Legal Opinion
Vernita L. Anderson v. Humana, Inc.
Court of Appeals for the Seventh Circuit
Decided May 11, 1994No. 93-2283PublishedCited by 35 opinions
1Opinion of the Court
EASTERBROOK, Circuit Judge.
A health maintenance organization (HMO) offers, for a fixed fee, as much medical care as the patient needs. Providers using traditional fee-for-service methods, by contrast, charge for each procedure. Each method creates an unfortunate incentive: a physician receiving a fee for each service has an incentive to run up the bill by furnishing unnecessary care, and an HMO has an incentive to skimp on care (once patients have signed up and paid) in order to save costs. Each incentive encounters countervailing forces: patients, or insurers on their behalf, resist paying…
2Cases cited19 opinions
- Shaw v. Delta Air Lines, Inc.Supreme Court of the United States · 1983
- Pilot Life Insurance v. DedeauxSupreme Court of the United States · 1987
- Metropolitan Life Insurance v. TaylorSupreme Court of the United States · 1987
- Fort Halifax Packing Co. v. CoyneSupreme Court of the United States · 1987
- Group Life & Health Insurance v. Royal Drug Co.Supreme Court of the United States · 1979
14 more not listed; retrieve them via the Exa API.
3Cited by35 opinions
- Jass v. Prudential Health Care Plan, Inc.Court of Appeals for the Seventh Circuit · 1996
- David Rice v. Kanu Panchal, M.D., Rodrigo Sotillo, M.D., Rodrigo Sotillo, P.C., a CorporationCourt of Appeals for the Seventh Circuit · 1995
- Suzanne Cahnmann, on Behalf of Herself and All Others Similarly Situated v. Sprint CorporationCourt of Appeals for the Seventh Circuit · 1998
- Alexander Menkes v. Prudential Insurance Co of AmeCourt of Appeals for the Third Circuit · 2014
- Tommy Land, Cross-Appellee v. Chicago Truck Drivers, Helpers and Warehouse Workers Union (Independent) Health and Welfare FundCourt of Appeals for the Seventh Circuit · 1994
30 more not listed; retrieve them via the Exa API.