Open Access. Powered by Scholars. Published by Universities.®

Health Law and Policy Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 19 of 19

Full-Text Articles in Health Law and Policy

The Shadows Of Life: Medicaid's Failure Of Health Care's Moral Test, Barak D. Richman, Kushal T. Kadakia, Shivani A. Shah Jan 2019

The Shadows Of Life: Medicaid's Failure Of Health Care's Moral Test, Barak D. Richman, Kushal T. Kadakia, Shivani A. Shah

Faculty Scholarship

North Carolina Medicaid covers one-fifth of the state’s population and makes up approximately one-third of the budget. Yet the state has experienced increasing costs and worsening health outcomes over the past decade, while socioeconomic disparities persist among communities. In this article, the authors explore the factors that influence these trends and provide a series of policy lessons to inform the state’s current reform efforts following the recent approval of North Carolina’s Section 1115 waiver by the Centers for Medicare and Medicaid Services. The authors used health, social, and financial data from the state Department of Health and ...


Changing The Tax Code To Create Consumer-Driven Health Insurance Competition, Regina Herzlinger, Barak D. Richman Jan 2017

Changing The Tax Code To Create Consumer-Driven Health Insurance Competition, Regina Herzlinger, Barak D. Richman

Faculty Scholarship

Because current tax laws exclude employer-paid health insurance premiums from employees’ taxable wages and income, employer-sponsored insurance remains the primary source of health insurance for most employed Americans. Economists have long blamed the employer-based insurance tax exclusion for inflating health care costs, and, more recently, for constraining income growth and exacerbating income inequality.

We execute a simulation to test the effect of permitting employees to receive their employers’ premium contribution directly and then purchase health insurance themselves, using tax-free funds. Employees could deduct for income tax purposes the amount used for insurance and, if they spend less than the amount ...


N.C. Medicaid Reform: A Bipartisan Path Forward, Barak D. Richman, Allison Rice Jan 2017

N.C. Medicaid Reform: A Bipartisan Path Forward, Barak D. Richman, Allison Rice

Faculty Scholarship

The North Carolina Medicaid program currently constitutes 32% of the state budget and provides insurance coverage to 18% of the state’s population. At the same time, 13% of North Carolinians remain uninsured, and even among the insured, significant health disparities persist across income, geography, education, and race.

The Duke University Bass Connections Medicaid Reform project gathered to consider how North Carolina could use its limited Medicaid dollars more effectively to reduce the incidence of poor health, improve access to healthcare, and reduce budgetary pressures on the state’s taxpayers.

This report is submitted to North Carolina’s policymakers and ...


Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster Jan 2016

Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.


Valuing Health Care: Improving Productivity And Quality, Barak D. Richman, Arti K. Rai Jan 2012

Valuing Health Care: Improving Productivity And Quality, Barak D. Richman, Arti K. Rai

Faculty Scholarship

No abstract provided.


Theorizing And Generalizing About Risk Assessment And Regulation Through Comparative Nested Analysis Of Representative Cases, Jonathan B. Wiener, Brendon Swedlow, Denise Kall, Zheng Zhou, James K. Hammitt Jan 2009

Theorizing And Generalizing About Risk Assessment And Regulation Through Comparative Nested Analysis Of Representative Cases, Jonathan B. Wiener, Brendon Swedlow, Denise Kall, Zheng Zhou, James K. Hammitt

Faculty Scholarship

This article provides a framework and offers strategies for theorizing and generalizing about risk assessment and regulation developed in the context of an on-going comparative study of regulatory behavior. Construction of a universe of nearly 3,000 risks and study of a random sample of 100 of these risks allowed us to estimate relative U.S. and European regulatory precaution over a thirty-five-year period. Comparative nested analysis of cases selected from this universe of ecological, health, safety, and other risks or its eighteen categories or ninety-two subcategories of risk sources or causes will allow theory-testing and -building and many further ...


Lessons From India In Organizational Innovation: A Tale Of Two Heart Hospitals, Barak D. Richman, Krishna Udayakumar, Will Mitchell, Kevin A. Schulman Jan 2008

Lessons From India In Organizational Innovation: A Tale Of Two Heart Hospitals, Barak D. Richman, Krishna Udayakumar, Will Mitchell, Kevin A. Schulman

Faculty Scholarship

Recent discussions in health reform circles have pinned great hopes on the prospect of innovation as the solution to the high-cost, inadequate-quality U.S. health system. But U.S. health care institutions--insurers, providers and specialists--have ceded leadership in innovation to Indian hospitals such as Care Hospital in Hyderabad and the Fortis Hospitals around New Delhi, which have U.S.-trained doctors and can perform open heart surgery for $6000 (compared to $100,000 in the United States). The Indian success is a window into America's stalemate with inflating costs and stagnant innovation.


Human Genetics Studies: The Case For Group Rights, Laura S. Underkuffler Jan 2007

Human Genetics Studies: The Case For Group Rights, Laura S. Underkuffler

Faculty Scholarship

With the importance of genetic information has come bitter battles over its control. In these battles, some principles have emerged that are beyond dispute. The ability of individuals to control the disposition and genetic testing of their own biological materials is (as a matter of theory, at least) beyond question. No one would argue today that an individual could be subject to genetic testing for studies against her will, or that biological samples obtained from individuals under specified conditions could be simply deemed "free" of such conditions by researchers. Although difficult problems remain in the interpretation of research agreements, the ...


Contesting Anticompetitive Actions Taken In The Name Of The State: State Action Immunity And Health Care Markets, Clark C. Havighurst Jan 2006

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 ...


Against “Individual Risk”: A Sympathetic Critique Of Risk Assessment, Matthew D. Adler Jan 2005

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

Faculty Scholarship

No abstract provided.


Politics, Power, And Public Health: A Comment On Public Health’S New World Order, Laurence R. Helfer Jan 2004

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

Faculty Scholarship

No abstract provided.


Health Care Fraud And Abuse: A Tale Of Behavior Induced By Payment Structure, Arti K. Rai Jan 2001

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)


Foreword: Public And Private Barriers To Competitive Reform Of Health Care Services Delivery, Clark C. Havighurst Jan 1984

Foreword: Public And Private Barriers To Competitive Reform Of Health Care Services Delivery, Clark C. Havighurst

Faculty Scholarship

No abstract provided.


Health Planning And Antitrust Law: The Implied Amendment Doctrine Of The Rex Hospital Case, Clark C. Havighurst Jan 1983

Health Planning And Antitrust Law: The Implied Amendment Doctrine Of The Rex Hospital Case, Clark C. Havighurst

Faculty Scholarship

No abstract provided.


Foreword: Symposium On Hospital Law, Clark C. Havighurst Jan 1983

Foreword: Symposium On Hospital Law, Clark C. Havighurst

Faculty Scholarship

No abstract provided.


Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 1, Clark C. Havighurst, Nancy M. P. King Jan 1983

Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 1, Clark C. Havighurst, Nancy M. P. King

Faculty Scholarship

This Article explores the antitrust and other implications of private credentialing and accrediting programs in the health care industry. Although such programs are usually sponsored by powerful competitor groups, they serve the procompetitive purpose of providing useful information and authoritative advice to independent decision makers. Part One examines the risk that credentialing will sometimes be unfair to competitors and deceive consumers. Its survey of common-law, antitrust, and regulatory interventions to correct such unfairness and deception seeks to determine the degree of oversight to which credentialing and similar activities have been and should be subjected. In recommending that judicial or regulatory ...


Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 2, Clark C. Havighurst, Nancy M. P. King Jan 1983

Private Credentialing Of Health Care Personnel: An Antitrust Perspective, Part 2, Clark C. Havighurst, Nancy M. P. King

Faculty Scholarship

Having argued in Part One against extensive judicial or regulatory interference with private personnel credentialing in the health care field, this Article now shifts its focus to emphasize the anticompetitive hazards inherent in credentialing as practiced by professional interests. Competitor-sponsored credentialing is shown to be a vital part of a larger cartel strategy to curb competition by standardizing personnel and services and controlling the flow of information to health care consumers. Instead of altering the conclusions reached in Part One, however, Part Two sets forth a new and hitherto unexplored agenda for antitrust enforcement, one that the authors believe will ...


More On Regulation: A Reply To Stephen Weiner, Clark C. Havighurst Jan 1978

More On Regulation: A Reply To Stephen Weiner, Clark C. Havighurst

Faculty Scholarship

In Volume 3, Number 3 of this journal, Professor Havighurst* wrote a brief Comment in which he observed that the function of health care cost-containment regulation is the rationing of health care resources, and argued that the fostering of health care consumers' and providers' free choice in the competitive marketplace is preferable to conventional cost-containment regulation as a mechanism for such rationing. He briefly outlined various reforms, including changes in federal tax treatment of health insurance premiums, aimed at implementing his ap- proach. Subsequently, in a Comment in Volume 4, Number 1, Stephen M.Weiner, then Chairman of the Massachusetts ...


Health Care Cost-Containment Regulation: Prospects And An Alternative, Clark C. Havighurst Jan 1977

Health Care Cost-Containment Regulation: Prospects And An Alternative, Clark C. Havighurst

Faculty Scholarship

Regulation of the health care system to achieve appropriate containment of overall costs is characterized by Professor Havighurst as requiring public officials to engage, directly or indirectly, in the rationing of medical services. This rationing function is seen by the author as peculiarly difficult for political institutions to perform, given the public's expectations and the symbolic importance of health care. An effort on the part of regulators to shift the rationing burden to providers is detected, as is a trend toward increasingly arbitrary regulation, designed to minimize regulators' confrontations with sensitive issues. Irrationality and ignorance are found to plague ...