Beyond "safe and effective": the role of the federal government in supporting and disseminating comparative-effectiveness research

Over the past century, medical advancements have resulted in tremendous health gains for Americans. Although the federal government has played a prominent role in ensuring that new treatments are safe and effective, questions about which medical treatments work best under which circumstances have largely remained unanswered. Thus, the federal government's recent major investments in comparative-effectiveness research have potential to play a significant role in helping both patients and health care providers navigate the vast array of available treatment options, as well as in improving the quality, efficiency, and delivery of health care system-wide. Yet, the controversial nature of the government's foray into comparative-effectiveness research also suggests that the path toward realizing these goals may be treacherous. This Article describes the rationales for federal support of comparative-effectiveness research and potential models for that involvement, analyzes the federal government's recent investments in the research, and concludes with predictions about the probable outcomes of these investments. While increased federal support for comparative-effectiveness research is unlikely to achieve all of the benefits anticipated by its supporters, it is a crucial step toward ensuring that Americans are able to take full advantage of the benefits of medical innovation     

The federal government and technology transfer implementing the 1986 act: Signs of progress

The Technology Transfer Act of 1986 clearly brought into focus the importance of technology-transfer activities in the federal government. Recognition of the potential benefit to be realized by access to results of federally sponsored research was acknowledged at the highest levels of government. While many departments and agencies had been transferring technology within the limits of existing authority and budgets, the act stimulated them as well as less-aggressive agencies to further strengthen their transfer operations. This paper reviews the status of selected agency technology transfer in 1985, describes important progress since passage of the act in 1986, and notes issues that remain to be resolved.     

The impact of Federal Alcohol and Drug Abuse block grants on state and local government substance abuse program expenditures: the role of federal oversight

Are the federal Alcohol and Drug Abuse (ADA) block grant funds substituting for or supplementing state and local government spending on substance abuse? Using panel data on state and local government substance abuse programs, this study explores the fiscal effects of the ADA block grant money and the increased enforcement (after 1989) of federal restrictions on state spending of ADA block grants. The findings here reveal that for the current period, the federal ADA grant has no statistically significant effect on state and local government substance abuse spending both before and after 1989, and the increased enforcement of federal restrictions on the ADA grants after 1989 does not change this result. An additional finding is that lagged ADA grants have had a large effect on substance abuse spending both before and after 1989--a feature of the program not considered in previous studies.     

论制度创新中政府主导型角色

我国正处于社会大转型时期,政治经济体制改革不断深入。在制度建设方面,旧的制度不断退出历史舞台,新的制度不断涌现,发挥作用,推动社会进步。在制度创新的过程中,政府的作用举足轻重。全面认识政府在制度创新中的利弊,对于推动制度创新提高制度的有效性,具有十分重要的理论和现实意义,。     

政府在医疗广告监管中的角色及对策分析

随着我国医疗市场的开放,医疗行业竞争加剧,虚假违法医疗广告屡禁不止,对社会造成了很大的危害和不良影响。本文拟对政府部门在医疗广告监管中承担何种角色以及当前医疗广告政府监管体系存在的问题进行分析讨论,并提出相应的对策建议,以供商讨。     

Amendment of the fee exemption for federal, state and local government employees--DEA, Justice. Final rule

This final rule limits the exemption from payment of application fees for registration or reregistration to Federal, state, or local government operated hospitals or institutions. This will eliminate the need for DEA to dedicate manpower or other resources to controlling abuse of the fee exempt status.     

论和谐社区建设中的政府角色定位

本文以城市和谐社区建设中的地方政府角色为着眼点,分析了和谐社区建设中政府角色错位的原因.提出在构建和谐社区过程中,政府应与社区之间建立分工合作的新型关系,应扮演好社区建设的服务者和保障者、社区组织的培育者、社区建设的谋划者和组织者、社区关系的协调者等新角色,发挥政府在建设和谐社区中的作用,以期实现社区和谐的战略目标.     

Stumbling toward equity: the role of government in kidney transplantation

In Mortal Peril, Professor Epstein is critical of the current, regulated system for organ donation and suggests that a market for organ tissue would better meet the needs of patients. In this response to Professor Epstein, Professor Laura Dooley and Dr. Robert Gaston pair their skills to attack Professor Epstein's analysis. As they have done on several other occasions, Professors Dooley and Gaston argue that the kidney donation and transplantation arena is fraught with racial inequity, and that Professor Epstein's proposal for a market in kidneys will exacerbate this inequity. The authors maintain that to prevent the poor from being excluded from transplants, the government plays a critical (if imperfect) role in the allocation of these scarce resources. Furthermore, government intervention is acceptable to correct past discrimination because there is scientific evidence that the disproportionate incidence of kidney failure in African Americans is related to the evolutionary pressures of slave trading and slavery. Professors Dooley and Gaston also defend their previous efforts to change the government system of allocation and characterize the government's willingness to adopt their recommendations as an appropriate response to scientific research rather than a governmental susceptibility to lobbying from special interest groups. Finally, the authors criticize Professor Epstein's argument that dialysis is a viable alternative to transplantation because there are significant differences in "quality of life, morbidity and survival." Professors Dooley and Gaston conclude that government intervention is necessary for maintaining the equity in kidney transplantation that a market system would not.     

经济欠发达地区政府行政角色定位和职能作用的界定

地方政府职能不清、界限不明是地方政府机构改革“败进”的关键,也是建立廉洁高效、运转协调、行为规范的地方政府管理体制的最大障碍。实践证明,地方政府职能转而未变的关键是职能定位不清,行政角色盲目。因此,以比较研究的方法分析经济发达地区和经济不发达地区政府职能的异同,尽可能的界定、梳理、勾划出理想的政府角色和职能作用,对于经济欠发达地区如何创建协调规范、群众满意的高效政府具有十分重要的现实意义和指导意义。     

Few and far between: understanding the role of the victim in federal environmental crime prosecutions in the United States

Efforts to gather systematic data and undertake empirical studies on the extent of environmental crime, the magnitude of environmental victimization, and the punishment of environmental offenders in the United States remains elusive in the criminological literature. We take a novel approach to studying these gaps in the literature, by examining federal environmental crime prosecutions. While not all encompassing, this approach advances the literature by providing valuable insights into what types of human victimization occur, the role victims play in prosecutions, and how offenders are punished. What is the nature and extent of case-documented environmental victimization with regard to human victimization in the U.S. over the past decade? We address this question through a content analysis of the Environmental Protection Agency’s (EPA) criminal investigation cases, 2001–11. Out of 972 total criminal cases, we find that only 3 % of cases involve acute or identifiable victimization. Environmental crime victims, unless immediately harmed, are not likely to play a major role in environmental crime cases; thereby limiting potential political and public attention to victims of environmental crime.