How MFN clauses used in the health care industry unreasonably restrain trade under the Sherman Act

When used in the health care industry, an MFN clause is a contractual agreement that guarantees a health insurer the same best price as their market competitors. MFN clauses have the effect of unnecessarily raising consumer costs, reducing choice among providers, constraining access to care and preventing the development of alternative health care delivery models. The purpose of this paper is four-fold. First, to design a four-quadrant matrix to evaluate the pro-competitive and anticompetitive purposes and effects of MFN clauses under Section 1 of the Sherman Act. Second, to defeat the jurisprudential presumption that MFN clauses are pro-competitive in the health care industry and to recommend that this presumption be abolished. Third, to examine the U.S. Department of Justice's paradigmatic shift over the last decade toward prosecuting large insurers who employ MFN clauses resulting in U.S. Consent Decrees. Fourth, to outline the indicia of a meritorious claim against an insurer who employs an MFN clause.     

Challenging Institutional Denial: Psychological Discourse,Therapeutic Culture and Public Inquiries

ABSTRACT

The damaging effects of abuse in childhood were repeatedly emphasised in public hearings and in media coverage of the Royal Commission into Institutional Responses to Child Sexual Abuse. Testimony from earlier Australian inquiries, which documented widespread experiences of child maltreatment, particularly in institutions, also underscored the ongoing and often intergenerational impact of abuse. Taking institutional child abuse inquiries as a case study, this article examines how psychological and therapeutic concepts have been mobilised politically. It argues that therapeutically oriented and psychologically informed cultural narratives of childhood trauma and its ongoing effects have provided a framework for making sense of long-term experiences of adversity and suffering and have enriched attention to “the question of justice” for survivors of historical institutional child abuse.     

The Neglected Strata: States in the City-Federal Politics of Malaysia

Another version of this paper was prepared for Conference on"The Politics of Intergovernmental Relations in Federal Systems:Urban Perspectives," Center for the Study of Federalism, TempleUniversity, Philadelphia, August 26–28, 1973. In revisingthis paper, I am indebted to Dorothy and James Guyot for theirperceptive and helpful suggestions.     

A critique of the research literature concerning pregnant adolescents, 1960–1970

A perspective on the research literature from 1960 to 1970 concerning pregnant adolescents (this literature was abstracted and reviewed in a previous publication) is presented. Research methodology and potential content for research are examined and suggestions made that would contribute to a stronger empirical base for the research. Several assumptions (of difference, of homogeneity, and of special need) regarding pregnant adolescents that seem to be implicit in the research are brought to light. Finally, an analysis of the risk concept is presented.Has degrees in social work (M.S. and Ph.D.) and public health (M.S.), with research interests in adolescent health status, human service for youth, and the process of (research) consultation.Has M.A. in sociology.Has degrees in theology (B.D.) and medical sociology (Ph.D.). He teaches the latter, while focusing his research interests on the mental health consequences on women as a result of their labor force participation and the evaluation of accelerated medical education programs.M.D. degree and a degree also in public health. Before his academic career, he was a high public official in the New York State Department of Health. His publications include studies of the medical aspects of water fluoridation and high-risk groups receiving maternity care. Current research interests include studies of patterns of provision of maternal and child health services in the United States, the incidence and prevalence of long-term diseases of childhood, and followup studies of low birth weight and other vulnerable infants.     

Teenage pregnancy and neonatal behavior: Effects in Puerto Rico and Florida

The purpose of this study was to examine the relationship between neonatal behavior and prenatal and perinatal risk factors in infants of teenage and older mothers in Puerto Rico and Mainland United States. The sample included approximately 300 newborn infants;half were examined in Puerto Rico, the other half in Florida, using the Brazelton Neonatal Behavioral Assessment Scale. Comparisons by maternal age and the number of obstetrical complications showed that for the Puerto Rican group, infants with fewer obstetrical complications were better able to regulate their crying and active states. Infants of teenage mothers with fewer complications had a higher level of arousal than infants of older mothers with fewer complications. Infant behavior in the Mainland sample did not vary by maternal age or complications. Multiple regression analysis indicated that the combination of biomedical variables significantly predicted neonatal behavior in both cultures. Mother's age was not separately correlated with neonatal behavior, but was repeatedly combined with other variables in the significant regressions. The findings suggest that infants of teenage mothers may differ from infants of older mothers, particularly in the organization of state behavior, and that the effects of maternal age on neonatal behavior are increased in the presence of biological outcome factors.This article is based on a final report to the NICHD Center for Population Research, Contract N01-HD-7283.Received Ph.D. from Michigan State University. Main research interests are determinants of neonatal and infant development, assessment of preterm and at risk infant.Received Ph.D. from Harvard University. Main research interests are sociocultural aspects of development, teenage pregnancy, infant temperament and psychophysiology.Received M.A. from University of Florida. Main research interests are prenatal and prenatal factors on development, maternal obstetric medication, and behavioral teratology.     

Employee buy-outs and privatization: Issues and implications for LDCs and post-communist countries of UK experience

Privatization has become an international phenomenon. Most attention has been devoted to privatization by stock market flotation or by sales to third parties. Management and employee buy-outs present a third main possibility for transferring assets from the public to the private sector. This paper discusses the scope for privatization buy-outs in LDCs and ‘post-communist’ economies in the light of conceptual issues and UK experience. The positive aspects of privatization by management and employee buy-outs concern: ownership incentives; the introduction of control mechanisms by institutional investors and various types of financing instruments; indigenous ownership, decentralized privatization; greater incentives in firms where specific skills are involved; the ability to improve trading relationships between a privatized supplier (the buy-out) and its former parent, which remains in the public sector where the supplier is heavily dependent on its former parent; and the general contribution of buy-outs to a redrawing of a state firm's spread of activities to create a more viable entity. The potential problems with buy-outs concern such issues as: absence of entrepreneurial skills; the scope of their applicability; the potentially restrictive effects of debt and debt-like finance; the need to deal with investment requirements of firms; the lack of personal wealth; the use of inside information by managers to purchase a firm at a price which is to the detriment of the public interest; and the possibility of social and political problems if individuals are perceived to enhance their personal wealth significantly as an accident of where they work. There are means by which many of these potential problems can be dealt with and the paper addresses these.