Preventing medical malpractice and compensating victimised patients in China : a law and economics perspective / Xiaowei Yu.
2017
KNQ3100.5 .Y558 2017 (Map It)
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Details
Author
Title
Preventing medical malpractice and compensating victimised patients in China : a law and economics perspective / Xiaowei Yu.
Published
Cambridge, United Kingdom : Intersentia, [2017]
Copyright
©2017
Call Number
KNQ3100.5 .Y558 2017
Former Call Number
Ch.P 270 Y901 2017
ISBN
9781780684680 (pbk)
1780684681 (pbk)
1780684681 (pbk)
Description
xxvi, 599 pages : illustrations ; 24 cm
System Control No.
(OCoLC)971969820
Summary
Preventing Medical Malpractice and Compensating Victimised Patients in China' is the first book in English on the legal remedies for preventing medical errors and compensating victims of medical malpractice in China from an economic and legal perspective. Specifically, those legal remedies include tort liability, regulation, insurance and social security. The new medical liability regime based on the Tort Liability Law 2009 currently provides the primary legal remedy against medical malpractice. However, the role of alternative regimes in medical quality assurance and victim compensation should not be ignored. This book: 0- gives a full description of all the current legal remedies for the prevention of medical malpractice and compensation for iatrogenic injuries in China, in order to see how those different legal instruments interact with and impact on one another; 0- examines how those legal remedies work in practice and what impact they have on society, based on an extensive analysis of court decisions, several semi-structured interviews, and a review of the available empirical literature; 0- summarises the law and economics studies on medical malpractice and applies economic theories to the legal remedies in China, in order to put forward policy recommendations to China --Back cover.
Note
Preventing Medical Malpractice and Compensating Victimised Patients in China' is the first book in English on the legal remedies for preventing medical errors and compensating victims of medical malpractice in China from an economic and legal perspective. Specifically, those legal remedies include tort liability, regulation, insurance and social security. The new medical liability regime based on the Tort Liability Law 2009 currently provides the primary legal remedy against medical malpractice. However, the role of alternative regimes in medical quality assurance and victim compensation should not be ignored. This book: 0- gives a full description of all the current legal remedies for the prevention of medical malpractice and compensation for iatrogenic injuries in China, in order to see how those different legal instruments interact with and impact on one another; 0- examines how those legal remedies work in practice and what impact they have on society, based on an extensive analysis of court decisions, several semi-structured interviews, and a review of the available empirical literature; 0- summarises the law and economics studies on medical malpractice and applies economic theories to the legal remedies in China, in order to put forward policy recommendations to China --Back cover.
Bibliography, etc. Note
Includes bibliographical references (pages 511-569).
Record Appears in
Table of Contents
Acknowledgements
v
Abbreviations
xxi
List of Figures and Tables
xxv
ch. 1
Introduction
1
1.
Background
1
1.1.
Basic Definitions
1
1.1.1.
Medical Disputes
1
1.1.2.
Iatrogenic/Treatment Injuries
3
1.1.3.
Adverse Events
5
1.1.4.
latrogenic Injuries, Errors, and Negligence
6
1.2.
Doctor-Patient Conflicts in China
8
1.2.1.
Frequency of Medical Disputes and Iatrogenic Injuries
8
1.2.2.
Violence against Doctors
9
1.2.3.
Provider Negligence and Medical Disputes
11
2.
Research Questions
12
3.
Methodology
14
3.1.
Doctrinal Approach
14
3.2.
Empirical Legal Research
14
3.3.
Comparative Law and economics
15
3.3.1.
Why Law and Economics?
15
3.3.2.
Use of Comparative Law
17
4.
Structure
18
Part I: Legal Remedies For Medical Malpractice In China
21
Introductory Note
23
ch. 2
Health Care Provision and Regulation
25
1.
Introduction
25
2.
Medical Profession
25
2.1.
Introduction
25
2.2.
Institutional Providers
26
2.3.
Individual Providers
29
2.4.
Summary
31
3.
Financing of Public Health Care Provision
32
3.1.
Introduction
32
3.2.
Health Care Reforms and Financial Burdens on Individuals
32
3.3.
Currently Covered Groups and Government Subsidies
35
3.4.
Summary
37
4.
Regulation of the Medical Profession
37
4.1.
Introduction
37
4.2.
Input Controls
38
4.2.1.
Controls on the Entry of Institutional Providers
38
4.2.2.
Controls on the Entry of Individual Providers
40
4.3.
Output Controls
42
4.3.1.
Controls on the Performance of Institutional Providers
42
4.3.1.1.
Codes of Conduct and Sanctions
42
4.3.1.2.
Hospital Accreditation
47
4.3.2.
Controls on the Performance of Individual Providers
50
4.3.2.1.
Codes of Conduct and Sanctions
50
4.3.2.2.
Periodical Doctor Assessment
55
4.3.3.
Medical Quality and Safety Incident Management
57
4.3.3.1.
Incident Reporting
57
4.3.3.2.
Regulatory Threats
59
4.4.
Role of Self-Regulation
60
4.5.
Summary
63
5.
Conclusions
64
ch. 3
Compensation for Iatrogenic Injuries under Tort Law
65
1.
Introduction
65
2.
Development
65
3.
Substantive System of Private Law Compensation
70
3.1.
Introduction
70
3.1.1.
Relevance of Contract Law
70
3.1.2.
General Clause for Medical Malpractice Claims
74
3.2.
Technical Malpractice
76
3.2.1.
Introduction
76
3.2.2.
Statutory Standards, Written Treatment Norms, and Unwritten Customary Practices
77
3.2.3.
Proof and Causation Issues
80
3.2.3.1.
General Proof Rules
80
3.2.3.2.
Defining Causation
82
3.2.3.3.
Uncertainty over Factual Causation
83
3.3.
Ethical Malpractice
84
3.4.
Medical Products Liability
86
3.5.
Equitable Liability
91
3.6.
Expert Evidence
92
3.6.1.
Introduction
92
3.6.2.
Basics
92
3.6.2.1.
MATAS
92
3.6.2.2.
JAS
94
3.6.3.
Comparison and Contrast
96
3.6.4.
Two Systems after the Inception of the Tort Law
98
3.7.
Law of Damages
98
3.7.1.
Introduction
98
3.7.2.
Compensation for Pecuniary Losses
99
3.7.2.1.
Legal Basis
99
3.7.2.2.
Abstract/Standardised Approach to Future - Damage
101
3.7.2.3.
Caps on Pecuniary Damages
105
3.7.3.
Compensation for Non-Pecuniary Losses
107
3.7.3.1.
Legal Basis
107
3.7.3.2.
Measure of Non-Pecuniary Damages
108
3.7.4.
Uncertainty over Legal Causation
110
3.8.
Summary
112
4.
Conclusions
113
ch. 4
Medical Disputes, Iatrogenic Injury, Malpractice Litigation, and Patient Compensation: Empirical Evidence
115
1.
Introduction
115
2.
Results of the Court Decisions from the Gulou Court
117
2.1.
Frequency and Outcomes of Claims
117
2.2.
Representatives and Defendants
120
2.3.
Length of Trials
121
2.4.
Causes of Action and Legal Standards Applied
121
2.5.
Impact of Expert Testimony on the Trial
125
2.6.
Pre-Existing Conditions and Specialities Involved
128
2.7.
Seriousness and Causes of Iatrogenic Injuries
130
2.8.
Damages Awards
132
2.9.
Litigation Costs
137
3.
Discussions (Supplemented with Interview Results)
138
3.1.
High-Risk Hospitals, Specialities and Medical Disputes
138
3.2.
Role of Expert Witnesses
139
3.3.
Locus of Liability and Standard of Care
143
3.3.1.
Locus of Liability
143
3.3.2.
Technical Malpractice
144
3.3.3.
Ethical Malpractice
147
3.4.
Causal Uncertainty and Proportional Liability
149
3.4.1.
Uncertainty over Factual Causation
149
3.4.2.
Uncertainty over Legal Causation
152
3.5.
Defective Medical Products and Substandard Blood
152
3.6.
Payment of Medical Malpractice Claims
153
3.7.
Time and Money Spent on Malpractice Litigation
155
3.7.1.
Burden of Time
155
3.7.2.
Burden of Financial Costs
156
3.8.
Impact of the Tort Law 2009 and the Role of Chinese Courts
157
3.9.
Medical Dispute Resolution and Violence
159
3.9.1.
Negotiation, Administrative Mediation, and Litigation
159
3.9.2.
Yi-Nao Incidents
160
3.9.3.
People's Mediation
162
3.10.
Defensive Medicine
165
3.10.1.
Does Defensive Medicine Exist in China?
165
3.10.2.
Causes of Defensive Medicine
168
4.
Conclusions
169
ch. 5
Other Compensation Schemes
173
1.
Introduction
173
2.
Medical Liability Insurance (MLI)
173
2.1.
Introduction
173
2.2.
Legal Basis
173
2.3.
Evolution of MLI in China: Local Experiments
175
2.3.1.
Introduction
175
2.3.2.
Yunnan MLI Scheme
176
2.3.3.
Shanghai MLI Scheme
177
2.3.4.
Beijing MLI Scheme
180
2.3.5.
Shenzhen Medical Professional Risk Insurance Scheme
181
2.3.6.
Ningbo MLI Scheme
2.3.7.
Nanjing Scheme
183
2.3.8.
Comparison and Contrast
184
3.
Other Compensation Schemes
189
3.1.
Introduction
189
3.2.
Private Insurance
190
3.2.1.
Private Health Insurance
190
3.2.2.
Medical Mishap Insurance
190
3.3.
Social Security Schemes
191
3.3.1.
Introduction
191
3.3.2.
Social Security Schemes Covering Medical Expenses
192
3.3.2.1.
Basic Medical Insurance Schemes
192
3.3.2.2.
Urban-Rural Medical Assistance System
193
3.3.3.
Social Security Schemes Covering Other Losses
194
3.3.3.1.
Basic Pension Insurance
194
3.3.3.2.
Minimum Subsistence Guarantee and Support of the Especially Poor
194
3.3.4.
Summary and Evaluation
195
3.4.
Relationship with Tort Law
196
4.
Conclusions
196
ch. 6
Doctrinal Evaluation and Tentative Conclusions
197
1.
Introduction
197
2.
Doctrinal Evaluation
198
2.1.
Regulatory Quality Assurance System
198
2.2.
Victim Compensation System: Input Analysis
199
2.2.1.
Liability Rules
199
2.2.2.
Quantum Rules
200
2.3.
Victim Compensation System: Output Analysis
201
2.3.1.
Claims Initiation
201
2.3.2.
Claims Disposition
202
2.3.3.
Liability Insurance
203
3.
Tentative Conclusions and Discussion
203
3.1.
Summary of the Doctrinal Evaluations
203
3.2.
Call for Law and Economics
205
Part II: Economic Theories And Empirical Evidence
207
Introductory Note
209
ch. 7
Preventing Medical Errors through Tort Law-Theoretical Models
211
1.
Introduction
211
2.
Classic Model of Tort Law
212
2.1.
Introduction
212
2.2.
Model of Primary Accident Cost Avoidance
214
2.3.
Tertiary Cost Avoidance
216
3.
Applying the Classic Model to Medical Malpractice
217
3.1.
Introduction
217
3.2.
Features of Health Care Services and the Choice between Negligence and Strict Liability
219
3.2.1.
Product Uncertainty
219
3.2.2.
Information Asymmetry
220
3.2.3.
Externalities
220
3.2.4.
Negligence versus Strict Liability
222
3.3.
Standard of Care
223
3.3.1.
Learned Hand Rule
223
3.3.2.
Prior Precautions and Competence
224
3.3.3.
Uncertainty over the Standard of Care
225
3.3.4.
Impact of Regulation
227
3.4.
Causation
229
3.4.1.
Causation in Fact
229
3.4.2.
Uncertainty over Causation in Fact
230
3.4.2.1.
Potential Inefficiency of the Threshold Approach
230
3.4.2.2.
Efficiency of the Proportional Approach
231
3.5.
Proof Rules
233
3.6.
Law of Damages
235
3.6.1.
Introduction
235
3.6.2.
Full Compensation
235
3.6.3.
Assessment of Damages
238
3.6.3.1.
Objective versus Subjective Methods
238
3.6.3.2.
Compensation for Wrongful Death
239
3.6.3.3.
Compensation for Non-pecuniary Losses in Non-Fatal Accidents
242
3.6.3.4.
Collateral Benefits
244
3.6.4.
Off-setting Benefits Rule/Re-stated Negligence Rule (Scope of Liability)
246
3.6.5.
Uncertainty over the Magnitude of Liability
249
3.7.
Dispute Resolution and Tertiary Costs
250
4.
Conclusions
251
ch. 8
Preventing Medical Errors through Tort Law-Empirical Evidence and Updated Models
253
1.
Introduction
253
2.
Empirical Evidence: Iatrogenic Injury, Malpractice Litigation, and Deterrent Effect
254
2.1.
Introduction
254
2.2.
Incidence, Severity, and Costs of latrogenic Injuries
254
2.2.1.
Introduction
254
2.2.2.
Retrospective Studies
255
2.2.3.
Prospective Studies
257
2.2.4.
Costs of Medical Errors/AEs
258
2.3.
Malpractice Claims Filed
259
2.3.1.
Initiation of Malpractice Claims
259
2.3.1.1.
Theoretical Predictions
259
2.3.1.2.
Empirical Findings
260
2.3.2.
Trends in Medical Malpractice Claims Filed
261
2.4.
Accuracy of Claims Resolution
264
2.4.1.
Defining Claim Accuracy
264
2.4.2.
Empirical Findings
265
2.5.
Does Medical Malpractice Liability Have a Deterrent Effect?
267
2.5.1.
Introduction
267
2.5.2.
Defining Defensive Medicine
269
2.5.2.1.
Defining Defensive Medicine
269
2.5.2.2.
Positive versus Negative Defensive Medicine
270
2.5.3.
Extent of Defensive Medicine
271
2.5.3.1.
Different Approaches
271
2.5.3.2.
Direct Physician Surveys
272
2.5.3.3.
Survey Studies using Clinical Scenarios
273
2.5.4.
Statistical Evidence on the Extent of PDM
274
2.5.4.1.
Introduction
274
2.5.4.2.
Statistical Studies on PDM in the Speciality of Obstetrics
275
2.5.4.3.
Statistical Studies on PDM in the General Ailment Setting or Other Specialities than Obstetrics
278
2.5.4.4.
Summary
280
2.5.5.
Statistical Evidence on the Extent of NDM
280
2.5.5.1.
Statistical Studies on NDM in the Specialty of Obstetrics
280
2.5.5.2.
Statistical Studies on NDM in the General Ailment Setting
281
2.5.5.3.
Summary
283
2.5.6.
Summary and Evaluation
283
2.6.
Is the Medical Malpractice System Cost-Effective?
284
2.6.1.
Costs of the Medical Malpractice System
284
2.6.2.
Deterrence Benefits Compared to the Costs
286
3.
New Empirically-Grounded Model of Medical Malpractice Liability
289
3.1.
Introduction
289
3.2.
Empirical Evidence on the Causes of Iatrogenic Injuries
290
3.2.1.
Risk Factors
290
3.2.2.
Deliberate or Accidental Negligence?
291
3.2.3.
Human Errors and System Failures
292
3.3.
Updating the Classic Model of Malpractice Liability
294
3.3.1.
Patient Safety Investments
294
3.3.2.
Enterprise (Hospital) Liability 2%
3.3.2.1.
Direct Hospital Liability and Vicarious Liability
296
3.3.2.2.
Enterprise Medical Liability
299
4.
Conclusions
301
ch. 9
Preventing Medical Errors through Alternative Regimes
303
1.
Introduction
303
2.
Contractual Approach: A Desirable Alternative?
304
2.1.
Introduction
304
2.2.
Case for the Contractual Approach
305
2.3.
Arguments against the Contractual Approach
307
2.3.1.
Information Problems
307
2.3.2.
Other Arguments against Waivers of Statutory Liability
308
2.3.3.
Other Arguments against Contractual Variation in the Standard of Care
310
2.4.
Summary and Evaluation
311
3.
Regulation: A General Overview
313
3.1.
Introduction
313
3.2.
Arguments for Regulating Health Care Provision
315
3.2.1.
Introduction
315
3.2.2.
Public Interest Arguments for Health Care Regulation
316
3.2.2.1.
Asymmetric Information
316
3.2.2.2.
Negative Externalities
317
3.2.2.3.
Public Goods
318
3.2.2.4.
Market Power
319
3.3.
Summary
319
4.
Input Controls: Is Licensing a Desirable Alternative?
320
4.1.
Introduction
320
4.2.
Arguments for Licensing
321
4.3.
Arguments against Licensing
322
4.3.1.
Is Licensing an Optimal Way to Provide Information?
322
4.3.2.
Is Licensing an Optimal Way to Ensure Quality?
323
4.4.
Summary and Evaluation
324
5.
Output Controls: Is Quality Regulation a Desirable Alternative?
327
5.1.
Introduction
327
5.2.
Forms of Quality Regulation
327
5.2.1.
Introduction
327
5.2.2.
Ex-Ante versus Ex Post Regulation by Regulators
329
5.2.3.
Regulation versus Liability
331
5.2.3.1.
Ex-Ante Safety Regulation versus Liability
331
5.2.3.2.
Ex Post Regulation by Regulators versus Liability
332
5.3.
Choice of Sanctions
333
5.3.1.
Introduction
333
5.3.2.
Optimal Size of Sanctions
334
5.3.3.
Licensing Sanctions
336
5.3.4.
Administrative Sanctions versus Criminal Penalties
337
5.4.
Summary and Evaluation
339
6.
Public Regulation versus Self-Regulation
340
7.
Empirical Evidence
343
7.1.
Detection of Non-Complying Providers
343
7.2.
Licensing Sanctions
346
7.3.
Criminal Penalties
347
8.
Conclusions
349
ch. 10
Fault-Based Compensation Mechanisms for Iatrogenic Injuries
351
1.
Introduction
351
2.
Basic Theories of Secondary Cost Avoidance
352
3.
Compensation via Tort Law Alone
355
3.1.
Introduction
355
3.2.
Enterprise Liability
355
3.3.
Optimal Compensation
357
3.3.1.
Insurance Theory
357
3.3.2.
Decoupled Liability
358
3.3.3.
Inefficiencies of Treating Tort Law as an Insurance Scheme
360
3.4.
Summary
361
4.
Compensation via Liability Insurance
361
4.1.
Introduction
361
4.2.
Rationale of Liability Insurance
363
4.2.1.
Loss Distribution and Private Insurance
363
4.2.2.
Demand for Insurance
363
4.2.2.1.
Risk Aversion and Insurance
363
4.2.2.2.
Demand for MLI under the Negligence Rule
364
4.2.2.3.
Institutional Providers
365
4.2.2.4.
Coverage for Non-Pecuniary Losses
366
4.2.3.
Supply of Insurance
366
4.2.3.1.
Pooling, Re-insurance, and Co-Insurance
366
4.2.3.2.
Insurability of the Medical Malpractice Risk
368
4.2.4.
Informational Problems in the Insurance Market
371
4.2.4.1.
Moral Hazard
371
4.2.4.2.
Adverse Selection
373
4.2.4.3.
Risk Differentiation
373
4.2.5.
Impact of Special Liability Sub-Rules on Insurability
374
4.2.5.1.
Causal Uncertainty
374
4.2.5.2.
Channelling under EML
375
4.2.5.3.
Retroactive Liability
376
4.2.5.4.
Financial Limits on Liability
377
4.2.6.
Compulsory Insurance
378
4.2.6.1.
Case for Compulsory Liability Insurance
378
4.2.6.2.
Some Warnings
380
4.3.
Empirical Evidence
381
4.3.1.
Rating and Partial Coverage
381
4.3.1.1.
Risk Differentiation in Practice (Experience Rating)
381
4.3.1.2.
Why Is Detailed Risk Differentiation Not Widely Accepted?
382
4.3.1.3.
Partial Coverage
384
4.3.2.
Typical Case: The American Malpractice Crisis
384
4.3.3.
Traditional Tort Reforms
387
4.3.3.1.
Content of the Reforms
387
4.3.3.2.
Impact of the Reforms
388
4.3.4.
Other Causes of the Malpractice Crisis
389
4.4.
Summary
391
5.
Self-Insurance: A Perfect Alternative to Market MLI?
392
5.1.
Inter-temporal Loss Spreading and Self-Insurance
392
5.2.
Self-Insurance versus Market MLI
393
5.3.
Summary
396
6.
Conclusions
396
ch. 11
Medical Compensation Mechanisms Not Based on Fault
399
1.
Introduction
399
2.
First-Party Insurance
401
2.1.
Rationale of First-Party Insurance
401
2.2.
Relationship with the Fault-Liability-Insurance System (FLIS)
402
2.3.
Empirical Evidence Concerning the (Voluntary) First-Party Insurance Market
404
2.4.
Solution: A Compulsory First-Party Insurance Scheme?
405
2.5.
Summary and Evaluation
406
3.
Theories of Compensation Funds
406
3.1.
Defining Compensation Funds
406
3.2.
Fair and Efficient Compensation
408
3.3.
Causation: How Should Iatrogenicity Be Defined?
409
3.3.1.
Defining Iatrogenic Injuries
409
3.3.2.
Iatrogenicity versus Due Care
410
3.3.3.
Iatrogenicity and Omissions
411
3.3.4.
Causal Uncertainty
411
3.4.
Funds versus Insurance
412
3.5.
Summary and Evaluation
413
4.
Theories of Social Security
415
4.1.
Rationale of Social Security
415
4.2.
Distinction between Social Security and Tort Liability
417
4.3.
Interplay between Social Security and Tort Liability
418
4.3.1.
Compensation Models
418
4.3.2.
Combined Use in Practice
419
5.
Empirical Evidence on No-Fault Compensation Schemes in Practice
421
5.1.
Introduction
421
5.2.
Core Features of the NFCS: A Comparative Analysis
423
5.2.1.
Eligibility
423
5.2.1.1.
New Zealand
423
5.2.1.2.
Scandinavia
427
5.2.1.3.
Comparison and Summary
432
5.2.2.
Other Features
433
5.2.2.1.
Benefits
433
5.2.2.2.
Procedures
437
5.2.2.3.
Financing
440
5.2.2.4.
Costs
441
5.3.
Evaluation
442
6.
Conclusions
443
Part III: Applying The Economic Observations To China
445
Introductory note
447
ch. 12
Economic Analysis of the Chinese Medical Malpractice System
449
1.
Introduction
449
2.
Tort Law: Prevention (Deterrence)
451
2.1.
Introduction
451
2.2.
Input Analysis
452
2.2.1.
Introduction
452
2.2.2.
Liability Rules
452
2.2.2.1.
Negligence versus Strict Liability
452
2.2.2.2.
Standards of Care
453
2.2.2.3.
Feasance versus Nonfeasance
456
2.2.2.4.
Causation and Proof Rules
457
2.2.2.5.
Contractual Waiver of or Alteration to Tort Liability?
458
2.2.3.
Quantum Rules
459
2.2.4.
Claims Initiation
461
2.2.5.
Claims Resolution
461
2.2.6.
Medical Liability Insurance (MLI)
462
2.2.7.
Defendant Responsiveness
463
2.2.8.
Summary
464
2.3.
Output Analysis
464
2.4.
Summary
466
3.
Tort Law: Compensation
467
3.1.
Introduction
467
3.2.
Benefit Levels
468
3.3.
Eligibility Criteria
469
3.4.
Claims Disposition
470
3.5.
Administrative Costs
470
3.6.
Financing
471
3.7.
Summary
471
4.
Penal and Regulatory Alternatives: Prevention (Deterrence)
472
5.
Alternative Compensation Mechanisms: Compensation
474
5.1.
Medical Liability Insurance (MLI)
474
5.2.
First-Party Insurance and Social Security
476
6.
Impact of Yi Nao Incidents on the Malpractice System
476
7.
Conclusions
477
ch. 13
Concluding Remarks and Policy Recommendations
479
1.
Introduction
479
2.
Summary of Main Findings
480
2.1.
Sub-Question 1-a: What Are the Legal Remedies Currently Available in China That Are Aimed at the Prevention of Medical Malpractice and Victim Compensation?
480
2.1.1.
Introduction
480
2.1.2.
Regulation
480
2.1.3.
Medical Malpractice Liability System
481
2.1.4.
Medical Liability Insurance (MLI)
482
2.1.5.
First-Party Private Insurance
483
2.1.6.
Social Security Schemes
483
2.2.
Sub-Question 1-b: Are These Remedies Sound according to Legal Doctrines?
483
2.2.1.
Introduction
483
2.2.2.
Regulation
483
2.2.3.
Medical Malpractice Liability System
484
2.2.4.
Medical Liability Insurance (MLI)
485
2.2.5.
First-Party Private Insurance
485
2.2.6.
Social Security Schemes
485
2.3.
Sub-Question 2-a: How Should the Legal Remedies Be Structured in Order to Prevent Medical Malpractice and Compensate Victims for Iatrogenic Injuries Efficiently in the light of Economic Benchmarks and Available Empirical Evidence?
486
2.3.1.
Introduction
486
2.3.2.
How Should Legal Remedies Be Designed in Order to Prevent Medical Errors (Medical Malpractice) Efficiently?
487
2.3.2.1.
Tort Law
487
2.3.2.2.
Regulation
488
2.3.2.3.
Contractual Approach
489
2.3.3.
How Should Legal Remedies Be Structured in Order to Compensate Victims for Iatrogenic Injuries Efficiently?
490
2.3.3.1.
Tort Law Per Se
490
2.3.3.2.
Liability Insurance
490
2.3.3.3.
Self-Insurance
491
2.3.3.4.
First-Party Insurance
491
2.3.3.5.
Compensation Funds
492
2.3.3.6.
Social Security
492
2.4.
Sub-Question 2-b: Are These Legal Remedies for Iatrogenic Injury Prevention and Patient Compensation in China Efficient as Well?
493
2.4.1.
Legal Remedies for Injury Prevention
493
2.4.1.1.
Medical Malpractice Liability System
493
2.4.1.2.
Regulation
494
2.4.2.
Legal Remedies for Victim Compensation
494
2.4.2.1.
Medical Malpractice Compensation System
494
2.4.2.2.
Medical Liability Insurance (MLI)
495
2.4.2.3.
Social Security
496
3.
Policy Recommendations: How Can We Improve These Systems? (Main Question 3)
496
3.1.
Introduction
496
3.2.
Reforming the Tort and Relevant Systems Piecemeal
497
3.3.
No-Fault Compensation Schemes
503
3.4.
Comparison of the Different Reform Plans
505
4.
Limitations
505
5.
Future Research
506
Summary
509
Bibliography
511
Appendix 1: Legislation
571
Appendix 2: Cases
585
Appendix 3: Semi-Structured Interviews
591
Valorisation Addendum
595
Curriculum Vitae
599