Yale journal of health policy, law, and ethics最新文献_第4页

Medicare, Medicaid, and pharmaceuticals: the price of innovation. 医疗保险、医疗补助和药品:创新的代价。

Yale journal of health policy, law, and ethics Pub Date : 2015-01-01

Daniel J Kevles

引用次数: 0

Criminal law and HIV testing: empirical analysis of how at-risk individuals respond to the law. 刑法和艾滋病毒检测:风险个体如何应对法律的实证分析。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Sun Goo Lee

{"title":"Criminal law and HIV testing: empirical analysis of how at-risk individuals respond to the law.","authors":"Sun Goo Lee","doi":"","DOIUrl":"","url":null,"abstract":"This Note assesses the effect of laws that specifically criminalize behaviors that expose others to the human immunodeficiency virus (HIV). This Note examines the relationship between HIV testing decisions by high-risk individuals and the existence of these HIV-specific statutes, as well as the amount of media coverage related to them. One of the main reasons public health experts criticize criminalization of HIV-exposing behavior is that it may discourage at-risk individuals from undergoing HIV testing. This argument, however, remains empirically untested to date. This study quantitatively examines whether at-risk individuals living in jurisdictions with HIV-specific statutes are less likely to report having been tested for HIV in the past year compared to those living in jurisdictions without HIV-specific statutes. Regression analysis is conducted using data collected in the United States over a seven-year span. The results show that at-risk individuals residing in states with HIV-specific statutes are no less likely to report having been tested for HIV than those who live in other states. However, the number of people who reported that they had been tested for HIV is inversely correlated with the frequency of newspaper coverage of criminalization of HIV-exposing behavior. These findings imply that at-risk individuals' HIV testing is associated with media coverage of criminalizing HIV-exposing behavior. The negative impact that criminal law has on HIV testing rates could be a serious public health threat. Testing is often the initial step in public health interventions that most effectively modify the risky behavior of HIV-positive individuals. The adverse consequence of criminalization should weigh heavily in the design and application of criminal sanctions for HIV-exposing behavior. In addition, future research should further explore the relationships between criminalization, media coverage of criminalization, and HIV testing decisions for a more nuanced understanding of the consequences of criminalization.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 1","pages":"194-238"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32528487","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}

引用次数: 0

The young, the old, and the economists: rethinking how agencies account for age in cost-benefit analysis. 年轻人、老年人和经济学家:重新思考机构在成本效益分析中如何考虑年龄。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Daniel Herz-Roiphe

{"title":"The young, the old, and the economists: rethinking how agencies account for age in cost-benefit analysis.","authors":"Daniel Herz-Roiphe","doi":"","DOIUrl":"","url":null,"abstract":"Federal agencies count all fatalities prevented by regulation as having the same value for the purposes of cost-benefit analysis, making no adjustment for the age of the person saved. This uniform valuation is guided by empirical studies that find that the young are not willing to pay more than the elderly for small risk reductions in private markets. This Note argues for a different approach. It proposes that agencies take account of a previously ignored body of \"public choice\" research that finds that most individuals think government should adopt lifesaving programs that benefit the young over those that benefit the old. These data illustrate a divergence between people's private and public preferences. While the economic theory that guides current agency practice prioritizes the former over the latter, this Note argues that it should be the other way around. The Note maintains that public choice data reflect a wider range of societal commitments than individual willingness-to-pay metrics, and therefore that the use of public choice data could help agencies satisfy their mandate under Executive Order 13,563 to engage in broader forms of analysis. The Note also posits that public choice data actually provide a better guide to the welfare consequences of prioritizing lifesaving regulations for different age groups than do individual willingness-to-pay data. It accordingly recommends a new system of age adjustment based on public choice results.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 2","pages":"350-75"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32889723","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}

引用次数: 0

Making the case for a model mental health advance directive statute. 为模范精神健康预先指示法规辩护。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Judy A Clausen

{"title":"Making the case for a model mental health advance directive statute.","authors":"Judy A Clausen","doi":"","DOIUrl":"","url":null,"abstract":"Acute episodes of mental illness temporarily destroy the capacity required to give informed consent and often prevent people from realizing they are sick, causing them to refuse intervention. Once a person refuses treatment, the only way to obtain care is as an involuntary patient. Even in the midst of acute episodes, many people do not meet commitment criteria because they are not likely to injure themselves or others and are still able to care for their basic needs. Left untreated, the episode will likely spiral out of control. By the time the person finally meets strict commitment criteria, devastation has already occurred. This Article argues that an individual should have the right to enter a Ulysses arrangement, a special type of mental health advance directive that authorizes a doctor to administer treatment during a future episode even if the episode causes the individual to refuse care. The Uniform Law Commissioners enacted the Uniform Health-Care Decisions Act as a model statute to address all types of advance health care planning, including planning for mental illness. However, the Act focuses on end-of-life care and fails to address many issues faced by people with mental illness. For example, the Act does not empower people to enter Ulysses arrangements and eliminates writing and witnessing requirements that protect against fraud and coercion. This Article recommends that the Uniform Law Commissioners adopt a model mental health advance directive statute that empowers people to enter Ulysses arrangements and provides safeguards against abuse. Appendix A sets forth model provisions.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 1","pages":"1-65"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32527030","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}

引用次数: 0

Principles over principals? How innovation affects the agency relationship in medical and legal practice. 原则高于原则?创新如何影响医疗和法律实践中的代理关系。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Julian J Z Polaris

{"title":"Principles over principals? How innovation affects the agency relationship in medical and legal practice.","authors":"Julian J Z Polaris","doi":"","DOIUrl":"","url":null,"abstract":"This Note outlines a conceptual framework for defining and analyzing innovation in the professional practice of medicine and law. The two professions have structural and historical similarities, and both are organized around the principal-agent relationship. Some types of professional activity adhere to the traditional agency model of principal-centered practice, but innovative professionals who develop novel tools and techniques often deviate from the agency model in interesting ways. This Note explores how that distinction plays out by identifying examples from academic medicine, public interest \"cause lawyering\", and corporate law. The field of medicine is governed by a regulatory regime that strictly differentiates routine practice from the experimental activities of clinical research, but the legal profession is governed by a monolithic code of conduct that does not explicitly acknowledge the types of innovation described here. Certain key events in the twentieth century help to explain why the government has chosen to tightly regulate innovation in medicine but not in law, and it turns out that innovators in both fields have found ways to stretch or bend the rules. These observations shed light on each profession's unique culture and can inform current debates over regulatory reform.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 2","pages":"296-349"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32889722","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}

引用次数: 0

Human research subjects as human research workers. 作为人类研究工作者的人类研究对象。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Holly Fernandez Lynch

引用次数: 0

Making the case for a model mental health advance directive statute. 为模范精神健康预先指示法规辩护。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01 DOI: 10.2139/ssrn.3607503

Judy A. Clausen

{"title":"Making the case for a model mental health advance directive statute.","authors":"Judy A. Clausen","doi":"10.2139/ssrn.3607503","DOIUrl":"https://doi.org/10.2139/ssrn.3607503","url":null,"abstract":"Acute episodes of mental illness temporarily destroy the capacity required to give informed consent and often prevent people from realizing they are sick, causing them to refuse intervention. Once a person refuses treatment, the only way to obtain care is as an involuntary patient. Even in the midst of acute episodes, many people do not meet commitment criteria because they are not likely to injure themselves or others and are still able to care for their basic needs. Left untreated, the episode will likely spiral out of control. By the time the person finally meets strict commitment criteria, devastation has already occurred. This Article argues that an individual should have the right to enter a Ulysses arrangement, a special type of mental health advance directive that authorizes a doctor to administer treatment during a future episode even if the episode causes the individual to refuse care. The Uniform Law Commissioners enacted the Uniform Health-Care Decisions Act as a model statute to address all types of advance health care planning, including planning for mental illness. However, the Act focuses on end-of-life care and fails to address many issues faced by people with mental illness. For example, the Act does not empower people to enter Ulysses arrangements and eliminates writing and witnessing requirements that protect against fraud and coercion. This Article recommends that the Uniform Law Commissioners adopt a model mental health advance directive statute that empowers people to enter Ulysses arrangements and provides safeguards against abuse. Appendix A sets forth model provisions.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 1 1","pages":"1-65"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68612587","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}

引用次数: 11

Scaling cost-sharing to wages: how employers can reduce health spending and provide greater economic security. 将费用分摊扩大到工资:雇主如何减少医疗支出并提供更大的经济保障。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Christopher T Robertson

{"title":"Scaling cost-sharing to wages: how employers can reduce health spending and provide greater economic security.","authors":"Christopher T Robertson","doi":"","DOIUrl":"","url":null,"abstract":"In the employer-sponsored insurance market that covers most Americans; many workers are \"underinsured.\" The evidence shows onerous out-of-pocket payments causing them to forgo needed care, miss work, and fall into bankruptcies and foreclosures. Nonetheless, many higher-paid workers are \"overinsured\": the evidence shows that in this domain, surplus insurance stimulates spending and price inflation without improving health. Employers can solve these problems together by scaling cost-sharing to wages. This reform would make insurance better protect against risk and guarantee access to care, while maintaining or even reducing insurance premiums. Yet, there are legal obstacles to scaled cost-sharing. The group-based nature of employer health insurance, reinforced by federal law, makes it difficult for scaling to be achieved through individual choices. The Affordable Care Act's (ACA) \"essential coverage\" mandate also caps cost-sharing even for wealthy workers that need no such cap. Additionally, there is a tax distortion in favor of highly paid workers purchasing healthcare through insurance rather than out-of-pocket. These problems are all surmountable. In particular, the ACA has expanded the applicability of an unenforced employee-benefits rule that prohibits \"discrimination\" in favor of highly compensated workers. A novel analysis shows that this statute gives the Internal Revenue Service the authority to require scaling and to thereby eliminate the current inequities and inefficiencies caused by the tax distortion. The promise is smarter insurance for over 150 million Americans.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 2","pages":"239-95"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32889825","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}

引用次数: 0

Refereeing the public health. 监督公共卫生。

Yale journal of health policy, law, and ethics Pub Date : 2014-01-01

Hosea H Harvey

{"title":"Refereeing the public health.","authors":"Hosea H Harvey","doi":"","DOIUrl":"","url":null,"abstract":"Between January 2009 and October 2013, 49 states and the District of Columbia passed laws focusing on mitigating the consequences of traumatic brain injuries (TBIs) in organized youth sports. Using historical, contextual, and empirical methods, this Article describes the content, goals, and structure of youth sports TBI laws, while hypothesizing about their underlying legislative logic and long-term public health consequences. The Article's empirical evidence suggests two key findings: first, that a dominant interest group, the National Football League, helped to define the problem and its associated solutions for the vast majority of states, thus curving the legislative story are in favor of its policy prescriptions; second, that existing youth sports TBI laws are focused on secondary, not primary, prevention, and may thus shift attention away from more comprehensive solutions. Finally, the Article explains why such state laws will likely fail to substantially resolve the larger untackled problem--significantly reducing the overall rate and number of TBIs in youth sports. After explaining why existing state youth sports TBI laws fail to accomplish this broader goal, the Article queries whether alternative policy or public health measures might offer more robust solutions.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"14 1","pages":"66-121"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32527031","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}

引用次数: 0

EPCRA: a retrospective on the environmental Right-to-Know Act. EPCRA:回顾环境知情权法案。

Yale journal of health policy, law, and ethics Pub Date : 2013-01-01

Danielle M Purifoy

{"title":"EPCRA: a retrospective on the environmental Right-to-Know Act.","authors":"Danielle M Purifoy","doi":"","DOIUrl":"","url":null,"abstract":"October 2011 marked the 25th Anniversary of the Emergency Planning and Community Right-to-Know Act (EPCRA), which was celebrated for its \"significant role in protecting human health and the environment over the last quarter century by providing communities and emergency planners with valuable information on toxic chemical releases in their area.\" This Note aims to evaluate the effectiveness of three important provisions of the statute-the Toxics Release Inventory, the emergency planning mandate, and the citizen suit provision-through a case study of their implementation in Institute, West Virginia, the site of an industrial accident that prompted the enactment of EPCRA in 1986. This Note argues that although EPCRA made significant improvements to industry transparency in terms of its production and release of hazardous substances, there remain significant barriers concerning adequate resources, informational tools, and enforcement measures. These challenges must be addressed to ensure that citizens are provided with equitable opportunities to inform and ultimately protect their communities from health and environmental hazards. Through interviews with Institute residents and members of a local community advocacy group, along with analyses of the current informational tools available to the public under the statute, the Note will discuss specific challenges facing industrial communities, and offer a series of practical and legal solutions to increase the effectiveness of the statute, particularly in the most economically and politically vulnerable communities.","PeriodicalId":85893,"journal":{"name":"Yale journal of health policy, law, and ethics","volume":"13 2","pages":"375-417"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31957704","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}

引用次数: 0