Health Law and Policy Commons^™

Nursing The Primary Care Shortage Back To Health: How Expanding Nurse Practitioner Autonomy Can Safely And Economically Meet The Growing Demand For Basic Health Care , Michael B. Zand

Journal of Law and Health

This article first discusses the history and educational requirements of the Nurse Practitioner profession. It then discusses the policy reasons why Nurse Practitioners should, and do, play an important role in the country's health care delivery system. The core of the article deals with the legal issues surrounding the NP's scope of practice including the need for collaborative agreements with physicians, authority to prescribe drugs, and identification. Finally the article discusses how NPs fit into the health insurance scheme and their liability for malpractice.

Ppaca And Public Health: Creating A Framework To Focus On Prevention And Wellness And Improve The Public's Health, Gwendolyn R. Majette

Law Faculty Articles and Essays

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA), a major piece of health care reform legislation.This comprehensive legislation includes provisions that focus on prevention, wellness, and public health. Some, including authors in this symposium, question whether Congress considered public health, prevention, and wellness issues as mere afterthoughts in the creation of PPACA. As this article amply demonstrates, they did not.This article documents the extent of congressional consideration on public health issues based on personal experience working on the framework for health care reform--specifically, my experience as a Fellow for a member of the …

Ohio's Aggressive Attack On Medical Identity Theft, Stanley C. Ball

Journal of Law and Health

This note explains the severity of medical identity theft and the state and federal legislative reactions to the problem. Specifically, the note discusses data breach notification statutes that require healthcare providers to notify consumers when the systems holding customer personal information are breached. The note concludes that Ohio’s data breach notification statute, which does not expressly cover healthcare providers, should be amended to protect residents from medical identity theft and provide redress when healthcare providers violate state law.

Making Language Access To Health Care Meaningful: The Need For A Federal Health Care Interpreters' Statute, Alvaro Decola

Journal of Law and Health

This Note will argue that there are strong public policy, and legal and equity considerations for Congress to enact a federal statute to address the inadequacies of the current policies and regulations pertaining to language access to health care. The issue has become a significant one throughout the United States, given the influx of LEP (Limited English Proficiency) Americans navigating the health care system. Part II of this writing discusses the existing federal laws dealing with language access and the hurdles faced by LEP individuals in bringing legal action, because of existing case law on the subject. Part II also …

Post-Traumatic Stress Disorder In The Military: The Need For Legislative Improvement Of Mental Health Care For Veterans Of Operation Iraqi Freedom And Operation Enduring Freedom, Madeline Mcgrane

Journal of Law and Health

This Note argues that legislation requiring improved mental health treatment for veterans of OIF (Operation Iraqi Freedom) and OEF (Operation Enduring Freedom) is necessary to protect American service members from the dangers of mental illness. In order to prevent crimes and suicides committed by veterans of OIF and OEF as a result of undiagnosed PTSD (post-traumatic stress disorder), the United States Congress should enact legislation imposing requirements on all branches of the military that: 1) mandates screening of all veterans at risk for PTSD upon their return from deployment; 2) ensures veterans are provided with adequate and timely mental healthcare; …

Food-Borne Ultimatum: Proposing Federal Legislation To Create Humane Living Conditions For Animals Raised For Food In Order To Improve Human Health, The, Lynn M. Boris

Journal of Law and Health

In order to reduce the large number of human health risks associated with reckless farming practices, Congress must enact federal legislation that requires humane living conditions for farm animals and declares a moratorium on the routine use of unnecessary antibiotics. Part II of this Note will briefly review traditional farming and animal husbandry practices and examine the shift to the modern practices used by producers of animal products today. Part II will also present several farming practices utilized today that are particularly dangerous to human health. Part III of this Note will explore the immense human suffering that is occurring …

The Supreme Court’S Assault On Litigation: Why (And How) It Could Be Good For Health Law, Abigail R. Moncrieff

Law Faculty Articles and Essays

In recent years, the Supreme Court has narrowed or eliminated private rights of action in many legal regimes, much to the chagrin of the legal academy. That trend, although certainly not limited to health law, has had a significant impact on the field; the Court's decisions have eliminated the private enforcement mechanism for at least three important healthcare regimes: Medicaid, employer-sponsored insurance, and medical devices. In a similar trend outside the courts, state legislatures have capped non-economic and punitive damages for medical malpractice litigation, weakening the tort system's deterrent capacity in those states. This Article suggests that the trend of …

Pushing Back: Protecting Maternal Autonomy From The Living Room To The Delivery Room, Benjamin Grant Chojnacki

Journal of Law and Health

As mothers are given more freedom to make their delivery choices, problems with the current maternity care system and the legal protections afforded fetus have the potential to diminish maternal independence. At one end of the spectrum, the home birth movement and reactions against "medicalized" birth have the potential to create physician distrust and a greater resistance to medical treatment. This resistance, when coupled with an expansive view of fetal rights may result in compelled medical treatment, injury, or the loss of parental rights. At the other end of the spectrum, elective C-sections and inductions will diminish the likelihood that …

Form & Reform: The Economic Realities Of The United States Healthcare System, Mark Votruba

Journal of Law and Health

Good afternoon, everybody. My name is Eric Steiger, I'm one of the editors-in-chief from the Journal of Law and Health. And I'm happy to welcome all of you to the second speaker event in the 2009/2010 Journal of Law and Health Speaker Series. Thank you all for coming. Now, I know that the news last week was dominated by the story of Sandra Bullock's breakup; however, some of you might have noticed that a small piece of minor legislation also got passed through Congress last week. And you also might have noticed that it wasn't quite as full of bipartisan …

Much Ado About Possibly Pretty Little: Mccarran-Ferguson Repeal In The Health Care Reform Effort, Christopher L. Sagers

Law Faculty Articles and Essays

Since 1945, the McCarran-Ferguson Act (MFA) has shielded the “business of insurance” from antitrust liability, so long as the challenged conduct is “regulated by State Law” and does not constitute “boycott, coercion, or intimidation.” This law, like the dozens of other statutory antitrust exemptions that still exist for other industries, has more or less always been controversial, and efforts to repeal it date back more than thirty years. This Essay asks two questions: (1) what consequences the pending repeal measures might have if one of them becomes law; and (2) what a close examination of this effort might teach us …

Healthcare Reform & The Missing Voice Of Complementary And Alternative Medicine, Gwendolyn R. Majette

Law Faculty Articles and Essays

Given the high prevalence of complementary and alternative medicine (CAM) use by Americans, coupled with the emphasis placed on prevention in many of the healthcare reform proposals, this article argues that CAM should play a role in the healthcare reform conversation. Part I provides the background information on CAM including its definition, CAM use, and its cost. This section also broadly outlines the contours of the early healthcare reform proposals, those in existence as of January 2009. Part II describes how CAM would ideally be integrated into the United States healthcare system. Part III outlines the reasons CAM has been …

Contraception, Abortion, And Health Care Reform: Finding Appropriate Moral Ground, Dena S. Davis

Law Faculty Articles and Essays

In this essay, I make the argument that abortion and contraception are fundamentally different actions that occupy fundamentally different moral space, and that justify fundamentally different political action. I conclude that, while it is morally licit, even morally obligatory, for people who believe that embryos are people like us, to attempt to impede access to abortion, it is morally illicit to attempt to block access to contraception (including sterilization).

Whom Would Jesus Cover - A Biblical, Ethical Lens For The Contemporary American Health Care Debate, Jeffrey R. Baker

Journal of Law and Health

This paper attempts a view of the contemporary health care debate in America through the prism of Biblical scripture and proposes that people of faith should recognize the current state of the American health care system as a moral crisis of justice and charity. First, I provide a survey of the current state of American health care for the uninsured, describing the demographic and economic circumstances of the uninsured and the resources available to them when they need medical care. Second, I ask whether, in light of scripture, this state of affairs presents a moral question that should drive our …

Lines Of Communication: Advances In Stem Cell Policy, Dena Davis, Debra Grega

Journal of Law and Health

This is a transcription of the Journal of Law and Health's Speaker Series event held on November 17, 2009 at the Joseph W. Bartunek III Moot Court Room, Cleveland-Marshall College of Law. The speakers discussed stem cell policy, ethics, oversight, funding restrictions and research restrictions.

What's All The Headache: Reform Needed To Cope With The Effects Of Concussions In Football, Erika A. Diehl

Journal of Law and Health

In order to effectively manage this public health concern, it is imperative to gain an understanding of the issues surrounding head injuries in sporting events. This Note will discuss the increasing frequency and dangers of concussions in amateur and professional football. It will suggest that athletes, schools, coaches, and doctors must become more educated on the causes and dangers of concussions in order to ensure the safety of participants. In order to do so, this Note introduces a medical overview of concussions, while briefly outlining the diagnosis, long-term effects, and management of concussions. Part III discusses the legal theories athletes …

Book Review, Laura Ray

Journal of Law and Health

Reviewing Real Collaboration: What it Takes for Global Health to Succeed, Mark L. Rosenberg, Elisabeth S. Hayes, Margaret H. McIntyre, and Nancy Neill, California/ Milbank Books on Health and the Public; no. 20. Berkeley: University of California Press; New York: Milbank Memorial Fund, c2010.

Not Of Woman Born: How Ectogenesis Will Change The Way We View Viability, Birth, And The Status Of The Unborn, Eric Steiger

Journal of Law and Health

Over seventy-five years ago, Aldous Huxley envisioned a future in which the creation of human individuals is not left to chance and sweaty biology, but is a feat of engineering individuals to established specifications. Huxley described a process by which human ova are fertilized in-vitro, then "budded" through an imaginary technique into multiple copies, and finally into identical twins in incubators, entirely absent of a mother's womb. While many of Huxley's predictions about the future have come to pass, such as helicopters, the assembly line, and indeed, in-vitro fertilization, the prospect of ectogenesis, of gestating a child completely outside of …

A Closer Look At The Federalization Snowball, Abigail R. Moncrieff

Law Faculty Articles and Essays

While on the academic job market, I presented Federalization Snowballs to several stellar law faculties.1 My argument, in short, was that: (1) federal healthcare spending allows the states to externalize onto the federal government about 40% of the utilization costs associated with their medical malpractice policies (such as the cost of defensive medicine); (2) such an externality systematically distorts a rational state’s incentive to reform medical malpractice; and (3) federalization of medical malpractice is necessary to correct the distortion. In other words, I argued that federalization of healthcare spending through Medicare, Medicaid, and similar programs has snowballed into a need …

Federalization Snowballs: The Need For National Action In Medical Malpractice Reform, Abigail R. Moncrieff

Law Faculty Articles and Essays

Because tort law and healthcare regulation are traditional state functions and because medical, legal, and insurance practices are localized, legal scholars have long believed that medical malpractice falls within the states' exclusive jurisdiction and sovereignty. This conventional view fails to consider the impact that federal healthcare programs have on the states' incentives to regulate. As a result of federal financing, each state externalizes some of the costs of its malpractice policy onto the federal government. The federal government therefore needs to take charge of medical malpractice in order to fix the spillover problem created by existing federal healthcare programs.

Importantly, …

The Neglect Of The Umbilical Cord: Ohio's Failure To Adequately Promote Banking Of Umbilical Cord Blood Stem Cells And The Need For New Legislation, Shannon Folger

Journal of Law and Health

Because current legislation, including OH H.B. 237, is insufficient in that it does not have the potential to significantly increase the number of cord blood donations, it will be necessary to enact legislation that is more demanding. Such legislation should be modeled after current "required request" organ donation laws, which mandate that health professionals actively pursue organ donations by expressly asking the family to consent to donation. Modeled after these laws, better legislation will not only require that state health departments generate information about donation opportunities, but also that health professionals then provide each maternity patient with materials about cord …

Germs On A Plane: Legal Protections Afforded To International Air Travelers And Governments In The Event Of A Suspected Or Actual Contagious Passenger And Proposals To Strengthen Them, Alexandra R. Harrington

Journal of Law and Health

This article calls for the creation of an international public health do-not-fly list akin to those used by Interpol and the United States government as a stop-gap measure to ensure that passengers who have been diagnosed with infectious diseases or have been exposed to infectious diseases are unable to travel until it is established that it is medically safe for them to do so. This article has also called for amendments to the IHR and the Vienna Conventions to clarify the rights and obligations of travelers and states in the event of a suspected or established case of infectious disease …

Reverse Pre-Empting The Federal Arbitration Act: Alleviating The Arbitration Crisis In Nursing Homes, Jana Pavlic

Journal of Law and Health

In Casarotto, the Supreme Court enunciated that Montana's notice requirement conflicted with the "goals and policies of the FAA." The inequities associated with the process of pre-dispute arbitration agreements in nursing homes, however, confirm that the FAA's "goals and policies"' conflict with "accepted principles of contract law"' in this context. Long standing principles of contract law that predate the FAA, as well as basic human morality, should supersede the interests of efficiency and convenience purportedly served by the general enforceability of the statute. State case law as well as attempted state legislation already evince an underlying public policy to protect …

Physician Peer Review Immunity: Time To Euthanize A Fatally Flawed Policy, Charles R. Koepke M.D.

Journal of Law and Health

Dr. X is a young, charismatic, board-certified surgeon at the local hospital. While popular among her patients and non-surgical colleagues, to the established surgical "Old Guard," she appears somewhat of a threat. Her training in new advanced techniques, coupled with splendid bedside manner, has caused her practice to become quite busy. However, disruption in some well-established referral patterns has occurred, and business has been siphoned away from her older colleagues. . . . This hypothetical - but not uncommonly recurring - fact pattern demonstrates the destruction of a promising medical career, elimination of competition, promotion of status quo cronyism, and …

Hiv Testing In State Correctional Systems, James Lee Pope

Journal of Law and Health

In recent years, reports have surfaced that the prevalance of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) within U.S. prison systems is three to five times higher than that of the general population. These reports, combined with the release of new HIV testing guidelines by the Centers for Disease Control (CDC) in 2006, have caused many states to change their laws and policies regarding HIV testing in state correctional facilities. This report briefly discusses some of the issues related to HIV testing within state correctional facilities. This report also discusses the methods of HIV testing currently used in …

Dying To Wait: How The Abigail Court Got It Wrong, Juan Joel Tovanche

Journal of Law and Health

At age twenty-one, Abigail Kathleen Burroughs met a fate usually reserved for aged men who have spent much of their lives drinking and smoking. Diagnosed with cancer at nineteen, Abigail battled the squamous cell carcinoma that invaded her body even as she struggled to maintain her characteristic optimism. Abigail struggled with more than her illness, however. In the last years of her life, Abigail and her family also wrestled with Food and Drug Administration (FDA) regulations that denied her access to medication that could have saved her life. The policy at issue was the FDA's practice of progressive testing, which …

To Pay Or Not To Pay: Medicare And The Preventable Adverse Event: A Rational Decision Of Dangerous Philosophical Change, Amy J. Chaho M.D.

Journal of Law and Health

The proposed Medicare reimbursement schedule intended to become effective in October 2008 represents a drastic change to the traditional policy of payment for needed services. The proposal mandates that certain preventable adverse events should not be reimbursed. This spending scheme is intended to improve quality while decreasing cost to the Medicare system. The goals of the spending scheme are laudable. Quality improvement, when used to improve the health, safety and general welfare of the intended patient beneficiary of the Medicare program, is a rational and compelling government interest that warrants coercive use of authorized spending power. This beneficial interest may …

Regional Health Information Organizations: Lower Health Care Costs, Fewer Iatrogenic Illnesses, And Improved Care - What Are We Waiting For, Angela Ferneding

Journal of Law and Health

Rising health care costs have a significant impact on our economy, and medical errors pose a meaningful and costly risk to health care consumers. The adoption of information technology, including the implementation of RHIOs (Regional Health Information Organizations) and electronic medical record systems, is critical to addressing these issues. Although President Bush's vision of a NHIN (National Health Information Network)is a positive first step in governmental involvement, Congress must address the biggest challenge health care providers cite in implementing information technology: the lack of funding. The national government must demonstrate its commitment to reducing costs and improving care by committing …

Discretion To Follow The Law: The Collision Of Ohio's Nursing Home Bill Of Rights With Ohio's Political Subdivision Tort Liability Act, Peter Traska Elk & Elk Co., Ltd., Katherine Knouff

Journal of Law and Health

The Ohio Political Subdivision Tort Liability Act confers general immunity on political subdivisions. Therefore, government owned homes seek to avoid liability by raising the defenses provided by the Ohio Political Subdivision Tort Liability Act, despite the resident's rights under the Nursing Home Bill of Rights. The result is that residents of government owned nursing homes have inferior remedies for the tortious acts of a county home's employees. The disparate treatment meted out to residents of county owned homes opens the Political Subdivision Act to another challenge: equal protection. The law formerly recognized that government actors taking part in the marketplace …

The Deficit Reduction Act Of 2005 - Reducing The Number Of Recipients And Applicants Eligible To Receive Medicaid Benefits, Christal Contini

Journal of Law and Health

Medically impaired individuals such as George, as well as disaster victims, mentally handicapped persons, homeless persons, and foster children, will be adversely affected by the new citizenship documentation requirements imposed upon the states by the Act. States will also be adversely affected by the increased administrative costs of implementing the Act's requirements. This note asserts that aspects of the citizenship verification requirements treat citizen applicants worse than immigrant applicants, which violates the Due Process Clause of the Fifth Amendment. Amendments should be made to the United States Code and the Code of Federal Regulations to ease the burden on individuals …

The Likely Impact Of Mandated Paid Sick And Family-Care Leave On The Economy And Economic Development Prospects Of The State Of Ohio, Edward W. Hill, Spence Christopher, Daila Shimek, Ziona Austrian

All Maxine Goodman Levin School of Urban Affairs Publications

This report analyzes the potential impact of a proposed paid sick and family care leave legislation on the economy of the state of Ohio, the economic development prospects of the state and on the management of production processes that depend on highly integrate teams. The report also reviews the literature on the effect of mandated paid sick and family care leave on the industrial relations system—workplace performance and worker retention. Our analysis concludes that there would have been a net cost associated with the paid sick leave and family-care initiative proposed in Ohio with a lower bound estimate of $63.84 …