges mathematically: an empirical study of the medical malpractice litigations in Shanghai

The post-Mao China has been increasingly managed mathematically, not the least in its judicial system. In this paper, I looked into some of the mathematical indicators used to judge the performance of judges in this nation, and ascertained their effects on the judicial decisions on medical malpractices in Shanghai. The findings of this paper support the previous study that qualitatively identified the judicial responses to such a quantified evaluation system. Underlying the effect of performance indicators is the Chinese judiciary’s bending toward populist pressure. Essentially, therefore, this paper serves to place in perspective the judicial populism well documented in the latest literature on Chinese judiciary. At the same time, however, my study also endorses the theory on courts’ reluctance to exercise discretion in a hierarchical judicial system. Thus, as hinted by the data, the actual behaviors of Chinese judges might be complex under a combination of institutional constraints embodying policy preferences of political leaders as well as structural characteristics of the judiciary.     

Courts of Law and Unforeseen Contingencies

We study a contracting model with unforeseen contingencies inwhich the court is an active player. Ex ante, the contractingparties cannot include the risky unforeseen contingencies inthe contract they draw up. Ex post, the court observes whetheran unforeseen contingency occurred and decides whether to voidor uphold the contract. If the contract is voided by the court,the parties can renegotiate a new agreement ex post. There aretwo effects of a court that voids contracts. The parties' incentivesto undertake relationship-specific investment are reduced, andthe parties enjoy greater insurance against the unforeseen contingenciesthat the ex ante contract cannot account for. In this context,we fully characterize the optimal decision rule for the court.The behavior of the optimal court is determined by the trade-offbetween the need for incentives and the gains from insurancethat voiding in some circumstances offers to the agents.     

Population uncertainty,social insurance,and actuarial bias

The authors examine the relation between changes in the size of the working population and the value of a social insurance contract between unborn workers and future retirees. They develop a model suggesting that such a contract will benefit both of the generations concerned. The implied geographical focus is on developed countries.     

Unemployment insurance, moral hazard, and economic growth

It is important but difficult to distinguish between desirable and undesirable effects of unemployment insurance (UI) that are observationally equivalent when designing optimal UI schemes. For example, a UI-induced rise in the wage rate caused by workers taking more time to match their skills with job vacancies is desirable. However, another view of the same observation is that UI causes permanently higher involuntary unemployment by raising the reservation wage. This paper avoids this problem by regarding the trade-off between the UI replacement rates and unemployment as an intermediate relationship that matters only as far as it impacts economic growth. An empirical analysis of UI replacement rates, unemployment rates, and growth rates using annual panel data finds UI replacement rates are associated with higher unemployment. However, no significant relationship is found between UI-related unemployment and the real growth rate of gross domestic product.An earlier version of this paper was presented at the Fiftieth International Atlantic Economic Conference, October 15–18, 2000, Charleston, South Carolina. Financial support from the Scottish Economic Society and the University of Stirling is gratefully acknowledged. The Organization for Economic Cooperation and Development generously provided access to their database on benefit entitlements and gross replacement rates. The authors are grateful to an anonymous referee for constructive comments.