HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, March 4, 2006

Paul Krugman and the Health Care Crisis

Paul Krugman,  with Robin Wells, has a great article in the New York Review of books reviewing three new books that address our health care crisis and discussing in detail the problem of adverse selection in the insurance markets.  Enjoy!  Thanks to Eschaton for the cite. [bm]

March 4, 2006 | Permalink | Comments (0) | TrackBack (0)

Friday, March 3, 2006

Misleading Health Information?

I find articles like this one posted at Majikthise rather upsetting.  If you don't agree for moral reasons with certain drugs or other health choices that are available to people (mostly women), just say so - I respect that more than if you instead apparently make up scary health risks to prevent people from using or accepting whatever health product you find objectionable.  From Majikthise:

Emma, an OB-GYN blogging at The Well Timed Period, spotted a very suspicious claim in the Medline Plus entry on ectopic pregnacy:

The "morning after pill" is associated with a 10-fold increase in risk of this condition [ectopic pregnancy] when its use fails to prevent pregnancy.

MedlinePlus is a online health encycolpedia for consumers published by the National Institutes of Health. . . . .

Emma goes on to review the literature.

Synopsis: If ECP increases ectopic pregancy, nobody told science. Au contraire, ECP is so effective at preventing pregnancy that it reduces a woman's risk of both ectopic and regular pregnancy.


March 3, 2006 | Permalink | Comments (0) | TrackBack (0)

Health Savings Account Cartoon

Here is a link to a cartoon on Health Savings Accounts (I kid you not  ... of course, it really isn't terribly funny since it could be a hint of the future . . . .

Thanks to Ezra Klein for the link. [bm]

March 3, 2006 | Permalink | Comments (0) | TrackBack (0)

Thursday, March 2, 2006

The Dangers of Spell Check

Just for fun, Paul Caron of TaxProfBLog points to an amusing article in discussing the dangers of spell check.  According to the article a solo practicioner replaced sua sponte (latin for "on its motion") with sea sponge throughout his brief.  This lead to some great sentences, such as:

That left the justices reading -- and probably laughing at -- such classic statements as: "An appropriate instruction limiting the judge's criminal liability in such a prosecution must be given sea sponge explaining that certain acts or omissions by themselves are not sufficient to support a conviction."

And: "It is well settled that a trial court must instruct sea sponge on any defense, including a mistake of fact defense."

Oops!  Never rely solely on spell check. [bm]

March 2, 2006 | Permalink | Comments (0) | TrackBack (0)

The Terror Within

The LA Times reports on the United States' Surgeon General Richard H. Carmona's  announcement yesterday that fat is the "terror within" and threatens the United States as much as the 9/11 terrorists.  He said,

"Obesity is the terror within," Richard H. Carmona said in a University of South Carolina lecture. "Unless we do something about it, the magnitude of the dilemma will dwarf 9/11 or any other terrorist attempt.

"Where will our soldiers and sailors and airmen come from?" he said. "Where will our policemen and firemen come from if the youngsters today are on a trajectory that says they will be obese — laden with cardiovascular disease, increased cancers and a host of other diseases when they reach adulthood?"

Perhaps the use of 9/11 has gone just a bit too far . . . [bm]

March 2, 2006 | Permalink | Comments (0) | TrackBack (0)

Wednesday, March 1, 2006

Tarasoff Symposium

On March 17th, the University of Cincinnati College of Law Glenn M. Weaver Institute of Law and Psychiatry will host a symposium entitled, "The Future of the "Duty to Protect":
Scientific and Legal Perspective.   The symposium runs from 8am until 4:30pm at the Tangeman Center, Great Hall on the Campus of the University of Cincinnati

Here is a brief overview:

July 2006 will mark the 30th anniversary of Tarasoff v. Regents of the University of California, a decision that established psychotherapists' duty to protect the public from violent acts of their patients. Even after three decades, Tarasoff remains one of the most influential decisions in mental disability law. No court ruling has had a broader or more enduring impact on mental health practice and scholarship. Rare is the practicing mental health professional who is not acquainted with the decision and the discomfort that arises in clinical situations that trigger a duty to protect.

This symposium, especially targeted for attorneys, psychologists, psychiatrists, and other mental health professionals, uses Tarasoff 's 30th anniversary as an occasion to take stock of the decision's impact and to examine a broad range of legal and scientific problems that remain unrecognized, unaddressed, or underappreciated three decades after the 1976 decision was issued. This activity is jointly sponsored by the University of Cincinnati College of Medicine, the University of Cincinnati College of Law, University Hospital and the Glenn M. Weaver Institute of Law and Psychiatry.

For more information and how to register, click here.  [bm]

March 1, 2006 | Permalink | Comments (0) | TrackBack (0)

Editorial on Partial Birth Abortion Case has an interesting editorial on the partial birth abortion case, Gonzales v . Carhart (05-380), recently granted cert. by the Supreme Court.  William Saletin, the author notes,

Here's a different way to think about the case. It isn't about whether you're for or against abortion. It's about how confident you are that an unwelcome medical scenario will never happen.

The ban has become so politically central to the abortion debate that it's easy to forget how medically marginal it is. At most, it would affect fewer than one in 250 U.S. abortions. Of these 2,000 to 5,000 unborn babies—if that's what you believe they are—it would save none. It doesn't ban abortions beyond a stage of pregnancy; it just regulates the methods by which they're done.

Despite this empty result—or maybe because of it—many pro-choice politicians are willing to accept the ban. If you can end a pregnancy safely by other means, it seems gratuitously revolting to partially extract the fetus during the procedure. But that's a big if. What pro-choicers demand, and pro-lifers reject, is an exception to allow this method in situations where it's ostensibly necessary to protect the woman's health. According to the National Right to Life Committee, "the vast majority of partial-birth abortions do not involve any acute medical circumstances." So, in theory, the dispute is confined to a fraction of a fraction of all abortions.

Because the justifying scenarios are exceptional, and because the rationales for the procedure are technical, the federal judge who heard testimony in this case issued an opinion short on generalizations and long on details. His opinion runs 474 pages. It spends 57 pages reviewing congressional testimony over a nine-year period and another 278 pages reviewing medical testimony at the trial. It discusses numerous health conditions that, according to doctors who testified, make partial-birth abortion possibly the safest procedure for the woman. It concludes, "The trial evidence establishes that a large and eminent body of medical opinion believes that partial-birth abortions provide women with significant health benefits in certain circumstances." Not all circumstances—just certain ones.

The appeals court opinion affirming this ruling takes similar care. It enumerates scenarios in which testimony and logic indicate that partial-birth abortion might be the safest procedure. It acknowledges contrary testimony but concludes, "If one thing is clear from the record in this case, it is that no consensus exists in the medical community." Quoting a six-year-old Supreme Court opinion, it warns that "the division of medical opinion about the matter at most means uncertainty, a factor that signals the presence of risk, not its absence."

The ban's authors in Congress, like its defenders in the Bush administration, show no such humility. The nine years of congressional testimony that took 57 pages to describe in the trial court's opinion are boiled down in the ban's text to five pages. Every inconvenient nuance, witness statement, or piece of evidence is obliterated. The word "never" appears 10 times. "Congress finds that partial-birth abortion is never medically indicated to preserve the health of the mother," says the law, offering no details. "These findings reflect the very informed judgment of the Congress that a partial-birth abortion is never necessary to preserve the health of a woman." Who needs information when you've got informed judgment? Who needs sometimes when you've got never?


March 1, 2006 | Permalink | Comments (0) | TrackBack (0)

Monday, February 27, 2006

Medical Malpractice Crisis:

The Washington Monthly's Kevin Drum reports that medical malpractice insurance premiums are steady for this year, and thus, the end of the "medical malpractice crisis" may be at hand.  He cites to a report from the Americans for Insurance Reform, which  states,

Contrary to the medical and insurance lobbies’ message — that medical malpractice lawsuits and claims were to blame for the increase in insurance rates — the fact is that in 2001, commercial property insurance rates jumped across the board. In other words, rate hikes for doctors were only a small part of a much larger insurance problem that affected homeowners, motorists and all kinds of policyholders..

Gosh, what will lawmakers do now . . . . [bm]


February 27, 2006 | Permalink | Comments (0) | TrackBack (0)

Wisconsin Senate Passes Bill Denying Benefits to Undocumented Aliens

From today's Kaiser Famiily Foundation Health Policy Today:

Wisconsin Senate Passes Bill Denying Public Benefits to Undocumented Immigrants
     Applicants for public benefit programs in Wisconsin would have to prove they are legal residents under a bill the state Senate on Thursday voted 19-14 to approve, the AP/Milwaukee Journal Sentinel reports. The bill, which has yet to be considered by the state Assembly, would apply to the state's medical assistance programs such as BadgerCare and SeniorCare, as well as the state's welfare-to-work program and programs that pay for funeral and burial expenses for low-income people and others. Sen. Tom Reynolds (R) said it would be up to each agency to determine the type of documents applicants will have to present to confirm their legal status. The state Department of Health and Family Services currently does not allow undocumented immigrants to receive benefits, according to department spokesperson Stephanie Marquis. She added that one exception is that the federal government requires the state to provide benefits to anyone in a health emergency, and it is uncertain if that practice would be outlawed by the state bill (Foley, AP/Milwaukee Journal Sentinel, 2/23).


February 27, 2006 | Permalink | Comments (0) | TrackBack (0)

Tenet Settles Outlier Rico Case with Florida

From's "Government News of the Week" site:

In a Robin Hood-like resolution to allegations of Medicare outlier payment fraud, most of Tenet Healthcare Corp.’s $7 million settlement with the Florida attorney general (AG) will be turned over to the public hospitals that claim they were the losers of Tenet’s alleged outlier games.

AG Charlie Crist alleged that Tenet violated the Racketeer Influenced and Corrupt Organizations (RICO) Act when it engaged in a scheme to leverage more Medicare outlier payments than it was entitled to by inflating charges for its services between 2000 and 2003. Because Medicare caps outlier payments in advance annually, hospitals that take too much are depriving hospitals of needed funds, according to a March 2005 complaint filed by Crist and 13 public hospitals that lost money to Tenet’s activities. (Outlier payments are Medicare add-ons for resource-intensive patients who cost far more money to treat than the money hospitals get from DRG reimbursement.)

The lawsuit, filed in the U.S. District Court for the Southern District of Florida, alleges that Tenet inflated its hospital charges so patients qualified for outlier payments. “By artificially inflating their billed charges, the Tenet Hospitals transformed ordinary or average-cost [inpatient prospective payment system] patients into outlier patients, even though the costs actually incurred by the hospital to treat those patients fell within the norm and, therefore, would not entitle the hospital to receive outlier payments,” the suit says.

The Feb. 21 settlement calls for Tenet to put $4 million into an “Uninsured Patient Fund.” The public hospitals that are parties to this case will submit requests for money from the fund to cover the costs of treating indigent patients who aren’t covered by Medicare, Medicaid or other payers, the settlement states. An additional $2 million will be distributed directly to the hospitals, and $1 million will be returned to the AG to cover the costs of the investigation.

Tenet “explicitly” denies the RICO allegations, says spokesman Harry Anderson. . . .

This settlement is just the tip of the iceberg of outlier cases against Tenet, says former OIG attorney Paul Danello. Anderson says Tenet is cooperating in a DOJ investigation of its pre-2003 outlier payments. . . .

Reprinted from the Feb. 27, 2006, issue of REPORT ON MEDICARE COMPLIANCE,


February 27, 2006 | Permalink | Comments (0) | TrackBack (0)

South Dakota's New Abortion Law

Some really useful stuff from Law Librarian (and blogger) extraordinaire, Joe Hodnicki, on South Dakota's Women's Health and Human Life Protection Act:


February 27, 2006 | Permalink | Comments (0) | TrackBack (0)

Changes Coming to Medicare Part D

Kate Steadman, an editor and contributor to TPM Cafe as well as her Healthy Policy blog, writes about some changes that CMS has suggested on Friday to make Medicare Part D work better.  She is not too thrilled with either proposed change.  She states,

In a major reversal, CMS (Center for Medicare and Medicaid Services) sent out a call for suggestions on Friday to fix Medicare Part D. 

Half the battle has been won; the Administration has finally recognized that changes need to be made.  That's a major step towards fixing the legislation.  Unfortunately (but unsurprisingly), CMS's two suggestions are lackluster:

The agency proposed limiting to two the number of drug plans a company can offer per region. Many insurers now offer three, and since there are often more than a dozen insurers per region, consumers often have more than 40 choices.

The agency also said it expects that an insurer's two plans must have meaningful differences to make comparisons easier.

Doing a little math, if there's 40 plans now with insurers offering three, there would be 26 plans per region after limiting plans to two. But there's no qualitative difference between offering 26 and 40 plans.  Both numbers are much too large to compare.    

For more on these suggested changes and Ms. Steadman's views, click here. [bm]

February 27, 2006 | Permalink | Comments (0) | TrackBack (0)

Sunday, February 26, 2006

More on Bird Flu

The New York Times has an informative article about the spread of the bird flu to Nigeria and France.  It doesn't look good when your President is eating chicken to calm people's fears.  According to the Times the bird flu seems to be spreading rather rapidly, 

The announcement on Saturday that the deadly strain of bird flu was discovered in domesticated turkeys in France has disrupted the country's $7 billion poultry market and raised fears among the French that they could be vulnerable to the disease.


President Jacques Chirac, a former agriculture minister, met with farmers and veterinarians on Saturday morning at the opening of France's annual international agricultural fair and urged calm.

There is no "absolutely no danger in eating poultry and eggs," Mr. Chirac said, eating a chicken dish to press the point. He said that the industry had been "profoundly hurt and disrupted," and that "a completely unjustified sort of total panic" was developing.

For the first time in the fair's 42 years, no live birds are on display.

Detection of the A(H5N1) flu strain on a turkey farm in eastern France represented the first time the virus had been found in farm animals in the 25 countries of the European Union.

France had already been reeling from the news that a wild duck, found dead nearly two weeks ago in the department of Ain, the same area where the turkey farm is situated, had been infected.

Those fears, followed by the confirmation on Saturday that a farm with a flock of 11,000 turkeys had been struck by the disease, have sent poultry sales plummeting.

As always, the Effect Measure blog has excellent reporting on this issue.  [bm]

February 26, 2006 | Permalink | Comments (0) | TrackBack (0)