Health Law and Policy Commons^™

Fundamentals Of Underwriting In The Nongroup Health Insurance Market: Access To Coverage And Options For Reform, Mark Merlis

National Health Policy Forum

Although the majority of Americans with health insurance obtain coverage through their employers, many individuals must negotiate the nongroup insurance market alone. Insurers use a process called medical underwriting to identify applicants with current or recent medical problems. Because these applicants are likely to cost the insurer more in claims than a healthier person, insurers may charge them higher premiums or restrict or deny coverage. This background paper reviews the practice of underwriting, state and federal regulation of insurers offering nongroup health coverage, and several proposed options for improving access to coverage for applicants who are in poor health.

Health Savings Accounts: The Fundamentals, Beth Fuchs, Julie A. James

National Health Policy Forum

This paper explores the fundamentals of health savings accounts (HSAs). While not intended to be an exhaustive review of these accounts, it describes their intellectual and legislative origins and the mechanics of how they work, explores the early returns on how they are faring in the insurance market, and identifies major issues and controversies that they raise. The paper looks specifically at the basic rules for HSAs and the requirements for health insurance that qualifies as a high-deductible health plan (HDHP) for HSA purposes. Also considered are issues related to provider payments under HSAs and the administration of the benefit …

Law & Health Care Newsletter, V. 12, No. 2, Spring 2005

Law & Health Care Newsletter

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Spring 2005

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Newsletter, Spring 2005

Newsletter

No abstract provided.

A New Kind Of "Outrageous Misconduct": Effects To Undermine The Law's Ability To Deter And Punish Intentional And Outrageous Corporate Behavior, Candace Howard

Student Articles and Papers

The current tort "reform" movement, if successful, will completely undermine our most effective tool for deterring outrageous corporate misconduct: the threat of punitive damages. Such "reform" would have a particularly egregious impact on the environment and public health because, due to a lack of enforcement and the undetectable nature of many pollutants, environmental offenses are often more difficult to deter than other types of offenses. The essay argues that, although rarely imposed for environmental offenses, punitive damages are especially vital in that arena because, when imposed, they are richly deserved. It concludes that, rather than tort reform, what we need …

The Price We Are Willing To Pay For Punitive Justice In The Juvenile Detention System: Mentally Ill Delinquents And Their Disproportionate Share Of The Burden, Jessica Ann Garascia

Indiana Law Journal

No abstract provided.

Beyond The Bylaws: Hospital—Physician Relationships, Economics, And Conflicting Agendas, John D. Blum

Buffalo Law Review

No abstract provided.

Emtala And Hospital "Community Engagement": The Search For A Rational Policy, Sara Rosenbaum, Bruce Siegel, Marsha Regenstein

Buffalo Law Review

No abstract provided.

Government Reinsurance Programs And Consumer-Driven Care, John V. Jacobi

Buffalo Law Review

No abstract provided.

Medicare Should, But Cannot, Consider Cost: Legal Impediments To A Sound Policy, Jacqueline Fox

Buffalo Law Review

No abstract provided.

Universal Hospital Insurance And Health Care Reform: Policy Legacies And Path Dependency In The Development Of Canada's Health Care System, Lesley A. Jacobs

Buffalo Law Review

No abstract provided.

Drug Development And The Public Health Mission: Collaborative Challenges At The Fda, Nih, And Academic Medical Centers, Sheila R. Shulman, Andrea Kuettel

Buffalo Law Review

No abstract provided.

Watch Out For Whistleblowers, Leslie C. Griffin

Scholarly Works

No abstract provided.

Consumer-Directed Health Care And The Chronically Ill, John V. Jacobi

University of Michigan Journal of Law Reform

Insurance plans with consumer-controlled spending accounts are advocated as tools for reducing health costs and empowering consumers. This Article describes their recent development and argues that they are likely to fail. Instead of focusing on the small number of consumers with chronic illnesses who account for the bulk of health spending they focus on the majority of relatively well consumers. This Article proposes market-based and regulatory changes focused on high-cost patients. To best serve cost and quality goals, health finance responsibility should be divided between consumers and their employers for predictable and routine costs, and government for chronic and catastrophic …

Puncturing The Funnel—Saving The "Any Willing Provider" Statutes From Erisa Preemption, Sharon Reece

University of Arkansas at Little Rock Law Review

No abstract provided.

Physician Collective Bargaining: State Legislation And The State Action Doctrine, Roger D. Blair, Kristine L. Coffin

Cardozo Law Review

No abstract provided.

Akinbola E. Akinwumi On Sickness And Wealth: The Corporate Assault On Global Health By Meredith Fort, Mary Anne Mercer And Oscar Gish (Eds). Cambridge: South End Press, 2004. 237pp., Akinbola E. Akinwumi

Human Rights & Human Welfare

A review of:

Sickness and Wealth: The Corporate Assault on Global Health by Meredith Fort, Mary Anne Mercer and Oscar Gish (eds). Cambridge: South End Press, 2004. 237pp.

The Game Of Pleasant Diversion: Can We Level The Playing Field For The Disabled Athlete And Maintain The National Pastime, In The Aftermath Of Pga Tour, Inc. V. Martin: An Empirical Study Of The Disabled Athlete, Donald H. Stone

All Faculty Scholarship

Kenny Walker, a deaf football player; Jim Abbott, a one-handed professional baseball player; Tom Dempsey, a physically disabled professional football kicker; Brad Doty, a paralyzed auto racer; and Nick Ackerman, a wrestler with amputated legs, have all competed at the highest level of sports. Persons with mental illness, individuals who are blind, and students with hearing impairments are seeking an opportunity to compete in fair competition with their non-disabled competitors. Can this occur in a fair, open, and just manner between competing athletes?

Does the Americans with Disabilities Act of 1990 ("ADA"), the landmark civil rights act protecting an individual …

Law And Public Health: Beyond Emergency Preparedness, Wendy K. Mariner

Faculty Scholarship

This Article examines three questions: What is public health? What is public health law? What roles can lawyers play in public health? It first describes the breadth of public health, highlighting six trends shaping its future: social determinants of health; synergy between medicine and public health; shifts in focus from external (e.g., environmental and social) to internal (behavioral) risks to health; federalization of public health law; globalization of health risks and responses; and bioterrorism. Because the domains of law that apply to public health are equally broad, the Article next offers a conceptual framework for identifying the types of laws …

Exploring California's Rural Health System: From The Redwood Forests To The Baja Border, Eileen Salinsky, Jessamyn Taylor

National Health Policy Forum

This three day site visit to California explored the state’s rural health system with a particular focus on the financial health of inpatient and outpatient providers and how that affects access to care. The role of telemedicine as a tool for expanding access was explored as well as the special needs of vulnerable populations such as farmworkers. Participants learned how state and federal regulation and payment policies and state budget deficits impact the viability of rural health systems.

A Right To No Meaningful Review: The Aftermath Of Shalala V. Illinois Council On Long Term Care, Inc., Ruqaiijah Ayanna Yearby

ExpressO

A RIGHT TO NO MEANINGFUL REVIEW: THE AFTERMATH OF SHALALA v. ILLINOIS COUNCIL ON LONG TERM CARE, INC. Ruqaiijah A. Yearby

The Due Process Clause of the Fifth Amendment has been perverted in the federal administrative system. Federal agencies, such as the U.S. Department of Health and Human Services (HHS), regularly deprive individuals of liberty and property with little to no review. In its regulation of the health care industry through the Medicare program, HHS often turns a blind eye to procedural Due Process protections, such as providing individuals an opportunity to challenge the deprivation of property at a hearing, …

Soft Regulators, Tough Judges, Gerrit De Geest, Giuseppe Dari-Mattiacci

George Mason University School of Law Working Papers Series

Judges have a tendency to be more demanding than regulators. In the United States, a majority of the courts has adopted the rule that the unexcused violation of a statutory standard is negligence per se. However, the converse does not hold: compliance with regulation does not relieve the injurer of tort liability. In most European legal systems, the outcome is similar. We use a framework in which, on the one hand, the effects of tort law are undermined by insolvency and evidence problems and, on the other hand, regulation is expensive in terms of monitoring and information gathering. We show …

2005 Pinellas County Human Services Priorities Conference Summary Report, Eric M. Eisenberg

Mental Health Law & Policy Faculty Publications

On March 2, 2005, influential leaders in Pinellas County Human Services gathered to discuss the state of the county and set priorities for the future. The starting point for this conversation was findings from a comprehensive assessment of services conducted by researchers at the Louis de la Parte Florida Mental Health Institute at the University of South Florida. The purpose of this brief report is to summarize the main points made in the conference in the hope that they can provide significant direction for the development of future plans and initiatives in this arena.

Taking Biologics For Granted? Takings, Trade Secrets, And Off-Patent Biological Products, Andrew Wasson

Duke Law & Technology Review

Biologics are complex medicines which are often genetically engineered, and which are sure to play an important role in curing some of humankind's worst diseases. Not surprisingly, generic companies want a part of the biologic market. The FDA believes that it has the authority to approve off-patent versions of biologics that were originally regulated under the Food, Drug & Cosmetic Act, but in order to effectively do so the FDA would have to rely on findings based on data produced by the brand name companies. This iBrief examines whether the FDA's reliance on previous findings would give rise to a …

Disclosure Of Clinical Trial Data: Why Exemption 4 Of The Freedom Of Information Act Should Be Restored, Janene Boyce

Duke Law & Technology Review

Clinical trial data generated during the FDA drug approval process can be very valuable. While patients and doctors desperately need this information to make informed choices about medical treatment, drug sponsors strive to keep this resource secret to ensure their ability to profit from their own research. In the wake of the controversy over antidepressant use in children, both the public and Congress have called for the disclosure of all clinical trial data. However, rather than taking an all-or-nothing approach that could harm the development of new drugs, this iBrief argues that Congress should address the issue of trial data …

Organizational Misconduct: Beyond The Principal-Agent Model, Kimberly D. Krawiec

ExpressO

This article demonstrates that, at least since the adoption of the Organizational Sentencing Guidelines in 1991, the United States legal regime has been moving away from a system of strict vicarious liability toward a system of duty-based organizational liability. Under this system, organizational liability for agent misconduct is dependant on whether or not the organization has exercised due care to avoid the harm in question, rather than under traditional agency principles of respondeat superior. Courts and agencies typically evaluate the level of care exercised by the organization by inquiring whether the organization had in place internal compliance structures ostensibly designed …

What Do Exit Polls And Flu Vaccine Shortages Have In Common?, Albert A. Foer, Robert H. Lande, F.M. Scherer

All Faculty Scholarship

What do exit polls and flu vaccine shortages have in common? Both involve situations where society has come to rely excessively on too few entities. When even one company makes a mistake society can suffer significantly. This short piece advocates that we abandon our almost laissez faire tolerence towards high concentration, and rely upon competition, rather than on monopoly or a small number of producers.

Disappearing Defendants V. Judgment Proof Injurers: Upgrading The Theory Of Tort Law Failures, Giuseppe Dari-Mattiacci, Barbara Mangan

George Mason University School of Law Working Papers Series

Do injurers’ insolvency and victims’ reluctance to sue affect accident prevention in the same way? Are these circumstances less of a problem under the negligence rule than under strict liability? We argue, contrary to the literature, that the answer is, in most cases, negative and make three main points. First, the judgment proof problem and the disappearing defendant problem are shown to have different effects on injurers’ behavior and hence yield dissimilar levels of social welfare. Second, when these two problems occur simultaneously they may have offsetting effects. Third, the negligence rule is superior to strict liability only under some …

Studying Medical Error In Situ: Implications For Malpractice Law And Policy, Lori B. Andrews

All Faculty Scholarship

No abstract provided.