Health Law and Policy Commons^™

Dances With Elephants: Administrative Resolution Of Medical Injury Claims By Medicare Beneficiaries, Eleanor D. Kinney, William M. Sage

Faculty Scholarship

In our judgment, Hoffmann and Rowthorn's research clearly demonstrates that the QIO-based complaint review process does not provide genuine relief to beneficiaries. People who complain typically want an explanation of their bad experience, compensation for harm they may have suffered, and assurance that future experiences will be better for themselves and for others. Medicare beneficiaries, however, receive minimal information about the resolution of their complaints and no substantive relief whatsoever.

As Hoffmann and Rowthorn point out, several reform proposals are now before Congress, including moving the beneficiary complaint function from QIOs to new "Medicare Provider Review Organizations." It is not …

Tercer Congreso Nacional De Organismos Públicos Autónomos, Bruno L. Costantini García

Bruno L. Costantini García

Tercer Congreso Nacional de Organismos Públicos Autónomos

"Autonomía, Reforma Legislativa y Gasto Público"

Against Financial Literacy Education, Lauren E. Willis

All Faculty Scholarship

The dominant model of regulation in the United States for consumer credit, insurance, and investment products is disclosure and unfettered choice. As these products have become increasingly complex, consumers’ inability to understand them has become increasingly apparent, and the consequences of this inability more dire. In response, policymakers have embraced financial literacy education as a necessary corollary to the disclosure model of regulation. This education is widely believed to turn consumers into “responsible” and “empowered” market players, motivated and competent to make financial decisions that increase their own welfare. The vision is of educated consumers handling their own credit, insurance, …

Public-Private Partnerships And Insurance Regulation, Alexander A. Boni-Saenz

All Faculty Scholarship

A public-private partnership (PPP) is an institutional arrangement that embodies a collaborative approach to policy and regulation; it is a joint venture between the government and one or more private sector entities. Joint financing partnerships link public financing and private insurance to pay for certain social goods. Where the financing for social goods is fragmented and overlapping, as it is for health and social care, joint financing PPPs may help organize existing financing streams. This piece argues that partnerships of this type also present an opportunity for consumer-protective regulation of the insurance industry if certain conditions are met. Private insurers …

The Virtues Of Medicare, Jill R. Horwitz

Reviews

Most of us look forward to a heaven where people don't get sick. But if they do, health care would be traded among fully informed patients and providers in perfectly competitive and frictionless markets. In that perfect world, sick citizens simply shop for doctors the way they shop for other consumer goods. The better doctors, like the most elegant hotel rooms and fanciest cars, would cost more than inferior doctors. Patients would consult their utility meters and, with appropriate attention to discounting over an infinite lifetime, choose accordingly. After each treatment, the patients would know the quality of their outcome …

Non-Profit Hospitals, Tax Exemptions And Access For The Uninsured, Mary Crossley

Articles

These comments approach the topic of tax exemption for non-profit hospitals from the perspective of the 46 plus million Americans who have no health insurance and the significant additional number who are underinsured. In essence, persons who are underinsured have some form of health coverage but they remain at serious risk for significant out-of-pocket expenditures when they become sick. From this perspective, the key question is what role, if any, do the non-profit health care sector and, more particularly, non-profit hospitals have to play in addressing the vexing problems posed by the large number of uninsured and underinsured. These problems …

Core Values In Conflict: The United States Approach To Economic Assistance To The Elderly, Lawrence A. Frolik

Articles

In devising programs to assist the elderly, the United States has, for the most part, rejected the social welfare model, which is premised on a belief that the government has an obligation to care for the elderly. Many Americans believe that beyond a minimum safety net, the government should not, and likely cannot, save everyone from every bad outcome. Individuals must accept personal responsibility and care for themselves. As a result of this conflict in values, the United States does not usually operate programs modeled on social insurance, but rather provides care to those identified as 'needy'. The degree of …

A Gift Worth Dying For?: Debating The Volitional Nature Of Suicide In The Law Of Personal Property, Adam J. Macleod

Faculty Articles

Suicide poses difficult and foundational problems for the law. Those who most highly value personal autonomy, those who believe in the inviolability of human life, and those who remain uncommitted on end-of-life issues, all must settle challenging questions about suicide before advancing upon the more complex terrain of physician-assisted suicide, euthanasia, and infanticide. And the way in which a society fashions legal responses to suicidal choices reveals much about the society's cultural commitments and legal assumptions.

The bodies of insurance law, tort, and health care law are also among those areas of the law in which lawmakers reserve special exceptions …

Book Review - Uninsured In America: Life And Death In The Land Of Opportunity, Elizabeth Pendo

Book Reviews

Health care reform tops our national policy agenda, ranking second only behind Iraq as the issue that the public wants the 2008 Presidential candidates to address. This is no surprise, as health care spending represents nearly one out of every six dollars spent in the national economy, costs continue to climb, and health insurance is increasingly hard to get, keep, and afford. The numbers are staggering, and numbing. Most of us have heard that 46.5 million people were without insurance for the entire year in 2006, and nearly 89.6 million people were without insurance for some period during 2006 or …

A Philosophy Of Privatization: Rationing Health Care Through The Medicare Modernization Act Of 2003, Eleanor Bhat Sorresso

Journal of Law and Health

The trend in coping with these rising Medicare costs has been to increase the role that private insurance plays in providing coverage for Medicare recipients. Much of this movement towards an increased "privatization" of Medicare has been born of the belief that the private sector of health care insurance coverage has been made more efficient by existing market forces and will provide a way to both continue providing health care to elderly Americans while containing Medicare costs through these increased efficiencies as exemplified through the managed care model. This premise will be further explored in this article. First, this article …

Patients As Consumers: Courts, Cotnracts, And The New Medical Marketplace, Mark A. Hall, Carl E. Schneider

Michigan Law Review

The persistent riddle of health-care policy is how to control the costs while improving the quality of care. The riddle's oncepromising answer-managed care-has been politically ravaged, and consumerist solutions are now winning favor This Article examines the legal condition of the patient-as-consumer in today's health-care market. It finds that insurers bargain with some success for rates for the people they insure. The uninsured, however, must contract to pay whatever a provider charges and then are regularly charged prices that are several times insurers'pricesa nd providers' actual costs. Perhaps because they do not understand the healthcare market, courts generally enforce these …

Risk Governance And Deliberative Democracy In Health Care, Nan D. Hunter

Georgetown Law Faculty Publications and Other Works

I argue in this article that the concept of risk-centered governance is the best theoretical paradigm for understanding health law and the health care system. Over the past 20 years, an insurance-inflected discourse has migrated from the purely financial side of the health system into the heart of traditional medicine - the doctor-patient relationship. Rather than focus on doctrinal strands, I argue that scholars should analyze the law of health care as a set of governance practices organized around managing and allocating financial, as well as clinical, risk.

Over the same period, the body of law that structures most private …

Baby Ka-Boom! Coming Developments In Erisa Litigation Due To Social, Demographic, And Financial Pressures From The Baby Boom Generation, 41 J. Marshall L. Rev. 1037 (2008), Craig C. Martin, Matthew J. Renaud, Douglas A. Sondgeroth

UIC Law Review

No abstract provided.

Case Note: Golden Gate Restaurant Association V. City And County Of San Francisco: Setting The Stage For Supreme Court Review Of The Most Important Preemption Matter In The History Of Erisa, 41 J. Marshall L. Rev. 995 (2008), Joshua Waldbeser

UIC Law Review

No abstract provided.

The Vesting, Modification, And Financing Of Public Retiree Health Benefits In Light Of New Accounting Rules, 41 J. Marshall L. Rev. 1147 (2008), John Sanchez

UIC Law Review

No abstract provided.

The New Retiree Health Vebas, Kathryn L. Moore

Law Faculty Scholarly Articles

Granted tax exempt status since 1928, Voluntary Employees' Beneficiary Associations (VEBAs) have received considerable attention since the fall of 2007 when General Motors, Ford, and Chrysler reached separate landmark agreements with the United Auto Workers union pursuant to which the companies agreed to contribute billions of dollars to VEBAs in exchange for transferring their retiree health care liabilities to the VEBAs. Specifically, General Motors agreed to contribute $31.9 billion while Ford agreed to contribute $13.6 billion, and Chrysler agreed to contribute $11 billion. Sometimes referred to as "defeasance" VEBAs, these "new," "stand-alone" retiree health VEBAs, differ significantly from traditional VEBAs …

(Debate) Medicare: Did The Devil Make Us Do It?, D. A. Hyman, Jill R. Horwitz

Articles

In this lively and creative debate, Professors David Hyman and Jill Horwitz argue about the virtues and vices of the federal Medicare program. As some predict a bleak future for the American’s government’s ability (or inability) to continue paying for Medicare as the population ages, this debate shows that there is genuine disagreement about the severity of the problem. In his Opening Statement, Professor Hyman offers a satirical letter to the Devil from one of his demonic servants, describes the Medicare program through the lens of the seven deadly sins. Arguing that Medicare’s faults are represented in each sin, the …