'Health law 2000': the legal system and the changing health care market

The failure of national health reform confirmed in many ways the conservative nature of the American legal system. Legislatures, regulatory agencies, and courts usually find themselves in a reactive posture, responding to groups and individuals aggrieved by changing circumstances. The rapid transformation of the U.S. health care system through managed care presents an extreme example of this phenomenon, involving billions of dollars, millions of lives, and thousands of existing laws. Over the next few years the legal system will face a host of difficult issues deriving from the integration of health care financing and delivery, and the consolidation of fragmented providers into large corporations and contractual networks. What emerges may be neither logical nor consistent but no doubt will reflect the intricate interplay of societal and individual interests in health care.