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Social and Behavioral Sciences Commons™
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- Cost of medical care (4)
- Cost effectiveness (3)
- Health care reform (3)
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- Welfare economics (2)
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- AIDS (Disease)—Prevention. Southern States (1)
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Articles 1 - 24 of 24
Full-Text Articles in Social and Behavioral Sciences
Social Welfare Functions And Health Policy: A New Approach, Matthew D. Adler
Social Welfare Functions And Health Policy: A New Approach, Matthew D. Adler
Faculty Scholarship
The social welfare function (SWF) framework converts the possible outcomes of governmental policy choice into vectors (lists) of interpersonally comparable well-being numbers, measuring the lifetime well-being of each individual in the population of interest. The SWF proper is a rule for ranking these vectors. The utilitarian SWF adds up well-being numbers. A prioritarian SWF adds up well-being numbers plugged into a strictly increasing and strictly concave transformation function. Governmental policies are conceptualized as probability distributions over well-being vectors. A recent literature applies the SWF framework to health policy. This article first provides a brief overview of the SWF framework and …
The Shadows Of Life: Medicaid's Failure Of Health Care's Moral Test, Barak D. Richman, Kushal T. Kadakia, Shivani A. Shah
The Shadows Of Life: Medicaid's Failure Of Health Care's Moral Test, Barak D. Richman, Kushal T. Kadakia, Shivani A. Shah
Faculty Scholarship
North Carolina Medicaid covers one-fifth of the state’s population and makes up approximately one-third of the budget. Yet the state has experienced increasing costs and worsening health outcomes over the past decade, while socioeconomic disparities persist among communities. In this article, the authors explore the factors that influence these trends and provide a series of policy lessons to inform the state’s current reform efforts following the recent approval of North Carolina’s Section 1115 waiver by the Centers for Medicare and Medicaid Services. The authors used health, social, and financial data from the state Department of Health and Human Services, the …
Changing The Tax Code To Create Consumer-Driven Health Insurance Competition, Regina Herzlinger, Barak D. Richman
Changing The Tax Code To Create Consumer-Driven Health Insurance Competition, Regina Herzlinger, Barak D. Richman
Faculty Scholarship
Because current tax laws exclude employer-paid health insurance premiums from employees’ taxable wages and income, employer-sponsored insurance remains the primary source of health insurance for most employed Americans. Economists have long blamed the employer-based insurance tax exclusion for inflating health care costs, and, more recently, for constraining income growth and exacerbating income inequality.
We execute a simulation to test the effect of permitting employees to receive their employers’ premium contribution directly and then purchase health insurance themselves, using tax-free funds. Employees could deduct for income tax purposes the amount used for insurance and, if they spend less than the amount …
A Better Calculus For Regulators: From Cost-Benefit Analysis To The Social Welfare Function, Matthew D. Adler
A Better Calculus For Regulators: From Cost-Benefit Analysis To The Social Welfare Function, Matthew D. Adler
Faculty Scholarship
The “social welfare function” (SWF) is a powerful tool that originates in theoretical welfare economics and has wide application in economic scholarship, for example in optimal tax theory and environmental economics. This Article provides a comprehensive introduction to the SWF framework. It then shows how the SWF framework can be used as the basis for regulatory policy analysis, and why it improves upon cost-benefit analysis (CBA).
Two types of SWFs are especially plausible: the utilitarian SWF, which sums individual well-being numbers, and the prioritarian SWF, which gives extra weight to the well-being of the worse off. Either one of these …
N.C. Medicaid Reform: A Bipartisan Path Forward, Barak D. Richman, Allison Rice
N.C. Medicaid Reform: A Bipartisan Path Forward, Barak D. Richman, Allison Rice
Faculty Scholarship
The North Carolina Medicaid program currently constitutes 32% of the state budget and provides insurance coverage to 18% of the state’s population. At the same time, 13% of North Carolinians remain uninsured, and even among the insured, significant health disparities persist across income, geography, education, and race.
The Duke University Bass Connections Medicaid Reform project gathered to consider how North Carolina could use its limited Medicaid dollars more effectively to reduce the incidence of poor health, improve access to healthcare, and reduce budgetary pressures on the state’s taxpayers.
This report is submitted to North Carolina’s policymakers and citizens. It assesses …
Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster
Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster
Faculty Scholarship
No abstract provided.
Right-Skilling: Rabbis And The Rabbinic Role For A New Century, Barak D. Richman, Daniel Libenson
Right-Skilling: Rabbis And The Rabbinic Role For A New Century, Barak D. Richman, Daniel Libenson
Faculty Scholarship
This chapter applies Clayton Christensen's model of organizational innovation to Jewish contexts. It observes a parallel between the many challenges that currently confront U.S. healthcare and American Jewry: a mismatch in the skills acquired by professionals and the needs expressed by the broader public; expensive institutions with high fixed costs that are struggling to provide value and maintain sustainable revenues; a failure to respect individual autonomy and cultural mores; and a disenfranchised public that suffers from high costs and unmet demand for meaningful services. It then applies Christensen's adapted model for the healthcare sector to American Jewish institutions, suggesting reforms …
Better Ways To Study Regulatory Elephants, Jonathan B. Wiener, Brendon Swedlow, James K. Hammitt, Michael D. Rogers, Peter H. Sand
Better Ways To Study Regulatory Elephants, Jonathan B. Wiener, Brendon Swedlow, James K. Hammitt, Michael D. Rogers, Peter H. Sand
Faculty Scholarship
No abstract provided.
Valuing Health Care: Improving Productivity And Quality, Barak D. Richman, Arti K. Rai
Valuing Health Care: Improving Productivity And Quality, Barak D. Richman, Arti K. Rai
Faculty Scholarship
No abstract provided.
Fragmentation In Mental Health Benefits And Services: A Preliminary Examination Into Consumption And Outcomes, Barak D. Richman, Daniel Grossman, Frank Sloan
Fragmentation In Mental Health Benefits And Services: A Preliminary Examination Into Consumption And Outcomes, Barak D. Richman, Daniel Grossman, Frank Sloan
Faculty Scholarship
In this chapter, we examine consumption patterns and health outcomes within a health insurance system in which mental health benefits are administered under a carved-out insurance plan. Using a comprehensive dataset of health claims, including insurance claims for both mental and physical health services, we examine both heterogeneity of consumption and variation in outcomes. Consumption variation addresses the regularly overlooked question of how equal insurance and access does not translate into equitable consumption. Outcomes variation yields insights into the potential harms of disparate consumption and of uncoordinated care. We find that even when insurance and access are held constant, consumption …
Theorizing And Generalizing About Risk Assessment And Regulation Through Comparative Nested Analysis Of Representative Cases, Jonathan B. Wiener, Brendon Swedlow, Denise Kall, Zheng Zhou, James K. Hammitt
Theorizing And Generalizing About Risk Assessment And Regulation Through Comparative Nested Analysis Of Representative Cases, Jonathan B. Wiener, Brendon Swedlow, Denise Kall, Zheng Zhou, James K. Hammitt
Faculty Scholarship
This article provides a framework and offers strategies for theorizing and generalizing about risk assessment and regulation developed in the context of an on-going comparative study of regulatory behavior. Construction of a universe of nearly 3,000 risks and study of a random sample of 100 of these risks allowed us to estimate relative U.S. and European regulatory precaution over a thirty-five-year period. Comparative nested analysis of cases selected from this universe of ecological, health, safety, and other risks or its eighteen categories or ninety-two subcategories of risk sources or causes will allow theory-testing and -building and many further descriptive and …
Lessons From India In Organizational Innovation: A Tale Of Two Heart Hospitals, Barak D. Richman, Krishna Udayakumar, Will Mitchell, Kevin A. Schulman
Lessons From India In Organizational Innovation: A Tale Of Two Heart Hospitals, Barak D. Richman, Krishna Udayakumar, Will Mitchell, Kevin A. Schulman
Faculty Scholarship
Recent discussions in health reform circles have pinned great hopes on the prospect of innovation as the solution to the high-cost, inadequate-quality U.S. health system. But U.S. health care institutions--insurers, providers and specialists--have ceded leadership in innovation to Indian hospitals such as Care Hospital in Hyderabad and the Fortis Hospitals around New Delhi, which have U.S.-trained doctors and can perform open heart surgery for $6000 (compared to $100,000 in the United States). The Indian success is a window into America's stalemate with inflating costs and stagnant innovation.
Human Genetics Studies: The Case For Group Rights, Laura S. Underkuffler
Human Genetics Studies: The Case For Group Rights, Laura S. Underkuffler
Faculty Scholarship
With the importance of genetic information has come bitter battles over its control. In these battles, some principles have emerged that are beyond dispute. The ability of individuals to control the disposition and genetic testing of their own biological materials is (as a matter of theory, at least) beyond question. No one would argue today that an individual could be subject to genetic testing for studies against her will, or that biological samples obtained from individuals under specified conditions could be simply deemed "free" of such conditions by researchers. Although difficult problems remain in the interpretation of research agreements, the …
Contesting Anticompetitive Actions Taken In The Name Of The State: State Action Immunity And Health Care Markets, Clark C. Havighurst
Contesting Anticompetitive Actions Taken In The Name Of The State: State Action Immunity And Health Care Markets, Clark C. Havighurst
Faculty Scholarship
The so-called state action doctrine is a judicially created formula for resolving conflicts between federal antitrust policy and state policies that seem to authorize conduct that antitrust law would prohibit. Against the background of recent commentaries by the federal antitrust agencies, this article reviews the doctrine and discusses it's application in the health care sector, focusing on the ability of states to immunize anticompetitive actions by state licensing and regulatory boards, hospital medical staffs, and public hospitals, as well as anticompetitive mergers and agreements. Although states are free, as sovereign governments, to restrict competition, the state action doctrine requires that …
Against “Individual Risk”: A Sympathetic Critique Of Risk Assessment, Matthew D. Adler
Against “Individual Risk”: A Sympathetic Critique Of Risk Assessment, Matthew D. Adler
Faculty Scholarship
No abstract provided.
Politics, Power, And Public Health: A Comment On Public Health’S New World Order, Laurence R. Helfer
Politics, Power, And Public Health: A Comment On Public Health’S New World Order, Laurence R. Helfer
Faculty Scholarship
No abstract provided.
Health Care Fraud And Abuse: A Tale Of Behavior Induced By Payment Structure, Arti K. Rai
Health Care Fraud And Abuse: A Tale Of Behavior Induced By Payment Structure, Arti K. Rai
Faculty Scholarship
The campaign to curtail "fraud and abuse" in the Medicare and Medicaid programs represents an attempt by regulators to evade more fundamental and difficult questions regarding cost and quality control. In the Medicare arena, tackling these larger questions will require dismantling the program's fee-for-service structure and imposing on providers financial incentives to evaluate carefully health care costs and benefits. Commentary on, David A. Hyman, Health Care Fraud and Abuse: Market Change, Social Norms and the Trust "Reposed in Workmen," 30 Journal of Legal Studies 531 (2001)
Foreword: Public And Private Barriers To Competitive Reform Of Health Care Services Delivery, Clark C. Havighurst
Foreword: Public And Private Barriers To Competitive Reform Of Health Care Services Delivery, Clark C. Havighurst
Faculty Scholarship
No abstract provided.
Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 2, Clark C. Havighurst, Nancy M. P. King
Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 2, Clark C. Havighurst, Nancy M. P. King
Faculty Scholarship
Having argued in Part One against extensive judicial or regulatory interference with private personnel credentialing in the health care field, this Article now shifts its focus to emphasize the anticompetitive hazards inherent in credentialing as practiced by professional interests. Competitor-sponsored credentialing is shown to be a vital part of a larger cartel strategy to curb competition by standardizing personnel and services and controlling the flow of information to health care consumers. Instead of altering the conclusions reached in Part One, however, Part Two sets forth a new and hitherto unexplored agenda for antitrust enforcement, one that the authors believe will …
Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 1, Clark C. Havighurst, Nancy M. P. King
Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 1, Clark C. Havighurst, Nancy M. P. King
Faculty Scholarship
This Article explores the antitrust and other implications of private credentialing and accrediting programs in the health care industry. Although such programs are usually sponsored by powerful competitor groups, they serve the procompetitive purpose of providing useful information and authoritative advice to independent decision makers. Part One examines the risk that credentialing will sometimes be unfair to competitors and deceive consumers. Its survey of common-law, antitrust, and regulatory interventions to correct such unfairness and deception seeks to determine the degree of oversight to which credentialing and similar activities have been and should be subjected. In recommending that judicial or regulatory …
Foreword: Symposium On Hospital Law, Clark C. Havighurst
Foreword: Symposium On Hospital Law, Clark C. Havighurst
Faculty Scholarship
No abstract provided.
Health Planning And Antitrust Law: The Implied Amendment Doctrine Of The Rex Hospital Case, Clark C. Havighurst
Health Planning And Antitrust Law: The Implied Amendment Doctrine Of The Rex Hospital Case, Clark C. Havighurst
Faculty Scholarship
No abstract provided.
More On Regulation: A Reply To Stephen Weiner, Clark C. Havighurst
More On Regulation: A Reply To Stephen Weiner, Clark C. Havighurst
Faculty Scholarship
In Volume 3, Number 3 of this journal, Professor Havighurst* wrote a brief Comment in which he observed that the function of health care cost-containment regulation is the rationing of health care resources, and argued that the fostering of health care consumers' and providers' free choice in the competitive marketplace is preferable to conventional cost-containment regulation as a mechanism for such rationing. He briefly outlined various reforms, including changes in federal tax treatment of health insurance premiums, aimed at implementing his ap- proach. Subsequently, in a Comment in Volume 4, Number 1, Stephen M.Weiner, then Chairman of the Massachusetts Rate …
Health Care Cost-Containment Regulation: Prospects And An Alternative, Clark C. Havighurst
Health Care Cost-Containment Regulation: Prospects And An Alternative, Clark C. Havighurst
Faculty Scholarship
Regulation of the health care system to achieve appropriate containment of overall costs is characterized by Professor Havighurst as requiring public officials to engage, directly or indirectly, in the rationing of medical services. This rationing function is seen by the author as peculiarly difficult for political institutions to perform, given the public's expectations and the symbolic importance of health care. An effort on the part of regulators to shift the rationing burden to providers is detected, as is a trend toward increasingly arbitrary regulation, designed to minimize regulators' confrontations with sensitive issues. Irrationality and ignorance are found to plague regulatory …