Law Commons^™

Democratizing Hmo Regulation To Enforce The "Rule Of Rescue", Kent G. Rutter

University of Michigan Journal of Law Reform

Despite heightened public concern about HMOs, misguided regulatory measures have not guaranteed HMO patients access to the treatment options many consider vital. This Note recommends four changes to the current regulatory system that would preserve HMOs' ability to control health care costs while allowing patients and doctors, rather than lawmakers or HMO administrators, to set health care priorities.

Health Security Act: Coercion And Distrust For The Market , H. Richard Beresford

Cornell Law Review

No abstract provided.

Health Care Reform And Competing Visions Of Medical Care: Antitrust And State Provider Cooperation Legislation , James F. Blumstein

Cornell Law Review

No abstract provided.

Managed Competition Integrated Delivery Systems And Antitrust , Thomas L. Greaney

Cornell Law Review

No abstract provided.

Federal Mandates In The Health Care Context, Kerry Hughes

University of Miami Business Law Review

No abstract provided.

Universal Health Care And The Continued Reliance On Custom In Determining Medical Malpractice, James A. Henderson Jr., John A. Siliciano

Cornell Law Faculty Publications

No abstract provided.

Outcomes Assessment In Health Care Reform: Promise And Limitations, Wendy K. Mariner

Faculty Scholarship

If the fundamental goals of the health care reform effort are to ensure universal access to an acceptable quality of health care at an affordable cost, then the threshold question for reform is: What health care services should be provided in an efficient, equitable system?

Answering this question requires weighing a complex mix of medical and social policy factors, a process not attempted in this article. But the starting point for that process should be determining what health care services “work” and what they cost. Outcomes assessment holds considerable promise in finding answers to these subsidiary questions, because it is …

Constitutional Impediments To National Health Reform: Tenth Amendment And Spending Power Hurdles, S. Candice Hoke

Law Faculty Articles and Essays

This Article proceeds in four Parts. The first briefly summarizes the approach of each of the pending health reform bills and distills those portions relevant to current Tenth Amendment and Spending Clause analysis. Provisions that would impose on States the financial and administrative responsibility for achieving Federal regulatory objectives or that specify punitive measures to be taken against States choosing not to participate in the cooperative program are critical features for the inquiry. Employing these criteria, the first Part identifies seven distinct and largely novel models of problematic regulatory instructions that warrant more probative analysis.The second Part briefly outlines the …

Securing Health Or Just Health Care? The Effect Of The Health Care System On The Health Of America, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The author first analyzes why the prevention of illness and promotion of health provide the leading justification for the government to act for the welfare of the population. His analysis focuses principally on the foundational importance of health for human happiness, the exercise of rights and privileges, and the formation of family and social relationships. He explains why health care, although critically important; is not the only, nor even the most important, determinant of health. Most morbidity and mortality in the United States is attributable to environmental conditions, pathogens, and human behavior, which are all more responsive to population-based interventions …

Three Visions Of Managed Competition, 1920-1950, Rudolph J.R. Peritz

Articles & Chapters

No abstract provided.

Managed Competition, Integrated Delivery Systems And Antitrust, Thomas L. Greaney

All Faculty Scholarship

A central question confronting proponents of managed competition during the health reform debate in 1994 was whether competitive networks or integrated delivery systems would emerge. Under reformers’ vision, controlling costs depended on the emergence of a sufficient number of efficient and viable integrated delivery systems. Conversely, if one or a few integrated networks dominate the market for physician or hospital services, rivalry on the main issues of health care cost control would likely dissipate. This article argues that vigilant and sensible antitrust enforcement was also a prerequisite for the success of the managed competition model. Despite the considerable emphasis on …

Federalism And Health Care Reform: Is Half A Loaf Really Worse Than None?, Richard Briffault

Faculty Scholarship

Health care reform dominates the domestic agenda of the Clinton Administration. Policy analysts, media pundits, and ordinary citizens are abuzz with the once-arcane terminology of health reform – "managed competition," "single-payer," "regional alliances," "global budgets" – as they ponder the merits and demerits of the leading reform alternatives. At the center of the public debate are questions concerning the role of government in constraining health care costs, maintaining quality, and widening access. But in our federal system there are two governments that can address most domestic problems – the national government and the states – and, although considerable ink has …

Selected Bibliography On Aids And Health Insurance, Patricia G. Court, Linda Karr O'Connor

Cornell Journal of Law and Public Policy

No abstract provided.

Aids And Access To Care: Lessons For Health Care Reformers, Michael T. Isbell

Cornell Journal of Law and Public Policy

No abstract provided.

Statement From The Secretary Of Health And Human Services, Donna E. Shalala

Cornell Journal of Law and Public Policy

No abstract provided.

Aids And Private Health Insurance: A Crisis Of Risk Sharing, Robert A. Padgug, Gerald M. Oppenheimer, Jon Eisenhandler

Cornell Journal of Law and Public Policy

No abstract provided.

Book Review: An Overview Of Health Care Reform: A View Of The Forest--An Introduction To Taft Strategic Atlas: U.S. Health Care Reform By Frederick I. Taft, Stephen J. Werber, Stephen R. Smith

Law Faculty Articles and Essays

Those interested in health law, who wish to follow and participate in the national debate, need a method of organizing the trees of definition, individual issues, and plans found in the forest of the debate. The cliche of not seeing the forest for the trees is reversed in this debate as we all can see the forest, but we cannot distinguish or truly discern its contents. To aid in understanding these issues, The Journal of Law and Health has taken the unusual step of reprinting a significant portion of a new book. The Editors believe that a traditional Book Review …

The Need For A Process Theory: Formulating Health Policy Through Adjudication, Margaret G. Farrell

Journal of Law and Health

This essay sets out a preliminary, theoretical framework within which to analyze remedial options and begin the search for the values they promote. It is based on the premise that the process used to enforce substantive rights to health care should promote values that are consistent with, and even supportive of, the values that health care reform itself would promote. The framework proceeds upon an analysis of the kinds of claims at issue, the alternative decision making models available to settle them, and the forums in which those models might be used. In conclusion, I urge scholars, policy makers and …

Health Care Reform And Fraud By Health Care Providers, Pamela H. Bucy

Villanova Law Review

No abstract provided.

Health Care Reform In The United States, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The author presents a brief description of the design features and objectives of the health care reform package, together with the reasons to support reform of the health care system in the United States.

Foreword: Health Care Reform In The United States—The Presidential Task Force, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This essay serves as the foreword to Implementing U.S. Health Care Reform, a symposium held in 1993.

The exact specifications of the new health care system depend on the package that President Clinton will send to Capitol Hill and the changes that Congress will make in the reform package. Some of the basic structures and organizing principles of the new system that are being considered by the President are already the subject of intense public scrutiny.

The design being considered would involve new relations between the federal government and the states, between the public and private sectors, and between …

Problems With Employer-Provided Health Insurance — The Employee Retirement Income Security Act And Health Care Reform, Wendy K. Mariner

Faculty Scholarship

Health care reform is in the wind. As the nation prepares for a new presidential term, a more equitable and cost-effective health care system is beginning to sound inevitable.1 But the shape of that system remains a matter of debate. Employer-provided health insurance is the cornerstone of several national proposals for reform.2 3 4 5 6 The Bush administration's preference for tax credits rested on the assumption that most employers would continue to provide health insurance to their employees. President-elect Bill Clinton's proposal relies on insurance reform to enable small businesses to buy affordable private health insurance. Lawmakers …

Introduction: Caring For The Nation--Current Issues In Health Care Reform, Susan E. Powley

Vanderbilt Law Review

Health care reform is once again on the "front burner" of American politics. With health care costs in the United States rising at three times the rate of inflation and an increasing portion of the population falling through the cracks of the current health care delivery system,' legislators, health care professionals, and the population at large now have little difficulty agreeing that the system is badly in need of reform. This consensus, however, falls apart when discussion turns to what needs to be fixed and how to fix it. Federal legislators currently have over twenty health bills pending before them, …

Rethinking The Health Care Delivery Crisis: The Need For A Therapeutic Jurisprudence, Bruce J. Winick

Journal of Law and Health

In designing a sensible system of national health insurance we need to avoid a repetition of the built-in inflationary pressures that followed the adoption of Medicaid and Medicare. Medicaid and Medicare eligibility encouraged many to increase their use of health care services, in part because they no longer needed to bear the costs (or full costs) or services. This increased demand, exceeding the supply of health care services, predictably produced price hikes. Other factors undoubtedly have contributed to the escalation of health care costs, including the tendency of some doctors to order unnecessary diagnostic tests, over-reliance on high technology, and …

State And Local Government Legal Responsibilities To Provide Medical Care For The Poor, Michael A. Dowell

Journal of Law and Health

This article will provide an overview of the extent to which state and local government entities must provide medical care for the poor and ways to enforce these obligations. Delineation of specific medical assistance program responsibilities requires careful review of the legislative intent and statutory purpose. Remedies for state or local failure to meet statutory or constitutional obligations to provide indigent medical care will be discussed in the enforcement section.

Competitive Reform In Health Care: The Vulnerable Revolution, Thomas L. Greaney

All Faculty Scholarship

This article, written at the dawn of the era of "competitive reform" in health care examines the case and prospects for the introduction of competition in health care delivery and financing. It observes the failures of the ancienne regime of fee for service payment and professional sovereignty and discusses the benefits of market-oriented policy. Its contribution, still salient today, is the lesson that competition cannot succeed without regulation. It identifies legislative, professional, and cultural hurdles to effective implementation of competitive norms and policies that have impeded the success of competition policy in health care.