Health Law and Policy Commons^™

Special Care: Medical Decisions At The Beginning Of Life, Jonathan H. Margolies

Michigan Law Review

A Review of Special Care: Medical Decisions at the Beginning of Life by Fred M. Frohock

How To Argue About Health Care, Don Herzog

Articles

Despite the aggressive title of this article, my goals are modest. I begin by explaining briefly what should at any rate be obvious: that health care policies inescapably raise moral and political difficulties, difficulties that no technical fix could resolve. I move on to puzzle over the connections between some of the more abstract issues of moral and political theory and medical policy: here I urge that we develop a more sustained taste for exploring the moral conflicts embedded in our current practices. Finally, I suggest a strategy for making nitty-gritty facts-from the concrete world of third-party payment, expensive technology, …

Abusing The Patient: Medicare Fraud And Abuse And Hospital-Physician Incentive Plans, Kathryn A. Krecke

University of Michigan Journal of Law Reform

Part I provides a background discussion of the PPS, DRGs, and incentive plans. Part II focuses on the fraud and abuse provisions of the Medicare statute and argues that incentive plans violate the plain language · of the statute, which prohibits any knowing and willful remuneration for the inducement of referrals. Part III concentrates on the fraudulent and abusive practices that incentive plans encourage. The plans frustrate legislative intent because they encourage practices that subvert the cost-containment purposes of the PPS and have an adverse effect on patient care.

The Medicare Rx: Prospective Pricing To Effect Cost Containment, H. Lynda Kugel

University of Michigan Journal of Law Reform

This Note analyzes the impact of changing hospital reimbursement while maintaining charge-based reimbursement for physicians on hospital-physician relationships and on cost and quality of care. This Note contends that if the stated goals of redirecting incentives and containing costs are to be realized, physicians must be drawn into the revised reimbursement scheme. An indirect, aggregate approach is advocated to maintain the integrity of the physician-patient relationship and to avoid a direct financial impact upon the physician regarding patient care decisions. Part I will briefly examine the reasons for changing hospital reimbursement from retrospective cost-based reimbursement to prospective fixed rates. Part …

Euthanaisa Legislation: Some Non-Religious Objections, Yale Kamisar

Book Chapters

A book by Glanville Williams, The Sanctity of Lift and the Criminal Law, 1 once again brought to the fore the controversial topic of euthanasia, more popularly known as 'mercy-killing'. In keeping with the trend of the euthanasia movement over the past generation, \Villiams concentrates his efforts for reform on the voluntary type of euthanasia, for example the cancer victim begging for death, as opposed to the involuntary variety-that is, the case of the congenital idiot, the permanently insane or the senile.

When a legal scholar of Williams's stature joins the ranks of such formidable law thinkers as America's Herbert …

From Coitus To Commerce: Legal And Social Consequences Of Noncoital Reproduction, Joan Heifetz Hollinger

University of Michigan Journal of Law Reform

This paper argues that there is an urgent need for the creation and clarification of a legal framework within which contemporary efforts to produce or procure children can take place. State legislatures should act now in order to avoid the kind of crisis that confronts Great Britain, where an infant girl, the product of a breached surrogacy contract, has been impounded by a British court. While the court ponders how to determine the legal parentage of this particular child, Parliament considers criminal penalties for those who arrange surrogacy contracts and general regulations to constrain IVF and ET research and practice. …

Beyond State Intervention In The Family: For Baby Jane Doe, Martha Minow

University of Michigan Journal of Law Reform

Newspapers and broadcasters gave major billing to the story. Headlines announced: "The Life or Death Question of Baby Doe;" and "Baby Doe's Parents Call U.S. Action Intimidating." The medical care decisions about this infant born with spina bifida, microcephaly, and other severe disabilities, not only attracted mass media attention, but also led to both state and federal court proceedings. Legislative hearings raised the issue of her care. Many commentators debated what should happen to this infant of Long Island parents. This article instead will ask: what was all the attention about?; why are cases like this so riveting?; and might …

Of Foxes And Hen Houses: Licensing And The Health Professions, Michigan Law Review

Michigan Law Review

A Review of Of Foxes and Hen Houses: Licensing and the Health Professions by Stanley J. Gross

Selective Nontreatment Of Handicapped Newborns, Michigan Law Review

Michigan Law Review

A Review of Selective Nontreatment of Handicapped Newborns by Robert Weir

Making Health Care Decisions: A Report On The Ethical And Legal Implications Of Informed Consent In The Patient-Practitioner Relationship, Volume 1, Michigan Law Review

Michigan Law Review

A Review of Making Health Care Decisions: A Report on the Ethical and Legal Implications of Informed Consent in the Patient-Practitioner Relationship, Volume 1 by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research

The Insanity Plea: The Uses And Abuses Of The Insanity Defense, Michigan Law Review

Michigan Law Review

A Review of The Insanity Plea: The Uses and Abuses of the Insanity Defense by William J. Winslade and Judith Wilson Ross

The Theory And Practice Of Civil Commitment, Andrew Scull

Michigan Law Review

A Review of The Court of Last Resort: Mental Illness and the Law by Carol A.B. Warren, contributions by Stephen J. Morse and Jack Zusman

Equality, "Anisonomy," And Justice: A Review Of Madness And The Criminal Law, Andrew Von Hirsch

Michigan Law Review

A Review of Madness and the Criminal Law by Norval Morris

The Hardest Drug: Heroin And Public Policy, Michigan Law Review

Michigan Law Review

A Review of The Hardest Drug: Heroin and Public Policy by John Kaplan

The Propriety Of Denying Entry To Homosexual Aliens: Examining The Public Health Service's Authority Over Medical Exclusions, Robert Poznanski

University of Michigan Journal of Law Reform

This Note defends the position that the PHS has the authority to define homosexuality for the purpose of the section 212(a)(4) exclusion, and that the PHS definition is binding upon the INS. Therefore, the PHS's decision to refuse to examine aliens for homosexuality precludes the INS from excluding aliens on that basis. Part I of this Note traces the history of the policy of excluding homosexual aliens. Part II maintains that, regardless of the psychiatric profession's interpretation of ''psychopathic personality,'' Congress intended the expression to encompass homosexuality. Part III contends that Congress intended to empower the PHS to change its …

Employee Selection Base On Susceptibility To Occupational Illness, Mark A. Rothstein

Michigan Law Review

This Article attempts to compile the latest information available concerning this difficult problem. Part I reviews the scientific literature, explaining the biological basis of increased risk of occupational disease. Part II explores the efforts of various employers to incorporate this research into their personnel practices. Part III surveys the legal response to these practices. Employees may challenge medical screening on a variety of theories, most of which were not designed to deal with the problem of susceptibility to occupational disease. Not surprisingly, none of the approaches offers an entirely satisfactory response to the problem. This Article offers no clear answers. …

Who Speaks For The Child: The Problems Of Proxy Consent, Michigan Law Review

Michigan Law Review

A Review of Who Speaks for the Child: The Problems of Proxy Consent edited by Willard Gaylin and Ruth Macklin

Deducting The Cost Of Smoking Cessation Programs Under Internal Revenue Code Section 213, Michigan Law Review

Michigan Law Review

This Note argues that enrollment fees for a smoking cessation program should be classified as deductible medical expenses. Part I defends this conclusion without questioning the accepted interpretation of section 213(e). Recent medical evidence indicates that the nicotine addiction that cessation program patients seek to break is itself a disease. And even prior to the onset of more serious health consequences, sustained cigarette smoking significantly impairs the functioning of the lungs and heart. Under this analysis, enrollment fees should be deductible as expenses for the treatment of an existing disease or defect, and as "amounts paid . . . for …

Regulating America, Regulating Sweden: A Comparative Study Of Occupational Safety And Health Policy, Michigan Law Review

Michigan Law Review

A Review of Regulating America, Regulating Sweden: A Comparative Study of Occupational Safety and Health Policy by Steven Kelman

Mental Health Law: Major Issues, Michigan Law Review

Michigan Law Review

A Review of Mental Health Law: Major Issues by David B. Wexler

Conscience And Convenience: The Asylum And Its Alternatives In Progressive America, Michigan Law Review

Michigan Law Review

A Review of Conscience and Convenience: The Asylum and Its Alternatives in Progressive America by David J. Rothman

Regulation Through The Looking Glass: Hospitals, Blue Cross, And Certificate-Of-Need, Sallyanne Payton, Rhoda M. Powsner

Michigan Law Review

A clear focus on the commitment of the public health and hospital establishments to the large teaching hospital and their belief in rationalizing the health care system through community-based planning allows us to understand the ideas and institutions that have produced our present system of hospital regulation. It can also help us to understand the structure and behavior of the hospital industry and can illuminate current controversies over health care policy.

What follows is a narrative account of the development of regional planning and certificate-of-need legislation. As part of that story, we trace the evolution of the Blue Cross, explain …

Michigan's Nursing Home Reform Law, John D. Croll

University of Michigan Journal of Law Reform

This article examines Michigan's new nursing home reform law, which has been hailed as "landmark legislation" and as a model for the entire country. Part I examines the past failures of nursing home regulation and the need for reform. Part II analyzes the law's key provisions. Part III examines the weaknesses of certain enforcement measures. The article proposes the following improvements: (1) extension of the law's protection to residents of homes for the aged; (2) greater access to patients by approved organizations; (3) adoption of nurse-patient ratios; (4) improvement of inspection procedures; and (5) allowance for patients or their representatives …

Resolving Doctor-Patient Conflicts, Bernard L. Diamond

Michigan Law Review

A review of Taking Care of Strangers: The Rule of Law in Doctor-Patient Relations by Robert A. Burt

Rewriting Roe V. Wade, Donald H. Regan

Book Chapters

Roe v. Wade is one of the most controversial cases the Supreme Court has decided. The result in the case — the establishment of a constitutional right to abortion — was controversial enough. Beyond that, even people who approve of the result have been dissatisfied with the Court's opinion. Others before me have attempted to explain how a better opinion could have been written. It seems to me, however, that the most promising argument in support of the result of Roe has not yet been made. This essay contains my suggestions for ""rewriting" Roe v. Wade.

The Abortion-Funding Cases And Population Control: An Imaginary Lawsuit (And Some Reflections On The Uncertain Limits Of Reproductive Privacy), Susan Frelich Appleton

Michigan Law Review

Two issues are before us today: (I) the meaning of the term "medically necessary" in a public hospital's charter and (II) the constitutionality of state action that provides free medical treatment to indigent pregnant women seeking an abortion but denies them such assistance for prenatal care and childbirth. On the basis of recent Supreme Court authority, we find that such action violates neither the hospital's charter nor the United States Constitution.

The Politics Of Cancer, Michigan Law Review

Michigan Law Review

A Review of The Politics of Cancer by Samuel S. Epstein

Hospital Medical Staff: When Are Privilege Denials Judicially Reviewable?, David Hejna

University of Michigan Journal of Law Reform

The relationship between a hospital and its medical staff is unique. Most physicians serving as hospital staff are not salaried employees . Rather, they use hospital facilities to care for their patients pursuant to "staff privileges" granted by the hospital's board of governors. Staff privileges at one area hospital are practically indispensable for the modern physician, and privileges at a conveniently located hospital are considered important. By extending staff privileges the hospital benefits from having a staff large enough to ensure maximum use of its facilities. The public benefits when an adequate number of qualified physicians have access to hospital …

Regulation Of Electroconvulsive Therapy, Michigan Law Review

Michigan Law Review

Regulation of ECT has generally focused on whether the patient or his representative effectively consented to the treatment. The highly intrusive nature of ECT and the unique circumstances of those patients who are likely to receive it create particularly difficult legal issues concerning the validity of the patient's consent. This Note will examine the various methods that are available to protect the rights of patients for whom ECT is proposed. After briefly explaining the nature of the therapy, the Note will discuss the efficacy of judicial remedies with respect to both competent and incompetent patients. It will argue that, because …

Judicial Review Of Private Hospital Activities, Michigan Law Review

Michigan Law Review

This Note will examine the judicial review of hospitals under state law and the fourteenth amendment and will suggest that unless certain clear requirements for "publicness" are met, judicial restraint based on the failure of legislative institutions to mandate judicial interference is the better course.