The backlash against managed care drive-through deliveries and gag rules illustrate a more general problem: the folly of relying exclusively on market choice to protect the interests of health care consumers. Yet government rule making about medical care isn't the only alternative. There's...

The most frequently proposed means to counter physicians' conflicts of interest is their disclosure. Nevertheless, the rationale for disclosure and its anticipated effects are rarely examined critically. There has been little discussion of what must be disclosed and to whom, the manner of...

Prescribing drugs for uses that the FDA has not approved — off-label drug use — can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed...

Improper dependencies slant policy over a drug’s life span, biasing the development of new drugs, the testing and marketing approval for new drugs, and the monitoring of patient safety after drugs are marketed. This article examines five ways in which the public improperly depend on...

Human behavior is typically described in the language of self-interest and incentives drawn from economic models of the marketplace. Public education programs have assumed that people will change their behavior if they have the right incentives and information. Insurance underwriters encourage...

Drug manufacturers face a fundamental conflict of interest. Pursuit of profit compromises their impartial assessment of their drugs’ benefits and risks. Their biased evaluation can corrupt public knowledge of drugs, lead to marketing unsafe and/or ineffective drugs, compromise medical practice...

This article analyzes the concept of accountability and the role that managed care organizations play in promoting accountable health care. It examines the challenges to promoting accountable health care by analyzing conflicting goals within managed care and the conflicting interests of various...

Adverse drug events cause significant injuries to consumers. Between half and three-quarters of these injuries are uncompensated under tort law because they are not due to negligence or fraud. This article argues that fundamental fairness and sound economics favor holding manufacturers of...

This article contrasts the prevailing model for assessing and improving medical care - the quality of care paradigm - with an alternative approach - the patient accountability paradigm. The first approach is technocratic: it measures and promotes the quality of medical care through technical and...

This article examines the problems consumers face in managed care organizations and analyzes the emerging legal approaches to consumer protection in state legislation. It reviews the main problems consumers face in other contexts, and the legal and economic tools used to protect them and...