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Full-Text Articles in Law
One Child Town: The Health Care Exceptionalism Case Against Agglomeration Economies, Elizabeth Weeks
One Child Town: The Health Care Exceptionalism Case Against Agglomeration Economies, Elizabeth Weeks
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This Article offers an extended rebuttal to the suggestion to move residents away from dying communities to places with greater economic promise. Rural America, arguably, is one of those dying places. A host of strategies aim to shore up those communities and make them more economically viable. But one might ask, “Why bother?” In similar vein, David Schleicher’s provocative 2017 Yale Law Journal article, Stuck! The Law and Economics of Residential Stagnation urged dismantling a host of state and local government laws operating as barriers to migration by Americans from failing economies to robust agglomeration economies. But Schleicher said little …
Regulating Care Robots, Valarie K. Blake
Regulating Care Robots, Valarie K. Blake
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Care robots are already assisting the elderly in some nursing homes around the globe and could be in widespread use in hospitals and homes sooner than we think. These robots promise great hope for patients: to help them remain independent, to provide assistance with daily living, to comfort and distract during procedures, to educate, and to be companions during the vulnerable and lonely times in patient lives. Yet, care robots will have unprecedented access to personal lives, combined with designs aimed at winning patient trust and affection, and with recording and sensory capabilities beyond any human. They pose significant risk …
Medicalization Of Rural Poverty: Challenges For Access, Elizabeth Weeks
Medicalization Of Rural Poverty: Challenges For Access, Elizabeth Weeks
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This article was prepared for a live conference, on “The Medicalization of Poverty,” held at the University of Illinois College of Law, and a symposium to be published in the Journal of Law, Medicine & Ethics. My piece focuses on a constellation of challenges for health care delivery and access to care in rural areas. Discussions regarding health and poverty often seem to focus on the admittedly persistent and multilayered problems of the urban poor: unemployment, substandard and unaffordable housing, violent crime, nutrition and “food desserts,” recreation and safe outdoor spaces, and under-resourced public schools, to name a few. While …
The Hipaa Privacy Rule And The Eu Gdpr: Illustrative Comparisons, Stacey A. Tovino
The Hipaa Privacy Rule And The Eu Gdpr: Illustrative Comparisons, Stacey A. Tovino
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In this Article, Professor Tovino compares and contrasts three illustrative concepts and rights in the Privacy Rule and/or the GDPR, including the concepts of authorization and consent, the rights of amendment and rectification, and the right to erasure. Identified similarities reflect the core values of HHS and the EU with respect to maintaining the confidentiality and privacy of personal data and protected health information, respectively. Identified differences reflect the Privacy Rule's original, narrow focus on health industry participants and individually identifiable health information compared to the GDPR's broad focus on data controllers and personal data. Other differences reflect, perhaps, the …
Remedying Stigma-Driven Health Disparities In Sexual Minorities, Valarie K. Blake
Remedying Stigma-Driven Health Disparities In Sexual Minorities, Valarie K. Blake
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This paper explores the health harms of stigma in both patient-provider relationships and health insurer arrangements, before turning to legal solutions to combat healthcare discrimination on the basis of sex. It argues that Section 1557 of the Affordable Care Act is aptly designed to remedy stigma against sexual minorities in healthcare and has already done significant work to that end. This article also discusses the implications of repeal of either the ACA or Section 1557.
What Is (And Isn't) Healthism, Jessica L. Roberts, Elizabeth Weeks Leonard
What Is (And Isn't) Healthism, Jessica L. Roberts, Elizabeth Weeks Leonard
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What does it mean to discriminate on the basis of health status? Health is, of course, relevant in a number of ways. It can speak to the length of our lives, our ability to perform mentally and physically, our need for health care, and our risk of injury and incapacity. But the mere relevance of a particular attribute does mean that considering it should be legally permissible. Moreover, the potential harms that may result from health-status discrimination raise important moral questions. This Essay explores when differentiating on the basis of health is socially acceptable and, by contrast, when it is …
Controlling Health Care Spending: More Patient "Skin In The Game?", David Orentlicher
Controlling Health Care Spending: More Patient "Skin In The Game?", David Orentlicher
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In this article, Professor Orentlicher explores the high cost of healthcare and the trend in health insurance to shift the cost of health care to patients in an attempt to influence their behavior and health decisions. He examines such strategies as reference pricing, scaled cost-sharing, and employee wellness programs.
Medicaid At 50: No Longer Limited To The "Deserving" Poor?, David Orentlicher
Medicaid At 50: No Longer Limited To The "Deserving" Poor?, David Orentlicher
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Professor David Orentlicher considers the significance of the passage of the Affordable Care Act on the Medicaid program. He discusses the expansion of the program's recipients from merely children, pregnant women, single caretakers of children, and disabled persons to all persons up to 138% of the federal poverty level. Professor Orentlicher argues that the Medicaid expansion reflects concerns about the high costs of health care rather than an evolution in societal thinking about the "deserving" poor. As a result, the expansion may not provide a stable source of health care coverage for the expansion population.
The Commerce Power And Congressional Mandates, Dan T. Coenen
The Commerce Power And Congressional Mandates, Dan T. Coenen
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In National Federation of Independent Business v. Sebelius, a five-Justice majority concluded that the commerce power did not support enactment of the so-called “individual mandate,” which imposes a penalty on many persons who fail to buy health insurance. That ruling is sure to spark challenges to other federal laws on the theory that they likewise mandate individuals or entities to take certain actions. Federal laws founded on the commerce power, for example, require mine operators to provide workers with safety helmets and (at least as a practical matter) require mine workers to wear them. Some analysts will say that laws …
Silence Is Golden . . . Except In Health Care Philanthropy, Stacey A. Tovino
Silence Is Golden . . . Except In Health Care Philanthropy, Stacey A. Tovino
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No abstract provided.
I Need A Doctor: A Critique Of Medicare Financing Of Graduate Medical Education, Stacey A. Tovino
I Need A Doctor: A Critique Of Medicare Financing Of Graduate Medical Education, Stacey A. Tovino
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In its broadest sense, this Article examines the complex relationship between population booms, doctor shortages, and United States government financing of graduate medical education (GME). More specifically, this Article argues that current rules governing the calculation of Medicare payments to teaching hospitals for the costs of GME are based on cost, population, and other data that are no longer relevant. As applied, these formulas discriminate in favor of the nation's oldest teaching hospitals, located in New England and the Middle Atlantic, and against current and future teaching hospitals located in growing population centers, especially regions in the South and West. …
Giving Thanks: The Ethics Of Grateful Patient Fundraising, Stacey A. Tovino
Giving Thanks: The Ethics Of Grateful Patient Fundraising, Stacey A. Tovino
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Grateful patient fundraising, defined as the solicitation of philanthropic donations by health care providers from current and former patients, raises a number of legal and ethical issues. Elsewhere, I detailed the confidentiality issues raised by the use and disclosure of patient identifiable information by hospital development officers, major gifts officers, institutionally-related foundations, and commercial fundraisers, and proposed corrections to federal health information confidentiality regulations to better balance the competing aims of health care philanthropy and health information confidentiality. In this Article, I analyze several outstanding issues raised by physician involvement in grateful patient fundraising. That is, physicians who solicit philanthropic …
Employers United: An Empirical Analysis Of Corporate Political Speech In The Wake Of The Affordable Care Act, Elizabeth Weeks Leonard, Susan Scholz, Raquel Meyer Alexander
Employers United: An Empirical Analysis Of Corporate Political Speech In The Wake Of The Affordable Care Act, Elizabeth Weeks Leonard, Susan Scholz, Raquel Meyer Alexander
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Is the Patient Protection and Affordable Care Act (ACA) bad for business? Did the countries' most prominent companies game the Securities and Exchange Commission (SEC) disclosure process to make negative political statements about ObamaCare? Immediately following the ACA's enactment on March 23, 2010, a number of companies drew scrutiny for issuing SEC filings writing off millions – and in AT&T's case, one billion dollars – against expected earnings for 2010 alone, based on a single, discrete tax-law change in the ACA. Congressional and Administration officials accused the firms of being "irresponsible" and using "big numbers to exaggerate the health reform's …
Conflicts Of Interest In Medicine, Research, And Law: A Comparison, Stacey A. Tovino
Conflicts Of Interest In Medicine, Research, And Law: A Comparison, Stacey A. Tovino
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Several of the remarks and articles presented in this symposium have addressed conflicts of interest arising during the provision of legal counsel to individuals who are elderly, including specific conflicts of interest implicated by estate planning, retirement planning, and long-term care planning. Topics examined thus far include conflicts of interest with respect to the application of rules of confidentiality within state rules of professional conduct to elderly clients with impaired decision-making capacity; conflicts of interest involving representative payees for Social Security benefits; conflicts of interest in distributions when parents enter into marriages that are unprotected by law; and conflicts of …
The Individual Mandate's Due Process Legality: A Kantian Explanation, And Why It Matters, Peter Brandon Bayer
The Individual Mandate's Due Process Legality: A Kantian Explanation, And Why It Matters, Peter Brandon Bayer
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In National Federation of Independent Business v. Sebelius, one of the most controversial decisions of this young century, an intensely divided Supreme Court upheld the Patient Protection and Affordable Care Act's most provocative feature-the Individual Mandate-under Congress's taxing power. In so doing, the Court rejected what appeared to be the Individual Mandate's more applicable constitutional premise-Congress's authority to regulate interstate commerce. Yet, neither the Constitution's Taxing Clause nor its Commerce Clause provide the ultimate answer as to whether Congress may regulate the multi-billion dollar healthcare market by compelling unwilling persons to buy private health insurance. The final determination of the …
Affordable Care Act Litigation: The Standing Paradox, Elizabeth Weeks Leonard
Affordable Care Act Litigation: The Standing Paradox, Elizabeth Weeks Leonard
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The Patient Protection and Affordable Care Act (ACA) litigation presents a standing paradox. In the current posture, it appears that states lack standing to challenge the federal law on behalf of individuals, while individuals possess standing to challenge the federal law on behalf of states. This Article contends that there is no principled reason for this asymmetry and argues that standing doctrine should apply as liberally to states as individuals, assuming states allege the constitutional minimum requirements for standing and especially where the legal challenge turns on allocation of power between the federal government and states. The Article proceeds by …
Insights From A National Conference: "Conflicts Of Interest In The Practice Of Medicine", David Orentlicher
Insights From A National Conference: "Conflicts Of Interest In The Practice Of Medicine", David Orentlicher
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No abstract provided.
Rhetorical Federalism: The Value Of State-Based Dissent To Federal Health Reform, Elizabeth Weeks Leonard
Rhetorical Federalism: The Value Of State-Based Dissent To Federal Health Reform, Elizabeth Weeks Leonard
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This Article makes the affirmative case for the widespread trend of state resistance to the recently enacted, comprehensive federal health reform law, the Patient Protection and Affordable Care Act of 2010, or ACA. A significant number of states have engaged in various forms of objection to the new federal laws, including filing lawsuits against the federal government, enacting laws providing that ACA will not apply to residents of the state, and refusing to cooperate with implementing the new laws. This Article identifies reasons why those actions should not be disregarded simply as Tea Party antics or election-year gamesmanship but instead …
State Constitutionalism And The Right To Health Care, Elizabeth Weeks Leonard
State Constitutionalism And The Right To Health Care, Elizabeth Weeks Leonard
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This Article examines state constitutions and health care rights. Notably, close to a third of states’ constitutions recognize health while the U.S. Constitution contains no reference. Ample scholarly commentary exists on the absence of a right to health care under the U.S. Constitution but little attention has been paid to state constitutional law. This Article begins by explaining the absence of a federal right and the rationale for looking to state constitutional protections for health. The Article then provides a comprehensive survey of state constitutional provisions and judicial decisions enforcing or interpreting them. The survey reveals certain common themes and …
Reconstructing The Individual Mandate As An Escrow Account, Gregg Polsky
Reconstructing The Individual Mandate As An Escrow Account, Gregg Polsky
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This short essay in Michigan Law Review First Impressions describes how the individual mandate could be reconstructed as an escrow account. Such a restructuring would ameliorate policy concerns regarding the mandate while still deterring the opportunistic behavior that would otherwise occur as a result of the nondiscrimination rules imposed on insurers.
Aspirations And Reality In The Law And Politics Of Health Care Reform: Examining A Symposium On (E)Qual(Ity) Care For The Poor, Ann C. Mcginley
Aspirations And Reality In The Law And Politics Of Health Care Reform: Examining A Symposium On (E)Qual(Ity) Care For The Poor, Ann C. Mcginley
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Although the poor had suffered from insufficient health care for years, it was only when the middle class felt the economic pinch that health care reform moved to the top of the national agenda. In this way, the poor, a group with little political power, could benefit from the enormous political power of the middle class. In the Fall of 1992, it appeared that it was time for the poor to consider building a coalition with the middle class to work for universal coverage and improved quality of care. Yet, many questions remained about whether a coalition would benefit the …