MEDGuide and patient package inserts--again?

This article will trace the history and effects of the PPI from the time of its original concept by the FDA in the early 1970's to its current status. It will also address the response to this FDA initiative by the industry, medical community and consumer groups. Initiatives in other countries and future issues will also be discussed.     

Institutions, Ideology, and the Tragedy of the Commons: West Texas Groundwater Policy

West Texas is the setting for an unintended experiment in commonsresource management. Dispersed, autonomous, local groundwaterdistricts use nonregulatory strategies to promote conservationand groundwater quality. The central force driving this organizationalform appears to be ideological. West Texans seek alternativesto state management of groundwater pumping. This study useskey-informant interviews to evaluate the strength of ideologyin explaining West Texas groundwater policy and to provide atheoretical framework for discussing the importance of the "localsolution.’ Time-series data substantiate the claim thatlocal groundwater districts succeed in slowing depletion rates.     

The government's best offense is deference: the decision of the Supreme Court in Shalala v. Guernsey Memorial Hospital

The United States Supreme Court agreed with the Secretary of Health and Human Services that Guernsey Memorial Hospital's advance refunding transaction costs would be subject to a medicare reimbursement policy that is not based upon generally accepted accounting principles. According to the sharp dissent in this case, this policy, set forth in a manual provision, contradicts federal regulations.     

Physician recruitment after Hermann Hospital

The state of physician recruitment changed after the Internal Revenue Service required Hermann Hospital to publish its closing agreement with the IRS. The closing agreement released the long-awaited IRS "Hospital Physician Recruitment Guidelines." The IRS' recently proposed revenue ruling provides additional insight on acceptable physician recruitment practices as well.