Special report on reimbursement. HCFA enacts new enforcement remedies covering nursing facilities

While the regulations are revolutionary in their use of "substantial compliance," the interpretation and application of HCFA's new remedial scheme are still uncertain, as states are given broad discretion in defining important terms and in applying and interpreting the criteria to select remedies. Further complicating the issue is the fact that some states, including California, intend to seek waivers from HCFA to substitute their own state enforcement systems for most, if not all, of the new federal system. Based upon these uncertainties, the enforcement of nursing facility standards will likely be in a state of flux for some time to come.     

The hate that dare not speak its name: Pornography qua semi-political speech

In this essay we shall examine the contemporary jurisprudential thinking and legal precedents surrounding the issue of the sanctionability of pornography. We shall catalogue them by their logical presumptions, such as whether they view pornography as speech or act, whether they view pornography as obscenity, political hate-speech or anomalous other, whether they would scrutinize legislation governing pornography by a balancing of the harm of repression against the harm of permission, and who exactly they view as the victims.We shall take a special interest in the most recent, but unsuccessful, attempt by a subgroup of feminists to proscribe pornography by treating it as neither political speech nor sexual speech but speech which causes harm which is both political and sexual. They would like it to be considered as a special kind of odious propaganda undeserving of protection because it promulgates a mental state conducive to criminal activity, and hence is criminal in and of itself. However, the repression of propaganda, even odious propaganda, is not so easily accomplished in this country.Most anti-censors have emphasized the uncertainty of the causal connection between pornography and sexual violence. We shall contend that this is not the essential issue, and that, even if we agree with the allegations of pornography's prurient non-intellectual appeal and its tendency to excite criminal hostility, the current understanding of the Bill of Rights allows sanctioning only under the stringent requirement of the showing of a clear and present danger of specific and immediate acts.We raise the question of whether there should be a new standard for speech which is simultaneously political and sexual, and/or for speech whose harmful message is presented subliminally, on the grounds that such speech may not be adequately opposed by counter speech in the marketplace of ideas.