Portal de Periódicos da CAPES

Narrowing Provider Choice: Any Willing Provider Laws After New York Blue Cross v. Travelers

1997; Cambridge University Press; Volume: 23; Issue: 1 Linguagem: Inglês

10.1017/s0098858800010625

2375-835X

Dianne McCarthy,

Legal and Constitutional Studies

Two competing public policies, an individual’s right to choice of medical provider and the need to reduce health care costs, have collided as the federal government and the states implement health care reform. During his first year in office, President William J. Clinton focused on health care reform; however, Clinton was unsuccessful in implementing his “Health Security Act" and national debate dissolved into partisan bickering. With the failure to establish a coherent national policy on health care, the states and private and public health care entities are reshaping the market. Simultaneously, the courts and administrative agencies entertain public policy arguments favoring choice or cost reductions. Fee-for-service (FFS) medical care allows individuals to receive medical care from their provider of choice. Under the FFS model, individuals chose their health care provider, receive care, and the provider bills an indemnity insurance plan on the basis of service provided. The emergence of managed care organizations (MCOs) narrowed and, in some cases, eliminated this right to choose one’s health care provider.