Friday, August 23, 2013
The University of Arkansas at Little Rock Law Review is pleased to announce a call for papers for its 2014 Symposium, on policy aspects of the implementation of the Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act of 2010 (together, the ACA), to be held on Friday, Feb. 28, 2014.
The ACA is the most significant change to health care law since the creation of Medicare and Medicaid in the 1960s. The act’s constitutionality was upheld by the United States Supreme Court in 2012, with the limitation that states could not be penalized by losing their federal Medicaid funding for refusing to expand Medicaid under the ACA.
As a result, states are approaching ACA compliance in various ways. Some have decided to expand their Medicaid programs as anticipated in the ACA. Others are opting not to participate in coverage expansion. Still others, such as Arkansas, are crafting alternative approaches to expanding healthcare coverage. Arkansas has decided to pursue a unique (for now) option–accepting federal money originally designated for Medicaid expansion under the ACA but seeking a federal waiver to use these funds to buy private insurance in the coming marketplaces for about a quarter of a million low-income Arkansans. Arkansas has received federal approval to proceed with its plan for the present.
The Law Review seeks papers on national and state health policy aspects of the expansion of healthcare coverage, whether through Medicaid expansion and/or other options. Papers could focus on such topics as how the Supreme Court decision politicized implementation; legal aspects of such topics as state choices; state- or federally-run marketplaces or partnership agreements; race, age and gender issues relating to insurance coverage; and aspects of Arkansas’s or other states’ plans. Papers may also address non-Medicaid issues associated with the ACA, such as the interface between the ACA and state healthcare laws.
The University of Arkansas at Little Rock Law Review will publish articles from the symposium in volume 36, which is slated for publication in the spring of 2014. Authors should submit an abstract and a cover letter to Sydney Brown, Symposium Editor, at email@example.com. The deadline for submissions of article proposals is Friday, Oct. 11, 2013; finished articles will be due at the time of the symposium. Please feel free to email Ms. Brown with any questions.
A letter from our fine colleagues at the Cleveland-Marshall College of Law:
You are invited to submit an Article for possible inclusion in the Journal of Law and Health’s Annual Symposium: Issues of Reproductive Rights: Life, Liberty, and the Pursuit of Policy. The Journal of Law and Health is a student-run publication dedicated to publishing innovative articles that offer diverse perspectives on the intersection between law, health and medicine.
Our Symposium is titled “Issues of Reproductive Rights: Life, Liberty, and the Pursuit of Policy." The selection of this Symposium topic was a result of major developments in the area of Reproductive Rights in the past year. For example, state legislation in Texas, Ohio, or Arkansas severely restricting women's access to abortion. Another example would be the recent 10th Circuit decision in Hobby Lobby v. Sebelius which provided for-profit corporations with a right to challenge the Affordable Care Act’s so-called “contraceptive mandate” on the basis that a corporation is a “person” who can have and exercise its own religious beliefs. The Symposium aims to give judges, legislators, and academics the opportunity to present research that highlights the legal and ethical issues that may occur because of these developments.
If you are interested in submitting an abstract for consideration please find the instructions and important dates for submission below. If you have any questions, please don’t hesitate to contact me at firstname.lastname@example.org.
Thank you so much for your time and consideration and we look forward to hearing from you.
Gordon R. Gantt, Jr.
Cleveland-Marshall College of Law
Cleveland State University
Senior Editor- The
Journal of Law and Health
Raphael Cohen-Almagor, First Do No Harm: Pressing Concerns Regarding Euthanasia in Belgium, 36 Int'l J. of L. & Psychiatry ___ (2013).
Linda Christine Fentiman, Are Mothers Hazardous to Their Children's Health?: Law, Culture, and the Framing of Risk, 21 Va. J. of Soc. Pol'y & the L. (Forthcoming 2014).
Robert B. Leflar, Medical Malpractice Reform Measures and Their Effects, 144 Chest 306 (2013).
Edmund Henden, Heroin Addiction and Voluntary Choice: The Case of Informed Consent, 27 Bioethics 395 (2013).
Wednesday, August 21, 2013
Professor Jill Horwitz has coauthored a very troubling critique of workplace wellness programs, characterizing them as a possible form of cost-shifting to unhealthy workers.
[H]ealth-contingent programs encouraged by the Affordable Care Act rely on the assumption that the returns to health improvement are generally highest for employees with modifiable risk factors, such as an unhealthy diet or a behavior like smoking.
To assess these three assumptions, we reviewed research on the relationships among financial incentives, behavior, health status, and medical spending. We focused on randomized controlled trials involving four conditions—smoking, hypertension, high cholesterol, and obesity—that are typically included in health-contingent programs.
In our review, we found mixed evidence that employees with these conditions have higher health costs than other employees, which undermines the argument that employees with the conditions are particularly effective targets for incentives. We also found little evidence that working-age people change their behavior as a result of financial incentives, particularly over the long term.
These findings suggest that program savings may not, in fact, derive from health improvements. Instead, they may come from making workers with health risks pay more for their health care than workers without health risks do.
Penn State University’s wellness program has become every human resources director’s worst nightmare: national news. . . . [E]ven the major academic proponents of conventional wellness programs don’t think they save money, that vendors make up savings numbers, that the screens they insisted upon can’t even theoretically save money and a whole body of research opposes them, and that all the extra preventive doctor visits they required were useless.
The fusion of the nanny state and the nanny corporation is not a pretty sight. Professor Wendy Mariner recognized problems with wellness programs years ago; too bad the architects of these programs are not paying more attention to her work.[FP]
Tuesday, August 20, 2013
Pennsylvania State University apparently likes to do a lot of things "to the max" besides engaging in higher education scandals. Reuters reported last week that more than 2,000 faculty and staff employees are protesting Penn State's wellness program. Unlike most workplace wellness programs, which use more carrots than sticks to encourage employees to take better care of themselves in the hope of decreasing health insurance and health care spending, Penn State uses a really big stick and no carrot. If an employee does not complete a 12-page on-line survey (which includes a question about men performing regular testicular exams--oh, the irony!) and have a preventive physical, the employee will be hit with a $100 per month paycheck deduction. The protesting employees are uncomfortable with turning over their private health care information to the companies running the wellness program, and question whether the $1,200 penalty is a "Sandusky tax." Penn State assures its employees that the program is unrelated to the Sandusky scandal.
The protest raises interesting legal questions about medical records privacy and the use of coercive measures to improve health as a condition of employment. It also highlights the fact that workplace wellness programs may actually increase health care costs, at least in the short-term, as people go get physicals or bloodwork that they would not have otherwise received, in order to answer questionnaires and avoid fines, and the evidence to date is that such programs do very little to decrease health-care costs. The Affordable Care Act encourages the use of workplace wellness programs. Will they be the next piece of the law to be delayed or jettisoned?