Judicial Opinions Involving Health Insurance Coverage: Trompe L’oeil
نویسنده
چکیده
between health insurer and insured has remained relatively untested empirically. There has been considerable research on access to health insurance and its cost, but relatively little on how insurance operates for those who have it. Studies which have been performed tend to focus on one important subset of coverage issues—disputes regarding the “medical necessity” of treatment or its “experimental” or “investigational” character—and apply an even narrower method: explaining the legal system by examining the written opinions of courts in cases they have decided. A recent example of this genre is an ambitious, methodologically sophisticated, two-year investigation headed by Mark A. Hall and Gerard F. Anderson, and funded by the Federal Agency for Health Care Policy and Research (the “Hall study”). The Hall study was designed to test several 2
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