Health Policy Commons^™

Health And Foreign Policy, David P. Fidler, Nick Drager

Articles by Maurer Faculty

No abstract provided.

Contesting Anticompetitive Actions Taken In The Name Of The State: State Action Immunity And Health Care Markets, Clark C. Havighurst

Faculty Scholarship

The so-called state action doctrine is a judicially created formula for resolving conflicts between federal antitrust policy and state policies that seem to authorize conduct that antitrust law would prohibit. Against the background of recent commentaries by the federal antitrust agencies, this article reviews the doctrine and discusses it's application in the health care sector, focusing on the ability of states to immunize anticompetitive actions by state licensing and regulatory boards, hospital medical staffs, and public hospitals, as well as anticompetitive mergers and agreements. Although states are free, as sovereign governments, to restrict competition, the state action doctrine requires that …

The Epidemiology Of U.S. Immunization Law: Translating Cdc Immunization Guidelines Into Practice: State Laws Related To The Use Of Standing Orders Covering Immunization Practice, Alexandra M. Stewart, Marisa A. Cox, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This pilot study examines how five states -- Georgia, Massachusetts, New York, Oregon, and Texas – approach the legal question of delegation of medical practice powers in an immunization practice context.

Achieving "Readiness" In Medi-Cal's Managed Care Expansion For Persons With Disabilities: Issues And Process, Sara J. Rosenbaum, Sara E. Wilensky, Peter Shin

Health Policy and Management Faculty Publications

This Policy Brief examines issues that can be expected to arise as California moves to significantly expand the use of mandatory managed care arrangements for Medi-Cal enrollees with disabilities. This analysis is based on information gleaned from more than a decade of Medicaid managed care specification analyses for the federal government and private funders, focusing on both the general beneficiary population and persons with chronic illnesses and disabilities. This Policy Brief also reflects experiences in furnishing technical assistance to state purchasers and in developing model managed care purchasing specifications for both general and special needs managed care populations for both …

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.

Against “Individual Risk”: A Sympathetic Critique Of Risk Assessment, Matthew D. Adler

Faculty Scholarship

No abstract provided.

Health As Foreign Policy: Between Principle And Power, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Obesity And The Struggle Within Ourselves, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

The author argues that we ought to treat our eating, exercise habits, and girth as personal matters, for the most part, but that law can and should make a contribution, as an ally of our longer-term will against our immediate cravings. Law can be our ally in this fashion without command-and-control intrusion into our private lives. Such intrusion is at odds with our core beliefs and unlikely to produce public health success. It is more likely to provoke popular backlash--one reason why some who stand to gain from our unhealthy dining choices try to cast government efforts to inform these …

The Effects Of Copayments On The Use Of Medical Services And Prescription Drugs In Utah's Medicaid Program, Leighton Ku, Elaine Deschamps, Judi Hilman

Health Policy and Management Faculty Publications

In recent years, a number of states have increased cost-sharing for low-income Medicaid beneficiaries as one approach to Medicaid cost-containment. While copayments have been most commonly applied to prescription drugs, they also have been assessed for other services, such as physician visits, hospital admission, or outpatient clinic use.

Prior research has found that when low-income patients are required to pay more for health care services or for prescription drugs, they use fewer services or medications.[2] In some cases, their health could deteriorate, with the result that they may subsequently require more expensive emergency room or inpatient hospital care. While …

Medicaid Prescription Drug Spending And Use, Brian Bruen, Arunabh Ghosh

Health Policy and Management Issue Briefs

No abstract provided.

Democratic Ideas To Address The Problem Of Americans Without Health Insurance, Jeanne Lambrew

Health Policy and Management Congressional Testimonies

No abstract provided.

Politics, Power, And Public Health: A Comment On Public Health’S New World Order, Laurence R. Helfer

Faculty Scholarship

No abstract provided.

Access To Health, Natalie Huls

Human Rights & Human Welfare

Access to health is an often-overlooked aspect of the right to health. Without practical access, the right to health becomes an empty promise. International human rights conventions and declarations do not directly mention access to health, but the above comment on the International Covenant on Economic, Social, and Cultural Rights does address the issue.

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …

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.

Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart

Center for Integrated Behavioral Health Policy

No abstract provided.

Legal Movements In Intellectual Property: Trips, Unilateral Action, Bilateral Agreements, And Hiv/Aids, Margo A. Bagley

Faculty Articles

This Article begins with an overview of the relationship between the Agreement on Trade-Related Aspects of Intellectual Property Rights (the "TRIPS Agreement") and the HIV/AIDS pandemic which created the need for the Doha Declaration. It then discusses two trade-related movements, unilateral action and TRIPS-plus bilateral agreements, that call into question the long-term effectiveness of the TRIPS Agreement process, generally, and the benefits of the Doha Declaration, in particular, in addressing multiple facets of the access to essential medicines problem. This Article concludes that a consideration of these issues should be included in the development of any further TRIPS-related solutions to …

The Politics Of Public Health: A Response To Epstein, Lawrence O. Gostin, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

Conservatives are taking aim at the field of public health, targeting its efforts to understand and control environmental and social causes of disease. Richard Epstein and others contend that these efforts in fact undermine people’s health and well-being by eroding people’s incentives to create economic value. Public health, they argue, should stick to its traditional task—the struggle against infectious diseases. Because markets are not up to the task of controlling the transmission of infectious disease, Epstein says, coercive government action is required. But market incentives, not state action, he asserts, represent our best hope for controlling the chronic illnesses that …

State Eligibility Rules Under Separate State Schip Programs--Implications For Children's Access To Health Care, Sara Rosenbaum, Anne Rossier Markus

Health Policy and Management Issue Briefs

This Policy Brief is the fourth in a series of reports1 issued by the George Washington University Center for Health Services Research and Policy that examine the design of separately-administered State Children’s Health Insurance Programs (SCHIP) that is, programs that operate directly under the authority of the federal SCHIP statute rather than expansions of state Medicaid programs.2 These Policy Briefs also consider the implications of states’ design choices for children’s access to health care.

The Medicaid Buy-In Program: Lessons Learned From Nine "Early Implementer" States, Donna Folkemer, Allen Jensen, Robert Silverstein, Tara Straw

Center for Health Policy Research

For many individual Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) recipients, the risk of losing Medicaid coverage linked to their cash benefits is a powerful work disincentive. Eliminating barriers to health care and creating incentives to work can greatly improve financial independence and well being. To support this goal, Congress included a Medicaid Buy-In option in the Balanced Budget Act of 1997 and enacted the Ticket to Work and Work Incentives Improvement Act (TWWIIA) in 1999. These laws authorized states to create Medicaid Buy-In programs to extend Medicaid coverage to persons with disabilities who go to work. …

Policy Frameworks For Designing Medicaid Buy-In Programs And Related State Work Incentive Initiatives, Allen Jensen, Robert Silverstein, Donna Folkemer, Tara Straw

Center for Health Policy Research

This report provides policy frameworks to assist stakeholders (such as Medicaid directors, state legislators, and cross-disability coalitions) design and implement Medicaid Buy-In programs and related work incentive initiatives to enhance the level of economic self-sufficiency of persons with significant disabilities. Of particular focus of the paper are the design decisions affecting enrollment, costs, and a state's fiscal exposure.

The policy frameworks describe the interrelationships between federal and state cash assistance programs (particularly SSDI, SSI, and state SSI supplementation programs) and health entitlements (particularly the Medicaid program). The policy frameworks are derived from the experiences of the nine early implementation states …

Welfare Reform Reauthorization In 2002:What Are The Issues For Tribal Communities And Indian Families?, Kathleen A. Maloy

Health Policy and Management Issue Briefs

American Indian tribes have new options under the 1996 Welfare Reform legislation that created Temporary Assistance for Needy Families (TANF), a block grant enacted to replace the Aid to Families with Dependent Children (AFDC). TANF, which expires in September of this year, provides cash assistance to poor families with children, including poor American Indian Families, and gives tribes the option to design and administer their own family assistance programs following approval of the plan by the Department of Health and Human Services. As Congress considers TANF reauthorization, three new publications prepared for the Kaiser Family Foundation provide insight into the …

Women, Poverty, Access To Health Care, And The Perils Of Symbolic Reform, Mary Anne Bobinski, Phyllis Griffin Epps

Faculty Articles

This article looks at health care through gendered eyes. We sift though available data on access to health care, health status, and health treatments to determine whether men and women experience health care differently in the United States. While we do not doubt that overt gender-based discrimination occasionally occurs in health care, this article focuses on the importance of unintended consequences and unconscious bias. We also explore the impact of symbolism about women's roles on the process of health care reform. The results have important implications for policy makers, advocates, and health care providers.

The United States has a large …

Trust And Betrayal In The Medical Marketplace, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

The author argues in this Comment that disingenuity as first resort is an unwise approach to the conflict between our ex ante and our later, illness-endangered selves. Not only does rationing by tacit deceit raise a host of moral problems, it will not work, over the long haul, because markets reward deceit's unmasking. The honesty about clinical limit-setting that some bioethicists urge may not be fully within our reach. But more candor is possible than we now achieve, and the more conscious we are about decisions to impose limits, the more inclined we will be to accept them without experiencing …

Access To Pediatric Services Under Medicaid Managed Care In The District Of Columbia, Karen Shaw, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

No abstract provided.

State Benefit Design Choices Under Schip - Implications For Pediatric Health Care, Sara J. Rosenbaum, Anne Rossier Markus, Colleen Sonosky, Lee Repasch

Health Policy and Management Issue Briefs

This policy brief1 is the second in a series of reports focusing on the design of state SCHIP programs as they near full implementation. It examines the extent to which state agencies adopt conventional insurance norms or adhere to special principles of Medicaid coverage design for children in designing separately administered (or freestanding) SCHIP programs. The issue of coverage design is particularly relevant for children with low prevalence conditions and special health care needs. Increasingly, conventional insurance uses standardized coverage norms to limit coverage and treatment. These standardized norms take the form of across-the-board treatments and exclusions, limited definitions of …

State Schip Design And The Right To Coverage, Sara J. Rosenbaum, Barbara Smith

Health Policy and Management Issue Briefs

No abstract provided.

Race And Discretion In American Medicine, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

The author’s focus in this article is on racial disparities in medical care provision--that is, on differences in the services that clinically similar patients receive when they present to the health care system. Racial disparities in health status, which is not greatly influenced (on a population-wide basis) by medical care, are beyond his scope here. Disparities in medical care access-potential patients' ability, financial and otherwise, to gain entry to the health care system in the first place, are also outside his focus. The author begins this article by putting the problem of racial disparities in medical care provision within the …

Health Care Fraud And Abuse: A Tale Of Behavior Induced By Payment Structure, Arti K. Rai

Faculty Scholarship

The campaign to curtail "fraud and abuse" in the Medicare and Medicaid programs represents an attempt by regulators to evade more fundamental and difficult questions regarding cost and quality control. In the Medicare arena, tackling these larger questions will require dismantling the program's fee-for-service structure and imposing on providers financial incentives to evaluate carefully health care costs and benefits. Commentary on, David A. Hyman, Health Care Fraud and Abuse: Market Change, Social Norms and the Trust "Reposed in Workmen," 30 Journal of Legal Studies 531 (2001)

Understanding Medicaid Home And Community Services: A Primer, Gary Smith, Janet O'Keeffe, Letty Carpenter, Pamela Doty, Brian Burnwell, Robert Mollica, Loretta Williams, George Washington University, Center For Health Policy Research

Center for Health Policy Research

No abstract provided.