ABSTRACT
As of 2004, both the cost of health care and the cost of health insurance continue to rise. 1 In 2003,45 million Americans did not have health insurance. 2 With costs on the rise and in the midst of a recession, employers/payers are considering a change in the nature of their involvement in the nation's health care. Yet, there is no sign of a move toward a national health insurance program. Though enrollment in managed care had declined, it seems again to be stabilizing. Nonetheless, there appears to be increased interest by employers in consumer-driven plans. 3 Indeed, the recently enacted Medicare Prescription Drug Improvement and Modernization Act of 2003 included the creation of legislation providing for tax-deductible health savings accounts. 4 No one knows whether federal protection of managed care will continue. Although the Supreme Court in Kentucky Association of Health Plans v. Miller surprised many with its protection of any-willing-provider laws and, in turn, the relationship between doctor and patient, 5 its decision in Aetna Health, Inc. v. Davila 6 does not bode well for the doctor-patient relationship.
