Why we must end insurance discrimination against mental health care

In this Policy Essay, Representative Patrick Kennedy argues that insurance discrimination against those suffering from mental illness constitutes a serious and often overlooked deficiency of the modern American health care system. While the Mental Health Parity Act of 1996 was an important step toward resolutions of this issue, many loopholes remain that allow insurance companies to deny much-needed coverage to those suffering from such illnesses. This Essay details how improving access to health insurance for the mentally ill is not only socially beneficial, but also economically sound; the cost of instituting mental health parity is far outweighed by the costs that employers bear because of the reduced productivity of untreated mental illness sufferers. Representative Kennedy recommends that these problems may be addressed by additional mental health policy legislation--specifically, the proposed Paul Wellstone Act.     

Like bringing a knife to a gunfight: Why IRC Section 2036 is not the right weapon to combat abusive family limited partnerships

Family Limited Partnerships (“FLPs”), which were once a great estate planning technique, have now become victim to Section 2036 assertions made by the IRS. Over the years, the IRS has struggled to find a means to combat abusive FLPs until the courts began to embrace Section 2036 as a weapon for them to use. Different courts, however, have maintained different rules and have now subjected both abusive and non-abusive FLPs to inclusion of their assets into their gross estates. This has shed light onto the main issue, that is, that Section 2036 is not the appropriate tool to combat abusive FLPs.     

Enrollment--provision of hospital and outpatient care to veterans--VA. Proposed rule

This document proposes to amend VA's medical regulations. The Veterans' Health Care Eligibility Reform Act of 1996 mandates that VA implement a national enrollment system to manage the delivery of healthcare services. Accordingly, the medical regulations are proposed to be amended to establish provisions consistent with this mandate. Starting October 1, 1998, most veterans must be enrolled in the VA healthcare system as a condition of receiving VA hospital and outpatient care. Veterans would be allowed to apply to be enrolled at any time. They would be eligible to be enrolled based on funding availability and their priority status. In accordance with statutory provisions, the proposed rule also states that some categories of veterans would be eligible for VA hospital and outpatient care even if not enrolled. This document further proposes to establish a "medical benefits package" setting forth, with certain exceptions, the hospital and outpatient care that would be provided to enrolled veterans and certain other veterans.     

Extending due process protections in managed care credentialling to hospital privileges

The Article analyzes two recent state court decisions granting due process rights to physicians deselected from managed care networks. The author applauds these decisions and argues that managed care organizations wishing to deselect a physician should be required to demonstrate (1) that they have a legitimate reason for doing so relating to quality of care, economic factors, or administrative considerations, and (2) that the deselection will not unduly affect the quality of healthcare available in the network. In addition, the author contends that these same due process requirements may be applied to the closely analogous area of hospital staff privileges in situations in which the privileges of hospital-based practitioners are tied to employment, or the grant or termination of exclusive contracts.     

Applying antitrust concepts to the acute care hospital industry: defining the relevant market for hospital services

In considering the possible antitrust implications of a merger of two or more competing hospitals, the courts have generally found that hospitals provide a cluster of services which have significant peculiar characteristics that allow them to be considered a single product market. Spurred by changes in their environments, hospitals during the last decade have become markedly less homogeneous in their range of products and geographic markets. As a result, the impact of hospital mergers in the future may need to be assessed in multiple, more narrowly defined relevant markets, for which several possible definitional bases are suggested in this paper. The increased precision associated with such multidimensional antitrust analysis should permit a more effective consideration of the trade-offs between increases in hospitals' market power and advances in their relative operating efficiency and/or quality of services.     

梁某诉深圳市某医院医疗损害赔偿案介评

案情简介原告梁某 ,主诉血压高二年 ,头痛、睡眠差到被告深圳某医院就诊 ,就诊中原告否认既往肾病等病史 ,体格检查血压 18/13ｋｐａ ,呼吸正常 ,心率 90次 /分 ,心律齐 ,各瓣膜区无杂音 ,双下肢无水肿 ,被告医生提出做心电图、尿常规检查 ,原告称没有时间 ,就是高血压 ,开点药就行了。被告的医生于是开具心得安 10ｍｇ× 10 0片 /瓶 ,嘱每次 10ｍｇ ,每日三次。原告舌下含服一片后当日病情恶化 ,经其他医院抢救后脱险并确诊为慢性肾小球肾炎、慢性肾功能不全、尿毒症、急性左心衰。迄后 ,原告三次住院治疗 ,并依靠透析疗法维持生命。于是原…     

田某诉北京某医院医疗损害赔偿案介评

案情简述 原告田某之母沈某因停经10个月,见红8小时于1996年6月24日入被告北京市某医院待产,入院诊断"孕1产040周头位未产".于1996年7月1日经阴道分娩生下原告田某.原告出生后即发现左上肢肌力差,左腕下垂.产后第二天经北京儿童医院会诊,诊断为左臂丛神经麻痹. 经北京市某区医疗事故鉴定委员会鉴定,认为"患儿左臂从神经损伤为产时处理不当所致" ,定为三级医疗技术事故.后经市级医疗事故鉴定委员会鉴定,认为"产时发生肩难产致新生儿左臂丛神经麻痹属分娩并发症",因而认定不属于医疗事故.     

田某诉北京某医院医疗损害赔偿案介评

案　情　简　述原告田某之母沈某因停经 10个月 ,见红 8小时于1996年 6月 2 4日入被告北京市某医院待产 ,入院诊断“孕1产 0 40周头位未产”。于 1996年 7月 1日经阴道分娩生下原告田某。原告出生后即发现左上肢肌力差 ,左腕下垂。产后第二天经北京儿童医院会诊 ,诊断为左臂丛神经麻痹。经北京市某区医疗事故鉴定委员会鉴定 ,认为“患儿左臂从神经损伤为产时处理不当所致” ,定为三级医疗技术事故。后经市级医疗事故鉴定委员会鉴定 ,认为“产时发生肩难产致新生儿左臂丛神经麻痹属分娩并发症” ,因而认定不属于医疗事故。原告田某之母沈某不…     

梁某诉深圳市某医院医疗损害赔偿案介评

案情简介 原告梁某,主诉血压高二年,头痛、睡眠差到被告深圳某医院就诊,就诊中原告否认既往肾病等病史,体格检查血压18/13kpa,呼吸正常,心率90次/分,心律齐,各瓣膜区无杂音 ,双下肢无水肿,被告医生提出做心电图、尿常规检查,原告称没有时间,就是高血压,开点药就行了.被告的医生于是开具心得安10mg×100片/瓶,嘱每次10mg,每日三次.原告舌下含服一片后当日病情恶化,经其他医院抢救后脱险并确诊为慢性肾小球肾炎、慢性肾功能不全、尿毒症、急性左心衰.迄后,原告三次住院治疗,并依靠透析疗法维持生命.于是原告起诉要求被告赔偿换肾、生活补助费和精神抚慰金等共计242万余元.案经两次开庭审理,已经作出一审判决, 目前本案正在二审中.     

Why a Criminal Prohibition on Sex Selective Abortions Amounts to a Thought Crime

In a sex selective abortion, a woman aborts a fetus simply on account of the fetus’ sex. Her motivation or underlying reason for doing so may very well be sexist. She could be disposed to thinking that a female child is inferior to a male one. In a hate crime, an individual commits a crime on account of a victim’s sex, race, sexual orientation or the like. The individual may be sexist or racist in picking his victim. He or she could be disposed to thinking that one race or sex is inferior to another. I argue that while a prohibition on sex selective abortions is anomalous in a liberal, criminal legal framework, hate crime legislation may not be. The former but not the latter constitutes a thought crime. I define a thought crime as one where an agent’s motivation is not just relevant but sufficient to take an act from the domain of the non-punishable to the domain of the punishable. Ignoring a woman’s sexist motivation in procuring an abortion suddenly renders her act of abortion legal. On the other hand, discounting an agent’s bias in committing a hate motivated assault or murder does not transform the act from a punishable one to a non-punishable one. Assaulting or murdering is already a crime.