Tuesday, January 3, 2006
The question has been debated endlessly. My colleague Greg Crespi's tenure piece (more than 10 years ago) suggested a futures market for organs might work nicely. Many others have chimed in over the years. This month, Chicago's Gary Becker and the Seventh Circuit's Richard Posner make the case nicely over at their blog. There isn't much new in their discussion, though I like Posner's extended analysis of why donation rates are higher in opt-out countries than in opt-in countries.
For those who are aghast at the classical economic analysis of organ shortages and the beneficial effects of a monetary market in organs, one commenter offers this tip:
A legal non-monetary market for organs exists in the United States. It's called LifeSharers. Anyone can participate for free at http://www.lifesharers.org.
When you join LifeSharers you agree to donate your organs when you die, and you also agree to offer them first to fellow members. In return you get preferred access to the organs of all other members.
This is an excellent trade. By giving up your organs after you can't use them anymore, you increase your chances of getting an organ if you ever need one. Given that more than half of the people who need a transplant die before they get one, this is a significant benefit.
By creating a pool of organs available first to members, LifeSharers creates an incentive for non-donors to donate and to join LifeSharers. This incentive gets more powerful as the number of members increases.
LifeSharers uses a form of directed donation that is legal under federal law and under the laws of all 50 states. Parents can enroll their minor children. No one is excluded because of any medical condition.
"Underneath Their Robes" is just about what it sounds like: a snappy, irreverent blog that actually has some of the most up-to-date info on what's happening on the federal bench (including nuggets of clerkship news), delivered by a babe named Article III Groupie. She (A3G, that is, not her alter ego, former AUSA David Lat) disappeared from view after a New Yorker profile let the proverbial cat out of the bag, but she's back, sassy as ever. Give her blog a try: You'll be in good company (Circuit Judge Richard Posner, for example, is a fan).
(OK, this has nothing to do with health law, except that federal judges occasionally have to decide health-law issues. Close enough. You can thank me later.) Back to health law. [tm]
Monday, January 2, 2006
From the Jan. 2 issue of AIS's Managed Care Week:
U.S. District Judge Richard Leon on Dec. 22 blocked Washington, D.C.’s Prescription Drugs Excessive Pricing Act. The law would have made it illegal for pharmaceutical companies to sell patented medicines at an excessive price, defined as 30% more than the prices in four other developed countries. In the case of Pharmaceutical Research and Manufacturers of America (PhRMA) v. District of Columbia, et al., Leon ruled that the act went against the will of Congress and violated constitutional protections of interstate commerce. D.C. Council member David Catania (I) had sponsored the bill, which the D.C. council passed unanimously and was signed by D.C. Mayor Anthony Williams (D). Catania’s office said he “is eager to continue to press the issue” of controlling drug costs. Billy Tauzin, PhRMA president and CEO, said the organization was pleased with the judge’s ruling (news release here).
Opinion is here. The D.C. ordinance is identified in the opinion as D.C. Act 16-174 in the opinion, but all I could find on-line was two versions of D.C. Act 16-114 and an unnumbered "Enrolled Original." I am linking to the latter; this should give you at least an idea of what the law says. And it is something of a disgrace that the D.C. City Council doesn't provide a legislative page that gives users easy access to the Council's session laws. Very few states have failed to meet this basic obligation of democratic governments . . . . [tm]
Sunday, January 1, 2006
The NY Times reported this week that the University of Medicine and Dentistry of New Jersey agreed to place its finances and management under the control of a federal monitor in order to avoid criminal charges in connection with Medicaid improprieties going back years. Herbert Stern, a former federal prosecutor and district judge, will fill the role and collect $500 per hour for his trouble, according to a sidebar article. [tm]
That was the top story in 2005, according to Harvard's World Health News. HWHN tracks the major developments, as reported in the pages of the Atlanta Journal-Constitution, Washington Post, International Herald Tribune, the New York Times, and the Guardian (London). [tm]