Law Commons^™

Gender Identity, Health, And The Law: An Overview Of Key Laws Impacting The Health Of Transgender And Gender Non-Conforming People, Naomi Seiler, Amanda Spott, Mekhi Washington, Paige Organick-Lee, Aaron Karacuschansky, Gregory Dwyer, Katie Horton, Alexis Osei

Saint Louis University Journal of Health Law & Policy

A growing population of transgender, nonbinary, and other gender non-conforming Americans experience the burden of multiple physical and mental health inequities. Largely rooted in discrimination and stigma, these disparities are compounded by barriers to respectful, appropriate healthcare.

A range of new policies, including state laws attempting to limit access to gender-affirming care for minors, may further compound health disparities. However, in some states and at the federal level, protective laws seek to prohibit discrimination and support access to care. Meanwhile, the constitutional status of gender identity under the Equal Protection Clause, and the legality of certain federal protections challenged on …

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Occupational Segregation As A Driver Of Racial Health Disparities Among Black Women, Pilar C. Whitaker

Saint Louis University Law Journal

No abstract provided.

At A Covid Crossroads: Public Health, Patient Privacy, And Health Information Confidentiality, Stacey A. Tovino

Saint Louis University Law Journal

This essay summarizes and assesses the various bulletins, guidance documents, and notices of enforcement discretion released by the federal Department of Health and Human Services regarding the application of the HIPAA Privacy Rule to the COVID-19 pandemic. Among other topics and actions, these authorities address the application of the HIPAA Privacy Rule to the use and disclosure of protected health information for public health activities, waive the application of certain HIPAA Privacy Rule requirements during the COVID-19 pandemic, and announce enforcement discretion regarding certain covered entities’ non-compliance with particular provisions within the HIPAA Privacy Rule. These authorities overwhelmingly, and appropriately, …

Disparities In Health Care: The Pandemic’S Lessons For Health Lawyers, Danielle Pelfrey Duryea, Nicole Huberfeld, Ruqaiijah Yearby

All Faculty Scholarship

Population-level disparities in health and health care came to the forefront of U.S. public consciousness in 2020. As the racial, ethnic, and socioeconomic stratification of COVID-19 infection and death rates emerged with chilling clarity, the Black Lives Matter protests of the summer focused millions of Americans on the complex, structural nature of inequity and its long-lasting effects.

Access to quality health care is a “social determinant of health,” meaning that it is one of the “non-medical factors that influence health outcomes . . . the conditions in which people are born, grow, work, live, and age, and the wider set …

Intellectual Property As A Determinant Of Health, Ana Santos Rutschman

All Faculty Scholarship

Public health literature has long recognized the existence of determinants of health, a set of socio-economic conditions that affect health risks and health outcomes across the world. The World Health Organization defines these determinants as “forces and systems” consisting of “factors combin[ing] together to affect the health of individuals and communities.” Frameworks relying on determinants of health have been widely adopted by countries in the global South and North alike, as well as international institutional players, several of which are direct or indirect players in transnational intellectual property (IP) policymaking. Issues raised by the implementation of IP policies, however, are …

The Intellectual Property Of Vaccines: Takeaways From Recent Infectious Disease Outbreaks, Ana Santos Rutschman

All Faculty Scholarship

This Essay examines the ways in which intellectual property regimes influence incentives for the development of new vaccines for infectious diseases. Charting the tension between market forces and public health imperatives, the Essay considers an emerging solution to the long-standing problem of insufficient incentives for vaccine research and development: the rise of public-private partnerships in the health space. The Essay provides a short case study on CEPI, a large-scale public-private partnership dedicated exclusively to funding research on vaccines for infectious diseases. In exploring how the interaction between intellectual property rules and practices affect vaccine innovation, the Essay offers illustrations from …

Health Justice In The Age Of Alternative Facts And Tax Cuts: Value-Based Care, Medicaid Reform, And The Social Determinants Of Health, Elizabeth Tobin-Tyler

Saint Louis University Journal of Health Law & Policy

Some provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) as well as regulatory policies under the Obama administration reflected the overwhelming evidence that to reduce health care costs, and to improve quality of care and population health, the social determinants of health (SDOH) must be addressed. These policies included funding for partnerships between public health agencies, community organizations, and health care institutions, promotion of value-based payment models that incentivize integrated health and social care delivery, and support for Medicaid program innovations that directly address social needs as part of health care. The Trump administration, through a …

Political Rhetoric And Minority Health: Introducing The Rhetoric-Policy-Health Paradigm, Kimberly Cogdell Grainger

Saint Louis University Journal of Health Law & Policy

Rhetoric is a persuasive device that has been studied for centuries by philosophers, thinkers, and teachers. In the political sphere of the Trump era, the bombastic, social media driven dissemination of rhetoric creates the perfect space to increase its effect. Today, there are clear examples of how rhetoric influences policy. This Article explores the link between divisive political rhetoric and policies that negatively affect minority health in the U.S. The rhetoric-policy-health (RPH) paradigm illustrates the connection between rhetoric and health. Existing public health policy research related to Health in All Policies and the social determinants of health combined with rhetorical …

What Hope For Health In All Policies’ Addition And Multiplication Of Equity In An Age Of Subtraction And Division At The Federal Level?: The Memphis Experience, Amy T. Campbell

Saint Louis University Journal of Health Law & Policy

Increasingly, people recognize that social factors, such as poverty, the living environment, and educational status, substantially affect health outcomes. A “health in all policies approach” (HiAP) seeks structural reform of policymaking to require purposeful consideration, across an interconnected range of public sector actors, of the health equity and justice policy-level considerations of these factors. With the election of Donald J. Trump as 45th President in the United States, however, the U.S. entered a world where the math of the day is division and subtraction, rather than addition or multiplication. And yet, hope in HiAP remains through examples of innovative approaches …

Ip Preparedness For Outbreak Diseases, Ana Santos Rutschman

All Faculty Scholarship

Outbreaks of infectious diseases will worsen, as illustrated by the recent back-to-back Ebola and Zika epidemics. The development of innovative drugs, especially in the form of vaccines, is key to minimizing future outbreaks, yet current intellectual property (IP) regimes are ineffective in supporting this goal.

IP scholarship has not adequately addressed the role of IP in the development of vaccines for outbreak diseases. This Article fills that void. Through case studies on the recent Ebola and Zika outbreaks, it provides the first descriptive analysis of the role of IP from the pre- to the post-outbreak stages, specifically identifying IP inefficiencies. …

Healthcare Blockchain Infrastructure: A Comparative Approach, Ana Santos Rutschman

All Faculty Scholarship

Blockchain has been hailed as the most disruptive technology of the next decade. One of the areas of immediate application is healthcare, where different types of blockchain applications could help streamline data sharing, protect patient privacy, and assist in the monitoring of drug shipments. This Article explores the first steps taken by healthcare companies in the United States to incorporate blockchain solutions into their business models. It then contrasts them to ongoing experiments in the European Union, with a focus on Sweden’s adoption of CareChain (a national, interoperable blockchain health data platform) and Estonia’s digitization of 95% of the country’s …

Nutrition And Health Equity: The Role Of Washington, D.C.’S East Capitol Urban Farm, Tia D. Jeffery

Saint Louis University Journal of Health Law & Policy

Disenfranchised communities have yet to become full beneficiaries of the core values of the Constitution. Health inequities are rooted in the social barriers connected to racism, classism, and sexism. Furthermore, marginalized groups in Washington, District of Columbia (D.C.), reside in food deserts. Urban agriculture has gained exposure as a working solution to the epidemic of food deserts in underserved urban communities. The East Capitol Urban Farm is one of the urban food hub extensions of the University of the District of Columbia College of Agriculture, Urban Sustainability, and Environmental Sciences. It operates in a food desert in Ward 7 of …

A Population Health Framework For Teaching Health Law, Robert Gatter

Saint Louis University Law Journal

No abstract provided.

On The Expansion Of “Welfare” And “Health” Under Medicaid, Laura D. Hermer

Saint Louis University Journal of Health Law & Policy

Medicaid was intended from its inception to provide financial access to health care for certain categories of impoverished Americans. While rooted in historical welfare programs, it was meant to afford the “deserving” poor access to the same sort of health care that other, wealthier Americans received. Yet despite this seemingly innocuous and laudable purpose, it has become a front in the political and social battles waged over the last several decades on the issues of welfare and the safety net. The latest battleground pits competing visions of Medicaid. One vision seeks to transform Medicaid from a health care program into …

The Health Exception, Monica E. Eppinger

All Faculty Scholarship

The abortion doctrine laid out in Roe v. Wade permits a procedure necessary to preserve the life or the health of the pregnant woman, setting out what has come to be called the “life exception” and the “health exception.” This Article investigates the background and antecedents of the health exception, identifying three periods of formation and change up to the drafting of the Model Penal Code in 1959. It argues that theories of health lie at the heart of legal doctrine, shaping common-law treatment of abortion and persisting in nineteenth- and twentieth-century statutes. This account reveals origins of a health …

Hitech Act: Building An Infrastructure For Health Information Organizations And A New Health Care Delivery System, Kalle Deyette

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Law And The Fog Of Healthcare: Complexity And Uncertainty In The Struggle Over Health Policy, Paul Starr

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Employers’ Use Of Health Insurance Exchanges: Lessons From Massachusetts, Mark A. Hall

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Is The Customer Always Right? Department Of Health And Human Services’ Proposed Regulations Allow Institutional Review Boards To Place Customer Service Ahead Of The Welfare Of Research Participants, Colleen O'Hare Zern

Saint Louis University Public Law Review

No abstract provided.

Making Room For Patient Autonomy In Health Information Exchange: The Role Of Informed Consent, Sarah R. Rupp

Saint Louis University Law Journal

No abstract provided.

New Governance In Action: Community Health Centers And The Public Health Service Act, Yolonda Campbell

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Making Health Markets Work Better Through Targeted Doses Of Competition, Regulation, And Collaboration, Len M. Nichols

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Human Capital And Transfer Taxation, Kerry A. Ryan

All Faculty Scholarship

This article addresses the question of whether education and healthcare transfers should be included in the federal gift tax base. It initially frames the issue in two ways: (1) through the lens of a proposal by the American Law Institute to exempt all “transfers for consumption” from gift taxation, and (2) within the context of a debate among economists about whether such expenditures should be included in the definition of “intergenerational transfers” for purposes of determining the total share of such transfers in U.S. accumulated wealth. Finding the first lens unsatisfactory on its own doctrinal terms and the second lens …

Personalizing Informed Consent: The Challenge Of Health Literacy, Jessica J. Flinn

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Disability, Equipment Barriers, And Women’S Health: Using The Ada To Provide Meaningful Access, Elizabeth Pendo

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Has Erisa Closed Our Laboratories? Options For State Health Reform, Terrence Burek

Saint Louis University Journal of Health Law & Policy

No abstract provided.

A Missouri Health Policy Agenda, James R. Kimmey

Saint Louis University Law Journal

No abstract provided.

Striving For Equality, But Settling For The Status Quo: Is Title Vi More Illusory Than Real?, Ruqaiijah Yearby

All Faculty Scholarship

A plethora of empirical studies, such as the Institute of Medicine’s Unequal Treatment report, have shown that racial inequities in health care continue at the same level as in the Jim Crow Era. Innumerable reasons have been offered to explain the continuation of these health inequities, including racial discrimination. Congress enacted Title VI of the Civil Rights Act of 1964 to put an end to racial discrimination in health care, but it still persists. Given the regulation and enforcement mechanisms established under Title VI explicitly aimed at remedying racial discrimination such as that directed at elderly African-Americans it is unbelievable …

Capital Punishment And Mental Health Issues: Global Examples, Nicola Browne, Seema Kandelia, Rupa Reddy, Peter Hodgkinson, O.B.E.

Saint Louis University Public Law Review

No abstract provided.