Health Law and Policy Commons^™

Building Healthy Cities: Legal Frameworks And Considerations, Wendy Collins Perdue

Law Faculty Publications

This chapter will explore the range of laws and government policies that have shaped the physical structure of U.S. cities and thereby impacted the health of those cities' residents. This analysis will highlight the many, apparently "private" decisions that have been impacted by government policies. Though some of the laws, policies, prohibitions, and incentives have been formulated explicitly to take into account health considerations, others have unintended effects - both good and bad - on the health of urban populations.

Is It Too Late For Title Vi Enforcement?: Seeking Redemption Of The Unequal Long Term Care System In The United States Through International Means, Ruqaiijah Yearby

All Faculty Scholarship

Legal and medical experts have noted continued racism in the health care system that prevents the equal distribution of quality care. Initially most racism was intentional and expressed through de jure segregation, as evidenced by federal funding of the construction of racial segregated health care facilities. Now most racism, expressed through de facto segregation, is subtly incorporated into the daily practices of institutions causing an adverse disparate impact on African-Americans. This institutional racism establishes separate and independent barriers through the neutral denial of opportunities and equal rights to individuals and groups that results from the normal operations of the institutions …

Be Not Afraid Of Change: Time To Eliminate The Corporate Practice Of Medicine Doctrine, Nicole Huberfeld

Faculty Scholarship

This article argues that the corporate practice of medicine doctrine is a physician-centric, guild type doctrine that is misplaced in the present incarnation of the American healthcare system and that does nothing to improve quality, efficiency, or accountability. The paper focuses on three key reasons that the corporate practice of medicine doctrine should be laid to rest. First, the motives for creating the corporate practice of medicine doctrine are long gone, as physicians have not been able to operate as a guild of autonomous providers of healthcare for quite some time. Second, it is disingenuous to pretend that physicians are …

The Law-Medicine Center 50tj Anniversary Symposium: The Field Of Health Law: Its Past And Futrue -- Introduction, Maxwell J. Mehlman

Health Matrix: The Journal of Law-Medicine

No abstract provided.

Be Not Afraid Of Change: Time To Eliminate The Corporate Practice Of Medicine Doctrine, Nicole Huberfeld

Law Faculty Scholarly Articles

This article focuses on three key reasons that the corporate practice of medicine doctrine should be laid to rest. First, the motives for creating the corporate practice of medicine doctrine are long gone; it has been some time since physicians have been able to operate as a guild of autonomous providers of health care. The delivery and financing of health care places physicians in an integrated system that is only frustrated by the corporate practice of medicine doctrine. Second, it is disingenuous to pretend that physicians are not influenced by financial gain. This is handily evidenced by the federal and …

Children’S Health And Human Rights, Norie Nogami

Human Rights & Human Welfare

One of the first international attempts to improve the health of children was by Ms.Eglantyne Jebb, a founder of Save the Children, during the aftermath of the WWI. She drafted the Geneva Declaration of the Rights of the Child, the first international children’s rights document adopted by the League of Nations in 1924. Today, in the Convention on the Rights of the Child (1989) we have a more comprehensive and near universal legal instrument for children’s rights.

Health Care Law, Kathleen M. Mccauley

University of Richmond Law Review

No abstract provided.

Making The Health Insurance Flexibility And Accountability (Hifa) Waiver Work Through Collaborative Governance, Barbara Zabawa

Faculty Works

This article examines the Health Insurance Flexibility and Accountability (HIFA) waiver introduced in 2001, focusing on its potential as a tool for collaborative governance in expanding health insurance coverage. The HIFA waiver grants states greater programmatic flexibility and encourages public-private partnerships, aiming to address the complex challenges of uninsured populations. Although the waiver has been criticized for possibly reducing benefits and increasing cost-sharing, the paper argues for its use as a vehicle to foster stakeholder collaboration. It highlights the importance of integrating diverse perspectives to design politically and economically viable health reforms. Challenges such as stakeholder engagement, accountability, and resource …

Against A Federal Patients' Bill Of Rights, Edward A. Zelinsky

Articles

The failure of the 107th Congress to pass a "Patients' Bill of Rights" (PBR) is widely considered a major disappointment, to be remedied in the 108th Congress by the adoption of such legislation. Indeed, federal PBR proposals have achieved the proverbial motherhood-and-apple-pie status; it is virtually impossible to find anyone actively opposing a federal PBR. Many members of the 108th Congress likely feel pressure to pass PBR legislation before returning to the electorate in 2004.

I advance a contrary perspective: A federal PBR is an idea whose time is past or, to be precise, is an idea whose rationales are …

The Right To Health And The Nevirapine Case In South Africa, George J. Annas

Faculty Scholarship

Thanks to activists in South Africa, the right to health as a human right has returned to the international stage, just as it was being displaced by economists who see health through the prism of a globalized economy and by politicians who see it as an issue of national security or charity. The current post-apartheid debate in South Africa is not about race but about health, and in this context, the court victory by AIDS activists in the nevirapine case has been termed not only, as stated in one British newspaper, “the greatest defeat for [President Thabo] Mbeki's government” but …

Increasing The Supply Of Organs In Transplantation Through Paired Organ Exchanges, Michael T. Morley

Scholarly Publications

No abstract provided.

Putting Health Care Providers At A Loss And Consumers At Risk: Why Hmos Should Be Held Accountable For The Financial Instability Of Their Delegated Networks., Anish P. Michael

St. Mary's Law Journal

This Comment explores why health maintenance organizations (HMOs) such as PacifiCare should be held accountable for the financial instabilities of their delegated networks. Part II discusses the organization of the managed care system and the assessment of Texas laws currently enforcing managed care in the state. Incorporated in this discussion is a look at the risks delegated networks bear when contracting with HMOs to provide payment for individualized care. Part III analyzes the increasing trend of financial instability by presenting the views of the HMOs, the delegated networks, the health care providers, and the consumers enrolled in the health plan. …

Genetic Health And Eugenics Precedents: A Voice Of Caution, Larry I. Palmer

Faculty Publications

No abstract provided.

The Louisa Van Wezel Schwartz Symposium On Mental Health Issues In Correctional Institutions - Proceedings, Brenda V. Smith

Scholarly Articles in Law Reviews & Journals

Now, you would think that I was as old as dirt after listening to that introduction. Well, the truth is, I am as old as dirt. And I told Paul Quander that we are both as old as dirt.

First, I want to thank Arlene for inviting me. Many, many months ago Arlene called and asked me if I would speak at this symposium on mental health in correctional institutions.

Protecting Human Research Subjects: A Jurisdictional Analysis, Jennifer Llewellyn, Jocelyn Downie, Robert Holmes

Articles, Book Chapters, & Popular Press

The most recent speech from the throne contained a pledge from the federal government to "work with provinces to implement a national system for the governance of research involving humans, including national research ethics and standards." This commitment signals a desire on the part of the federal government to address concerns about the inadequacies of the current governance of health research involving humans (RIH). To this end, Health Canada's Ethics Division is currently exploring the ways in which such a national governance system for RIH might be implemented. It is important for the federal government, as it moves toward making …

Protecting Human Research Subjects: A Jurisdictional Analysis, Jennifer Llewellyn, Jocelyn Downie, Robert Holmes

Articles, Book Chapters, & Popular Press

The most recent speech from the throne contained a pledge from the federal government to "work with provinces to implement a national system for the governance of research involving humans, including national research ethics and standards." This commitment signals a desire on the part of the federal government to address concerns about the inadequacies of the current governance of health research involving humans (RIH). To this end, Health Canada's Ethics Division is currently exploring the ways in which such a national governance system for RIH might be implemented. It is important for the federal government, as it moves toward making …

Health Care Law, Peter M. Mellette, Emily W. G. Towey, J. Vaden Hunt

University of Richmond Law Review

No abstract provided.

Proxy Consent To Organ Donation By Incompetents, Michael T. Morley

Scholarly Publications

No abstract provided.

Disability, Doctors And Dollars: Distinguishing The Three Faces Of Reasonable Accommodation, Elizabeth Pendo

All Faculty Scholarship

Despite a decade of litigation, there is no consistent understanding of the reasonable accommodation requirement of Title I of the Americans with Disabilities Act of 1990 (the 'ADA'). Indeed, there are three inconsistent distributive outcomes that appear to comport with the reasonable accommodation requirement: cost-shifting, cost-sharing, and cost-avoidance.

One reason for such inconsistent outcomes is a failure to develop a coherent and consistent theory of disability. Because disability has been and continues to be medicalized, this Article takes a fresh look at the medical literature on health, illness, and disability. It recommends the use of the experiential health model over …

The Hormesis Challenge For Environmental Health Regulators, Michael S. Baram

Faculty Scholarship

The hormesis hypothesis provides that human, animal or plant exposure to a low external dose of a hazardous chemical substance or physical agent may have beneficial health outcomes'. For example, human exposure to a precisely defined, low external dose of a carcinogenic pollutant in the workplace or ambient environment may lead to an internal dose or concentration, which stimulates a dormant defense mechanism that inhibits the growth of tumors.

Breaking Through The Erisa Blockade: The Ability Of States To Access Employer Health Plan Information In Medicaid Expansion Initiatives, Barbara Zabawa

Faculty Works

The article discusses the challenges and potential solutions for states to access employer health plan information under the constraints of the Employment Retirement Income Security Act (ERISA) of 1974. It focuses on the importance of such access in supporting Medicaid expansion programs, using Wisconsin’s BadgerCare initiative as a case study. The article highlights the growing concern about "crowd out," where public health programs may displace employer-sponsored insurance, and argues for balanced public-private health coverage. It examines legal avenues for circumventing ERISA preemption, including federal law exceptions, Qualified Medical Child Support Orders (QMCSOs), and provisions under Title XIX of Medicaid. By …

The "Access" Problem: How Employee And Employer Issues May Increase Badgercare Participation By Impeding The Verification Process, Barbara Zabawa

Faculty Works

In its effort to be a welfare reform pioneer, Wisconsin has led the nation in adopting one of the most expansive public health insurance programs, "BadgerCare," to address the health care needs of working families in the post-welfare reform era. One year after BadgerCare implementation, Wisconsin is experiencing the fiscal impact of the program due to unexpectedly high enrollment in BadgerCare. While some Wisconsin leaders praise this growth rate for reducing the number of uninsured, others raise a concern that the enrollment figures may be rising due to employees opting for BadgerCare rather than employer-sponsored insurance. Consequently, this "crowd-out" effect …

Quality Control, Enterprise Liability, And Distintermediation In Managed Care, Nicole Huberfeld, John V. Jacobi

Law Faculty Scholarly Articles

In this article, the authors examine the potential of enterprise liability in light of current health-care finance realities. The article begins by addressing background issues of medical malpractice theory and the development of proposals for a form of plan-based enterprise medical liability centered on managed care organizations (MCOs). The authors then describe recent trends in the evolution of more loosely structured MCOs, including the emergence of "disintermediated," or patient-directed, plans. The authors examine the extent to which these developments weaken the rationales for plan-based enterprise liability. The article concludes nevertheless that plan-based enterprise liability best serves the goal of reducing …

Responsible Regulation: A Sensible Cost-Benefit, Risk Versus Risk Approach To Federal Health And Safety Regulation, Steve Calandrillo

Articles

Federal health and safety regulations have saved or improved the lives of thousands of Americans, but protecting our citizens from risk entails significant costs. In a world of limited resources, we must spend our regulatory dollars responsibly in order to do the most we can with the money we have. Given the infeasibility of creating a risk-free society, this paper argues that a sensible cost-benefit, risk versus risk approach be taken in the design of U.S. regulatory oversight policy. The goal should always be to further the best interests of the nation, rather than to satisfy the narrow agenda of …

Genetic Testing For Susceptability To Disease From Exposure To Toxic Chemicals: Implications For Public And Worker Health Policies, Michael S. Baram

Faculty Scholarship

The Environmental Genome Program intends to identify "susceptibility genes" that would indicate if a person is more vulnerable to cancer or other disease as a result of exposure to certain chemicals in the workplace, the environment, foods, or other products. Research findings and the capability to test persons for such genes are likely to impugn and challenge health policies and regulatory programs that do not take genetic susceptibility into account when conferring health benefits and restricting chemical exposures. This article focuses on the Occupational Safety and Health Administration (OSHA) and discusses four options available to this agency for protecting genetically …

Global Village, Divided World: South-North Gap And Global Health Challenges At Century's Dawn, Obijiofor Aginam

Indiana Journal of Global Legal Studies

No abstract provided.

Tobacco, The Food And Drug Administration, And Congress, Leonard H. Glantz, George J. Annas

Faculty Scholarship

Smoking has been the number-one target of public health professionals in the United States for more than a decade because it is the leading cause of premature death. Nonetheless, no unified public health strategy has been developed. In 1995, with the strong endorsement of President Bill Clinton and Vice President Al Gore, the commissioner of the Food and Drug Administration (FDA), Dr. David Kessler, announced that the agency had jurisdiction over tobacco and would regulate cigarettes as “drug-delivery devices. The tobacco companies objected and sued the FDA, arguing that Congress had not given the FDA jurisdiction over their product. The …

Neither Science Nor Shamans: Globalization Of Markets And Health In The Developing World, David Fidler

Indiana Journal of Global Legal Studies

No abstract provided.

Harming Future Persons: Obligations To The Children Of Reproductive Technology, Philip G. Peters Jr.

Faculty Publications

Two paradigms dominate contemporary ethical and legal debate about the risks posed to children who owe their lives to reproductive technology. One asks whether the children have lives so tragic that life itself is harmful. The other approach asks whether children so conceived are likely to enjoy a minimally decent existence. Although the two approaches have quite different analytic foundations, they share one crucial trait. Each concludes that children who owe their lives to reproductive technology are harmed only when that technology causes genuinely catastrophic injuries.Because these conventional paradigms define harmful conduct exclusively by reference to the magnitude of the …

Burden Of Proof: Judging Science And Protecting Public Health In (And Out Of) The Courtroom, George J. Annas

Faculty Scholarship

The breast implant cases alleging systemic disease would in all likelihood have been lost had recipients been properly warned of potential dangers by the manufacturer or their surgeons.