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Full-Text Articles in Law
Choosing Affordable Health Insurance, Govind Persad
Choosing Affordable Health Insurance, Govind Persad
Sturm College of Law: Faculty Scholarship
The Affordable Care Act ("ACA") made health insurance accessible to many. Yet unaffordable insurance still abounds. This Article proposes a strategy for improving affordability that enables health insurance purchasers to choose, within reasonable limits, which treatments their insurance covers. After critiquing recently proposed strategies for improving affordability and reviewing past legal scholarship on content choice in health insurance, this Article introduces the "Affordable Choices" framework. This framework regulates choice in four ways. First, health plans should only exclude treatments whose merits are subject to reasonable disagreement among patients and physicians. Second, plans should appeal to purchasers' health-related values- values about …
Setting Priorities Fairly In Response To Covid-19: Identifying Overlapping Consensus And Reasonable Disagreement, David Wasserman, Govind C. Persad, Joseph Millum
Setting Priorities Fairly In Response To Covid-19: Identifying Overlapping Consensus And Reasonable Disagreement, David Wasserman, Govind C. Persad, Joseph Millum
Sturm College of Law: Faculty Scholarship
Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of first-come, first-served allocation; (iv) the relevance of post-episode survival; (v) the difference between age and other factors that affect life-expectancy; …
The Case For Valuing Non-Health And Indirect Benefits, Govind Persad, Jessica Du Toit
The Case For Valuing Non-Health And Indirect Benefits, Govind Persad, Jessica Du Toit
Sturm College of Law: Faculty Scholarship
Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely …
Expensive Patients, Reinsurance, And The Future Of Health Care Reform, Govind Persad
Expensive Patients, Reinsurance, And The Future Of Health Care Reform, Govind Persad
Sturm College of Law: Faculty Scholarship
In 2017, Americans spent over $3.4 trillion-nearly 18% of gross domestic product-on health care. This spending is unevenly distributed: Almost a quarter is spent on the costliest 1% of patients, and almost half on the costliest 5%. Most of these patients soon return to a lower percentile, but many continue or economic, analysis of existing and proposed options for sharing expensive patients' costs. Third, it bridges the disconnected literature on reinsurance, limit setting, and health care financing, identifying how proposals in these different areas intersect. to incur health care costs in the top percentiles year after year. This Article focuses …
Disability Law And The Case For Evidence-Based Triage In A Pandemic, Govind Persad
Disability Law And The Case For Evidence-Based Triage In A Pandemic, Govind Persad
Sturm College of Law: Faculty Scholarship
This Essay explains why model policies proposed or adopted in response to the COVID-19 pandemic that allocate scarce medical resources by using medical evidence to pursue two core goals—saving more lives and saving more years of life—are compatible and consonant with disability law. Disability law, properly understood, permits considering medical evidence about patients’ probability of surviving treatment and the quantity of scarce treatments they will likely use. It also permits prioritizing health workers, and considering patients’ post-treatment life expectancy. These factors, when based on medical evidence and not inaccurate stereotypes, are legal to consider even if they disadvantage some patients …