Sunday, July 27, 2014
HealthLawProf Blog is pleased to post the following introduction to a very interesting Symposium published by the North Carolina Law Review entitled "Health Care Decisions in the New Era of Health Care Reform:"
Optimal decision making in health care often proves challenging. Health care providers often confront multiple treatments for each condition with limited evidence as to which interventions work best; moreover, treatment decisions can implicate questions of ethics and personal values that may not be answerable by clinical expertise alone. Fragmented delivery systems lead to insufficient coordination among providers in managing patients’ overall care. Patients face significant informational disadvantage not only in dealing with clinical information, but also in making choices regarding health care insurance coverage. Payers must make reimbursement and coverage decisions with incomplete information about the value and cost effectiveness of many treatments. Governmental officials must make complex regulatory decisions in managing a health care system with seemingly endless demand, escalating costs, and limited resources.
According to some optimistic accounts, the new era of health care reform will radically improve health care decisions. The Patient Protection and Affordable Care Act includes many reform initiatives aimed at improving health care decision making. For example, the law encourages the formation of integrated delivery systems that share information and coordinate care, fosters the development of shared decision-making between providers and patients, develops a more comprehensive evidence base through comparative effectiveness research, and creates insurance exchanges where patients as consumers can choose between plans offering standardized benefits and compared in standardized formats. But there are also reasons for concern that, in the new era of health care reform, decision making will become all the more complex and daunting. This symposium will consider both the promise and limitations of recent reform efforts, highlighting the important issues that are likely to emerge as the health care system tries to improve decision making.
Symposium Articles Include:
- Health Care Decisions in the New Era of Health Care Reform: An Overview
By Joan H. Krause & Richard S. Saver
- States’ Decision Not to Expand Medicaid
By Mark A. Hall
- Health Care Spending and Financial Security After the Affordable Care Act
By Alison K. Hoffman
- Prospects for Regulation of Off-Label Drug Promotion in an Era of Expanding Commercial Speech Protection
By Aaron S. Kesselheim & Michelle M. Mello
- Health Regulators as Data Stewards
By Kristin Madison
- Health Care Reform and Efforts to Encourage Healthy Choices by Individuals
By David Orentlicher
- Private Certifiers and Deputies in American Health Care
By Frank A. Pasquale
- The End of End-of-Life Law
By Lois Shepherd
- Can Patients in the United States Become Savvy Health Care Consumers?
By Peter A. Ubel
Full issue available here.