Law Commons^™

A 'Public' Journey Through Covid-19: Donald Trump, Twitter, And The Secrecy Of U.S. Presidents’ Health, Mark Fenster

UF Law Faculty Publications

Donald Trump ignored numerous governance norms in his one term as U.S. President, especially those that prescribe disclosure of official and personal financial information. His brief period of illness from COVID-19, which he broadcast to the world via his Twitter account, revealed the complexity of Trump’s relationship to the concept and norms of transparency that presume information’s necessity for a functional and accountable state. At the same time that Trump offered little in the way of coherent and authoritative information about his health, he also provided an enormous amount of seemingly “inside” and direct accounts of the progress of his …

The Kids Are Not Alright: Leveraging Existing Health Law To Attack The Opioid Crisis Upstream, Yael Cannon

Florida Law Review

The opioid crisis is now a nationwide epidemic, ravaging both rural and urban communities. The public health and economic consequences are staggering; recent estimates suggest the epidemic has contracted the U.S. labor market by over one million jobs and cost the nation billions of dollars. To tackle the crisis, scholars and health policy initiatives have focused primarily on downstream solutions designed to help those who are already in the throes of addiction. For example, the major initiative announced by the U.S. Surgeon General promotes the dissemination of naloxone, which helps save lives during opioid overdoses.

This Article argues that the …

Positive Rights: The New York “Baby Aids Bill” As State-Created Danger, Aaron Badida

Florida Law Review

The New York “Baby AIDS Bill” created a requirement for mandatory, unblind testing of newborns for HIV. This law, and its associated regulatory infrastructure, is contrary to a number of deeply rooted substantive due process rights, including the right to refuse life-sustaining treatment and the right to privacy and bodily autonomy. When the state requires that a physician initiate care or treatment, the government exposes itself to liability under the state-created danger doctrine, particularly when resistance-prone conditions like HIV are involved. In this unique situation, the state’s requirement to initiate antiretroviral care without providing for its continuity puts infants living …

Regulate Physician Restrictive Covenants To Improve Healthcare, Judy Ann Clausen

UF Law Faculty Publications

The U.S. healthcare reform agenda seeks to expand patient choice and access, improve quality, and control costs. This Article argues these goals should govern enforceability of physician non-compete and non-solicitation agreements (restrictive covenants). Most jurisdictions apply a reasonableness test to assess the enforceability of physician restrictive covenants. Some jurisdictions hold physician non-competes per se invalid. Courts applying the reasonableness test often disrupt continuity of care and harm patients; continuity of care is key to patient health. Moreover, physicians departing a practice have an ethical obligation to notify patients of the physician's departure and how to transfer to the physician's new …

Cash Me Outside, Howbow Dah?–An Alternative To Wasteful Medical Spending In Terminally Ill Patients, Christopher Neal Loy, Jr.

Florida Law Review

The U.S. health care system is an inefficient machine that is burdened by overconsumption and wasteful spending. The system has long defaulted into maximizing the quantity of life over quality—a choice influenced by corporations that stand to profit with every additional procedure. To stymie health care spending and attempt to restore the true cost of treatment to patients, this Note proposes an alternative to how health insurers provide options to terminally ill cancer patients by offering a partial cash rebate to forgo any life-extending measures. The patient would be free to leave his or her legacy, the health insurer would …

Investing In The Ill: The Need To Curb Third-Party Payment Of Qualified Health Plan Premiums, Brad M. Beall

Florida Law Review

Hospitals and physicians have begun encouraging their high-cost patients to switch from Medicare or Medicaid to government-subsidized Qualified Health Plans by offering to pay their insurance premiums. Providers make these third-party payments because insurance payouts are much higher under Qualified Health Plans than under Medicare or Medicaid. However, this practice is not always in the best interests of patients, issuers, and the health-care Marketplace. This Note delineates the regulatory responses to this issue, as well as the various advantages and disadvantages that stem from the practice in different contexts. This Note argues that a federal criminal statute is needed to …

Cybermedicine: The Benefits And Risks Of Purchasing Drugs Over The Internet, David Mills

Journal of Technology Law & Policy

In today's rapidly changing world of e-commerce, almost anything can be bought over the Internet and delivered right to your front door. Virtually every day there is news of yet another company selling some type of product online. Included in this barrage of products is prescription medication. Not only is it possible to order prescription medication over the Internet, in some cases it is not necessary to be examined, or even to consult with a physician. ~ To some, this new type of "cybermedicine" is an affront to traditional medicine, as well as potentially dangerous to consumers. In addition, the …

Hospital Mergers And Economic Efficiency, Roger D. Blair, Christine Piette Durrance, D. Daniel Sokol

UF Law Faculty Publications

Consolidation via merger both from hospital-to-hospital mergers and from hospital acquisitions of physician groups is changing the competitive landscape of the provision of health care delivery in the United States. This Article undertakes a legal and economic examination of a recent Ninth Circuit case examining the hospital acquisition of a physician group. This Article explores the Saint Alphonsus Medical Center-Nampa Inc. v. St. Luke’s Health System, Ltd. (St. Luke’s) decision—proposing a type of analysis that the district court and Ninth Circuit should have undertaken and that we hope future courts undertake when analyzing mergers in the …

Quality-Enhancing Merger Efficiencies, Roger D. Blair, D. Daniel Sokol

UF Law Faculty Publications

The appropriate role of merger efficiencies remains unresolved in US antitrust law and policy. The Patient Protection and Affordable Care Act (ACA) has led to a significant shift in health care delivery. The ACA promises that increased integration and a shift from quantity of performance through increased competition will create a system in which quality will go up and prices will go down. Increasingly, due to the economic trends that respond to the ACA, including considerable consolidation both horizontally and vertically, it is imperative that the antitrust agencies provide an economically sound and administrable legal approach to efficiency enhancing mergers. …

Licensing Health Care Professionals, State Action And Antitrust Policy, Roger D. Blair, Christine Piette Durrance

UF Law Faculty Publications

In this Essay, we raise some economic concerns about the wisdom of conferring antitrust immunity on professional licensing boards, which are often comprised of members of the profession and therefore apt to be motivated by self-interest rather than the public interest. In Part II, we examine the political economy of special interest legislation, which suggests that little public good results from replacing competitive market forces with self-regulation. In Part III, we employ a basic economic model to generate predictions of the economic effects of professional licensing. Part IV provides a survey of the empirical research in this area, which confirms …

The Paradox Of The Obamacare Decision: How Can The Federal Government Have Limited Unlimited Power?, Robert J. Pushaw Jr.

Florida Law Review

National Federation of Independent Business v. Sebelius, the Supreme Court’s decision upholding the landmark Patient Protection and Affordable Care Act (ACA or “Obamacare”), sets forth the most important judicial examination of constitutional power since the New Deal era. The political and media frenzy over the Obamacare case has obscured its actual legal analysis and larger constitutional implications, which warrant more reflective study. This Article seeks to provide such a scholarly perspective.

My starting point is the ACA, which has three key provisions. First, it requires “guaranteed issue” of health insurance to all applicants and “community rating” to prevent insurance …

Diagnosis Dangerous: Why State Licensing Boards Should Step In To Prevent Mental Health Practitioners From Speculating Beyond The Scope Of Professional Standards, Jennifer S. Bard

UF Law Faculty Publications

This Article reviews the use of mental health experts to provide testimony on the future dangerousness of individuals who have already been convicted of a crime that qualifies them for the death penalty. Although this practice is common in many states that still retain the death penalty, it most frequently occurs in Texas because of a statute that makes it mandatory for juries to determine the future dangerousness of the defendant they have just found guilty. Both the American Psychiatric Association and the American Psychological Association have protested the use of mental health professionals in this setting because there are …

Responding To Requests For Assisted Reproductive Technology Intervention Involving Women Who Cannot Give Consent, Jennifer S. Bard, Lindsay Penrose

UF Law Faculty Publications

One of the plots of the Canadian science fiction thriller Orphan Black involves a scheme to create dozens of siblings by harvesting the eggs of one woman, fertilizing them with the sperm of a single man, and implanting them for gestation in dozens of apparently willing surrogates. The casualness of the procedure speaks to how comfortable we have all become with reproduction by technology. Yet there are still aspects of this process that remain outside the normative boundaries of most of our worldviews. This article considers recent advances in assisted reproductive technology (ART) that can result in a viable, fertilized …

No Small Feat: Who Won The Health Care Case (And Why Did So Many Law Professors Miss The Boat)?, Randy E. Barnett

Florida Law Review

In this Essay, prepared as the basis for the 2013 Dunwody Distinguished Lecture in Law at the University of Florida Levin College of Law, I describe five aspects of the United States Supreme Court’s decision in National Federation of Independent Business v. Sebelius that are sometimes overlooked or misunderstood: (1) the Court held that imposing economic mandates on the people was unconstitutional under the Commerce and Necessary and Proper Clauses; (2) Chief Justice John Roberts’s reasoning was the holding in the case, whether viewed from a formalist or a realist perspective; (3) the Court did not uphold the constitutionality of …

Corporations, Taxes, And Religion: The Hobby Lobby And Conestoga Contraceptive Cases, Steven J. Willis

UF Law Faculty Publications

Beginning in 2013, the federal government mandated that general business corporations include contraceptive and early abortion coverage in large employee health plans. Internal Revenue Code Section 4980D imposes a substantial excise tax on health plans violating the mandate. Indeed, for one company – Hobby Lobby – the expected annual tax is nearly one-half billion dollars. Dozens of “for profit” businesses have challenged the mandate on free exercise grounds, asserting claims under the First Amendment as well as under the Religious Freedom Restoration Act.

So far, courts have been reluctant to hold corporations have religious rights of their own; as a …

Playing God: The Legality Of Plans Denying Scarce Resources To People With Disabilities In Public Health Emergencies, Wendy F. Hensel, Leslie E. Wolf

Florida Law Review

Public health emergencies can arise in a number of different ways. They can follow a natural disaster, such as Hurricane Katrina, the 2004 tsunami, and the recent earthquakes in Haiti and Chile. They may be man-made, such as the September 11 attacks and the anthrax scare. They may also be infectious. While no pandemic flu has yet reached the severity of the 1918 flu, there have been several scares, including avian flu and most recently H1N1. Few questions are more ethically or legally loaded than determining who will receive scarce medical resources in the event of a widespread public health …

Reining In Abuses Of Executive Power Through Substantive Due Process, Rosalie Berger

Florida Law Review

Although substantive due process is one of the most confusing and controversial areas of constitutional law, it is well established that the Due Process Clause includes a substantive component that “bars certain arbitrary wrongful government actions ‘regardless of the fairness of the procedures used to implement them.’” The Court has recognized substantive due process limitations on law-enforcement personnel, publicschool officials, government employers, and those who render decisions that affect our property rights. Government officials who act with intent to harm or with deliberate indifference to our rights have been found to engage in conduct that “shocks the judicial conscience” contrary …

Just What The Doctor Ordered? How The Patient Safety And Quality Improvement Act May Cure Florida’S Patients’ Right To Know About Adverse Medical Incidents (Amendment 7), Kelly G. Dunberg

Florida Law Review

This Note addresses the impact of Florida’s Patients’ Right to Know About Adverse Medical Incidents (commonly known as Amendment 7) on the peer review process and the quality of healthcare in Florida. Enacted in 2004 as an amendment to the Florida Constitution, Amendment 7 provides citizens access to records and reports of past adverse medical incidents involving doctors, hospitals, and healthcare providers. Critics of Amendment 7 argue that peer review privilege protections are necessary to maintain high-quality healthcare in Florida, pointing to the need to encourage candid and vigorous evaluations by physicians of their colleagues. In contrast, Amendment 7 supporters …

Comparative Pragmatism, Rachel Rebouché

UF Law Faculty Publications

Although several commentators have previously suggested that the United States and Germany now share more commonalities than differences, this Article challenges the conventional wisdom by suggesting that the United States and Germany have moved in the opposite direction on a spectrum of available abortion services. In the United States, the constitutional right to an abortion is unrealizable for many women due to restrictive state and federal laws and the absence of providers in many areas. In Germany, by contrast, despite the country’s formal recognition of fetal rights, early abortion is widely available and often funded by the government. In short, …

The Path Between Sebastian's Hospitals: Fostering Reconciliation After A Tragedy, Jonathan R. Cohen

UF Law Faculty Publications

On October 8, 2007, Horst and Luisa Ferrero brought their healthy but short, three-year-old son Sebastian to a university hospital for a “routine” test to determine whether he lacked human growth hormone. Two days later, following a tragic string of errors, Sebastian was pronounced brain dead. Approximately two weeks later, the hospital offered a detailed public apology to the parents for Sebastian’s death. Several months after the apology, the parents began working collaboratively with the hospital to improve patient safety at the hospital and to advocate for a new children’s hospital in their community. This paper is a case study …

The Limits Of Reproductive Rights In Improving Women's Health, Rachel Rebouché

UF Law Faculty Publications

South Africa's Choice on Termination of Pregnancy Act (CTOPA) is heralded as one of the most progressive abortion laws in the world. The law permits unfettered access to government-funded abortion services for all women through the twelfth week of gestation, stating in its preamble that "every woman [has] the right to choose whether to have an early, safe and legal termination of pregnancy according to her individual beliefs." Despite increased availability of legal abortions' (and the inclusion of rights to reproductive health care and decision-making in South Africa's Constitution), the number of illegal terminations in South Africa does not appear …

On Disposable People And Human Well-Being: Health, Money And Power, Berta E. Hernández-Truyol

UF Law Faculty Publications

The foundational premise of this essay is that health and well-being are human rights issues. My focus on this theme, specifically within the human rights paradigm, is new, passionate, and personal. On December 15, 2005, just three months before the conference that prompted the writing of this essay, I lost my partner of over 20 years. She fought a valiant, strong, and dignified fight against cancer--a journey I traveled with her. During that time I learned much about health systems and health care. Most saliently, notwithstanding the reality of the extraordinarily good care she ultimately received, I realized there is …

The Insurance Aspects Of Damages, Robert H. Jerry Ii, Douglas R. Richmond

UF Law Faculty Publications

"[I]t is difficult ... to imagine an event or transaction that does not involve insurance in some way." So it is with the most salient event in the lives of Tony and Donna Sabia, whose son Tony John Sabia, or "Little Tony," was born with profound disabilities. In the final analysis, the ability of Tony and Donna to pay for the future medical care and living expenses needed by their son depends on whether they can reach the liability insurance coverage possessed by the health care providers who attended Donna and Little Tony at the time of his birth. It …

International Intellectual Property, Access To Health Care, And Human Rights: South Africa V. United States, Winston P. Nagan

UF Law Faculty Publications

This Article examines the question of access to patented medicines in international law. It analyzes the extent to which international agreements may lawfully limit affordable versions of these medicines that may be available through parallel imports or compulsory licensing procedures. It considers the concept of intellectual property rights from a national and international perspective to determine how these rights must be sensitive to matters of national sovereignty when extraordinary, life-threatening diseases afflict societies in catastrophic ways. This Article suggests that viewing property (including intellectual property) as a human right requires that its scope be delimited and understood in the context …

The Undue Burden: Parental Notification Requirements For Publicly Funded Contraception, Stephanie Bornstein

UF Law Faculty Publications

This article analyzes the legal impact of legislative proposals in 1998 and 1999 to require parental notification for minors seeking publicly funded contraception. Part I explores the history of Title X and some of its amendments, the HHS interpretive “squeal rule,” and the federal courts' rejection of the HHS rule based on the congressional intent behind Title X. Part II focuses on the Parental Notification Act of 1998 and its likelihood for success against a constitutional challenge, based on an analysis of precedent on parental consent requirements for contraception and abortion. Part III discusses the change in the legislative and …

Twerski & Cohen's Second Revolution: A Systems/Strategic Perspective, Lynn M. Lopucki

UF Law Faculty Publications

In an article published in 1992, Professors Twerski and Cohen suggested that basic principles of the law of informed consent require medical providers to tell their patients about competing providers could perform the same procedures better or more safely. In its 1996 decision in Johnson v. Kokemoor, the Supreme Court of Wisconsin cited Twerski and Cohen's article in holding a neurosurgeon liable for not telling a patient of such a competitor. As a result, Twerski and Cohen now argue, the law of informed consent now stands on the brink of a second revolution. This comment sets forth a systems/strategic analysis …

An Overview Of Health Law Research And An Annotated Bibliography, Richard A. Danner, Claire M. Germain

UF Law Faculty Publications

This analysis and the following bibliography are designed to meet the needs of researchers attempting to locate information in the field of health law. The analysis is written from the perspective of law librarians, but the same information retrieval problems apply to health administrators, hospital and medical counsel, and academic lawyers interested in health law and administration.