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Torts, Expertise, and Authority: Liability of Physicians and Managed Care Organizations

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  • Jennifer Arlen

    (New York University)

  • W. Bentley MacLeod

    (Columbia and IZA, Bonn)

Abstract

We examine optimal individual and entity-level liability for negligence when expected accident costs depend on both the agent's level of expertise and the principal's level of authority. We consider these issues in the context of physician and managed care organization (MCO) liability for medical malpractice. Under current law, physicians generally are considered independent contractors and hence MCOs are not liable for negligent acts by physicians. We find that the practice of reviewing the medical decisions of physicians affects their incentives to take care, which in turn implies that it is efficient for MCOs to be held liable for the torts committed by their physicians.

Suggested Citation

  • Jennifer Arlen & W. Bentley MacLeod, 2005. "Torts, Expertise, and Authority: Liability of Physicians and Managed Care Organizations," RAND Journal of Economics, The RAND Corporation, vol. 36(3), pages 494-519, Autumn.
    • Handle: RePEc:rje:randje:v:36:y:2005:3:p:494-519
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    References listed on IDEAS

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    Cited by:

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    2. Bisso, Juan Carlos & Choi, Albert H., 2008. "Optimal agency contracts: The effect of vicarious liability and judicial error," International Review of Law and Economics, Elsevier, vol. 28(3), pages 166-174, September.
    3. James B. Rebitzer & Mark E. Votruba, 2011. "Organizational Economics and Physician Practices," NBER Working Papers 17535, National Bureau of Economic Research, Inc.
    4. Ajit Mishra & Andrew Samuel, 2018. "Law Enforcement And Wrongful Arrests With Endogenously (In)Competent Officers," Economic Inquiry, Western Economic Association International, vol. 56(2), pages 1417-1436, April.
    5. Laurent Franckx & Frans P. Vries & Ben White, 2022. "A note on organizational structure and environmental liability," Environmental Economics and Policy Studies, Springer;Society for Environmental Economics and Policy Studies - SEEPS, vol. 24(2), pages 173-193, April.
    6. Patricia H. Born & Evan M. Eastman & E. Tice Sirmans, 2023. "Managed care or carefully managed? Management of underwriting profitability by health insurers," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 5-31, January.
    7. Yongmin Chen & Jianpei Li & Jin Zhang, 2022. "Efficient Liability In Expert Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(4), pages 1717-1744, November.
    8. Fu, Qiang & Gong, Jie & Png, I.P.L., 2018. "Law, social responsibility, and outsourcing," International Journal of Industrial Organization, Elsevier, vol. 57(C), pages 114-146.
    9. Chen, Yongmin & Li, Jianpei & Zhang, Jin, 2017. "Liability in Markets for Credence Goods," MPRA Paper 80206, University Library of Munich, Germany.
    10. Rebitzer, James B. & Taylor, Lowell J., 2011. "Extrinsic Rewards and Intrinsic Motives: Standard and Behavioral Approaches to Agency and Labor Markets," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 8, pages 701-772, Elsevier.
    11. Lakdawalla, Darius N. & Seabury, Seth A., 2012. "The welfare effects of medical malpractice liability," International Review of Law and Economics, Elsevier, vol. 32(4), pages 356-369.
    12. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 795-830.
    13. Paola Bertoli & Veronica Grembi, 2018. "Medical Malpractice: How Legal Liability Affects Medical Decisions," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 235-261, Emerald Group Publishing Limited.
    14. Lewis A. Kornhauser & W. Bentley MacLeod, 2012. "Contracts between Legal Persons [The Handbook of Organizational Economics]," Introductory Chapters,, Princeton University Press.
    15. Dylan Martin-Lapoirie, 2022. "Teamwork in health care and medical malpractice liability: an experimental investigation," European Journal of Law and Economics, Springer, vol. 54(2), pages 251-282, October.
    16. Donald J., Wright, 2011. "Medical malpractice and physician liability under a negligence rule," International Review of Law and Economics, Elsevier, vol. 31(3), pages 205-211, September.
    17. Janet Currie & W. Bentley MacLeod, 2017. "Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 1-43.
    18. Paola Bertoli & Veronica Grembi, 2018. "Courts, scheduled damages, and medical malpractice insurance," Empirical Economics, Springer, vol. 55(2), pages 831-854, September.
    19. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    20. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    21. Antoci, Angelo & Fiori Maccioni, Alessandro & Russu, Paolo & Sacco, Pier Luigi, 2022. "Curing is caring? Liability reforms, defensive medicine and malpractice litigation in a post-pandemic world," Socio-Economic Planning Sciences, Elsevier, vol. 80(C).
    22. Tim Friehe & Cat Lam Pham & Thomas J. Miceli, 2022. "Product Liability and Strategic Delegation: Endogenous Manager Incentives Promote Strict Liability," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 61(2), pages 149-169, September.
    23. Daniel Carvell & Janet Currie & W. Bentley MacLeod, 2012. "Accidental death and the rule of joint and several liability," RAND Journal of Economics, RAND Corporation, vol. 43(1), pages 51-77, March.
    24. Tim Friehe & Christoph Rössler & Elisabeth Schulte, 2023. "Probing the case for manufacturer liability for harms caused by judgment-proof consumers to others," European Journal of Law and Economics, Springer, vol. 56(3), pages 443-460, December.

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