Indiana Law Review IKOIAWA UNIVtRSlTY MAY 2 21987 SCHQOl CF lAW-taOPlS. law Review Volume 19 No. 4 1986 SYMPOSIUM ON FINANCING AND REGULATING HEALTH CARE SERVICES: HARD CHOICES AND ETHICAL DILEMMAS Coverage and Care for the Medically Indigent: Public and Private Options Randall R. Bovbjerg & William G. Kopit State Hospital Cost Containment: An Analysis of Legislative Initiatives Carl J. Schramm Liver Transplantation in Massachusetts: Public Policymaking as Morality Play Clark C. Havighurst & Nancy M. P. King The Lithotripsy Game in North Carolina: A New Technology Under Regulation and Deregulation Clark C. Havighurst & Robert S. McDonough Full Circle: The Return of Certificate of Need Regulation of Health Facilities to State Control James B. Simpson Reform Revisited: A Review of the Indiana Medical Malpractice Act Ten Years Later James D. Kemper & Myra C. Selby & Bonnie K. Simmons Making Hard Choices Under the Medicare Prospective Payment System: One Administrative Model for Allocating Medical Resources Under a Government Health Insurance Program Eleanor D. Kinney Bowen v. American Hospital Association: Federal Regulation Is Powerless to Save Baby Doe Dennis F. Cantrell NOTE Denying Hospital Privileges to Non-Physicians: Does Quality of Care Justify a Potential Restraint of Trade? Please enter my subscription to the INDIANA LAW REVIEW NAME ADDRESS Enclosed is $. Bill me for _ Mail to: for subscriptions. subscriptions. INDIANA LAW REVIEW INDIANA UNIVERSITY SCHOOL OF LAW -INDIANAPOLIS 735 West New York Street Indianapolis, Indiana 46202 Subscription Rates (one year): Regular, $18.00; Foreign, $21.50; Survey, $10.00; Single Issue, $5.00 Indiana Law Review We are pleased to announce that Volume 20, Number 1 1986 Survey of Recent Developments in Indiana Law will be available in May, 1987 Price $10.00 Send orders to: Business Editor Indiana Law Review Indiana University School of Law—Indianapolis 735 W. New York Street, Indianapolis, Indiana 46202 Indiana luai^ Revieiv Volume 19 1986 Number 4 Copyright C^J 1986 by the Trustees of Indiana University TABLE OF CONTENTS SYMPOSIUM ON FINANCING AND REGULATING HEALTH CARE SERVICES Foreword Eleanor D. Kinney Barbara McCarthy Green 853 ARTICLES Coverage and Care for the Medically Indigent: Public and Private Options Randall R. Bovbjerg William G. Kopit 857 State Hospital Cost Containment: An Analysis of Legislative Initiatives Carl J. Schramm 919 Liver Transplantation in Massachusetts: Public Policymaking as Morality Play Clark C. Havighurst Nancy M. P. King 955 The Lithrotripsy Game in North Carolina: A New Technology Under Regulation and Deregulation Clark C. Havighurst Robert S. McDonough 989 Full Circle: The Return of Certificate of Need Regulation of Health Facilities to State Control James B. Simpson 1025 Reform Revisited: A Review of the Indiana Medical Malpractice Act Ten Years Later James D. Kemper Myra C. Selby Bonnie K. Simmons 1129 Volume 19 Fall 1986 Number 4 The INDIANA LAW REVIEW (ISSN 0090-4198) is the property of Indiana University and is published quarterly by the Indiana University School of Law—Indianapolis, which assumes complete editorial responsibility thereof. Subscription rates: one year $18.00; foreign $21.50. Please notify us one month in advance of any change in address and include both old and new addresses with zip codes to ensure delivery of all issues. Send all correspondence to Editorial Assistant, Indiana Law Review, Indiana University School of Law—Indianapolis, 735 West New York Street, Indianapolis, Indiana 46202. Publication office: 735 West New York Street, Indianapolis, Indiana 46202. Second class postage paid at Indianapolis, Indiana 46201. POSTMASTER: Send address changes to INDIANA LAW REVIEW, 735 West New York Street, Indianapolis, Indiana 46202. Making Hard Choices Under the Medicare Prospective Payment System: One Administrative Model for Allocating Medical Resources Under a Government Health Insurance Program Eleanor D. Kinney 1151 Bowen v. American Hospital Association: Federal Regulation Is Powerless to Save Baby Doe Dennis F. Cantrell 1199 NOTE Denying Hospital Privileges to Non-Physicians: Does Quality of Care Justify a Potential Restraint of Trade? 1219 Indiana La^iv Reviep Volume 19 1986 Editor-in-Chief IDebra D. McVicker Executive Editors Articles and Production Notes and Topics Mary Arlien Findling Dennis F. Cantrell Articles Editors Jerry A. Garau Cathleen Johnson Perry Douglas Westfall Holly Michael B. Watkins Brian L. Woodward Business Editor John Gardner Note and Development Editof•s David C. Bransdorfer Michael Patrick Maxwell Mary Beth Claus Ellen C. Siakotos Herbert O. Hintze, Jr Andrew P. Wirick Associate Editors Vivian K. Aichele Elizabeth R. Gingerich Mark A. Bailey Douglas E. Greer Curtis Alan Baldwin Brian K Hugen Arthur R. Baxter Larry R . Jackson Jan Barteau Berg Todd J. Kaiser Philip A. Book Mark A . Kapouraios Hilary A. Bowe Sally A. Kendall Laura L. Bowker Andrew A. Kleiman Susan D. Burke Gary W . Larson Gregory M. Cole Susan D . Rafferty Kathryn J. Cook Jeffrey A. Riggs Robert T. Drew Patricia L. Sosbe Lucy A. Emison Lori A. Torres Michael J. Gabovitch Judy L. Peter C. Wright Woods Editorial Assistant Mary J. Deschler Faculty Advisor Paul J. Galanti Indiana University School of Law—Indianapolis 1985-86 ADMINISTRATIVE OFFICERS AND FACULTY Administrative Officers John W. Ryan, Ph.D., President of the University Glenn W. Irwin, Jr., M.D., Vice-President Gerald L. Bepko, LL.M., Dean James F. Bindley, J.D., Assistant Dean for Administration G. Kent Frandsen, J.D., Associate Dean for Student Affairs Jeffrey W. Grove, J.D., Associate Dean for Academic Affairs Faculty Thomas B. Allington, Professor. B.S., University of Nebraska, 1964; J.D., 1966; LL.M., New York University, 197 L Edward P. Archer, Professor. B.M.E., Rensselaer Polytechnic Institute, 1958; J.D., George- town University, 1962; LL.M., 1964. James F. Bailey, III., Associate Professor and Director of Law Library. A.B., University of Michigan, 1961; J.D., 1964; M.A.L.S., 1970. Gerald L. Bepko, Dean and Professor. B.S., Northern Illinois University, 1962; J.D., IIT/Chicago-Kent College of Law, 1965; LL.M., Yale University 1972. James F. Bindley, Assistant Dean for Administration and Lecturer in Law. B.A., Loyola University, 1969; J.D., University of Kentucky, 1972. Paul N. Cox, Visiting Professor. B.S., Utah State University, 1971; J.D., University of Utah, 1974; LL.M., University of Virginia, 1980. Clyde Harrison Crockett, Professor. A.B., University of Texas, 1962; J.D., 1965; LL.M., University of London (The London School ofEconomics and Political Science), 1972. Debra a. Falender, Professor. A.B., Mount Holyoke College, 1970; J.D., Indiana Univer- sity, 1975. G. Kent Frandsen, Associate Deanfor Student Affairs andAssociate Professor. B.S., Bradley University, 1950; J.D., Indiana University, 1965. David A. Funk, Professor. A.B., College of Wooster, 1949; J.D., Case Western Reserve Univer- sity, 1951; M.A., The Ohio State University 1968; LL.M., Case Western Reserve Univer- sity, 1972; LL.M., Columbia University, 1973. Paul J. Galanti, Professor. A.B., Bowdoin College, 1960; J.D., University of Chicago, 1963. Helen P. Garfield, Professor. B.S.J. , Northwestern University, 1945; J. D., University ofCol- orado, 1967. Harold Greenberg, Associate Professor. A.B., Temple University, 1959; J.D., University of Pennsylvania, 1962. Jeffrey W. Grove, Associate Dean for Academic Affairs and Professor. A.B., Juniata College, 1965; J.D., George Washington University, 1969. William F. Harvey, CarlM. Gray Professor ofLaw. A.B., University ofMissouri, 1954; J. D., Georgetown University, 1959; LL.M., 1961. W. William Hodes, Professor. A.B., Harvard College 1966; J.D., Rutgers Newark, 1969. Lawrence A. Jegen, III., Thomas F. Sheehan Professor of Tax Law and Policy, 1982. A.B., Beloit College, 1956; J.D., The University of Michigan 1959; M.B.A., 1960, LL.M., New York University, 1963. Henry C. Karlson, Professor. A.B., University of Illinois, 1965; J.D., 1968; LL.M., 1977. William Andrew Kerr, Professor. A.B., West Virginia University, 1955. J.D., 1957, LL.M., Harvard University, 1958; B.D., Duke University, 1968. Eleanor D. Kinney, Assistant Professor. A.B., Duke University, 1969; M.A., University of Chicago, 1970; J.D., Duke University, 1973. Walter W. Krieger, Associate Professor. A.B., Bellarmine College, 1959; J.D., University of Louisville, 1962; LL.M., George Washington University, 1969. David P. Leonard, Associate Professor. B.A., University of California at San Diego, 1974; J.D., UCLA School of Law, 1977. Robin Paul Malloy, Assistant Professor. B.S., Purdue University, 1971; J.D., University of Florida, 1980; LL.M., University of Illinois, 1983. William E. Marsh, Professor. B.S., University of Nebraska, 1965; J.D., 1958. SusANAH M. Mead, Associate Professor. B.A., Smith College, 1969; J.D., Indiana University, 1976. Mary H. Mitchell, Associate Professor. A.B., Butler University, 1975; J.D., Cornell Law School, 1978. David R. Papke, Associate Professor. A.B., Harvard College, 1969; J.D., Yale Law School, 1973; M.A. in American Studies, Yale University, 1973; M. Phil., in American Studies, The University of Michigan, 1980; Ph.D., 1983. David E. Pierce, Assistant Professor of Law. B.A., Pittsburgh State University, 1974; J.D., Washburn University, 1977; LL.M., University of Utah, 1982. Ronald W, Polston, Professor. B.S., Eastern Illinois University, 1953; LL.B., University of Illinois, 1958. Kenneth M. Stroud, Professor. A.B., Indiana University, 1958; J.D., 1961. James W. Torke, Professor. B.S., University of Wisconsin, 1963; J.D., 1968. James Patrick White, Professor (on special assignment). A.B., University ofIowa, 1953; J.D., 1956; LL.M., George Washington University, 1959. Law^rence p. Wilkins, Professor. B.A., The Ohio State University, 1968; J.D., Capital Univer- sity Law School, 1973; LL.M., University of Texas School of Law, 1974. Mary Wolf, Visiting Assistant Professor ofLaw, B.A., Saint Xavier College, 1969; J. D., Univer- sity of Iowa College of Law, 1974. Harold R. Woodard, Professorial Lecturer. B.S., Harvard University, 1933; J.D., 1936. Emeriti Agnes P. Barrett, Associate Professor Emeritus. B.S., Indiana University, 1942; J.D., 1964. Cleon H. Foust, Professor Emeritus. A.B., Wabash College, 1928; J. D., University ofArizona, 1933. John S. Grimes, Professor Jurisprudence Emeritus. A.B., Indiana University. 1929; J. D., 1931. Melvin C. Poland, Cleon H. Foust Professor ofLaw Emeritus, B.S. Kansas State University, 1940; LL.B., Washburn University, 1949; LL.M., The University of Michigan, 1950. R. Bruce Townsend, Cleon H. Foust Professor of Law Emeritus, A.B., Coe College, 1938; J.D., University of Iowa, 1940. Legal Writing Instructors Jeffrey Been, A.B., Wabash College, 1981; J.D., Indiana University, 1984. Michael Mullett, Lecturer. B.A., University of Michigan, 1966; M.A., 1973; J.D., Indiana University, 1982. Vickie Renfrov^, Lecturer. B.A., University of Northern Iowa, 1970; M.A., 1971; Ph.D., Indiana University, Bloomington, 1976; J.D., Indiana University, Bloomington, 1981. Joan Ruhtenberg, Lecturer. B.A., Mississippi University for Women, 1959; J.D., Indiana University, 1980. Law Library Staff Terri Lea Hardin, Affiliate Librarian, B.A., Indiana University, 1982; M.L.S., 1983. Mary P. Hudson, Assistant Librarian, B.A., Ball State, 1969; M.L.S., Indiana Universtiy, 1973. Wendell E. Johnting, Technical Services Librarian. A.B., Taylor University, 1974; M.L.S., Indiana University, 1975. Constance Matts, Associate Librarian. B.A., 1973, Case Western Reserve University; M.S.L.S., 1974, Case Western Reserve University; M.A.I.R., 1976, Creighton University. KiyoskiOtsv, Assistant Librarian, Parkland College, A.A., 1976; A. B., University ofIllinois, 1980; M.S., 1982; C.A.S., 1983. Digitized by the Internet Archive in 2011 with funding from LYRASIS IVIembers and Sloan Foundation http://www.archive.org/details/indianalawreview19486unse