HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Wednesday, December 5, 2007

Some Controversy Over Democratic Health Care Plans

In Iowa, both Democratic candidates Clinton and Obama have been arguing over their health care plans recently.  Ezra Klein, as usual, does an excellent job describing both plans and the controversy here and here, and the Wall Street Journal discusses the recent uproar over the topic of who will cover more Americans and whether a mandate will provide an answer to some of our health care problems.   The Journal states,

Clinton says Obama’s health care plan, which doesn’t require everyone to get coverage, would leave out 15 million people. Clinton’s own plan requires everybody to get coverage. But Obama says there’s not enough money in Clinton’s plan to pay for everybody to do so.

Both candidates are probably right, more or less, and which plan would cover more people is anyone’s guess, according to stories this morning in the WSJ and the New York Times. . . .

The WSJ notes that both candidates say they’d spend roughly the same amount of money — about $110 billion a year — on their plans, which share many similarities. The NYT points out that just because you have a mandate, it doesn’t mean everybody will follow it, citing the fact that an estimated 15% of the nation’s drivers flout the mandate for auto insurance.

December 5, 2007 | Permalink | Comments (0) | TrackBack (0)

Supreme Court Considers Medical Device Case

The New York Times' Linda Greenhouse reports on Riegel v. Medtronic Inc., argued yesterday in front of the Supreme Court.  The case considers, "whether the manufacturer of a medical device approved for sale by the Food and Drug Administration can be sued for damages under state law if the device injures a patient."  She writes,

The device at issue was a balloon catheter that burst during an angioplasty, causing serious injury to the patient, Charles R. Riegel. He and his wife, Donna, sued the manufacturer, Medtronic, which had received approval to market the device in 1994, two years before the incident. Two lower federal courts in New York dismissed the suit on the ground that the F.D.A.’s “premarket approval” precluded the imposition of liability under state law.

The Supreme Court last looked at a medical device case in 1996, when it ruled that devices approved by the F.D.A. under a different, more expedited process were not shielded from state liability. At that time, the federal government itself argued against pre-emption.  But in 2004, the Bush administration reversed the government’s position and began to take the manufacturers’ side, as it did before the justices on Tuesday in an argument by a deputy solicitor general, Edwin S. Kneedler. Explaining the change in policy, Mr. Kneedler said that in 2004, the F.D.A. “recognized that there would be a serious undermining of F.D.A.’s approval authority and its balancing of the risks and benefits if a state jury could reweigh those.”

A question in this case, Riegel v. Medtronic Inc., No. 06-179, is whether the court will give the government’s position the usual deference it accords an agency’s interpretation of its basic statute.

The federal law at issue is the Medical Device Amendments of 1976, which in its section on pre-emption bars states from imposing on medical devices “any requirement which is ifferent from, or in addition to, any requirement applicable under this chapter.”  Beginning with a case in 1992 about warning labels on cigarette cartons, the Supreme Court has treated the word “requirement” as including not only obligations directly imposed by state laws and regulations, but also the award of damages by state tort systems. 

For a jury to say, “Well, gee, it should have been done differently in this particular situation” is the equivalent of imposing a requirement in addition to federal approval, Theodore B. Olson, the lawyer representing Medtronic, told the justices.  “The F.D.A. is the right place for these decisions to be made and this balancing process to occur,” Mr. Olson said, adding that while “nothing is perfectly safe,” it would harm consumers to “discourage the marketing of products that might save our lives.” Medtronic no longer makes the balloon catheter, called Evergreen, involved in the case.

While Mr. Olson’s argument clearly found traction with some justices, most notably Justice Antonin Scalia, the lawyer for the plaintiffs, Allison M. Zieve, was also effective in sowing doubts that “premarket approval” by the agency was rigorous enough to justify shielding the manufacturer from state liability.  Ms. Zieve, a lawyer with the Public Citizen Litigation Group, conceded that the law would prevent a state from imposing its own premarket approval process that differs from the federal one. But she said that premarket approval was a preliminary judgment of safety and effectiveness that did not relieve a manufacturer of an obligation to make a device better and safer.  Premarket approval was not “irrelevant to the tort suit” but was not by itself adequate to invoke pre-emption, Ms. Zieve said. . . .

December 5, 2007 | Permalink | Comments (0) | TrackBack (0)