Health Law and Policy Commons^™

The Ghost That Slayed The Mandate, Kevin C. Walsh

Scholarly Articles

Virginia v. Sebelius is a federal lawsuit in which Virginia has challenged President Obama's signature legislative initiative of health care reform. Virginia has sought declaratory and injunctive relief to vindicate a state statute declaring that no Virginia resident shall be required to buy health insurance. To defend this state law from the preemptive effect of federal law, Virginia has contended that the federal legislation's individual mandate to buy health insurance is unconstitutional. Virginia's lawsuit has been one of the most closely followed and politically salient federal cases in recent times. Yet the very features of the case that have contributed …

The Anti-Injunction Act, Congressional Inactivity, And Pre-Enforcement Challenges To § 5000a Of The Tax Code, Kevin C. Walsh

Scholarly Articles

Section 5000A of the Tax Code is one of the most controversial provisions of federal law currently on the books. It is the minimum essential coverage provision of the Patient Protection and Affordable Care Act ("ACA" or "Act")-a provision more popularly known as the individual mandate. Opponents challenged this provision immediately upon its enactment on March 23, 2010. The Supreme Court is poised to hear arguments about its constitutionality in one of these challenges, just over two years later.

The Real Constitutional Problem With The Affordable Care Act, Timothy Stoltzfus Jost

Scholarly Articles

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Loopholes In The Affordable Care Act: Regulatory Gaps And Border Crossing Techniques And How To Address Them, Timothy Stoltzfus Jost

Scholarly Articles

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Bounty Hunters And Whistleblowers: Constitutional Concerns For False Claims Actions After Passage Of The Patient Protection And Affordable Care Act Of 2010, A.G. Harmon

Scholarly Articles

Recently, the False Claims Act (FCA) was amended by the Patient Protection and Affordable Care Act of 2010 (PPACA). In a five-word alteration, the PPACA has greatly expanded the reach of the statute, in terms of how a case must be proven, who has to prove it, and what circumstances, if any, will bar the proceeding from going forward." Additionally, new constitutional and policy concerns stem from the increased governmental discretion in deciding which suits can and cannot proceed.6 The problems resulting from the government's expanded discretion go to the very nature of qui tam actions themselves.

This article will …

Health Care: Why Jurisdiction Matters, Kevin C. Walsh

Scholarly Articles

Congress’s enactment of comprehensive healthcare reform legislation last year was the culmination of one round of an intense debate that continues today. The second round began the same day that the first round ended, when President Obama signed the legislation. In this second round, the locus of debate has shifted from Congress to the courts, which are processing a slew of lawsuits filed immediately after enactment.

One of the most prominent is Virginia v. Sebelius. The lawsuit presents on its face a prominent and critically important question of federalism: Did Congress exceed the limits of its enumerated legislative powers by …

Refractory Pain, Existential Suffering, And Palliative Care: Releasing An Unbearable Lightness Of Being, George P. Smith Ii

Scholarly Articles

Since the beginning of the hospice movement in 1967, “total pain management” has been the declared goal of hospice care. Palliating the whole person’s physical, psycho-social, and spiritual states or conditions is central to managing the pain which induces suffering. At the end-stage of life, an inextricable component of the ethics of adjusted care requires recognition of a fundamental right to avoid cruel and unusual suffering from terminal illness. This Article urges wider consideration and use of terminal sedation, or sedation until death, as an efficacious palliative treatment and as a reasonable medical procedure in order to safeguard the “right” …

Oversight Of Marketing Relationships Between Physicians And The Drug And Device Industry: A Comparative Study, Timothy Stoltzfus Jost

Scholarly Articles

Throughout the world, complex mutually-dependent relationships exist between physicians and pharmaceutical and medical device companies. This articlef ocuses on one particulara spect of these relationships--paymentsm ade by drug and device companies to physicians and their organizations and institutions to market drugs and devices. It is widely believed that drug and device company marketing to physicians creates conflicts of interest that corrupt physician judgment and increase the cost of medical care. This article examines first the economic basis of physician/industry relationships that causes conflicts to arise. It next considers the measures that a number of developed countries have taken to respond …

The Death Of Jesse Gelsinger: New Evidence Of The Influence Of Money And Prestige In Human Research, Robin Fretwell Wilson

Scholarly Articles

Ten years ago, Jesse Gelsinger died while participating in a human gene therapy trial at the University of Pennsylvania (“Penn”). His death came to signify the corrosive influence of financial interests in human subjects research. After Jesse's death, the media reported that one researcher. Dr. James Wilson, held shares in a biotech company, Genovo, which stood to gain from the research's outcome — shares that The Wall Street Journal later valued at $13.5 million, although Wilson maintains he did not make nearly this much. At the time Penn authorized Wilson's deal, internal Penn documents implicitly valued Wilson's stake in Genovo …

Health Insurance Exchanges: Legal Issues, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

Weighing Medical Judgments: Explaining Evidentiary Preferences For Treating Physician Opinions In Erisa Cases After Black & Decker Disability Plan V. Nord, Roy F. Harmon Iii, A.G. Harmon

Scholarly Articles

No abstract provided.

The Elderly And Health Care Rationing, George P. Smith Ii

Scholarly Articles

This Monograph derives from research undertaken during my appointment as a Visiting Scholar at The Poynter Center for The Study of Ethics and American Institutions, Indiana University, Bloomington in July-August, 2000. The thesis of this Monograph is that before contemporary society can confront the issue of health care rationing for the elderly, it must seek to integrate the disciplines of moral and ethical reasoning with the qualitative formulations of needs and resources. Until such a point is reached, however, the greatest danger to avoid is the perpetuation of non-decisions regarding health care treatment. Such "decisions" all too frequently result in …

Reshaping The Common Good In Times Of Public Health Emergencies: Validating Medical Triage, George P. Smith Ii

Scholarly Articles

Public health ethics require individuals who are inherently at risk for transmitting communicable disease to be subjected, oftentimes, to isolation, quarantine, or compulsory vaccination - all undertaken, as such, to protect the common good and thereby secure the public-at-law for exposure to the spread of an infectious disease.

This article tests the extent to which public health emergencies necessitate a reinterpretation or reshaping of the common good and proceeds to analyze the extent to which the medical principle of triage is a relevant construct for allocating scarce medical resources during contemporary public health emergencies. The article proceeds to test the …

Global Health Care Financing Law: A Useful Concept?, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

Is Health Insurance A Bad Idea? The Consumer-Driven Perspective, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

Suicide On Campus: The Appropriate Legal Responsibility Of College Personnel, Ann Maclean Massie

Scholarly Articles

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Social Justice And Health Care Management: An Elusive Quest?, George P. Smith Ii

Scholarly Articles

Contemporary debate on health care resource management is tied to a central moral issue: namely, how to achieve an optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failing to tackle and resolve this issue in a confident and forthright manner assures the present approach to health care decision making to continue in a state of indecisiveness if, indeed, not lethargy.

Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Finding a just solution to an equitable distribution of finite health care resources is …

Shifting Risk Of Ruin To Consumers: The Role Of Tax Law In American Health Policy, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

The American Right-Wing Policy Agenda, Timothy Stoltzfus Jost

Scholarly Articles

Right-wing health policy is alive and well in the United States. Pro-business and libertarian health policy advocacy groups, generously funded by right-wing foundations (and, in some instances, by the health care industry), produce a continuous stream of press releases, policy-statements, books, articles, and symposia, as well as testimony before legislative and administrative bodies. Their positions are taken very seriously by the American media, who make certain that right-wing policy experts are represented in any discussion of current health policy issues.

The Massachusetts Health Plan: Public Insurance For The Poor, Private Insurance For The Wealthy, Self-Insurance For The Rest?, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

Policy Making And The New Medicine: Managing A Magnificent Obsession, George P. Smith Ii

Scholarly Articles

Scientific issues become - inevitably - political issues because of one principal fact: they put in focus the extent to which the government can restrict private medical research undertakings - either in the name of generational safety, morality or the public good. The multiple and varied concerns of applying the New Medicine, derived as such from the New Biology, conduce - essentially - to a suspicion continued reductionism in the biological analysis of humans will erode the notions of autonomy, dignity and personal integrity that have traditionally justified the constitutional protection of civil liberties. Driven by painful technologies and sciences, …

Cigarette Smoking As A Public Health Hazard: Crafting Common Law And Legislative Strategies For Abatemen, George P. Smith Ii

Scholarly Articles

The debate over when, and to what extent, the government may regulate public smoking, is a contentious one of great moment. The point at which the line will be drawn with regard to an individual's right to smoke in public is narrowing. This right may stop at public restaurants and the workplace; or it may reach as far as public stadia, outdoor gathering spots and public streets. In 2006, one report showed 461 municipalities in thirty-three states and the District of Columbia, had adopted one-hundred percent smoke-free coverage in restaurants, bars or workplaces; and 135 municipalities had one-hundred percent coverage …

Our Broken Health Care System And How To Fix It: An Essay On Health Law And Policy, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

Health Courts And Malpractice Claims Adjudication Through Medicare: Some Questions, Timothy Stoltzfus Jost

Scholarly Articles

No abstract provided.

The Impact Of The War Over The Corporate Attorney-Client Privilege On The Business Of American Health Care, Sarah Helene Duggin

Scholarly Articles

The purpose of this article is to review the current dispute over the corporate attorney-client privilege and work product doctrine and to explore its impact on the provision of health care. The article's principal thesis is that a strong attorney-client privilege, along with robust work product protection, is critical to the business of health care, the quality of medical services, and the effective enforcement of federal and state health care laws. Part I begins with a brief account of the origins and scope of the conflict between federal law enforcement policies and the corporate attorney-client privilege and work product doctrine …

Consumer-Driven Health Care In South Africa: Lessons From Comparative Health Policy Studies, Timothy Stoltzfus Jost

Scholarly Articles

Consumer-driven health care, based on health savings accounts and high deductible health insurance policies, seems to be the next big thing in U.S. health policy. Long supported by conservative and libertarian advocacy groups, it received a big-boost with the HSA tax subsidy provisions of the Medicare Modernization Act. The question remains, however, whether consumer-driven health care can really bring down health care costs while improving quality and access, as its supporters claim that it will.

This article examines the experience of South Africa, where medical savings accounts have long been available and are widely used. It concludes that South Africa's …

The Role Of State Regulation In Consumer-Driven Health Care, Timothy Stoltzfus Jost, Mark A. Hall

Scholarly Articles

The Consumer-directed health care movement has recently been given a major boost by section 223 of the Medicare Modernization Act, which provides federal income tax subsidies for health savings accounts coupled with high deductible health plans. The federal tax subsidy, however, will only be available in states whose program of insurance regulation permits high deductible health plans to exist. The MMA represents, therefore, a new approach to federalism in health insurance - offering tax incentives for states to change their approach to insurance regulation rather than preempting state regulation or imposing federal regulation. To date the states have generally responded …

Human Rights And Bioethics: Formulating A Universal Right To Health, Health Care, Or Health Protection?, George P. Smith Ii

Scholarly Articles

Codifying, and then implementing, an international right to health, health care, or protection is beset with serious roadblocks - foremost among them being contentious issues of indeterminacy, justiciability, and progressive realization. Although advanced - and to some degree recognized under the rubric of a social or cultural entitlement within the law of human rights and, more particularly, the U.S. Declaration on Human Rights, together with International Covenant on Economic, Social and Cultural Rights (ICESCR), the International Covenant on Civil and Political Rights, the European Convention on Human Rights, and presently UNESCO's Draft Declaration on Universal Norms on Bioethics - attainment …

The Supreme Court Limits Lawsuits Against Managed Care Organizations, Timothy Stoltzfus Jost

Scholarly Articles

In Aetna Health Inc. v. Davila, the United States Supreme Court revisited the question of whether the Employee Retirement Income Security Act (ERISA) precludes state lawsuits against ERISA plans. The Court held that ERISA preempts damage actions brought against managed care organizations under the Texas Health Care Liability Act because ERISA itself provides the exclusive remedy for challenging ERISA plans' coverage decisions. The Court suggested, however, that health plans might be liable for treatment decisions made by employed physicians. It also volleyed back to Congress the question of whether ERISA beneficiaries should have any remedy for damages caused by coverage …

Why Can't We Do What They Do? National Health Reform Abroad, Timothy Stoltzfus Jost

Scholarly Articles

This article describes how other countries organize and finance their health care systems, and how the performance of those health care systems compares with that of the United States. It also examines why the United States, unlike all other developed countries, has failed to provide universal access to health care services.