HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, October 29, 2005

Walmart and Health Care Costs

The New York Times has a terrific piece on Walmart's health care woes.  Walmart's concerns about the high price of providing health care may encourage Congress to reform our health care system (or at least we can hope so).

As the nation's largest employer, Wal-Mart cannot help but be entangled in the increasingly contentious debate over how best to provide health care to working Americans. Many of the company's 1.3 million employees are drawn from the most vulnerable part of the national labor pool: people who can find only low-paying jobs, who frequently cannot afford health coverage and who have no ability to absorb the kind of bank-breaking inflation in medical costs the country has experienced since the late 1990's.

For various social and economic reasons - including limited access to preventive medical care - low-income workers and their families often have the greatest health care needs, with the least ability to meet them. The Wal-Mart quandary involves a fundamental national issue: Who, if anyone, should provide care to the bulk of Americans.

"Whose responsibility is this?" said Carolyn Watts, a health professor at the University of Washington. "Is it the government's responsibility or the employer's?"

As health care costs continue to soar well above the general rate of inflation, Professor Watts says the United States can no longer rely on employers to provide widespread coverage and needs to grapple with that new reality. "It's a very different social contract than we have had," she said.

The controversy over Wal-Mart's benefits may mask what some experts see as an unraveling of the employer-based system of health coverage. "These are indications of the gaps in the health care system that are exposed by Wal-Mart," said Len Nichols, a health economist at the New America Foundation, an independent public policy group in Washington. "You can't blame Wal-Mart."



October 29, 2005 | Permalink | TrackBack (0)

Friday, October 28, 2005

Pharmaceutical Companies Use Fiction to Deter Canadian Drugs

The Pharmaceutical Research and Manufacturers of America, or PhRMA decided to pay an author to pen a novel that potrays dangers from the re-importation of drugs from Canada.  The LA Times reports,

According to the proposal, PhRMA would pay Phoenix a six-figure sum for the marketing and production of a written-to-order fictional thriller. The plotline was what Hollywood would term high-concept — a group of shadowy terrorists conspires to murder thousands of Americans by poisoning the medicine they're importing from Canada to beat U.S. drug prices. (Think "True Lies" meets the Physicians Desk Reference.)

If this scenario sounds familiar, it's because PhRMA has tried to scare state legislatures and Congress out of giving Americans access to cheap Canadian drugs by warning that terrorists might poison the imports.

Viner duly hired an author, Julie Chrystyn, who in turn enlisted a friend, Kenin Spivak, to help with the writing. Spivak, 48, has an interesting resume: Over the years he has worked at Merrill Lynch, held top executive positions at MGM/UA and Premiere Radio Networks and invested with Michael Milken. Since 1998 he has been chairman and chief executive of Los Angeles-based Telemac Corp., which licenses billing and accounting programs to wireless network operators.


October 28, 2005 | Permalink | TrackBack (0)

Firday Funnies

Here is a funny cartoon video entitled, "A Democrat's Advice on What to do Now."  It doesn't relate to health law but with all the excitement in Washington, DC concerning indictments and such, it provides a nice laugh.  Thanks to taxlawprof!  [bm]

October 28, 2005 | Permalink | TrackBack (0)

Thursday, October 27, 2005

Harriet Miers Withdraws Her Nomination

CNN reports that Harriet Miers has withdrawn her nomination to be on the Supreme Court and the President has relunctantly accepted it.  The New York Times piece concerning this news is here.  I am not sure who will be up next.  I haven't heard any speculation yet as to who might be next.[bm]

October 27, 2005 | Permalink | TrackBack (0)

Lester Crawford: Reasons for Resignation

The New York Times reports today of a possible reason for former FDA commissioner Lester Crawford's sudden resignation -- stock sales of FDA regulated companies.  The Times states,

Dr. Lester M. Crawford, the former commissioner of the Food and Drug Administration, or his wife sold shares in companies regulated by the agency in 2004, according to financial disclosure forms.

The sales may have played a role in Dr. Crawford's sudden resignation from the agency last month after only two months as its leader.

The latest disclosure form, signed by Dr. Crawford on June 28, shows that he or his wife sold shares in 2004 in companies including the Sysco Corporation, a large food supplier; Kimberly-Clark and Teleflex Inc., which have medical-products divisions; PepsiCo Inc. and Wendy's International, which sell food products; Wal-Mart Stores Inc., which includes pharmacies; and Embrex, an agriculture biotechnology company where Dr. Crawford was once a board member.

The value of the sales varied from $1,001 to $100,000, according to the form.

Embrex, Kimberly-Clark, Pepsico and Wendy's are not on a form listing the Crawfords' 2003 holdings, although that form states that the Crawfords sold shares that year in Wendy's and Sysco valued at $1,001 to $15,000.

Dr. Crawford was quoted by last month as saying that he had sold all of his interest in Embrex before he went to work for the F.D.A.


October 27, 2005 | Permalink | TrackBack (0)

Wednesday, October 26, 2005

Target's Pharmacy Conscience Issues

Majikthise has a post discussing the recent Target decision to support a Missouri pharmacist's actions in refusing to fill a prescription for emergency contraception. Apparently Target believes that its actions are supported by the Civil Rights Act of 1964.  Several commentators have debunked such a use of the CRA and its religious accommodation provision, here, here and here.  [bm]

October 26, 2005 | Permalink | TrackBack (0)

Walmart and the ADA: A Misunderstanding

The New York Times ran this article yesterday discussing Walmart's new efforts to cut health care costs.  An internal memo from the company reveals,

In the memorandum, M. Susan Chambers, Wal-Mart's executive vice president for benefits, also recommends reducing 401(k) contributions and wooing younger, and presumably healthier, workers by offering education benefits. The memo voices concern that workers with seven years' seniority earn more than workers with one year's seniority, but are no more productive.

To discourage unhealthy job applicants, Ms. Chambers suggests that Wal-Mart arrange for "all jobs to include some physical activity (e.g., all cashiers do some cart-gathering)."
. . . . .

The memo noted that Wal-Mart workers "are getting sicker than the national population, particularly in obesity-related diseases," including diabetes and coronary artery disease. The memo said Wal-Mart workers tended to overuse emergency rooms and underuse prescriptions and doctor visits, perhaps from previous experience with Medicaid.

The memo noted, "The least healthy, least productive associates are more satisfied with their benefits than other segments and are interested in longer careers with Wal-Mart."

The memo proposed incorporating physical activity in all jobs and promoting health savings accounts. Such accounts are financed with pretax dollars and allow workers to divert their contributions into retirement savings if they are not all spent on health care. Health experts say these accounts will be more attractive to younger, healthier workers.

"It will be far easier to attract and retain a healthier work force than it will be to change behavior in an existing one," the memo said. "These moves would also dissuade unhealthy people from coming to work at Wal-Mart."

Thanks to Labor Blog for this update.  [bm]

October 26, 2005 | Permalink | TrackBack (0)

Tuesday, October 25, 2005

Post Doctoral Fellowship

Post-doctoral Fellowship Position in Public Health Law

The Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and the Center for Law and the Public’s Health at Johns Hopkins and Georgetown Universities are seeking qualified candidates for a one-year post-doctoral fellowship position in public health law. The candidate will work full-time with a collaborative team of faculty, fellows, and students at the Johns Hopkins Bloomberg School of Public Health and Georgetown University Law Center pursuant to a multi-year project that the Center is engaged through funding of the Health Resources Services Agency (HRSA) and other potential projects.  For more information about the HRSA project, please see the Center’s website at:

Candidates must have their J.D. degree from an accredited law school, and should have exceptional academic credentials (preferably including scholarly or applied practice publications) and strong research interests, knowledge, course work, or experience in public health law, ethics, and policy. Candidates who also have a M.P.H. degree from an accredited school of public health or a public health background may be preferred.

Applications must be received by November 15, 2005, and should include: (1) a cover letter that states the candidate’s research interests and experience in public health law; (2) current resume; (3) writing sample[s] that are written solely by the candidate; and (4) at least two professional references.  Some candidates may also be asked to provide official academic transcripts or other data.  Applicants must be prepared to begin on or about January 1, 2006.  Salary and benefits through the Johns Hopkins Bloomberg School of Public Health will be based on federal guidelines for post-doctoral fellow positions.

For further information or to apply, please email or call:

James G. Hodge, Jr., J.D., LL.M., Executive Director, Center for Law and the Public’s Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, Room 588,  624 North Broadway, Baltimore, MD  21205-1996   (410) 955-7624

October 25, 2005 | Permalink | TrackBack (0)

Patented Genes

A recent report demonstrates that nearly 1/5 of all human genes have been patented.  From National Geographic,

A new study shows that 20 percent of human genes have been patented in the United States, primarily by private firms and universities.

The study, which is reported this week in the journal Science, is the first time that a detailed map has been created to match patents to specific physical locations on the human genome.

Researchers can patent genes because they are potentially valuable research tools, useful in diagnostic tests or to discover and produce new drugs.

"It might come as a surprise to many people that in the U.S. patent system human DNA is treated like other natural chemical products," said Fiona Murray, a business and science professor at the Massachusetts Institute of Technology in Cambridge, and a co-author of the study.

"An isolated DNA sequence can be patented in the same manner that a new medicine, purified from a plant, could be patented if an inventor identifies a [new] application."


October 25, 2005 | Permalink | TrackBack (0)

Monday, October 24, 2005

Susan Wood: Why I Resigned From the FDA

Do you remember Susan F. Wood, Ph.D?  She was the assistant commissioner for women's health and director of the Office of Women's Health at the Food and Drug Administration from November 2000 to August 2005, when she resigned in protest over the FDA's decision to indefinitely defer a decision whether to approve nonprescription sales of the emergency contraceptive Plan B to women 17 years of age and older.  She has an opinion piece (free access) in the current New England Journal of Medicine in which she explains the reasons for her resignation.  Here' a quote:

If the FDA is to continue to fulfill its important role in public health, both in the United States and internationally, its professional scientific and clinical staff must maintain its independence and thus its scientific credibility. In compromising these values and ignoring the expertise within the agency, the FDA's leadership has compromised the health of women and families.

The article doesn't come out and say, in so many words, that the agency bowed to political pressure, but it is damning in the way it details the mysterious and unprecedented departures from agency practice represented by the Plan B decision. 

The GAO is apparently prepared to be more explicit about the way science was trumped by politics at the FDA.  According to the Kaiser Family Foundation's "Daily Women's Health Policy Report," the GAO is circulating a draft report that says the decision on Plan B was" made with uncharacteristic involvement from leading agency officials and might have been decided several months prior to its formal announcement."  The Washington Post reports that a final version of the GAO report is due out at the end of this month.  [tm]

October 24, 2005 | Permalink | TrackBack (0)

Update on Bird Flu

Here is a great update from DailyKos on the bird flu and the latest preparations.  [bm]

October 24, 2005 | Permalink | TrackBack (0)

Stem Cell Debate Pushed Back

The New York Times reports that no review of the current ban on federal funding for stem cell research will occur this year.  According to the Times,

A Senate debate over whether to ease federal restrictions on stem cell research will be put off until next year, an influential senator seeking to relax the rules said Friday.

The lawmaker, Senator Arlen Specter, Republican of Pennsylvania and chairman of a subcommittee that oversees spending on health issues, said the majority leader, Senator Bill Frist of Tennessee, had agreed to make consideration of a measure governing stem cell research a priority when Congress reconvenes in 2006.

That pledge led Mr. Specter to drop his threat to use a health spending bill to try to lift the ban on federal financing of stem cell research involving destruction of human embryos.

"It would be a logical spot to remove it," Mr. Specter said of his previous plan, "but it would cause a multifaceted controversy" at a time when the Senate has an abundance of other issues to deal with.

Mr. Specter and some fellow Republicans including Senator Orrin G. Hatch of Utah had joined Senate Democrats in pushing for a vote before the end of this year despite opposition from other Republican lawmakers, the Bush administration and conservative activists. They had believed that they gained new momentum when Mr. Frist, a physician, broke with the administration in July and endorsed the concept of legislation passed by the House that would allow government financing of research on embryos that are in frozen storage at fertility clinics and due otherwise to be discarded.

But on Friday, Mr. Specter bowed to the crush of events that have crowded the Senate agenda with spending legislation, bills related to Hurricane Katrina and a second Supreme Court nomination. He said the stem cell measure would get fuller attention next year.


October 24, 2005 | Permalink | TrackBack (0)

Sunday, October 23, 2005

When Health Insurance Is Not a Safeguard

That's the title of a good article in today's New York Times, the latest in a series on how the health care system is experienced from the patient's perspective.  This one looks at the phenomenon of medical bankruptcies, focusing on the experience of an Indiana couple with pretty good health insurance coverage and a child with a medical mystery.  [tm]

October 23, 2005 | Permalink | TrackBack (0)

FDA Approves Stem Cell Transplant Into Brain

From the AP comes this story:

Federal regulators on Thursday approved what would be the first transplant of fetal stem cells into human brains, a procedure that if successful could open the door to treating a host of neural disorders.

The transplant recipients will be children who suffer from a rare, fatal genetic disorder.

The Food and Drug Administration said that doctors at Stanford University Medical Center can begin the testing on six children afflicted with Batten disease, a degenerative malady that renders its young victims blind, speechless and paralyzed before it kills them.


October 23, 2005 | Permalink | TrackBack (0)

Cost of Health Care

The New York Times continues with its health care series today with a piece examining the high cost of health care, even for those with insurance.  The Times reports,

Never have patients had so many medical options to extend, enrich or alter their lives. But these new options are expensive, and with them has come a change for which many Americans - even those with health insurance - are financially ill prepared.

After decades in which private and government insurance covered a progressively larger share of medical expenses, insurance companies are now shifting more costs to consumers, in the form of much higher deductibles, co-payments or premiums. At the same time, Americans are saving less and carrying higher levels of household debt, and even insured families are exposed to medical expenses that did not exist a decade ago. Many, like the Dorsetts, do not realize how vulnerable they are until the bills arrive.

Lawyers and accountants say that for the more than 1.5 million American families who filed for bankruptcy protection last year, the most common causes were job loss and medical expenses. New bankruptcy legislation, which went into effect Oct. 17, requires middle-income debtors to repay a greater share of their debt.


October 23, 2005 | Permalink | TrackBack (0)