Exposing the myths surrounding preventive outpatient commitment for individuals with chronic mental illness.

Using New York's "Kendra's Law" as an illustrative vehicle, this article addresses the principal criticisms lodged by opponents of preventive outpatient commitment. The authors argue that preventive outpatient commitment is a useful adjunct to conditional release or placement in the least restrictive alternative that has neither produced revolutionary change in psychiatric commitment standards nor will be used inappropriately to assert governmental control over mentally ill citizens. The authors contend additionally that preventive outpatient commitment does not violate federal constitutional norms or represent bad policy making. The authors acknowledge, however, that the coercion inherent in outpatient commitment schemes may produce certain undesirable side effects. Thus, they explore an alternative approach currently in development in Australia that promotes community-based treatment for chronically mentally ill persons without judicial intervention.     

THE INFORMATIONAL REQUIREMENTS FOR EFFECTIVE REGULATORY REVIEW: AN ANALYSIS OF THE EPA LEAD STANDARD

The shortcomings of the EPA lead standard were largely determined by the requirements of the Clean Air Act. EPA's analysis was inadequate since the underlying risks were modelled in terms of critical thresholds irrespective of the particular probability of the adverse health outcome associated with the exposure. The informational requirements for meaningful review are compared with the actual benefit and cost data provided by EPA.
The misplaced EPA approach prevented the generation of appropriate information on which to base a policy decision and hampered the subsequent review efforts by the White House oversight group. It is doubtful whether any oversight effort can be fully effective without a major change in the Clean Air Act.     

The status of OSHA reform: A comment on mendeloff's proposals

Since its inception, the Occupational Safety and Health Administration (OSHA) has been the target of regulatory reform proposals. OSHA has attracted this continued critical attention both because of inadequacies in the design of OSHA regulation and shortcomings in its implementation. John Mendeloff's critique and program of reform for OSHA focus primarily on inadequacies in the structure of OSHA policy rather than its implementation. Within that class of issues, Mendeloff provides a thoughtful analysis of OSHA policy. His regulatory proposals also address what appear to be the principal shortcomings of OSHA. However, the specific aspects of his proposal raise new problems with respect to the stability of regulatory policy and its unintended role in establishing barriers to entry in industry.     

Synthetic risks, risk potency, and carcinogen regulation.

This article analyzes a comprehensive sample of over 350 chemicals tested for carcinogenicity to assess the determinants of the probability of regulation. Controlling for differences in the risk potency and noncancer risks, synthetic chemicals have a significantly higher probability of regulation overall: this is due to the greater likelihood of U.S. Food and Drug Administration (FDA) regulation. Measures of risk potency increase the probability of regulation by the U.S. Environmental Protection Agency (EPA), have a somewhat weaker positive effect on regulation by the U.S. Occupational Safety and Health Administration (OSHA), and decrease the likelihood of regulation by the FDA. The overall regulatory pattern is one in which the FDA targets synthetic chemicals and chemicals that pose relatively minor cancer risk. The EPA particularly performed more sensibly than many critics have suggested.     

Tort Liability Litigation Costs for Commercial Claims

This article analyzes tort liability litigation costs usingthe Texas Department of Insurance Commercial Liability InsuranceClosed Claim database for the years 1988–2004. Insurercosts to defend claims in which a suit was filed average $35,000per claim in 2004$, which corresponds to a share of 0.18 oftotal expenditures. Claims with higher stakes and complexitylead to greater reliance on outside counsel and less relianceon in-house counsel. Total transactions costs for each dollarreceived by claimants average $0.75 for all claims and $0.83for claims in which the claimant retained an attorney and asuit was filed.     

How costly is “clean”? An analysis of the benefits and costs of Superfund site remediations

The cleanup of hazardous waste sites under the U.S. Environmental Protection Agency's Superfund program is governed by a number of legislative and regulatory constraints. Congress passed legislation in 1986 directing the Environmental Protection Agency (EPA) to pursue permanent remedies that embodied stringent cleanup standards. The agency has chosen to use conservative assumptions in risk assessments at hazardous waste sites, including a presumption that on‐site risks for hypothetical future residents should be calculated in the site remediation process. This article offers the first comprehensive assessment of the cost‐effectiveness of these Superfund cleanups. Our results reveal that many EPA Superfund remediations fail a partial benefit‐cost test. For a sample of the 150 Superfund sites, we find that at the majority of sites the expected number of cancers averted by remediation is less than 0.1 cases per site and that the cost per cancer case averted is over $100 million. The analysis demonstrates the importance of explicitly calculating the trade‐offs embodied in environmental cleanup decisions. © 1998 by the Association for Public Policy Analysis and Management     

Cotton dust regulation: An OSHA success story?

In 1978, OSHA took a major step in attempting to promote the health of workers in the textile industry, tightening its standard on cotton dust levels in textile plants. Because the OSHA cotton dust standard was widely believed to be ineffective, it became the target of a major political debate and a fundamental U.S. Supreme Court decision. The evidence indicates that the standard has had the expected beneficial effect on worker health, and at a cost much lower than originally anticipated. Nevertheless, the costs still remain very high, far higher than estimates of the value of the results they achieve or of the value that workers place on them. Moreover, much more efficient ways of achieving comparable results are available. Nevertheless, large firms in the industry now appear to have a vested interest in maintaining the standard in its original form and are unlikely to constitute a force for change.     

Safety through markets

His work on the economics of health, safety, and environmental risks includes Risk by Choice, Employment Hazards,and Learning About Risk(with Wesley A. Magat). His most recent book, Compensation Mechanisms for Job Risks(with Michael J. Moore) will be published by Princeton University Press in January, 1990.     

How do Judges think about risk?

A sample of almost 100 judges exhibited well-known patternsof biases in risk beliefs and reasonable implicit values oflife. These biases and personal preferences largely do not affectattitudes toward judicial risk decisions, though there are someexceptions, such as ambiguity aversion, misinterpretation ofnegligence rules, and retrospective risk assessments in accidentcases, which is a form of hindsight bias. Although judges avoidedmany pitfalls exhibited by jurors and the population at large,they nevertheless exhibited systematic errors, particularlyfor small probability-large loss events. These findings highlightedthe importance of judicial review and the input of expert riskanalysts to assist judicial decisions in complex risk cases.