Clark Havighurst

Clark Havighurst (born May 25, 1933) is a distinguished American legal scholar known for his contributions to health care law and policy.^[1][2]

He retired in 2005 as the William Neal Reynolds Professor Emeritus of Law at Duke University after forty years of service in its School of Law.^[3] He authored Health Care Law and Policy: Readings, Notes, and Questions, Deregulating the Health Care Industry, examined economic regulation in health care, and in 1995 he published Health Care Choices: Private Contracts as Instruments of Health Reform through the American Enterprise Institute.^[4]

He was born to Harold Canfield and Marion Perryman Havighurst in Evanston, Illinois.^[5] His father was a law professor at Northwestern University School of Law, where he served as dean from 1947 to 1957.^[6]

Havighurst graduated magna cum laude from Princeton University in 1955 and earned his law degree in 1958 (Order of the Coif) from Northwestern, which, for family reasons, he attended (instead of Michigan) during his father's deanship.^[7] At Princeton, his senior thesis in English was titled The South and Robert Penn Warren: A Study of Regional Influence in Modern Fiction.^[8]

In 1964, Havighurst left his New York law firm to become an associate professor of law at Duke, where he spent most of his academic career.^[9] In the early 1980s, he became the William Neal Reynolds Professor of Law. In 1999, he served briefly as the Law School's Interim Dean.^[3]

In his early years at Duke, he was for a time the faculty editor of Law and Contemporary Problems, a symposium-oriented journal founded at Duke in 1933.^[10]

Havighurst's own work in health care law soon led to several high-profile opportunities, including sabbatical leaves first as scholar-in-residence at the Institute of Medicine of the National Academy of Sciences in 1972-73 (its inaugural year); at the Federal Trade Commission in 1978-79; at a Washington law firm in 1988-89, and at the Rand Corporation in Santa Monica in 1999.^[11] He was also elected to membership in the Institute of Medicine in 1982, serving on its Board of Health Care Services from 1987 to 1997; the IOM is now the National Academy of Medicine, where Havighurst is an inactive member because so much of his work, originating in his initial teaching and research interests in antitrust law, has been critical of the medical establishment.^[12]

After writing very early about health maintenance organizations^[13], Havighurst found an occasion in 1973 to propose a selective "no-fault" system for medical malpractice^[14]; although clearly appealing to both consumers and many doctors, this program was never adopted but was still being discussed seriously in 2005.^[15]

In the mid-1970s, Havighurst, whose legal specialty was antitrust law, wrote a brief that seemed to prompt the Supreme Court to review (and later reverse) a lower-court ruling endorsing implied antitrust exemptions for the "learned professions."^[16]  

Havighurst's 1995 book, Health Care Choices, was a fairly strong endorsement of contracts as "instruments of health reform." A review by James C. Robinson, then a young business school professor, began by declaring, "Clark Havighurst is a radical".^[17]

Havighurst remained actively engaged with health policy scholarship through at least 2011, finally writing two ambitious articles focusing on monopolies and other features of the health care marketplace that regressively redistribute wealth, from lower- to higher-income players.  The first of these—both were written with Barak Richman—was entitled "Distributive Injustice(s) in American Health Care" and served as the lengthy lead article in a symposium entitled "Who Pays? Who Benefits? Distributional Issue(s) in Health Care."^[18]   

Havighurst has been noted for his commentary on health care policy.^[19] In 2013, Wall Street Journal columnist Holman W. Jenkins Jr. recommended one of Havighurst's articles over mainstream coverage, highlighting his critique of the limited choices in U.S. health care. Economist James C. Robinson, who later received the Nobel Prize in 2025, had previously reviewed Havighurst's 1995 book Health Care Choices, referring to him as "a radical" in a 1996 review.^[20]

Havighurst's other late article, on "The Provider Monopoly Problem in Health Care," emphasized how hospitals bundle their services to hide monopoly's effects and that health insurance gives working people deep pockets that steepen demand curves and hence the profitability of the numerous non-profit and other monopolies in health care markets.^[21]     

A key point in this and other of Havighurst's later works was that employers and labor unions provide Cadillac-quality health coverage to their workers without letting the latter know that they bear a significant share of its cost in reduced take-home pay and other benefits.^[22]

In 2018, he published a timely and provocative op-ed in the Wall Street Journal dramatizing this "Health-Care Conspiracy of Silence." No wonder, he thought, that consumers have only Hobson's choices. ^[23]

• Havighurst, Clark C., ed. (1974). Regulating health facilities construction: proceedings. Washington: American Enterprise Institute for Public Policy Research (published January 1, 1974). p. 314. ISBN 978-0-8447-2044-9.
• Havighurst, Clark C. (1982). Deregulating the health care industry: planning for competition. Cambridge/Mass: Bailinger. ISBN 978-0-88410-736-1.
• Havighurst, Clark C. (1988). Health care law and policy: readings, notes and questions. University Casebook Series. Westbury, NY: The Foundation Pr. ISBN 978-0-88277-638-5.
• Havighurst, Clark C. (1995). Health care choices: private contracts as instruments of health reform. Washington, D.C: AEI Press for the American Enterprise Institute. ISBN 978-0-8447-3867-3.

• Havighurst, Clark (1978-05-01). "Professional Restraints on Innovation in Health Care Financing". Duke Law Journal. 27 (2): 303–387. ISSN 0012-7086.
• Havighurst, Clark C.; Hackbarth, Glenn M. (1979-06-07). "Private Cost Containment". New England Journal of Medicine. 300 (23): 1298–1305. doi:10.1056/NEJM197906073002303. ISSN 0028-4793.
• Havighurst, Clark (1984-01-01). "Doctors and Hospitals: An Antitrust Perspective on Traditional Relationships". Duke Law Journal. 33: 1071–1162.
• Havighurst, Clark (1986-04-01). "Altering the Applicable Standard of Care". Law and Contemporary Problems. 49 (2): 265–275. ISSN 0023-9186.
• Havighurst, Clark (1989-01-01). "Practice Guidelines for Medical Care: The Policy Rationale". St. Louis University Law Journal. 34: 777–819.
• Havighurst, Clark C. (2003-02-01). "An Apology for Professionalist Regimes". Journal of Health Politics, Policy and Law. 28 (1): 159–164. doi:10.1215/03616878-28-1-159. ISSN 0361-6878.
• Havighurst, Clark; Richman, Barak (2011-01-01). "Who Pays? Who Benefits? Unfairness in American Health Care". Notre Dame Journal of Law, Ethics & Public Policy. 25: 493–526.