PMID: 18717152Aug 23, 2008Paper

Limited provider panels: their promise and problems in an individual health insurance market

Journal of Health & Life Sciences Law
William H Pitsenberger

Abstract

The cost of healthcare, and consequently of health insurance, continues to increase dramatically. A growing chorus calls for replacing the fundamental method by which people purchase insurance today--through their employers--with a system of individually acquired insurance. This article argues that changing how Americans purchase health insurance could change the dynamics between insurers and healthcare providers in a way that could favorably impact costs, primarily through reliance on highly limited provider networks. It examines the bases of legal obstacles to limited provider networks embedded in both statutory and case law and urges re-examination of those bases in light of changes in the distribution system of health insurance.

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