Law Commons^™

The Health Care Safety Net In A Time Of Fiscal Pressures, Richard Hegner

National Health Policy Forum

This background paper reviewed the role played by the health care safety net in serving the nation's uninsured, underinsured, and indigent populations as well as those Americans who experience problems in obtaining access to health care. Against the backdrop of the March 2000 Institute of Medicine report, America's Health Care Safety Net: Intact But Endangered, the paper examined the recurrent choice in U.S. health policy between underwriting public insurance and subsidizing direct provision of health care. It recounted a number of reasons for direct federal interest in the safety net — including the important role played by Medicaid, the major …

Mid-Atlantic Ethics Committee Newsletter, Spring 2001

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Trusting Doctors: Tricky Business When It Comes To Clinical Trials, Frances H. Miller

Faculty Scholarship

This article examines the troublesome ethical dilemmas arising out of physician conflicts of interest in the context of research on human beings. It focuses on the inevitable conflict between the objectives of clinical investigators and those of their human subjects to illuminate subtle divergences of interest in doctor-patient relationships that patients often do not recognize - or want to believe. Once perceived, however, these potentially corroding conflicts can stun research subjects and their families, and leave them feeling deeply betrayed by their clinicians. The article concludes that a researcher's substantial financial conflicts constitute material information which, absent compelling circumstances, the …

State Mental Hospital Continuity Of Care Study: Preliminary Report, Timothy Boaz, Keith Vossberg

Mental Health Law & Policy Faculty Publications

This study reports on the analysis of several existing administrative data sets to examine issues related to the continuity of care in the community for persons discharged from the Florida state mental health hospitals. The validity of conclusions based on such analysis is dependent on the adequacy of the existing data. While certain types of reporting errors can be identified and remediated (to a degree), other types of errors, particularly omission of reporting, often cannot be identified or remediated. Thus, the conclusions of this report need to be taken somewhat tentatively.

Welfare Reform And The Well-Being Of Families: Successes To Date And Challenges Ahead, Jane Koppelman

National Health Policy Forum

This issue brief discusses a key issue in evaluating the 1996 Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA): the status of families after the implementation of this landmark welfare reform program. The new block grant program to states to administer the Temporary Assistance to Needy Families(TANF) program has been extremely effective when measured by lower welfare rolls and higher work rates and earnings for recipients. However, an equally important dimension described by the paper is what is known about longer-term effects and the status of people who have left welfare, with special emphasis on how children have …

Welfare Reform And Substance Abuse: Innovative State Strategies, Ginger P. Parra

National Health Policy Forum

This issue brief highlights key facts about the impact of substance abuse on welfare reform and recipients of Temporary Assistance to Needy Families, or TANF. After outlining some of the data on the incidence of substance abuse as well as its costs and treatment, it concludes by describing innovative state welfare programs attempting to lower barriers to employment and self-sufficiency.

State Schip Design And The Right To Coverage, Sara J. Rosenbaum, Barbara Smith

Health Policy and Management Issue Briefs

No abstract provided.

The Role Of Law In Russian Health Reform: Report To The United States Agency For International Development, Wendy K. Mariner, Frank G. Feeley

Faculty Scholarship

True reform necessarily entails new law. In the newly independent Russian Federation, law has played a formative role in efforts to reform the health care system. Both historically and structurally, the health care system in Russia is more dependent on legal authorization than that in most Western industrialized countries. Reforms that providers might institute independently elsewhere are not likely to happen in Russia without specific laws authorizing them. Policy makers often formulate the substance of policy in the context of developing legislation, instead of drafting legislation to codify settled policy decisions. Thus, identifying and developing suitable laws has become an …

A Conceptual Framework For Genetic Policy, Lori B. Andrews

All Faculty Scholarship

No abstract provided.

Exploitation Of The Elite: A Case For Physician Unionization, Dionne L. Koller

All Faculty Scholarship

Our intuition tells us that physicians are elites, and therefore they cannot be exploited. Relying on this intuition, we adopt policies which attempt to provide a health care system that gives first-quality care, at the lowest prices, delivered through a “free-market” system. As the key gatekeepers to health care, physicians are thus caught in the middle. Top-notch American health care costs money and for-profit MCOs must watch their bottom line. Rationing, therefore, is key. The issue is, assuming we have decided that free-market health care is the solution, how much should physicians have to sacrifice in the name of the …

California & The Hiv/Aids Epidemic: The State Of The State Report 2001, Health & Human Services Agency

California Agencies

No abstract provided.

Voting And Nursing Home Residents: A Survey Of Practices And Policies, Joan L. O'Sullivan

Faculty Scholarship

No abstract provided.

Law & Health Care Newsletter, V. 8, No. 2, Spring 2001

Law & Health Care Newsletter

No abstract provided.

Law & Health Care Newsletter, V. 9, No. 1, Fall 2001

Law & Health Care Newsletter

No abstract provided.

Private Or Public Approaches To Insuring The Uninsured: Lessons From International Experience With Private Insurance, Timothy Stoltzfus Jost

Scholarly Articles

In the recent past a broad consensus has emerged in the United States that the best way to expand coverage of the uninsured is to use tax subsidies to encourage the purchase of private health insurance policies. Many advocates of this approach also call for replacing employment-related group policies with individual policies, and for minimizing regulation of private insurance. Those who advocate these policies, however, have rarely considered the experience that other nations have had with private health insurance.

In fact most other countries have private insurance markets, and in many countries private insurance plays a significant role in financing …

Overcoming Managed Care Regulatory Chaos Through A Restructured Federalism, John D. Blum

Faculty Publications & Other Works

No abstract provided.

Construing Intellectual Property Rights And Competition Policy Consistently With Facilitating Access To Affordable Aids Drugs To Low-End Consumers, James T. Gathii

Faculty Publications & Other Works

No abstract provided.

Longevity And The Future: Challenges Of Health Policy, John D. Blum

Faculty Publications & Other Works

No abstract provided.

The Potential For Discrimination In Health Insurance Based On Predictive Genetic Tests, Karen H. Rothenberg

Congressional Testimony

No abstract provided.

Book Review - Textbook Of Research Ethics: Theory And Practice, Elizabeth Pendo

Book Reviews

An intense and deeply divided debate is taking place over the testing of a short course of AZT to prevent maternal-fetal transmission of HIV in the developing world.' A long course of AZT-administered to HIV-infected pregnant women during their pregnancy and immediately before labor, and then to their newborn children for six weeks-is generally accepted in the United States as providing extensive protection against maternal-fetal transmission of HIV Given the expense and lengthy administration of the long course, American researchers in the developing world designed studies to test the efficacy of a shorter course of AZT administered during late pregnancy …

Evaluation Of Florida’S Sub-Acute Inpatient Psychiatric Program (Sipp), Kristen M. Snyder, Angela Gomez, Mary L. Armstrong, Kathy Thompson-Dailey, Tom Massey

Mental Health Law & Policy Faculty Publications

In March 1998, the State of Florida received approval of a 1915 (b) waiver from the Health Care Financing Administration (HCFA) to implement an alternative, Sub-acute Inpatient Psychiatric Program (SIPP) for children under the age of 18, who had two or more psychiatric inpatient stays in a year, or a length of stay greater than thirteen days. For these high risk youth, who were typically served in general hospitals, the SIPP model was designed to improve the transition from inpatient care to community based care, in an effort to reduce the high rates of readmission and improve their chances of …

Research Across Multiple Systems: Probabilistic Population Estimation (Ppe), Diane Haynes, Rebecca Larsen, Shabnam Mehra

Mental Health Law & Policy Faculty Publications

Today, social service administrators are examining client service utilization using cross system analysis, because often a client's needs require accessing governmentfunded services from multiple organizations. One technical problem that arises is that organizations do not share common unique identifiers from which to link one individual’s information together (i.e., system #1 uses Social Security Number (SSN) and system #2 uses Personal Identification Number (PIN)). Different methods have been employed to deal with the issue of working with information across data sets when there is no common unique identifier. Probabilistic Population Estimation (PPE), Caseload Segregation/Integration Ratio (C/SIR), and Probabilistic Population Matching (PPM) …

Responsible Regulation: A Sensible Cost-Benefit, Risk Versus Risk Approach To Federal Health And Safety Regulation, Steve Calandrillo

Articles

Federal health and safety regulations have saved or improved the lives of thousands of Americans, but protecting our citizens from risk entails significant costs. In a world of limited resources, we must spend our regulatory dollars responsibly in order to do the most we can with the money we have. Given the infeasibility of creating a risk-free society, this paper argues that a sensible cost-benefit, risk versus risk approach be taken in the design of U.S. regulatory oversight policy. The goal should always be to further the best interests of the nation, rather than to satisfy the narrow agenda of …

Slouching Toward Managed Care Liability: Reflections On Doctrinal Boundaries, Paradigm Shifts, And Incremental Reform, Wendy K. Mariner

Faculty Scholarship

Following the seemingly endless debate over managed care liability, I cannot suppress thoughts of Yeats’s poem, “The Second Coming.” It is not the wellknown phrase, “Things fall apart; the centre cannot hold,” that comes to mind; although that could describe the feeling of a health-care system unraveling. The poem’s depiction of lost innocence — “The best lack all conviction, while the worst/Are full of passionate intensity” — does not allude to the legislature, the industry, the public, or the medical or legal profession. What resonates is the poem’s evocation of humanity’s cyclical history of expectation and disappointment, with ideas as …

The Merger Between Public Health And Health Law – The Us Situation, Wendy K. Mariner

Faculty Scholarship

Law is an essential tool for protecting the public’s health. It is often the law that turns public health science into public health action. Sanitation, clean air and water, universal vaccination, injury prevention, tobacco control, drug policy, and a vast array of other interventions are achieved through a complex web of local, provincial and national statutes, regulations and judicial cases. The Institute of Medicine in the United States defines public health as “what we, as a society, do collectively to ensure the conditions in which people can be healthy.” And society acts collectively most often through law.

Thus, the merging …

“Partial-Birth Abortion” And The Supreme Court, George J. Annas

Faculty Scholarship

Aortion has long been, and remains, the most politicized medical procedure in the United States. It has been the subject of more state and federal legislation than all other medical procedures combined. The U.S. Supreme Court, which almost never hears cases about medical procedures, has regularly heard cases over the past 25 years concerning the constitutionality of various state laws designed to limit abortion. Thus, it was only a matter of time before the Court would hear a case on the constitutionality of laws restricting so-called partial-birth abortion. When the Court heard a challenge to Nebraska's law, statutes relating to …

The Globalization Of Public Health: The First 100 Years Of International Health Diplomacy, David P. Fidler

Articles by Maurer Faculty

Global threats to public health in the 19th century sparked the development of international health diplomacy. Many international regimes on public health issues were created between the mid-19th and mid-20th centuries. The present article analyses the global risks in this field and the international legal responses to them between 1851 and 1951, and explores the lessons from the first century of international health diplomacy of relevance to contemporary efforts to deal with the globalization of public health.

Alternative Dispute Resolution And The Occupational Safety And Health Review Commission: Settlement Judges And Simplified Proceedings, Morell E. Mullins Sr.

Faculty Scholarship

No abstract provided.

Curing Conflicts Of Interest In Clinical Research: Impossible Dreams And Harsh Realities, Patricia C. Kuszler

Articles

This article will explore conflicts of interest in the context of clinical research, focusing on the incentives and practices that foster such conflicts. Part I will briefly define and categorize the revenue streams at play in clinical research—both contemporaneous with the clinical trial, and the downstream, long-term gains available to the researcher and research university. Part II will discuss how these entangled revenue streams result in financial and non-financial conflicts of interest that affect the nature and balance of the research enterprise and potentially endanger patients and human subjects. Part III will summarize current conflicts of interest regulations and policies, …

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)