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.     

The State of American Federalism, 1996-1997

Federalism enjoyed political and popular salience during theperiod 1996–1997 as the so-called "Devolution Revolution"began to be implemented and analyzed in the United States. Whilethere were a few examples of important Revolutionary efforts,the federal government continued to hold much of the power andsignificance it has achieved over the past sixty years. Evenin the area of welfare policy, where in 1996 there were historicreforms enacted to end the federal entitlement, the federalgovernment maintained a significant presence that made the ideaof devolution of welfare policy responsibility some what questionable.Nevertheless, states continued to lead in policy innovationin areas ranging from education to health, and the U.S. SupremeCourt continued to question the limits of federal power. Thepast year illustrated, once again, the complexity of our federalsystem and how difficult it is to reform federalism—particularlywhen it involves a shift in power and creates the perceptionof winners and losers.     

Candidate Character vs. The Economy in the 1992 Election

The outcome of the 1992 U.S. presidential election has been explained largely as a function of perceptions of George Bush's economic performance. The economy submerged questions about Bill Clinton's character, awarding the advantage to the Democrat. In this article, we evaluate the effect of economic evaluations along with character attacks on candidate support in the 1992 presidential contest. Claims that the economy submerged character have been somewhat exaggerated. But while character remains an important issue in presidential evaluation, its role in judging candidates cannot be taken at face value. We show that both economic evaluations and character judgments are highly politicized. The findings indicate that those protesting Clinton's character turned almost exclusively to Bush. Those protesting Bush's economic record turned to both Perot and Clinton. Still, the economy did not trump character. The troubles of both major party candidates fueled a strong protest vote that contributed to Perot's strong showing.     

The Federalism Debate in the Transformation of Federal Habeas Corpus Law

Over the last several decades, the law governing access to federalhabeas corpus review has undergone a fundamental transformation,moving from a Warren Court approach that focused on individualrights to a Rehnquist Court approach that emphasizes deferenceto state courts. The enduring constitutional debate about thefederal system and the appropriate role of the federal courtsin that system has been at the heart of this transformation.This essay examines the leadership role of the U.S. SupremeCourt and the influence of other institutional actors, suchas the Congress, the executive, and the states, in the shapingof United States "constitutional dialogue" on this issue.     

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.