Our article analyzes whether the federal government may constitutionally supplant a traditional system of common-law trials before state judges and juries with new federal institutions designed by statute for compensating victims of medical injuries. Specifically, this article examines the federal constitutional issues raised by various proposals to replace traditional medical malpractice litigation in state courts with a federal system of administrative “health courts.” In doing so, we address the following constitutional issues:

  1. Is there federal authority to preempt state law (the commerce clause and spending clause issues)?

  2. May jurisdiction be created in non - article 3 tribunals, and may claims be decided without trial by jury (the separation of powers and Seventh Amendment issues)?

  3. Would pilot programs that require some claims to be pursued in a federal administrative forum while other claimants are left to pursue traditional state tort law remedies be constitutional (the equal protection issue)?

The article concludes that a federal compensation system through administrative health courts should be constitutional provided the statute is appropriately drafted and that appropriate factual findings are made concerning the benefits to patients and the public as well as to doctors and their insurers.

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