The trial record in an antitrust case against the Oregon State Medical Society, finally decided in 1952, was examined to reconstruct the behavior of a competitive market for health insurance coverage. Health insurers, called “hospital associations,” were found to have engaged individually in cost-control efforts similar to, but possibly more aggressive than, today's utilization review under professional sponsorship. The subsequent disappearance of these insurer-initiated cost controls in Oregon is traced to the medical society's organization of a competing Blue Shield plan as a model of insurer conduct and to a simultaneous boycott by physicians of the hospital associations as long as they persisted in questioning doctors' practices. Some modern parallels are noted, and the advantages of fostering privately sponsored cost-control efforts are suggested.
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Research Article|
February 01 1977
The Effect of Physician-Controlled Health Insurance: U.s. V. Oregon State Medical Society
J Health Polit Policy Law (1977) 2 (1): 48–78.
Citation
Lawrence G. Goldberg, Warren Greenberg; The Effect of Physician-Controlled Health Insurance: U.s. V. Oregon State Medical Society. J Health Polit Policy Law 1 February 1977; 2 (1): 48–78. doi: https://doi.org/10.1215/03616878-2-1-48
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