The impact of health insurance reform on the law governing the physician-patient relationship

Article Abstract:

Many physicians believe that health care reform will result in increased regulation of the physician-patient relationship, a loss of physician autonomy and a drop in the quality of care. However, physicians and patients are already constrained by state and federal regulations as well as insurance contracts. Individuals who have no insurance are even more constrained. Three types of insurance reform have been proposed: a single payer, an employer-based 'play or pay' system and tax credits for individuals and businesses that would leave the current system basically intact. All three proposals would increase the involvement of the federal government, which could eliminate many constraints by insuring everyone, standardizing insurance coverage and reforming malpractice law. The government may also encourage the development of practice guidelines, which would standardize care.

Social aspects, Health insurance, Health care reform

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The physician's role in helping smoke-sensitive patients to use the Americans With Disabilities Act to secure smoke-free workplaces and public spaces

Article Abstract:

Physicians have an important role to play in supporting patients' claims that they need a smoke-free workplace. Environmental tobacco smoke (ETS) is considered a health hazard, especially in people with chronic lung and heart disease. In 1995, a US appeals court ruled that Americans with chronic illness could use the Americans With Disabilities Act to encourage employers and owners of public businesses to ban smoking. Physicians will need to document that the patient requires a smoke-free environment and can also educate employers and businesspeople about the dangers of ETS.

Employment, Chronically ill, Nonsmoking areas

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Compromise, complicity, and torture

Article Abstract:

A 1996 study of Turkish physicians found that many falsified the medical records of political prisoners who had been tortured to cover up the torture. US physicians seldom treat a victim of torture but they may understand how it feels to be compromised by the state or major healthcare corporations. Many doctors who work in managed care plans are not allowed to tell patients about certain treatment options or refer them to appropriate specialists.

Care and treatment, Editorial, Torture victims

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