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The ACA, Provider Mergers and Hospital Pricing: Experimenting with Smart, Lower-Cost Health Insurance Options
Get PDFThis paper addresses the issue of whether the recent significant uptick in provider mergers and the implementation of the Affordable Care Act have a particularly adverse effect on provider pricing in the commercial insurance market. Uncompetitive provider markets exacerbate already existing high cost issues such as lack of transparency in provider pricing, patient behavior that conflates reputation and quality, and payers’ inability, or at least reluctance, to exclude high-price providers from their networks. The ACA’s incentives for providers to coordinate patient care and hospitals’ revenue losses from reductions in Medicare reimbursement create further rationales for consolidation. The burden of finding solutions to high non-transparent provider pricing is on all stakeholders who should be experimenting in earnest with remedies for the harms that high health care costs create for patients. But no stakeholders have more incentive to find solutions than those who ultimately pay for health care: the insurers, the employers, governments and individuals. The recent literature is replete with payer experiments in insurance design that are intended to provide smart, lower-cost options for consumers and may influence provider behavior as well. More experimentation with remedial measures is warranted and appears to be ongoing even among providers who also see the proverbial handwriting on the wall. The ACA promises health care security by creating near universal, affordable, adequate health care. The work continues to achieve these goals
Internet Giants as Quasi-Governmental Actors and the Limits of Contractual Consent
Get PDFAlthough the government’s data-mining program relied heavily on information and technology that the government received from private companies, relatively little of the public outrage generated by Edward Snowden’s revelations was directed at those private companies. We argue that the mystique of the Internet giants and the myth of contractual consent combine to mute criticisms that otherwise might be directed at the real data-mining masterminds. As a result, consumers are deemed to have consented to the use of their private information in ways that they would not agree to had they known the purposes to which their information would be put and the entities (including the federal government) with whom their information would be shared. We also call into question the distinction between governmental actors and private actors in this realm, as the Internet giants increasingly exploit contractual mechanisms to operate with quasi-governmental powers in their relations with consumers. As regulators and policymakers focus on how to better protect consumer data, we propose that solutions that rely upon consumer permission adopt a more exacting and limited concept of the consent required before private entities may collect or make use of consumer’s information where such uses touch upon privacy interests
Bridging Bisexual Erasure in LGBT-Rights Discourse and Litigation
No full textLGBT rights are at the forefront of current legal news, with “gay marriage” and other “gay” issues visible beyond dispute in social and legal discourse in the 21st Century. Less visible are the bisexuals who are supposedly encompassed by the umbrella phrase “LGBT” and by LGBT-rights litigation, but who are often left out of LGBTrights discourse entirely. This Article examines the problem of bisexual invisibility and erasure within LGBT-rights litigation and legal discourse. The Article surveys the bisexual erasure legal discourse to date, and examines the causes of bisexual erasure and its harmful consequences for bisexuals, the broader LGBT community, and jurisprudential integrity as a whole. This Article contributes to the bisexual erasure discourse through a unique examination of bisexual erasure through a survey of relevant terminology in LGBT-rights cases, including and beyond recent same-sex marriage litigation. The study documents an almost complete systemic erasure of bisexuals in briefings and opinions, including an absence of any mention of bisexuals by majority opinions in cases where the briefings have set a tone of bi erasure by arguing alternatively for “gay and lesbian” rights, “gay marriage,” or “same-sex marriage,” while completely omitting reference to bisexuals. In addition to documenting the absence of bisexuals in litigation documents (despite the actual presence of bisexuals as litigants), this Article compiles anecdotal evidence of bisexual erasure by attorneys, courts, and the media. The time is overdue for more widespread inclusion of bisexuality in LGBT-rights discourse and litigation. Increased bisexual inclusion can provide a bridge toward more meaningful, holistic, and accurate discourse on the rights of disenfranchised sexual minorities in this country. The tide may finally be turning toward increased bisexual inclusion, however, as some courts and LGBT organizations have employed more inclusive terminology, and one federal judge has explicitly recognized for the first time that bisexuals, like gays, are harmed by same-sex marriage bans. Bisexuality, the last sexual orientation that dare not speak its name, is finally claiming its seat at the table of equal liberty, dignity and respect under law and in the eyes of the LGBT-community itself. The legal community should join this move toward more honest and holistic discourse that acknowledges the equal validity of bisexuality along with other sexual orientations. This Article is one of many steps that must be taken for more meaningful and inclusive LGBT-rights discourse
Kevlar™ For the Innocent: Why Modeling Gun Regulation after Great Britain, Australia, and Switzerland Will Reduce the Rate of Mass Shootings in America
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From One Town\u27s \u27Alternative Families\u27 Ordinance to Marriage Equality Nationwide
Get PDFMany articles have already discussed the Supreme Court’s Obergefell v. Hodges decision. In that opinion, the Supreme Court held that individuals who are same-sex couples have a fundamental right to marry just as individuals who are different-sex couples. Basing its decision on the Due Process and Equal Protection Clauses of the Fourteenth Amendment, the Court held that states could not deny same-sex couples that right. Instead of the numerous scholarly works analyzing the Obergefell decision, this essay looks back at my part in the marriage equality movement, before it was a movement and before it was about marriage, and its transition to both. I have been working toward obtaining legal rights for same-sex couples since 1983. My work began when I helped draft what became the third domestic partnership ordinance in the country in Madison, Wisconsin, and my work will continue into early 2016 when my service as the chair of the board of directors for Freedom to Marry, Inc. will end. Over the past three decades, I played a small but regular role in helping to end the exclusion of same-sex couples from legal recognition of our relationships in the United States. This essay considers how my experiences as an activist, scholar, and married lesbian mirrored those of the movement since the early 1980s. The essay is divided into three parts that roughly correspond with the three decades of the marriage equality movement: the early 1980s to 1993, 1993 to 2003, and 2003 to 2015. Part I discusses the early efforts to win limited rights through city ordinances and employer health insurance benefits and how those efforts led activists to recognize the inherent limitations with the options to protect the legal rights of same-sex couples. Part II discusses the legal changes that resulted in the decade following the Hawaii Supreme Court’s decision in Baehr v. Lewin; changes not marriage itself, but numerous statutes and constitutional amendments purporting to deny recognition of any Hawaiian or other marriage by same-sex couples. Part III focuses its attention on the movement after the first state started marrying same-sex couples, the ups-and-downs resulting from the adoption or rejection of anti-marriage ballot measures by states across the country, and the national resolution that finally came with the Obergefell decision
The Remote Tippee Dilemma: Resolving Tippee Liability More Than Thirty Years After Dirks v. SEC
Get PDFDietary Supplements are Not all Safe and Not all Food: How the Low Cost of Dietary Supplements Preys on the Consumer
Get PDFDietary supplements are regulated as food, even though the safety and efficacy of some supplements are unknown. These products are often promoted as \u27natural.\u27 This leads many consumers to fail to question the supplements\u27 safety, and some consumers even equate \u27natural\u27 with safe. But, \u27natural\u27 does not mean safe. For example, many wild berries and mushrooms are dangerous although they are natural. Another example is tobacco -- a key ingredient in cigarettes: it is natural, but overwhelming studies have established the harm of cigarette smoke. The Food and Drug Administration (FDA) only has limited ability to regulate the entry of new dietary supplements into the marketplace because supplements are treated as food.
Two main arguments support the current regulatory structure of dietary supplements: (1) cost and (2) access. But lower cost and increased access to dietary supplements do not necessarily have an relationship to safety and efficacy. Manufacturers\u27 marketing techniques tout the health benefits of their supplements. Meanwhile, consumers are ingesting supplements without scientific studies indicating whether or not they are harmful.
The FDA Food Safety and Modernization Act, signed into law on January 4, 2011, did not address the safety concerns regarding dietary supplements. This article discusses the regulatory deficiencies concerning dietary supplements and proposes novel solutions to address this specific sector of the food supply. This article advocates for the use of scientific data to support a multi-tiered classification system to ensure that dietary supplements on the market are safe
