Journal of health politics, policy and law
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J Health Polit Policy Law · Feb 1999
ReviewNo-fault vaccine insurance: lessons from the National Vaccine Injury Compensation Program.
During the first eight years of the National Vaccine Injury Compensation Program (NVICP), 786 contested claims were resolved through published judicial opinions. The likelihood of compensation dependent in part on the closeness of the match between the described injury and a specified list of acknowledged untoward vaccine side effects. In addition, the chances of applicant success were influenced by the applicant's choice of attorney and expert witnesses, by the assignment of the Special Master to decide the case, and increasingly over time, by the applicant's ability to comply with procedural requirements. ⋯ For pertussis claims, the goal of insulating manufacturers from product liability suits has been achieved by granting compensation to applicants whose injuries are not scientifically recognized effects of the vaccine. In spite of (or because of) this jarring contradiction between the legal and medical understanding of causation, vaccine availability and childhood immunization rates improved during the early years of the plan. The apparent success of the program may encourage the substitution of no-fault compensation plans for tort-based consumer protection for other products, both medical and nonmedical.
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J Health Polit Policy Law · Feb 1999
ReviewOregon's bold experiment: whatever happened to rationing?
In 1994 Oregon began rationing health care for its Medicaid population, offering health policy makers and analysts around the country a view of one alternative future for health care delivery. The question now, four years after the experiment began, is what does that future look like? The short answer is that it does not look all that different from the present, but it looks different enough to offer important lessons to other states and the federal government. The Oregon experiment, including the prioritization of services and the aggressive use of managed care, has facilitated the expansion of health care coverage to over 100,000 additional Oregonians, helped decrease the percentage of the uninsured as well as reduce uncompensated care in hospitals, reduced the use of hospital emergency rooms, and reduced cost shifting. By most measures, the Oregon experiment appears to be a success.