Hastings-Bass: the true and the spurious

In his article in Trusts and Trustees, 2007, volume 13, No 7,Dakis Hagen discussed the increasingly widespread application,and the uncertain limits, of the ‘Unruly rule in Hastings-Bass’.In this article, co-editor Tony Molloy QC questions whetherwhat has come to be called the Rule in Hastings-Bass is anythingmore than a baseless snare.     

Introduction: Governing Regulatory Interaction: the Normative Question

Abstract:  The demise of the Keynesian National Welfare State and its transformation into a more competitive and interactive unit of governance has given rise to an increased interest in the processes that are shaping the legal framework for markets. For several decades, one force has been taken to be tantamount to the law of nature governing the interaction between jurisdictions, namely, the force of regulatory competition. However, this model is open to severe criticism of its emphasis on efficiency. First, elected decision-makers may not be interested in efficiency gains regardless of where the resulting distributive consequences may fall. Second, we suggest the theory of regulatory competition has a federalist bias that potentially blinds it to institutional alternatives. The model also rests on unexamined normative premises. Research has shown that competition is only one mode of regulatory behaviour. Cooperation and information flows play important roles in shaping regulatory activity as well. We contend that a more satisfactory model of regulatory interaction needs to take into account a variety of agents, standards, and systems. In devising such an alternative model, a satisfactory theory would have to understand the multiplicity of relevant agents beyond the narrow confines of the traditional nation-centred federal model. Standards guarding regulatory interaction would—not dissimilar to competition law—have to state its own limitations.     

Ginsberg: Under the World

Liverpool Law Review -     

PPOs: the employer perspective

This paper reports the results of a national survey on employer experiences with preferred provider organizations (PPOs). The survey, conducted in 1987, included information from almost 700 telephone interviews with employee benefit managers. We found that 11 percent of employees are in PPOs. PPOs now have a strong presence among employers of all sizes. However, whereas they are a major force in the West, where almost one-third of employees are members, they have garnered only a 1 percent market share in the East. We examine the impact of PPOs on health insurance premiums and on employer satisfaction. The results show that in 1987, the year of the survey, PPOs appeared to provide mild cost savings compared to conventional insurance, and that employers were very satisfied with almost all aspects of PPOs, whereas they were surprisingly critical of their HMOs.     

Cost-shifting: the discount dilemma

Cost-shifting, the practice by hospitals of raising their prices to make up for reimbursement shortfalls from payers that do not pay full charges, is an important and controversial issue. Concerns about cost-shifting, particularly its effects on payment equity and cost escalation, have led many insurers, business groups, and legislators to advocate rate-setting regulation for hospitals. This article seeks to clarify the definition of cost-shifting, and quantifies its magnitude in Minneapolis/St. Paul. We believe that cost-shifting is the consequential result of the failure of both public and private payers to structure payment policies that reward cost-effective hospitals, and we outline a market-oriented alternative to rate-setting to address the discount dilemma caused by cost-shifting.     

IP: the universal lubricant

Press coverage of IP law is generally pathological: it focuseson things that have gone wrong. Youngsters who have the brightidea of copying and file-sharing their favourite recordingsand movies end up in court, as do sellers of knock-off perfumesin street markets, as do fashion chains whose new ranges ofdresses or accessories bear a striking resemblance to the linespreviously unveiled on Paris catwalks by leading designers. Even when there isn't     

Hill-Burton: the unfulfilled promise

The poor and uninsured encounter numerous barriers to health care access. The Hill-Burton Act of 1946 required many hospitals to make their services available to all persons, yet ineffective enforcement has limited the utility of the act's requirements. Hill-Burton hospital audits have revealed widespread facility noncompliance. In light of these findings, alternative enforcement procedures should be considered.     

Limiting the psychotherapist-patient privilege: the therapeutic potential

The author first explores the law of the psychotherapist-patient privilege along with the traditional rationale for the privilege. The results of studies challenging the assumptions upon which the privilege rests are summarized. Finally, the potential therapeutic advantages are explored. The author suggests that the absence of an absolute privilege might in fact prevent harmful behavior. Those patients who communicate to their therapists the desire or intent, for example, to commit a crime, might not act on their urges for fear of disclosure of the communication in a future criminal proceeding.