Law Commons^™

Qalys And Policy Evaluation: A New Perspective, Matthew D. Adler

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“QALYs” (Quality-Adjusted Life Years) are a metric for health and longevity very widely employed by health researchers. Surveys are used to assign health states a quality ranking on zero-one scale, with zero representing a health state no better than death and one perfect health. The total QALY value of a health profile is calculated as the time spent in its component health states, each weighted by its quality. Until a few years ago, despite the huge academic literature on QALY measurement, this approach was seldom used by policymakers in the U.S. But there have been recent signs of governmental interest …

The Residency Match: Competitive Restraints In An Imperfect World, Kristin Madison

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Several years ago physicians filed a lawsuit alleging that “the match,” the more than fifty-year-old system by which medical students and other applicants are assigned to medical residency programs, violates Section 1 of the Sherman Act. Last year, without hearings or substantive debate on the issue, Congress found that the match was “highly efficient” and “pro-competitive” and granted a retroactive antitrust exemption for its operation. These seemingly incompatible views invite further analysis of the merits of the residency match from the perspective of public policy. This article considers the arguments of match advocates and critics, evaluating both theoretical models and …

Equity Measures And Systems Reform As Tools For Reducing Racial And Ethnic Disparities In Health Care, Sidney D. Watson

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Many health care quality regulators, including officials of the Centers for Medicare and Medicaid Services and other agencies, have embraced systems reform—largely through mandates that require health care providers to implement Quality Assessment and Performance Improvement (QAPI) initiatives. Currently, however, no QAPI requirements stipulate that individual plans or providers measure racial and ethnic disparities. Performance measurements that do not track data by race and ethnicity, the author says, not only miss inequities but are likely to overlook promising techniques for reaching patients of particular racial and ethnic backgrounds. Incorporating equity measures into existing QAPI requirements, the report finds, would not …

The Game Of Pleasant Diversion: Can We Level The Playing Field For The Disabled Athlete And Maintain The National Pastime, In The Aftermath Of Pga Tour, Inc. V. Martin: An Empirical Study Of The Disabled Athlete, Donald H. Stone

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Kenny Walker, a deaf football player; Jim Abbott, a one-handed professional baseball player; Tom Dempsey, a physically disabled professional football kicker; Brad Doty, a paralyzed auto racer; and Nick Ackerman, a wrestler with amputated legs, have all competed at the highest level of sports. Persons with mental illness, individuals who are blind, and students with hearing impairments are seeking an opportunity to compete in fair competition with their non-disabled competitors. Can this occur in a fair, open, and just manner between competing athletes?

Does the Americans with Disabilities Act of 1990 ("ADA"), the landmark civil rights act protecting an individual …

What Do Exit Polls And Flu Vaccine Shortages Have In Common?, Albert A. Foer, Robert H. Lande, F.M. Scherer

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What do exit polls and flu vaccine shortages have in common? Both involve situations where society has come to rely excessively on too few entities. When even one company makes a mistake society can suffer significantly. This short piece advocates that we abandon our almost laissez faire tolerence towards high concentration, and rely upon competition, rather than on monopoly or a small number of producers.

Studying Medical Error In Situ: Implications For Malpractice Law And Policy, Lori B. Andrews

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No abstract provided.

The Politics Of Infertility: Recognizing Coverage Exclusions As Discrimination, Elizabeth Pendo

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Infertility affects approximately ten percent of the reproductive-age population in the United States, and strikes people of every race, ethnicity and socio-economic level. It is recognized by the medical community as a disease, one with devastating physical, psychological, and financial effects.

In 1998, the Supreme Court held in Bragdon v. Abbott that reproduction is a major life activity within the meaning of the ADA. Many lawyers, activists and scholars thought that coverage for infertility treatment would follow soon after. In fact, in 2003 in the first major case applying Bragdon to health benefits, Saks v. Franklin Covey, the Second Circuit …

Ending The Exploitation Of The Vulnerable: The Promise Of The Intersection Of American Bioethics, Human Rights, And Health Law, Ruqaiijah Yearby

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Traditionally, American bioethics has served as a safety net for the rich and powerful, for they are not forced to act as research subjects to obtain access to general health care for themselves or their children. However, American bioethics has failed to protect the vulnerable, i.e. indigent minorities. The vulnerable are not treated the same as the rich. They do not have access to health care. They are exploited in clinical trials that promise monetary gain or access to health care and their autonomy rights are often ignored. Some of the vulnerable most affected by these disparities are African-Americans. African-Americans …

The Social, Professional, And Legal Framework For The Problem Of Pain Management In Emergency Medicine, Sandra H. Johnson

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Although supported by both ethical and pragmatic imperatives, pain treatment faces significant barriers, particularly in the setting of emergency medicine. This article argues that pain management is integral to good patient care and specifically, good emergency care. In order to achieve effective emergency pain management, it is crucial to understand the "root causes" of pain neglect in emergency medicine - i.e. to understand why emergency physicians behave as they do in pain treatment.

This article begins by addressing the neglect of pain in emergency medicine and the dearth of empirical research regarding the causes of this neglect. After considering barriers …

Is It Too Late For Title Vi Enforcement?: Seeking Redemption Of The Unequal Long Term Care System In The United States Through International Means, Ruqaiijah Yearby

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Legal and medical experts have noted continued racism in the health care system that prevents the equal distribution of quality care. Initially most racism was intentional and expressed through de jure segregation, as evidenced by federal funding of the construction of racial segregated health care facilities. Now most racism, expressed through de facto segregation, is subtly incorporated into the daily practices of institutions causing an adverse disparate impact on African-Americans. This institutional racism establishes separate and independent barriers through the neutral denial of opportunities and equal rights to individuals and groups that results from the normal operations of the institutions …

Is It Too Late For Title Vi Enforcement? - Seeking Redemption Of The Unequal United States' Long Term Care System Through International Means, Ruqaiijah A. Yearby

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Permeating every facet of life including health care, racial segregation has been a part of the history of the United States since its creation. In fact, the history of African-Americans has been one of tragedy, laced with the hope of equality. This tragedy is a result of three hundred years of slavery, one hundred years of the limited freedom of segregation, three years of the promise of equality granted from the civil rights struggle, and thirty-seven years of resegregation through white flight and institutional racism. Hence, African-Americans have been fighting for the right to freedom, equality, and human dignity for …

Make Room For Dying: End Of Life Care In Nursing Homes, Sandra H. Johnson

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The cornerstone of contemporary nursing home care is a commitment to patient rehabilitation. Improved care is an important and worthwhile goal, but it is a goal that has yet to make room for the dying. A significant proportion of older people will spend their final days in a nursing home. This article calls for a culture shift in nursing home care to promote improved care for not only those who can be rehabilitated but also those who are dying.

This article begins by addressing challenges to achieving this culture that are particular to the nursing home context. It then explains …

Telling Stories About Health Insurance: Using New Films In The Classroom, Elizabeth Pendo

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In keeping with the Symposium theme, "The Mass Media's Influence on Health Law and Policy," this essay is designed to share my experience using clips from three recent popular films as a method of enhancing coverage and discussion of legal and policy issues surrounding the private health insurance system, and to provide some practical advice for others interested in doing the same. Specific topics include the erosion of employer-sponsored health insurance, continuation of private coverage under COBRA and HIPAA, public health care programs, physician incentives, the uninsured and access to care and legal remedies for claim denial. This essay builds …

Privatization And Punishment In The New Era Of Reprogenetics, Dorothy E. Roberts

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No abstract provided.

Medical Malpractice And The Insurance Underwriting Cycle, Tom Baker

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No abstract provided.