Blending reform of tort liability and health insurance: a necessary mix

The thesis of this Article is that making more health insurance benefits available to more people, far from lessening injury victims' proclivity to sue in tort (as conventional wisdom argues), will increase such suits. Thus, it is necessary to accompany any increases in health care coverage with the type of tort reform proposed herein. This reform would allow parties to opt out of the cumbersome and expensive tort claim process with its compensation of noneconomic losses by substituting quicker and surer compensation of any unmet economic losses.     

相互保险:我国医疗责任保险的发展取向--美国医疗责任相互保险公司的启示

责任保险是重要的风险转移工具（Ahemative Risk Tansfer，ART），但商业性的保险公司为了追求商业利润往往不愿承保日益膨胀的医疗风险。美国非商业性的相互保险公司能为医疗风险提供弹性的保险计划。有力的风险管理。多功能的法律服务，而且低成本运作。我国应以美国医疗责任相互保险为模型，从社会系统工程的角度构建医疗损害赔偿制度。     

相互保险:我国医疗责任保险的发展取向--美国医疗责任相互保险公司的启示

责任保险是重要的风险转移工具(Alternative Risk Tansfer,ART),但商业性的保险公司为了追求商业利润往往不愿承保日益膨胀的医疗风险。美国非商业性的相互保险公司能为医疗风险提供弹性的保险计划,有力的风险管理,多功能的法律服务,而且低成本运作。我国应以美国医疗责任相互保险为模型,从社会系统工程的角度构建医疗损害赔偿制度。     

Effects of tort reforms on the value of closed medical malpractice claims: a microanalysis

Tort reforms enacted by state legislatures mainly seek to reduce the rate of increase in medical malpractice insurance premiums and other costs of the professional liability system, such as "defensive medicine." We examine the effects tort reforms enacted during the 1970s have had on the probability that a claim will be paid, the amount of payment, and the speed with which the claim is resolved. Claims frequency is not used as a variable in this analysis, but findings from other studies pertaining to frequency are noted. This study uses two closed claims databases--one from the National Association of Insurance Commissioners, and one from the U.S. General Accounting Office. We merged the two data sets for purposes of this analysis. The observational unit was the individual claim. Data on tort reforms came from our own analysis of statutory changes by state. Dollar ceilings on recoveries ("caps") are shown to be the strongest reforms in terms of their impact on paid claim size. Most caps limit recovery for noneconomic loss, though some limit dollar awards. Other reforms that reduced payments per claim were costs awardable provisions and mandatory collateral offsets.     

论强制性医疗损害赔偿保险制度的建立

通过对我国医疗损害赔偿给付现状的分析，对国外医疗责任保险及给付的比较，认为：只有通过立法考建兰二尊强制甚疗螽害赔偿保险制度才能较合理地解决医疗损害受害人损害赔偿的兑现问题，同时，又不使医疗法人的正常医疗行为因此受到影响；并进一步指出了建立该种保险制度所存在的问题和对策。     

论强制性医疗损害赔偿保险制度的建立

通过对我国医疗损害赔偿给付现状的分析,对国外医疗责任保险及给付的比较,认为:只有通过立法来建立一种强制医疗损害赔偿保险制度才能较合理地解决医疗损害受害人损害赔偿的兑现问题,同时,又不使医疗法人的正常医疗行为因此受到影响;并进一步指出了建立该种保险制度所存在的问题和对策。     

State responses to the malpractice insurance "crisis" of the 1970s: an empirical assessment

Almost all states enacted legislation in response to the rapid rise in malpractice insurance premiums which occurred during the mid-1970s. After describing the types of statutory changes enacted, this study evaluates the influence of these changes on levels and growth of premiums paid by general practitioners, ophthalmologists, and orthopedic surgeons during 1974-78. The empirical results of the study presented here give no indication that individual state legislative actions, or actions taken collectively, had their intended effects on premiums. Several explanations for this result are explored.     

侵权法视域下医疗过失认定标准的完善-兼论循证医学在医疗过失认定中的地位

医疗侵权诉讼中医疗过失的认定始终是一个热门而且沉重的话题。我国《侵权责任法》在医疗过失认定中坚守了“过错责任原则”,但由于规定较模糊和缺乏阐释,法官对依照何种标准认定医疗过失陷入了困境。有鉴于此,本文在科学界定医疗过失概念的基础上,考察了域外法医疗过失认定的抽象标准和具体标准,阐述了域外法理论和实务中循证医学在医疗过失中的优势和地位,最后结合我国现行的医疗过失认定标准的规定,从医疗过失认定抽象标准的完善、注意义务类型化和文本化、确立循证医学的证据地位、注意医疗过失认定标准和现有法律制度的衔接四个方面提出了建议和对策,以期为实务中医疗侵权诉讼的合理解决提供理论上的依据。     

论医疗事故及医疗事故技术鉴定结论的性质

医疗事故纠纷成为近年来的热点问题。要很好的处理医疗纠纷,制订出切实、可行的法规,必须明确医疗事故的法律性质和医疗事故技术鉴定委员会做出的鉴定结论的性质。笔者认为,造成医疗事故的不当医疗行为符合侵权行为的构成要件,因此,应是侵权行为。相应的,医疗机构对病员应予赔偿,而非补偿。目前的医疗事故鉴定体制存在着很多弊端。对于鉴定结论的性质,笔者认为,从证据规则的原理和民事诉讼法、行政诉讼法的规定看,它应是卫生行政机关和法院处理医疗纠纷的证据,而非依据。卫生行政机关和法院可审查其证明力,决定是否适用。这样才有利于做出正确裁判。此外,还应采取有力措施保障病员及其家属的知情权。     

论医疗事故及医疗事故技术鉴定结论的性质

医疗事故纠纷成为近年来的热点问题。要很好的处理医疗纠纷 ,制订出切实、可行的法规 ,必须明确医疗事故的法律性质和医疗事故技术鉴定委员会做出的鉴定结论的性质。笔者认为 ,造成医疗事故的不当医疗行为符合侵权行为的构成要件 ,因此 ,应是侵权行为。相应的 ,医疗机构对病员应予赔偿 ,而非补偿。目前的医疗事故鉴定体制存在着很多弊端。对于鉴定结论的性质 ,笔者认为 ,从证据规则的原理和民事诉讼法、行政诉讼法的规定看 ,它应是卫生行政机关和法院处理医疗纠纷的证据 ,而非依据。卫生行政机关和法院可审查其证明力 ,决定是否适用。这样才有利于做出正确裁判。此外 ,还应采取有力措施保障病员及其家属的知情权。     

On tort as an implicit insurance system with state-dependent utility: The case of child mortality risk

Parents deriving utility from children and their material standard of living will equate neither marginal utilities of consumption nor of income across states of the world and, contrary to claims in the literature but according with the historical record, will sometimes purchase fair insurance against child mortality risks even if a child's death reduces the marginal utility of consumption. Thus criticism of tort as an implicit insurance system should be refocused. It is not inefficient per se because it leads to payouts in death-contingent states but, rather, because the implicit third-party insurance which it provides crowds out more cost-effective first party insurance which households would and did purchase prior to the expansion of suppliers' liability under tort.     

No-fault cerebral palsy insurance: an alternative to the obstetrical malpractice lottery

Sixty percent of malpractice premiums paid by obstetricians go to cover suits for alleged birth-related cerebral palsy (CP). Yet substantially less than half of that money goes to CP victims, and less than 10 percent of children with CP receive any compensation at all from tort suits. This paper proposes a system that would compensate all children born with CP for most handicap-related expenses, in exchange for which the children would be foreclosed from bringing suits alleging birth-related malpractice. Malpractice would be policed by a state board, which would investigate all CP cases. This proposal would be more equitable than current systems. It would also be less expensive, since it would avoid costly litigation and decrease the cost of obstetrical malpractice insurance.