ABSTRACT
The doctor-patient relationship has the potential to confer benefits on the community. Nonetheless, its ability to create trust and foster social capital has been impaired by some aggressively managed care. Although many of the cost containment mechanisms that managed plans use burden the doctor-patient relationship, these plans are not alone in imposing this burden on the community. Just as the doctor-patient relationship can either increase or decrease social capital, so too can the laws and policies that govern the health-care system and the community. Although public policy can, in general, affect social capital, in our discussion we will focus specifically on laws that inform health policy. 1 Some legal statements have discouraged the production of social capital indirectly by enabling managed care and directly by lowering social levels of trust. My analysis of some of the law relevant to managed care is intended to be illustrative rather than comprehensive and exhaustive. The point to be drawn from this discussion is that health plans are not alone in affecting the potential of the doctor-patient relationship to create social capital. Public policy has also played a role, as have employers.
