Violations of service fairness and legal ramifications: The case of the managed care industry [Book Review]

Journal of Business Ethics 36 (4):315 - 336 (2002)

Adapted from Chan's (2000) model depicting success of litigation, this paper argues that with the application of various legislation, health maintenance organizations' (HMOs') violations of service fairness to each group: enrollees, physicians, and hospitals give rise to each group's lawsuits against the HMOs. Various authors (Bowen et al., 1999; Seiders and Berry, 1998) indicate that justice concepts such as distributive, procedural, and interactional justice can be applied to the area of service fairness. The violation of these underlying justice principles with HMOs' service unfairness to enrollees, physicians, and hospitals is examined. A general synopsis of the ethical issues in the managed care industry is provided. The various lawsuits launched by each group: enrollees, physicians, and hospitals together with the key statutes used are discussed. This paper also highlights the provisions and ramifications of the 11 April 2000 landmark agreement that Aetna made with Texas Attorney General John Cornyn to settle the 1998 lawsuit brought against the company. Lastly, the current ethical issues in the managed care industry are further discussed. The value of this paper can be adapted to the study of organizations' service fairness violations in other industries or in the educational, governmental, and not-for-profit sectors both nationally and internationally.
Keywords ethics in managed care  health maintenance organizations  justice (distributive, procedural, interactional)  lawsuits  service fairness
Categories (categorize this paper)
Reprint years 2004
DOI 10.1023/A:1014467601008
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 45,685
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

No references found.

Add more references

Citations of this work BETA

Add more citations

Similar books and articles

Managed Care and the Ethics of Regulation.Kenneth A. De Ville - 1999 - Journal of Medicine and Philosophy 24 (5):492 – 517.
The Importance of Management for Understanding Managed Care.George G. J. Agich - 1999 - Journal of Medicine and Philosophy 24 (5):518 – 534.
The Ethical Impacts of Managed Care.George W. Rimler & Richard D. Morrison - 1993 - Journal of Business Ethics 12 (6):493 - 501.
The Case for Managed Care: Reappraising Medical and Socio-Political Ideals.George Khushf - 1999 - Journal of Medicine and Philosophy 24 (5):415 – 433.


Added to PP index

Total views
27 ( #338,093 of 2,280,831 )

Recent downloads (6 months)
5 ( #249,587 of 2,280,831 )

How can I increase my downloads?


My notes

Sign in to use this feature