HealthLawProf Blog

Health Care: Debating an Effective Public Option

Using San Fransisco as a model, NYT columnists debate a public health care option. 

TWO burning questions are at the center of America’s health care debate. First, should employers be required to pay for their employees’ health insurance? And second, should there be a “public option” that competes with private insurance?

Answers might be found in San Francisco, where ambitious health care legislation went into effect early last year. San Francisco and Massachusetts now offer the only near-universal health care programs in the United States.

Read more about the results here.

D.C. and VA Schools Requesting Sixth Grade Girls Receive HPV Vaccination

Schools in both D.C. and Virginia are requesting sixth grade girls receive Gardasil, the vaccine that was approved by the FDA in 2006 that protects against genital warts and cervical cancer. The vaccine is most effective if it is administered before girls become sexually active. Though both D.C. and Virginia have provided for opting-out of the requirement, proponents are hopeful that this legislation will protect million girls from cervical cancer. However, opponents voice concerns that the drug has not been tested enough. Such apprehension is what has prevented other states, such as Maryland, from making the vaccination mandatory.

Seniors - Driving and Staying informed of Potential Safety Risks?

Many elderly drivers are unaware that prescription drugs may affect their ability to drive safely, reported the Wall Street Journal.

In all, 69% of those surveyed took a medicine that could impair driving, because of possible side effects such as dizziness, drowsiness or blurred vision. But only 28% of respondents were aware of those issues. Only 18% had been warned about the possible driving risks by a doctor, nurse of pharmacist.

Moms in D.C. Apprehensive about Flu Vaccine

Some mothers-to-be in D.C. are concerned that a new swine flu vaccine has not been tested enough to be administered to pregnant women. Debate stems from the recent recommendation by the Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists that pregnant women receive the swine flu vaccination as a preventative health measure. A recent study in the Lancet medical journal study indicated that pregnant women are more likely to be affected by swine flu than other groups.  Read here.

End of Life Care

When only about one third of Americans leave living wills or specify end of life protocol, physicians and hospitals are left to consider the costs and benefits of end of life care themselves. Some issues that remain include:

Should a feeding tube be installed when the patient can no longer be nourished by mouth? Should a ventilator be attached when breathing independently becomes difficult? If the patient has severe dementia, should antibiotics be used if pneumonia develops? Should cardiopulmonary resuscitation be attempted if the heart stops beating?

Or should the patient receive just comfort care — treatment for pain, nausea, anxiety, depression and other debilitating symptoms — and be allowed to die a natural death?

Lacking guidance from patients and families, physicians who know better too often end up providing costly life support for the terminally ill even though there is no hope for an improved quality of life.

Dr Charles A. Bush, the medical director of Richard M. Ross Heart Hospital at the Ohio State University, believes this adversely impacts the health care system through higher costs and debilitating procedures for patients.

Conflicts of Interest? Doctors and Pharmaceutical Ties

Washington Post discuss a sensitive question many patients find themselves wondering but perhaps not directly asking their doctors - what companies their doctors have relationships with and how deep those ties run.  One market research company estimated that pharmaceutical sales spends $20 billion a year marketing directly to doctors.

As a response in 2003, D.C. enacted legislation to improve transparency among drug manufacturers. A national effort was initiated this year:

In January, Sen. Chuck Grassley (R-Iowa) and Sen. Herb Kohl (D-Wis.) introduced legislation -- the Physician Payments Sunshine Act -- that would require drug and medical device manufacturers to report payments to any physician of more than $100, whether as a gift or for research purposes, and to publish the information online.

But then again, complete skepticism of doctor-pharmaceutical sales relationships may not always be fair, as Chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic points out:

"We can't lose sight of the fact that it is potentially beneficial [to the public] for industry to interact with physicians, because someone needs to develop these drugs. I work with many pharmaceutical companies, and I believe it is my responsibility as a physician to facilitate the development of new therapies."

Good Sam in California

California may be suffering from a terrible financial crisis but Governor Schwartzenner has found time to sign legislation that raises the standard for lawsuits against non-professional medical individuals who aid others in emergency situations.  Law.com reports

One piece of compromise legislation, Assembly Bill 83, protects people who are not in the medical profession from being sued after they help someone at the scene of an accident, unless their actions rise to the level of gross negligence or recklessness. The "Good Samaritan" bill was introduced after the California Supreme Court ruled, in Van Horn v. Watson, No. S152360 (Cal. 2008), that only trained emergency medical responders were immune from liability under the state's Health and Safety Code. In that case, a woman who was rendered a paraplegic by an automobile accident sued the friend who had pulled her out of the car.

The bill was supported both by the Consumer Attorneys of California and the Civil Justice Association of California, a tort reform group. Christine Spagnoli, president of the consumer attorneys and a partner at Greene, Broillet & Wheeler in Santa Monica, Calif., said that the legislation broadens the number of people who are protected from liability.

"The bar has been set higher," she said. "People who do something and unintentionally cause additional harm aren't going to be faced with having to be potentially sued. It's really more for someone who is aware of the fact that what they're doing is not right and they're going to potentially cause harm and go ahead and do it anyway." . . . .

Conference Announcements: LatCrit XIV and LatCrit/SALT New Faculty Workshop

LatCrit XIV promises to be a rich and memorable conference.  Over 145 panel and work-in-porogress proposals were submitted.  We hope that many of you will be able to join us.  Please note that September 14th is the deadline both for conference early bird registration (at a discounted rate) as well as for the early bird LatCrit hotel rate of $189, but that Labor Day, September 7th, is the deadline for an even lower "earlier bird" room rates of $169 for Friday and Saturday and $179 for other nights -- significantly less than the hotel's standard room rate.  Our room block is selling very swiftly, and the hotel may sell out before these deadlines, so please do not delay in making your reservations.  Washington is hosting a number of large conferences around the LatCrit XIV weekend and hotel rooms outside of our block may be scarce and expensive.

The full preliminary conference program schedule for LatCrit XIV and the LatCrit/SALT New Faculty Development Workshop, hosted by American University Washington College of Law Oct. 1-4, has been released.  It is here:

www.tinyurl.com/LatCritXIV-program

 

Hotel and conference registration materials are here:

www.tinyurl.com/LatCritXIV-registration

 

And the conference theme narrative and initial call for papers/panels are here, although the submission deadline has long past and, absent cancellations, there will be no more panel and work-in-progress slots available (with the exception of commentators for works-in-progress colloquia):

www.tinyurl.com/LatCritXIV-call

 

Diane Rehm Health Care Townhall

In case you are interested in a slightly more friendly town hall discussion of health care issues, you may want to tune into the Diane Rehm show today to hear some of your fellow citizens ask questions about some of the potential issues the health reform bills hope to address and how.

10:00A Radio Town-Hall Forum on the Health Care Debate

Angry debates over changing the nation's health care system break out at public forums across the country. Now it’s your turn to participate in a radio town hall. Your questions and concerns on health care overhaul.

Guests

Ceci Connolly, reporter, The Washington Post.

Mary Agnes Carey, senior correspondent with Kaiser Health News. She most recently served as associate editor for CQ HealthBeat, a daily report on health care policy. She has also served as Capitol Hill Bureau Chief for CQ.

Carrie Budoff Brown, Health Care reporter for Politico.