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Journal of health care law & policy最新文献

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Adverse impact of predisposition testing on major life activities: lessons from BRCA1/2 testing. 易感性测试对主要生活活动的不利影响:来自BRCA1/2测试的教训。
Pub Date : 2000-01-01
K A Schneider
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引用次数: 0
Bragdon v. Abbott, asymptomatic genetic conditions, and antidiscrimination law: a conservative perspective. Bragdon v. Abbott,无症状遗传病和反歧视法:一个保守的观点。
Pub Date : 2000-01-01
R Clegg
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引用次数: 0
Genetic discrimination: why Bragdon does not ensure protection. 基因歧视:为什么布拉格顿不能确保保护。
Pub Date : 2000-01-01
L F Rothstein
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引用次数: 0
Discrimination based on HIV/AIDS and other health conditions: "disability" as defined under federal and state law. 基于艾滋病毒/艾滋病和其他健康状况的歧视:联邦和州法律定义的"残疾"。
Pub Date : 2000-01-01
D W Webber, L O Gostin
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引用次数: 0
Bragdon v. Abbott: extending the Americans with Disability Act to asymptomatic individuals. Bragdon诉Abbott:将《美国残疾人法案》扩展到无症状个体。
Pub Date : 2000-01-01
E Liu
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引用次数: 0
Is there a pink slip in my gene? Genetic discrimination in the workplace. 我的基因里有解雇通知书吗?工作场所的基因歧视。
Pub Date : 2000-01-01
P S Miller
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引用次数: 0
Financing Long-Term Care: Options for Policy 长期护理融资:政策选择
Pub Date : 1999-10-01 DOI: 10.2139/ssrn.193515
Walter M. Cadette
The nation is ill-prepared to finance the quantum jump in long-term care spending that is on its way as the baby boom ages. By default rather than by design, Medicaid has become the main source of funds for long-term care. But reliance on Medicaid has fostered the institutionalization of the disabled elderly, has given rise to a two-tier care system, and has yielded the bizarre outcome of use of limited welfare funds by middle- and even high-income Americans who have succeeded in sheltering assets from Medicaid's spend-down requirements. Insurance would be a greatly better answer to the nation's long-term care needs. But the market will remain small and underdeveloped as long as Americans can make easy claim on Medicaid. The paper puts forth a plan for universal long-term care insurance, supported by income-scaled tax credits, to replace Medicaid in its current role. That would make for "honest government"--one that not only does not fund inheritance protection but also genuinely protects those with greatest need.
随着婴儿潮年龄的增长,国家还没有准备好为长期护理支出的大幅增长提供资金。由于默认而不是设计,医疗补助计划已经成为长期护理的主要资金来源。但是,对医疗补助的依赖助长了残疾老年人的制度化,导致了两层护理体系的产生,并产生了一个奇怪的结果:中高收入的美国人利用有限的福利基金,他们成功地保护了自己的资产,不受医疗补助的削减要求的影响。保险将是解决国家长期护理需求的一个更好的办法。但是,只要美国人能够轻松地获得医疗补助,医疗市场就会保持小而不发达的状态。该文件提出了一个由收入比例税收抵免支持的全民长期护理保险计划,以取代医疗补助计划目前的作用。这将造就一个“诚实的政府”——一个不仅不为遗产保护提供资金,而且真正保护那些最需要帮助的人的政府。
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引用次数: 2
Competition in Networks: An Analysis of Hospital Pricing Behavior 网络竞争:医院定价行为分析
Pub Date : 1999-09-01 DOI: 10.2139/ssrn.181608
R. Town, G. Vistnes
In this paper we develop a framework for analyzing the behavior of hospitals under selective contracting. We use a unique data set on hospitals in the Southern California region from 1990?1993 to estimate the factors affecting the actual negotiated prices paid to hospitals by two major HMOs. We find that a hospital?s bargaining power, and hence its price, decreases in the ability of the HMO to construct alternative networks that exclude the hospital. Our findings also indicate that hospitals should not be given free reign to merge as some hospital mergers, even in urban areas, can lead to anti-competitive price increases for inpatient services. Beyond hospitals, our methodology can also be applied to other industries where firms contract with multiple suppliers.
本文建立了一个分析选择性承包下医院行为的框架。我们使用了1990年以来南加州地区医院的独特数据集?1993年估计影响两个主要保健组织支付给医院的实际谈判价格的因素。找到医院了吗?医保的议价能力和价格,降低了HMO构建排除医院的替代网络的能力。我们的研究结果还表明,医院不应该被给予合并的自由,因为一些医院的合并,即使在城市地区,也会导致住院服务价格的反竞争上涨。除了医院之外,我们的方法也可以应用于其他企业与多个供应商签订合同的行业。
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引用次数: 12
The Geography of Medicare 医疗保险的地理分布
Pub Date : 1999-05-01 DOI: 10.2139/ssrn.165508
Louise M. Sheiner, D. Cutler
There is a great deal of geographic variation in Medicare spending. For example, while the average Medicare cost per beneficiary was around $5200 in 1996, Medicare spending, adjusted for diffences in regional prices and demographic composition, was about $8000 per person in Miami, but only $3500 in Minneapolis. In this paper, we explore the source of this variation. We find that a substantial amount can be explained by differences across areas in the health of the elderly population. This finding suggests that some of the geographic variation in Medicare spending is efficient. But even accounting for differences in the health of the population, significant variation remains. We have been able to explain some of the remaining variation. The strongest factors are supply variables: for-profit hospitals and specialist physicians both increase Medicare spending. If these factors are exogenous, public policy may want to consider the supply of medical services more than it currently does. We do not find that expensive places spend a disproportionate amount on those near death.
医疗保险支出有很大的地域差异。例如,1996年每位受益人的平均医疗保险成本约为5200美元,而根据地区价格和人口构成的差异进行调整后,迈阿密的医疗保险支出约为每人8000美元,而明尼阿波利斯只有3500美元。在本文中,我们探讨了这种变化的来源。我们发现,在很大程度上,这可以用老年人健康状况在各个地区的差异来解释。这一发现表明,医疗保险支出的一些地理差异是有效的。但即使考虑到人口健康状况的差异,仍存在显著差异。我们已经能够解释剩下的一些变异。最重要的因素是供给变量:营利性医院和专科医生都增加了医疗保险支出。如果这些因素是外生的,公共政策可能需要比目前更多地考虑医疗服务的供应。我们没有发现昂贵的地方在濒临死亡的人身上花了不成比例的钱。
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引用次数: 63
Treatment Decisions: Tort or Contract 处理决定:侵权还是合同
Pub Date : 1999-03-31 DOI: 10.2139/ssrn.157358
Paul H. Rubin
An issue that must be resolved under any health insurance policy is the locus of decisions on treatment. There will be times when a patient may want some treatment that the insurance company (HMO) will not want to provide. There may be other situations when a decision must be made about the amount to spend on care; two issues that come to mind are treatment at the end of life and amount of treatment for premature newborns. There are essentially two ways of making such decisions. They can be made ex ante through contract, or ex post through tort law. That is, it is possible to specify in advance what sort of payments will be provided through a contract between the patient and the HMO, or it is possible to wait until after some illness occurs and some treatment decision is made and then use tort law (or its variant, malpractice law) to decide if the treatment offered was adequate.
在任何健康保险政策下必须解决的一个问题是关于治疗的决定。有时,患者可能需要一些保险公司(HMO)不愿提供的治疗。可能在其他情况下,必须就护理费用作出决定;想到的两个问题是生命结束时的治疗和早产儿的治疗数量。做出这样的决定基本上有两种方式。可以通过事前合同,也可以通过事后侵权法。也就是说,可以通过患者和HMO之间的合同提前指定将提供何种付款,或者可以等到某些疾病发生并做出某些治疗决定之后,然后使用侵权法(或其变体,医疗事故法)来决定所提供的治疗是否足够。
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引用次数: 2
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