26 Am. J.L. & Med. 135 (2000)
The Changing Face of Law and Medicine in the New Millennium: Foreword

handle is hein.journals/amlmed26 and id is 137 raw text is: American Journal of Law &Medicine, 26 (2000): 135-141
V 2000 American Society of Law, Medicine & Ethics
Boston University School of Law
Douglas A. Hastingst
It is my distinct honor and privilege to provide this Foreword to the American
Journal of Law & Medicine Symposium Issue 2000, The Changing Face of Law and
Medicine in the New Millennium. Indeed, healthcare law at the dawn of the new
millennium is at the epicenter of the most critical underlying challenges to the ever-
evolving, complex, United States healthcare system.   For over 200 years, our
healthcare system has been, in effect, a mixed public and private system, essentially
built on a private chassis with a great deal of public funding, regulating and prodding.
It also has been a profoundly federalist system, generating fifty-one health regulatory
The Articles in the Symposium offer a broad-based and thought-provoking look
by some of the best contemporary thinkers in health law at the issues confronting the
healthcare system as it enters the new millennium. Each article offers a perspective,
to varying and lesser degrees, on where we are today and where we may be heading.
My comments in this Foreword focus on several of the key issues in health law in the
year 2000 that, I think, underlie many of the themes presented in the Symposium
Articles. It is my hope that these brief comments will provide a useful context by
which to introduce the Symposium.
As we head into the new millennium, managed care is clearly at a crossroads.
The optimism with which the challenge to control cost increases in healthcare was
thrust upon the private sector in general, and health maintenance organizations
(HMOs) in particular, in the early 1990s after the failure of the Clinton health plan
was replaced by a severe pendulum swing to the other extreme of vilifying these
same organizations, l notwithstanding the fact that they appear to have done what they
were asked, at least for most of the decade.2
The current debate over HMO liability illustrates the old adage about throwing
out the baby with the bath water. If the liability provisions of the House version of
the managed care reform bill,3 sponsored by representatives Charles Norwood (R.
Ga.) and John D. Dingell (D. Mich.) are enacted, we would risk making cost-
efficiency illegal in the name of patient protection.
Federally instituted Professional Review Organizations (PROs), which have
Senior Partner, Espstein Becker & Green, P.C.; President-Elect, American Health Lawyers
I See Geoffrey Cowley & Bill Turgque, Critical Condition, NEWSWEEK, Nov. 8, 1999, at 58.
2 See Randall R. Bovbjerg & Robert H. Miller, Managed Care and Medical Injury: Let's Not
Throw Out the Baby with the Backlash, 24 J. HEALTH POL., POL'Y & LAW 1145, 1145 (1999).
3 See Quality Care for the Uninsured Act of 1999, H.R. 2990, 106th Cong. (1999).

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