Health Law and Policy Commons^™

Unenumerated Rights And The Limits Of Analogy: A Critque Of The Right To Medical Self-Defense, O. Carter Snead

Journal Articles

Volokh’s project stands or falls with the claim that the entitlement he proposes is of constitutional dimension. If there is no fundamental right to medical self-defense, the individual must, for better or worse, yield to the regulation of this domain in the name of the values agreed to by the political branches of government. Indeed, the government routinely restricts the instrumentalities of self-help (including self-defense) in the name of avoiding what it takes to be more significant harms. This same rationale accounts for current governmental limitations on access to unapproved drugs and the current ban on organ sales. The FDA …

In The Back Alleys Of Health Care: Abortion, Equality And Community In Canada, Joanna Erdman

Articles, Book Chapters, & Popular Press

The decriminalization of abortion in Canada ensured neither its availability nor accessibility as an integrated and publicly funded health service. While Canadian women are increasingly referred to or seek abortion services from single-purpose clinics, their exclusion from public health insurance often render these services inaccessible. This article considers denied funding for clinic abortion services from the perspective of the Canadian constitutional guarantee of sex equality. The article focuses on the 2004 Court of Queen's Bench's judgment in Jane Doe I v. Manitoba, which framed denied public funding for clinic abortion services as a violation of women's equality rights under the …

On Disposable People And Human Well-Being: Health, Money And Power, Berta E. Hernández-Truyol

UF Law Faculty Publications

The foundational premise of this essay is that health and well-being are human rights issues. My focus on this theme, specifically within the human rights paradigm, is new, passionate, and personal. On December 15, 2005, just three months before the conference that prompted the writing of this essay, I lost my partner of over 20 years. She fought a valiant, strong, and dignified fight against cancer--a journey I traveled with her. During that time I learned much about health systems and health care. Most saliently, notwithstanding the reality of the extraordinarily good care she ultimately received, I realized there is …

Payments To Medicaid Doctors: Interpreting The “Equal Access” Provision, Abigail R. Moncrieff

Law Faculty Articles and Essays

This Comment analyzes the circuit split that has arisen as courts have confronted challenges to Medicaid payments. Part I provides background on the Medicaid program and the circuit split, and it identifies and explicates two competing rules for measuring adequacy of Medicaid payments: the Fifth and Seventh circuits' "access metric" and the Ninth Circuit's "cost metric." Parts II and III identify problems with these two rules, and criticizes them as inconsistent with the statute's text, purpose, and intent. Part IV proposes a new rule, an "MCO metric," and explains why that rule is the best interpretation of Medicaid's reimbursement provision.

Minor Discrepancies: Forging A Common Understanding Of Adolescent Competence In Healthcare Decision-Making And Criminal Responsibility, Kimberly M. Mutcherson

Nevada Law Journal

No abstract provided.

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 …

The Boundaries Of Medicare: Tensions In The Dual Role Of Ontario's Physician Services Review Committee, Colleen M. M. Flood, Joanna Erdman

Articles, Book Chapters, & Popular Press

In this research, we describe and analyse the Physician Services Committee (PSC) in Ontario, focusing on its role in determining what physician services are publicly funded and what services are de-listed (i.e. no longer eligible for public funding). We explain how the PSC's role in determining the boundaries of Medicare is in tension with its role as a medium for labour relations between the government and the medical profession. We suggest that while the values of privacy, secrecy and a lack of transparency may enhance the PSC's fulfillment of its labour relations mandate, they impede the Committee's successful fulfillment of …

Discoverability Of Healthcare Provider Policies And Incident Reports, Michael L. Goodman, Kathleen M. Mccauley, Suzanne S. Duvall

University of Richmond Law Review

No abstract provided.

Medical Malpractice And Contract Disclosure: An Equilibrium Model Of The Effects Of Legal Rules On Behavior In Health Care Markets, Kathryn Zeiler

Faculty Scholarship

This paper develops a theoretical model of how specific legal rules affect the types of contracts managed care organizations ("MCOs") use to compensate physicians. In addition, the analysis provides insights into how physician treatment decisions and the rate of medical malpractice lawsuits react to different legal rules. In particular, the model predicts that outcomes in jurisdictions forcing MCOs to disclose physician contract terms to patients differ from those that do not. Contracts vary depending on the disclosure rule and how treatment costs relate to expected damages and litigation costs. Moreover, the model predicts that jurisdictions forcing contract disclosure observe higher …

The Boundaries Of Medicare: Tensions In The Dual Role Of Ontario's Physician Services Review Committee, Colleen Flood, Joanna Erdman

Articles, Book Chapters, & Popular Press

In this research, we describe and analyse the Physician Services Committee (PSC) in Ontario, focusing on its role in determining what physician services are publicly funded and what services are de-listed (i.e. no longer eligible for public funding). We explain how the PSC's role in determining the boundaries of Medicare is in tension with its role as a medium for labour relations between the government and the medical profession. We suggest that while the values of privacy, secrecy and a lack of transparency may enhance the PSC's fulfillment of its labour relations mandate, they impede the Committee's successful fulfillment of …

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. …

Mid-Atlantic Ethics Committee Newsletter, Spring 2002

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

International Intellectual Property, Access To Health Care, And Human Rights: South Africa V. United States, Winston P. Nagan

UF Law Faculty Publications

This Article examines the question of access to patented medicines in international law. It analyzes the extent to which international agreements may lawfully limit affordable versions of these medicines that may be available through parallel imports or compulsory licensing procedures. It considers the concept of intellectual property rights from a national and international perspective to determine how these rights must be sensitive to matters of national sovereignty when extraordinary, life-threatening diseases afflict societies in catastrophic ways. This Article suggests that viewing property (including intellectual property) as a human right requires that its scope be delimited and understood in the context …

Dna Patenting And Access To Healthcare: Achieving The Balance Among Competing Interests, Melissa E. Horn

Cleveland State Law Review

Increasing evidence suggests that the biotechnology industry's interest in generating revenue and the public's desire to obtain the best healthcare may be at odds. The patenting of genetic information is at the core of this debate. Most, if not all, of the products of the biotech industry's research are patentable. Historically, patents have been justified on the grounds that they are needed to create an incentive for researchers and companies to invest time and money in projects that have uncertain outcomes. In the biotechnology arena, patents do not simply encourage innovation and allow innovators to recoup their costs. Patents can …

Making Clinical Trials Safer For Human Subjects, Michael S. Baram

Faculty Scholarship

Clinical trials, in which new biotech and other medical products are tested on human subjects, provide much of the data used by the FDA to determine whether the products are suitable for routine use in health care. Thus, the trials are of obvious importance to medical progress and improvement of public health, and to those who have career and financial interests at stake. But clinical trials are also important to the human subjects involved because the products being tested on them may remedy their illnesses, but may also pose risks since the products have usually not been previously tested on …

Doctors, Hmos, Erisa, And The Public Interest After Pegram V. Herdrich, Jeffrey W. Stempel, Nadia Von Magdenko

Scholarly Works

The Employee Retirement Income Security Act of 1974 was enacted in the wake of highly publicized pension disasters in order to protect employee pension rights. Born as a piece of pro-worker legislation, it initially was criticized by business groups as a cause of bureaucratic arteriosclerosis that was worse than the disease of pension failures. Even worse, it prompted many employers to consider dispensing with pension plans altogether rather than struggle with the administrative and financial obligations of ERISA. Business, labor, and the public all complained about the law's complexity. It even became something of a national joke as regulators took …

Alternative Dispute Resolution And The Occupational Safety And Health Review Commission: Settlement Judges And Simplified Proceedings, Morell E. Mullins Sr.

Law Faculty Scholarship

No abstract provided.

The Power Of Myth: A Comment On Des Rosiers' Therapeutic Jurisprudence And Appellate Adjudication, Edward A. Dauer

Seattle University Law Review

In the American legal system, the myths surrounding judicial decision-making may pose significant impediments to achieving therapeutic jurisprudence. Courts, we are taught, are confined to the preexisting law, applying it to the conflict as the law itself requires that the conflict be framed. This is, in many ways that matter, a belief system that is not conducive to the therapeutic jurisprudence way.

The Medical Savings Account Provision Of The Hipaa: Is It Sound Health And Tax Policy?, Danshera Cords

Seattle University Law Review

This Comment argues that the Medical Savings Account (MSA) provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) fails to meet the goals of either tax policy or health policy. As a result of this failure, the demonstration program should be redesigned to provide valid and reliable information about whether the availability of tax-preferred MSAs will decrease the affordability of health care and its availability to the less healthy.

Improving America's Health Care: Authorizing Independent Prescriptive Privileges For Advanced Practice Nurses, Mary M. Beck

Faculty Publications

Nursing and organized medicine are engaged in a heated and emotional debate over independent prescriptive privileges for advanced practice nurses. Uncontroverted data demonstrates that nurse practitioners provide high quality health care at a reduced cost, while increasing access to health care for under-served populations. It is apparent that advanced practice nurses could improve the delivery of American health care. However, organized medicine is opposed to autonomous advanced nursing practice and lobbies powerfully against it. Currently, the majority of state laws and regulations pertaining to advanced practice nursing do not promote a sound public health policy, do not contemplate liability issues …

Nonprofit Hospital Mergers And Section 7 Of The Clayton Act: Closing An Antitrust Loophole, Laura L. Stephens

Faculty Scholarship

Nonprofit hospitals developed out of the charitable hospital movement, which began in the mid-nineteenth century.' The early voluntary hospitals depended upon local benefactors for financing.² Originally conceived as charitable institutions providing long-term care, these hospitals began to change their focus around the turn of the century.³ A changed mission-providing care to all rather than just poor inpatients with chronic problems-required the latest medical technology.⁴ This in turn demanded increased construction of up-to-date facilities, as well as large operating expenses.

Recent years have seen further pressure on hospital budgets, as the health-care sector of the economy has become …

Patents In Health Care - Subsidy And Victimisation?, Michael Henry Davis

Law Faculty Articles and Essays

In theory, a patent provides a monopoly over a product or a process in return for the disclosure of an inventive discovery. In practice, however, it is an indirect form of government intervention in healthcare which carries enormous calculable costs but whose benefits are entirely a matter of faith. It is ironic that in healthcare of all areas, where the guiding principle is the application of the scientific method, extraordinary investments are made in a system which so far has not been subjected to any scientific test.

Consensus Development At Nih: What Went Wrong, Itzhak Jacoby

RISK: Health, Safety & Environment (1990-2002)

A close observer identifies the Science Court concept as inspiring consensus development conferences at the National Institutes of Health and describes the extent to which they have followed the model. Professor Jacoby also argues that, if the model were more closely followed, conference objectives would be better realized.

Health-Care Rights Of The Poor: An Introduction, Michele Melden, Michael Parks, Laura Rosenthal

University of the District of Columbia Law Review

Improving access to health care is a high priority for low-income people and their advocates. A variety of tools exist to establish legal rights to reimbursement and services. Mastery of these tools can provide dramatic improvements in the lives of the poor. This article provides a brief overview of the primary reimbursement sources for health care-Medicaid, Medicare, private insurance, and state and county indigent care programs. It covers the issues involved in and approaches to insuring the uninsured. It also explains the protection of access to health care provided by the Hill-Burton program, emergency room law, and civil rights. Basic …

Feeding The Permanently Unconscious And Terminally Ill Or Dying Is Not Always Compassion, Phebe Saunders Haugen

Faculty Scholarship

A surrogate decision maker may conclude that efforts to mechanically provide liquid nourishment would cause considerable suffering in return for little gain. But such a decision is unquestionably one that can produce great conflict for families and for medical caregivers. Assessment must be made of each patient's situation and of the benefits and burdens that will result if tube feeding is withheld or withdrawn. It may well be, however, that in some cases, the most humane and compassionate treatment for a patient is the withdrawal of all technological interventions, including those that supply nourishment.

Health Care: An Overview Of The Indian Health Service, William Boyum

American Indian Law Review

No abstract provided.

Tax Exempt Financing Of Health Care Facilities As A Component Of The Market Approach To Health Care Cost Containment, George A. King

Fordham Urban Law Journal

This Comment will discuss the current health delivery system in the context of a Market Approach to health care cost containment. Political and financial issues in health care as well as current judicial and tax policies affecting Market Approach theory will be examined. The Comment concludes that targeted tax exempt financing must play a major role in establishing competitive forces in the health care delivery system.

The Nonproliferation Mandate And The Appropriate Legal Standard In Health Care Bargaining Unit Determinations, Mary Esquivel Sciarra

Fordham Urban Law Journal

This Comment examines the ongoing controversy over the appropriate legal standard to be applied in the determination of bargaining units in the health care industry. It reviews the basic law which governs the selection of appropriate units, discusses the legislative history of the 1974 amendments as they relate to bargaining units, and considers the intent of the accompanying admonition against unit proliferation. Implementation of the congressional mandate is examined in Board unit determinations. The Board's persistent use of the traditional industrial community of interest test is examined in light of circuit court decisions which have advocated new approaches. This Comment …