Journal of health care law & policy最新文献

{"title":"Regulation of research with children: the evolution from exclusion to inclusion.","authors":"Duane Alexander","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40839127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Care Career Ladder Initiative (Eccli): Baseline Evaluation Report of a Massachusetts Nursing Home Initiative","authors":"S. Eaton, C. Green, T. Osypuk, Randall Wilson","doi":"10.2139/SSRN.292944","DOIUrl":"https://doi.org/10.2139/SSRN.292944","url":null,"abstract":"The Commonwealth of Massachusetts initiated the Extended Care Career Ladder Initiative (ECCLI) as part of a broader Nursing Home Quality Initiative, adopted by the Legislature in 2000. This legislation is a response to high turnover and vacancies among paraprofessionals in long-term care, creating instability that threatens quality and access to health care. Basic to these initiatives is the equation of good care for consumers with good jobs and opportunities for frontline caregivers. Thus it asks long-term care providers to partner with other organizations (including community based groups, unions, work force development agencies, community colleges, and other long-term care providers) to mount demonstration projects that offer insight into new care-giving and workplace practices that improve the quality of care and the quality of jobs. These projects should also demonstrate how the accomplishment of care giving and workforce quality goals can be mutually reinforcing. Sponsors hope that such projects will offer clear and replicable models for both the long term care industry, and the workforce development community that supports the industry and its potential and existing labor force. ECCLI'S overall program goal is to promote systemic change and build capacity within the long-term care and work force development communities in support of the following goals and objectives: (1)Improve quality of care; (2) Promote skill development; (3) Create and institutionalize career ladders and other workplace practices that support and develop workers; and (4) Improve employee retention. The attached baseline evaluation report is presented as a working paper for the information of researchers and practitioners in the field of nursing home quality and workforce development. It covers the period from March 2001 to June 2001 when the ECCLI program was getting underway, and was submitted to the Commonwealth Corporation of Massachusetts, the quasi--public agency that is administering the funds from the Nursing Home Quality Initiative. Future reports will analyze data collected by the researchers after this baseline and planning period. Major findings include insight into the process of forming consortia across unfamiliar realms of human services (health care and workforce development and education), and challenges for the participants as they consider and implement organizational change as well as training programs for frontline workers as well as supervisors.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76195629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Inequity in the Delivery of Public Health Care: Evidence from Spain (1997)","authors":"Rosa Urbanos Garrido","doi":"10.2139/ssrn.286593","DOIUrl":"https://doi.org/10.2139/ssrn.286593","url":null,"abstract":"This paper assesses horizontal equity in the delivery of public health care in Spain, and tries to identify those health care levels and population groups where inequality is concentrated. Different kinds of health care are analysed for 1997, both at disaggregate and aggregate level. The results show that the socio-economic population groups affected by inequity vary according to the specific health care level studied although, in global terms, there is not a clearly significant degree of inequity. The Spanish results are also compared to those obtained for other European countries.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84174125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Income Redistribution and the Political Economy of Social Health Insurance: Comparing Germany and Switzerland","authors":"F. Breyer","doi":"10.2139/ssrn.296083","DOIUrl":"https://doi.org/10.2139/ssrn.296083","url":null,"abstract":"In many countries, collectively financed health insurance systems or health services delivery systems (such as the NHS) exist. Typically, these institutions are financed via general taxes or specific contributions levied on earnings. As benefits are not dependent upon income, this implies a redistribution from high to low earners. An exception can be found in Switzerland, where equal per-capita contributions are used. From a public-choice perspective it is natural to ask whether the combination of health insurance and income redistribution leads to an expansion or a contraction of the size of a public health care system, a question that is particularly relevant in view of the projected rapid increase of health care costs in the next decades due to population ageing and medical progress. Building upon the work of Gouveia (1997) and an earlier paper by the author (Breyer 1995) I use a simple model of direct democracy to analyze under what circumstances income redistribution tends to expand the size of a public health insurance system. The predictions of the model are confronted with existing evidence from Germany and Switzerland and are used to develop hypotheses on the future development of the systems.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89279675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Can the Take-Up of Other Programs Teach Us About How to Improve Take-Up of Health Insurance Programs?","authors":"D. Remler, Jason E. Rachlin, S. Glied","doi":"10.3386/W8185","DOIUrl":"https://doi.org/10.3386/W8185","url":null,"abstract":"Many uninsured Americans are already eligible for free or low-cost public coverage through Medicaid or CHIP but do not take up that coverage. Several other programs, such as food stamps and unemployment insurance, also have less than complete take-up rates and take-up rates vary considerably among programs. This paper examines the take-up literature across a variety of programs to learn what effects non-financial features, such as administrative complexity, have on take-up. We find that making benefit receipt automatic is the most effective means of ensuring high take-up, while there is little evidence that stigma is important. Overall, surprisingly little is known about the quantitative impact, of non-financial characteristics of programs on take-up. New research that could be used to draw measurable causal inferences about how features as administrative complexity, renewal rules, and organizational structure affect participation, would be extremely valuable.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88561650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Managed Care Change the Mission of Nonprofit Hospitals? Evidence from the Managerial Labor Market","authors":"R. Arnould, Marianne Bertrand, Kevin F. Hallock","doi":"10.3386/W7924","DOIUrl":"https://doi.org/10.3386/W7924","url":null,"abstract":"This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the negative income pressures created by HMO penetration. Using a panel of about 1500 nonprofit hospitals over the period 1992 to 1996, we find that top executive turnover increases following an increase in HMO penetration. Moreover, the increase in turnover is concentrated among the hospitals that have low levels of economic profitability and are more financially leveraged. While the link between top executive pay and for-profit performance measures is on average very weak, HMO penetration substantially tightens that link: as HMO penetration increases, top executives are compensated more for improving the profitability of their hospitals. These results are consistent with the view that HMO penetration increases the importance of for-profit performance objectives among not-for-profit hospitals. Boards appear to fire the managers that are least able to compete in the new competitive environment and reward incumbent managers more for achieving for-profit goals. Consistent with donors' belief that these changes represent a weakening of the nonprofit mission and not simply an attempt by altruistic boards to protect intergenerational equity, we find that public donations fall as HMO market share increases.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79803086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sharing the Pain of Social Security and Medicare Reform","authors":"L. Thompson","doi":"10.2139/ssrn.256588","DOIUrl":"https://doi.org/10.2139/ssrn.256588","url":null,"abstract":"In combination with current trends in health costs, adjustments now scheduled for Social Security, Medicare and the income tax are likely to offset virtually all of the increase in Social Security cash benefits that future economic growth would otherwise produce. Current law will reduce future Social Security benefits in two ways, through the increase in the normal retirement and the expansion of the fraction of benefits included in the personal income tax base. Medicare projections suggest that beneficiaries also will have to devote an increasing fraction of their remaining benefit income to paying out-of-pocket health expenses and Medicare premiums and deductibles. Under current projections, the net earnings of future workers (their earnings after paying income and payroll taxes) will grow much more rapidly than the net benefits (Social Security benefits net of health costs) of retirees. The gap between the prospects of future workers and the prospects of future retirees is large enough that the current Medicare and Social Security financing problems could be addressed entirely through increases in taxes on future workers, without disadvantaging future workers relative to future beneficiaries. Indeed, the gap appears large enough also to allow the addition of a modest prescription drug benefit to Medicare. Restoring fiscal balance to Social Security and Medicare through higher taxes on future workers also does not appear to create intergenerational equity problems. The intergenerational transfers that current children can expect to receive from their parents within the confines of a typical family would still exceed the burden of the payroll tax payments flowing from these children back to their parents over the balance of their work careers.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79345085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Demand for Medical Care in Urban China","authors":"N. Mocan, E. Tekin, J. Zax","doi":"10.2139/ssrn.223289","DOIUrl":"https://doi.org/10.2139/ssrn.223289","url":null,"abstract":"This is the first paper to investigate the determinants of the demand for medical care in the People's Republic of China. It uses a data set that consists of detailed characteristics of 6407 urban households, a continuous measure of health care spending, and price. A two-part model and a discrete factor model are used in the estimation. Household characteristics and work conditions impact the demand for medical care. Income elasticity is around 0.3, indicating medical care is a necessity. Medical care demand is price inelastic, and price elasticity is larger in absolute value for poorer households.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77149534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tort Claims Against Gun Manufacturers for Crime-Related Injuries: Defining a Suitable Role for the Tort System in Regulating the Firearms Industry","authors":"Timothy D. Lytton","doi":"10.2139/ssrn.201729","DOIUrl":"https://doi.org/10.2139/ssrn.201729","url":null,"abstract":"Gun violence is a serious problem in the U.S. For many years, in order to decrease gun violence, the sale and possession of firearms has been regulated by statute. This article argues that tort claims against gun manufacturers can complement legislative regulation, providing gun sellers and manufacturers with incentives to take reasonable measures to prevent gun sales to criminals. The article does not, however, endorse all tort claims against the gun industry. It argues in favor only of narrowly tailored claims that identify specific marketing and sales practices that increase the risk that guns will be used to commit crimes. The likely effect of such claims would be to make the firearms industry more responsible and to reduce gun violence. This article advocates an essential, albeit secondary, role for the tort system in regulating the gun industry. Legislatures ought to decide whether and under what circumstances the sale of guns should be legal. The tort system, by means of liability exposure, ought to discourage attempts by manufacturers to legally circumvent the aims of the regulatory system. On one hand, this article advocates a greater role for the tort system than those who view tort claims against the gun industry as illegitimate attempts to achieve more stringent regulation of the gun industry through the court system, following failure to do so in state legislatures and Congress. On the other hand, this article advocates a more modest role for the tort system than those who view the tort system as a primary source for industry reform, free of the corrupting political influences that distort legislative policy making.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75324219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The definition of disability: perspective of the disability community.","authors":"D Kaplan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40837042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}