HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

A Member of the Law Professor Blogs Network

Saturday, March 21, 2009

Genetically Modified Foods

CrooksandLiars has an interesting post about the new food safety law, the Food Safety Modernization Act, now pending in Congress and some of its implications for the future of genetically modified foods.  The author notes,

There’s been quite a bit of contention erupt over a bill being proposed in the House, the Food Safety Modernization Act of 2009, HR 875: This bill is purportedly to establish a ‘Food Safety Administration’ within the DHHS to regulate food safety, labelling, and regulating the processing, storing, and transport of food from ‘food establishments’, promote food safety research by academic and State institutions. On the face of it, after the recent poison peanut fiasco, that doesn’t sound like such a bad idea, does it…?

… Except there’s a few problems, as it is a very rare bill that can ever be accepted ‘on the face of it’. The first problem with this bill was that is was introduced by Congresswoman Rosa DeLauro (D – CT), whose husband, Stanley Greenburg, works for Monsanto. This may not violate any specific legalities (or maybe it does) but this is the kind of ethical conflict of interest that stinks like a three day old dead genetically modified mackerel. That alone has been enough to raise hackles and suspicions, generating accusations that this bill would in effect criminalize seed banking, impose prison sentences and fines on farmers, require GPS tracking of animals, warrantless government entry onto farm easements, and even allegations of a massive police state plot to incorporate farmland into the hands of industrial giants like Monsanto in a planned elimination of independent farmers altogether.. . .

But beyond the accusations that Monsanto is manoeuvring to impose ‘standardized’ agricultural practices that would allow Monsanto and other GM agribusinesses to control and regulate seeds, pesticides and fertilizer that would, in effect, prohibit organic farming and open the way for unregulated GM food production, there is an underlying question:

Why are we so afraid of genetic modification? We on the left all cheered wildly when Obama lifted the Bush ban on embryonic stem cell research, and genetic modification in medicine has already offered thousands of patients genuine hope for treatment and cures for a variety of deadly illnesses. So just what is it about the science of genetically modified food that makes us so wary? Why is one ‘good science’ and the other ‘bad science’?

It isn’t as if humans haven’t been practicing genetic modification for centuries – farm animals themselves are largely the most obvious result of ‘natural’ selection for certain traits. A domestic pig bears as much resemblance to the wild boar it descended from as a Chihuahua resembles a wolf. Is it ethical to breed pigs that put on meat weight so quickly that they must be slaughtered at eighteen months because beyond that age their bones simply aren’t strong enough to support their own weight and they end up crippled? That has nothing to do with scientists artificially slicing DNA in a test tube somewhere – it’s been going on for the past 9,000 years, all quite ‘naturally’.. . .

When I started researching for this post, I contacted Jill Richardson, founder of La Vida Locavore, and author of the upcoming Recipe for America: Why Our Food System is Broken and How We Can Fix It for some background material. Instead of offering a bit of cursory advice, she was kind enough to send me the following detailed and erudite email, which is enough in itself as a post on its own . . .  .

March 21, 2009 | Permalink | Comments (0) | TrackBack (0)

Friday, March 20, 2009

Just for Fun: Sheep

S-EXTREME-SHEEP-ART-large From the HuffingtonPost.com,

"BaaaStuds," a group of men who seem to have been contracted by Samsung, "took to the hills of Wales armed to the teeth with sheep, LEDs and a camera, to create a huge amazing LED display."

They strapped the LEDs to the sheep and created expansive works of glowing sheep art by speeding up the footage. This approach helped them make a giant sheep out of many tiny sheep and sheep fireworks.  There's some debate over whether or not the video has been faked. . . .  (the video is at the above link and is quite fun).


March 20, 2009 | Permalink | Comments (0) | TrackBack (0)

What You Pay for Food and Your Weight

An article in Science Daily discusses a recent study appearing in the Milbank Quarterly that concluded that prices of food can impact obesity and lends support to those public policy folks who wish to tax or raise the price of various unhealthy foods. 

Raising the prices of less healthy foods (e.g., fast foods and sugary products) and lowering the prices of healthier foods (e.g., fruits and vegetables) are associated with lower body weight and lesser likelihood of obesity. Children and adolescents, the poor, and those already at a higher weight are most responsive to these changes in prices.

Small taxes on unhealthy food items or small subsidies for healthy foods are not likely to produce substantial changes in BMI or obesity prevalence while nontrivial pricing interventions may have a measurable effect on Americans’ weight outcomes.

“This review provides evidence about the potential effectiveness of using food pricing policies to affect weight outcomes, including the potential impact of excise and other taxes on less healthy products and of subsidies for more healthy products,” the authors conclude. . . .

March 20, 2009 | Permalink | Comments (0) | TrackBack (0)

Thursday, March 19, 2009

Media Consortium on Health Care Topics

Lindsay Beyerstein provides a great review of the recent health topics making the news.  She writes,

Single-payer health insurance was a hot topic for independent media this week. The private health insurance industry has failed to contain costs and cover the majority of Americans. The strain of the employer-funded health insurance system is crippling American competitiveness and leaving consumers unsatisfied. Universal, publicly-funded health insurance would be a better and cheaper alternative, explains Ramón Castellblanch in the Progressive. Castellblanch, an associate professor of health education at California State University, says that single-payer is simply a government-administered insurance program for everyone, not government-administered healthcare.

There’s also broad consensus that fixing the healthcare system must involve more than providing health insurance. Insurance is a tool for spreading risk and sharing cost, but it won’t fix the deeper problems that made healthcare unaffordable in the first place. In Salon, Rahul K. Parikh, M.D. describes the carrots and sticks built into Obama’s plan to motivate doctors to practice evidence-based medicine more efficiently. Evidence-based medicine means treatment supported by the best scientific research. It has been estimated that up to one third of medical treatment is unnecessary and ineffective. Some reformers believe, therefore, that making medicine more evidence-based will improve quality and cut costs . . . .

The whole webpage provides interesting information.



March 19, 2009 | Permalink | Comments (0) | TrackBack (0)

COBRA Revised

D  Wreck at DailyKos helpfully provides a brief overview of some of the recent changes in COBRA.  It might come in handy when discussing such lovely revisions with your health law class.  The author writes,

    There are nearly 48 million Americans without medical insurance.  Since September 2008, 3.3 million      jobs have been lost.  For the newly unemployed, COBRA provides an opportunity to maintain                 insurance coverage while out of work.  But the cost of COBRA can be staggering, especially in a              household running on limited income.

    In an effort to stem the growth of the uninsured during this recession, the American Recovery and             Reinvestment Act (ARRA) provides up to 9 months of reduced COBRA premiums for workers who are     involuntarily terminated from employment between September 1, 2008, and December 31, 2009. . . .

D Wreck then reviews some of the important provisions, including:

    ARRA provides for a 65% reduction in premium costs for certain COBRA eligible workers for up to nine     months.  Workers who are involuntarily terminated from their employment between September 1, 2008,     and December 31, 2009, are eligible for these reduced premiums.

    Eligible individuals who elect COBRA coverage will pay 35% of the normal COBRA premium.  The         Kaiser Family Foundation 2008 Health Benefits Survey pegs the average single rate at nearly $400 per     month, with family coverage averaging over $1,000 per month.  A 65% reduction equates to an average     savings between $2,340 and $5,850 over a 9 month period. . . .

There is more on the webiste.  I need to so some more reading myself but it does give a person a good starting place.

March 19, 2009 | Permalink | Comments (0) | TrackBack (0)

Wednesday, March 18, 2009

Medical Malpractice Reform

The Wall Street Journal's Health Blog notes a potential stumbling block on the road to health reform - medical malpractice reform.  Sarah Rubenstein writes,

The issue of medical malpractice lawsuits is among the touchiest in the debate over rising health-care costs. Doctors are burdened by the high cost of malpractice insurance and say they’re forced to practice “defensive” medicine, while lawyers say the suits are a check in the system meant to protect patients. The debate has been relatively quiet in recent months, but it’s now rising to the surface, Politico reports

Trial lawyers plan to distribute a 29-page research document saying the suits aren’t behind the rising cost of care, Politico says. Meantime, the American Medical Association is saying it can’t see how a health-reform bill would control costs without tort-reform measures in it. . . .

President Obama and other Democrats are signaling they’re open to some changes, though the details aren’t clear. Take a look at a perspective piece that Obama co-wrote with Hillary Clinton a few years ago in the New England Journal of Medicine. Their recommendation: “Instead of focusing on the few areas of intense disagreement, such as the possibility of mandating caps on the financial damages awarded to patients, we believe that the discussion should center on a more fundamental issue: the need to improve patient safety.” . . .

March 18, 2009 | Permalink | Comments (0) | TrackBack (0)

The House's Health Care Reform Team

The New York Times' Robert Pear discusses the working group in the House of Representatives that is quietly working to build a consensus around a health reform proposal.  He writes,

Three powerful House committee chairmen have agreed to work together on legislation to overhaul the health care system, starting with the view that most employers should help finance coverage and that the government should offer a public health insurance plan as an alternative to private insurance.  . . . 

The three chairmen, George Miller and Henry A. Waxman of California and Charles B. Rangel of New York, all Democrats, have a combined total of more than 100 years of service in the House.  Mr. Miller, chairman of the Education and Labor Committee, which has jurisdiction over employee benefits, said the three lawmakers had decided to “try and work as one committee to produce a comprehensive health care bill this summer.  In a letter to President Obama, the chairmen said, “Our intention is to bring similar legislation before our committees.”  Mr. Waxman, chairman of the Energy and Commerce Committee, said, “We intend to work from a single bill, and have that bill considered by the House before the August recess.”  The Senate committee chairmen responsible for health legislation, Max Baucus of Montana and Edward M. Kennedy of Massachusetts, both Democrats, have outlined a similar schedule.

Such agreements, while no guarantee of success, could help build momentum for a bill. A united front could make it harder for lobbyists to derail legislation. White House officials welcomed the prospect of cooperation by House leaders, saying it increased the chances of passing a bill to expand coverage this year, a top priority for Mr. Obama. . . .

March 18, 2009 | Permalink | Comments (0) | TrackBack (0)

LATCRIT Annual Conference: Call for Papers and Panels

CALL FOR PAPERS & PANELS

OUTSIDERS INSIDE:  CRITICAL OUTSIDER THEORY AND PRAXIS IN THE POLICYMAKING OF THE NEW AMERICAN REGIME

American University-Washington College of Law

Washington, D.C.

October 1 - 4, 2009

Please join us at LatCrit XIV, the Fourteenth Annual LatCrit (Latina and Latino Critical Legal Theory, Inc.) Conference, which will take place in Washington, D.C., from Thursday, October 1 through Sunday, October 4, 2009.

LatCrit/SALT Junior Faculty Development Workshop

The Seventh Annual Junior Faculty Development Workshop, sponsored jointly with the Society of American Law Teachers (SALT), will begin at 9:00 am, Thursday, October 1st and continue through Friday morning.

LATCRIT XIV THEME

OUTSIDERS INSIDE:  CRITICAL OUTSIDER THEORY AND

PRAXIS IN THE POLICYMAKING OF THE NEW AMERICAN REGIME

In October 2009, LatCrit will meet inside the Beltway for the first time in its history amidst a tectonic shift in American government.  With the January inauguration of President Barack H. Obama, the nation’s first “outsider” president, we also saw the ascendance of a new progressive governance philosophy in Washington.  As a biracial former law professor with working class and immigrant roots and an international and multicultural upbringing, Mr. Obama ran a progressive campaign that echoed many core LatCritical values, including internationalism and global-mindedness, the valorization of human rights and multidimensional diversity, the centrality of antidiscrimination work, a commitment to rigorous interrogation of longstanding dominant assumptions and norms, and a preference for discourse and dialogue over militarism.  Notably, President Obama’s Yes We Can! campaign slogan has its roots in the ¡Si Se Puede! rallying cry coined by Dolores Huerta of the United Farm Workers movement and invoked in more recent progressive and mostly Latino/a political actions.

The new Presidential administration and enlarged bicameral Democratic majority in Congress account only for part of the historic paradigmatic transition in American national government.  The ongoing deterioration of the American and world economies also has catalyzed an aggressive reassessment by moderate and even some conservative thinkers of the wisdom of the Reagan Revolution’s uber alles dependency on the private marketplace for the realization of the public good – an antiregulatory disposition that dominated federal government through the last seven presidential administrations.  In the United States, the failure of the government’s dominant antiregulatory disposition to prevent the ensuing economic meltdown has catalyzed a new, aggressive Federal response in the form of much more statist economic interventions, including the de facto nationalization of key economic components. To add irony, it was the administration of President George W. Bush – the loudest in exalting the power of unbridled private marketplaces to regulate themselves – that laid the foundation for the national takeover of large sectors of the financial services and banking industries.

These quantum changes in the leadership and driving philosophies of American government present unique and in some cases unprecedented opportunities for scholars engaged in critical outsider scholarship to influence and inform national policy and legislation. The new executive and legislative branch incumbents have telegraphed early receptivity to the instantiation of LatCritical and other progressive theories and principles in the tangible products of Federal government (i.e., legislation, regulation, presidential directives, and, of course, caselaw). As President Obama’s aspirational campaign continues to transition into the nouveau regime at the helm of the most powerful government on Earth, millions of Americans expect the vague Yes We Can promise to become the Yes We Are reality. 

 

But with these openings come potential pitfalls.  Although the ascendance of a putatively progressive president and likeminded Congressional majority indeed may open up new opportunities to bridge the theory/praxis chasm, it also may pose serious challenges to the independence and even legitimacy of progressive critical theory movements. Should the cooption or even distortion of conservative theory by militaristic, extremist partisan politicos serve as a cautionary tale in the formation of new relationships between the progressive government and outsider critical theorists? More specifically, what if the first year in office of the Yes We Can presidential candidate unfolds into more of a No We Won’t disappointment?  What if the exigencies of governing to and from the middle – which many pundits insist is the sine qua non for reelection viability – result in the sacrificing of Obama’s progressive promise?  What roles should outsider critical legal scholars and their scholarship assume then? More generally, what should the incarnation of progressive theory in the new American regime look like? And what prevents that theory from being co-opted and corrupted by the corroding influences of insider power?

 

The LatCrit XIV Host Committee invites the submission of proposals for panels and papers related to this open-textured theme and encompassing the fullest array of theoretical and doctrinal topics and approaches.  Because we will be in Washington, DC, we encourage the submission of paper and panel proposals propounding prescriptive critiques of discrete areas of law, policy and regulation of specific relevance to outsider communities, including (but by no means limited to) economic justice, international and comparative law, criminal law and the death penalty, civil rights and constitutional law (including gender and LGBT equality, reproductive and disability rights), feminist legal theory, immigration, political and electoral (dis)enfranchisement, communications policy and intellectual property, healthcare, education, employment, tax policy, and the environment.  We also, of course, welcome proposals for more theoretical panels and papers, particularly (but not exclusively) in areas linked to the challenges posed by progressive governance and the ascendance of outsiders to positions of ultimate authority. 

 

Please submit your panel and paper proposals through the online process at the LatCrit website (www.law.du.edu/latcrit/index.htm) no later than MONDAY, APRIL 27, 2009.  Please note that although paper proposals for work-in-progress sessions may be submitted now, we will continue to accept those proposals through mid-July (please refer to LatCrit website for forthcoming additional details).   

Continue reading

March 18, 2009 | Permalink | Comments (0) | TrackBack (0)

Tuesday, March 17, 2009

AIDS in Washington DC

The Washington Post reports on the AIDS epidemic in Washington, DC and notes that the spread of AIDS is most likely more widespread than current surveys show.  Darryl Fears and Jose Antonio Vargas write,

A report showing that 3 percent of D.C. residents are infected with HIV or AIDS is probably an undercount, and the prevalence of the disease is probably worse than is known, according to Shannon L. Hader, director of the city's HIV/AIDS Administration.  Hader said the city will work harder to administer testing, which is key to knowing the true number of residents with HIV and to diagnosing the illness before it develops into AIDS.   "These are people who are diagnosed and alive in our city," Hader said. "If you're not getting tested . . . we don't have a way of making you part of the response."

Mayor Adrian M. Fenty officially released the report at a news conference yesterday in Ward 7, one of several wards where the prevalence of HIV and AIDS is high. He called it a wake-up call for the District and one of the "most serious problems" facing the city. The report confirmed for the first time that at least 15,120 residents -- about 3,000 per every 100,000 over the age of 12 -- have HIV or AIDS.  The mayor also released a study on heterosexual behavior by George Washington University's School of Public Health and Health Services saying that residents in parts of the city with the highest AIDS prevalence and poverty rates engaged in sexually risky behavior that fuels the spread of the disease. . . .

The Centers for Disease Control and Prevention reported that the District is one of the top three jurisdictions in the country in conducting the most HIV tests and identifying the greatest number of HIV-infected residents. . . .   But, Hader said, "it's not the whole story." The report counted residents who were tested and had HIV and AIDS diagnosed, but not residents who had HIV but don't know it. . . .

Continue reading

March 17, 2009 | Permalink | Comments (0) | TrackBack (0)

Monday, March 16, 2009

Regulating Medical Tourism

BNA's Health Law Reports has an interesting article on the increasing popularity of Medical Tourism and the need to address the risks posed by such medicine.  Thom Wilder writes,

While medical tourism continues to become a tremendous growth industry as U.S. patients seek cheaper medical care abroad, it poses several possible risk and legal factors that must be addressed not only by patients, but also providers in both countries, experts in the field said Feb. 27.  In 2007, nearly 750,000 Americans engaged in medical tourism—defined as travel across international borders for the express purpose of receiving medical care—a number expected to swell to 6 million by 2010, representing $16 billion to $19 billion in expenditures, said J. Mark Waxman, a partner with Foley & Lardner LLP, Boston, during a BNA teleconference, titled, “Medical Tourism: From Idea to Implementation.’’

This growth has been fueled not only by the uninsured and underinsured seeking less expensive options for surgical care, but also by employers seeking to drive down costs by seeking health care in places such as India, Turkey, Dubai, and approximately 30 other countries, . . . .    These foreign medical centers—essentially promising world-class care at Third-World prices—are more cost-effective for several reasons, including lower facility construction costs and time, lower labor costs, an absence of legacy systems, very low medical malpractice and liability costs, and a corporate culture that is “better, faster, cheaper, and hungrier’’ than in the United States, according to Helfrick.  Most of that care has focused on elective procedures such as orthopedics (hip replacement, knee replacement, and spinal surgery), cardiovascular surgery (bypass surgery, valve replacements), cancer diagnosis and management, cosmetic surgery, and bariatric surgeries, Helfrick said. Dentistry also has risen in prominence in recent years, Waxman noted. . . .
In the end, it is all about money, Waxman said. For example, while heart bypass surgery in the United States can cost between $70,000 and $133,000, the same surgery would cost an average of $22,000 in Thailand and an average of $7,000 in India, Waxman said. The figures Waxman cited are from Patients Beyond Borders, a book on medical tourism authored by Josef Woodman, president of the Healthy Travel Media Co. (see chart).  But cost is not the only factor involved in deciding to seek care abroad, Dagi said. Part of this growth is a “real or perceived’’ lack of services available in the United States, or limitations imposed on care by payers or regulatory agencies, Dagi said. . . .
Dagi agreed, noting that while medical tourism is a legitimate choice, it does carry risks. Most of the medical centers abroad being sought out by Americans are “world-class facilities,’’ he said, but prospective patients must exercise some diligence in choosing where they seek treatment as not all foreign medical centers meet U.S. standards. In some instances there is variability and differences in training of medical and allied health professionals, in standards for medical institutions, and in interpretation of test results and indications for treatment, he said.
Other risks include a lack of follow-up and support networks, differences in physician/patient communication practices exacerbated by language and cultural barriers, accuracy and completeness of medical records, and possible exposure to endemic diseases, Dagi said . . . .

March 16, 2009 | Permalink | Comments (0) | TrackBack (0)

Sunday, March 15, 2009

Physicians Respond to Wyeth Ruling

AmNews has a brief story discussing physicians' responses to the Supreme Court's recent ruling in Wyeth state court warning label lawsuits against drug manufacturers are not preempted.  Amy Sorrel writes,

Some physicians say a recent U.S. Supreme Court ruling preserves a key safeguard in holding pharmaceutical manufacturers accountable for drug safety -- the courts.  But other doctors worry the decision could stifle drug access if juries are allowed to second-guess scientific determinations on the risks and benefits of certain medications.

On March 4, the high court ruled 6-3 that federal law does not preempt state claims against drugmakers over allegedly inadequate warning labels, despite approval of those labels by the Food and Drug Administration.  "Congress did not intend FDA oversight to be the exclusive means of ensuring drug safety and effectiveness," Justice John Paul Stevens wrote for the majority. "The FDA has limited resources to monitor the 11,000 drugs on the market, and manufacturers have superior access to information ... as new risks emerge." . . .

Some doctors said the threat of liability has helped ensure drug manufacturers monitor their drugs and report new or revised safety information to doctors and the FDA.  "Many times the manufacturer is the only one with that information," said Francisco Silva, California Medical Assn. vice president and general counsel. "Most importantly, the ruling does not shift the burden to physicians," who could be left liable if patients had no recourse against drug manufacturers. . . .

But other doctors fear juries are not equipped with the expertise that trained medical professionals and regulators possess to decide safe and effective medication use.  "If that [duty] is switched over to a court or jury, it creates significant variability and uncertainty" that could interfere with physicians' medical judgment, said Brian F. Keaton, MD, past president of the American College of Emergency Physicians, which filed a brief in the case.  The decision also could result in commonly used drugs, such as Phenergan, becoming so tightly regulated "that it takes it out of [doctors'] hands," Dr. Keaton said.  Wyeth attorney Bert W. Rein said in a statement that FDA experts "are in the best position" to weigh medication benefits and risks, and convey them in warning labels. . . .

March 15, 2009 | Permalink | Comments (0) | TrackBack (0)