AETNA HEALTHCARE INC. VS. JUAN DAVILA: CASE REVIEW
This paper reviews the Aetna Healthcare Inc. V. Juan Davila case. The case was one in which an employee of a company that contracted with Aetna Healthcare Inc., an HMO (health maintenance organization), a managed care company, to provide health care for its employees. The case also involved conflicts between federal and state laws (Aetna Healthcare Inc., FKA Aetna U. S. Healthcare Inc. et al. V. Juan Davila, 2004).
This review of Aetna Healthcare Inc. V. Juan Davila consists of a brief summary of the case two major discussions. The first major discussion reviews the major action and findings of the case. The second discussion assesses the advantages and disadvantages of the decision of the United States Supreme Court on the case when such advantages and disadvantages are considered from the perspective of private health care consumers, as opposed to the perspectives of health care funding entities and health care services provider organizations.
Summary of Aetna Health Inc. V. Juan Davila
Juan Davila participated in an employer-sponsored group health plan (an HMO) that was administered by Aetna Health Inc. Davila's employer contracted with Aetna Health Inc. to administer the health plan. In this capacity, Aetna Health Inc. established the formularies relevant to specific health conditions covered by the employer health plan. Davila's physician prescribed Vioxx for arthritis pain. Aetna Healthcare Inc., however, required Davila to try a less expensive drug first under Aetna's "step program" before Aetna would agree to pay for Vioxx. Soon thereafter, Davila experienced a severe reaction to the less expensive drug that required extensive treatment and hospitalization (Juan Davila V. Aetna U.S. Healthcare, Inc., 2002).
Major Actions and Findings Associated with the Case
Davila sued Aetna, in a state court in Texas under the Texas Health Care Liability Act (THCLA...