The eventuality of another influenza pandemic and the recent concern over H5N1, avian flu, require an assessment of local community healthcare capabilities. As the federal government has recently stated that such local communities will be primarily responsible for public health planning and implementation during a severe pandemic, an assessment of the current capabilities in these communities and planning for deficiencies must commence immediately. In this article, we have assessed the impact and capabilities of a model local county community in suburban Maryland. Our two statistical models demonstrate the likely impact of a mild, 1968 Hong Kong Flu pandemic in comparison to a severe, 1918 Spanish Flu type pandemic respectively. Both of these statistical models reveal significant resource deficiencies that many local communities may face. Additionally, we discuss some negative consequences that pandemic policy implementation itself may have on local communities and healthcare systems. Some recommendations for pandemic planning are suggested.
{"title":"Disaster Planning for Pandemic Flu: An Assessment of the Potential Effects of an Influenza Pandemic on Local Community Health Care Resources","authors":"Darren P. Mareiniss","doi":"10.2139/SSRN.946460","DOIUrl":"https://doi.org/10.2139/SSRN.946460","url":null,"abstract":"The eventuality of another influenza pandemic and the recent concern over H5N1, avian flu, require an assessment of local community healthcare capabilities. As the federal government has recently stated that such local communities will be primarily responsible for public health planning and implementation during a severe pandemic, an assessment of the current capabilities in these communities and planning for deficiencies must commence immediately. In this article, we have assessed the impact and capabilities of a model local county community in suburban Maryland. Our two statistical models demonstrate the likely impact of a mild, 1968 Hong Kong Flu pandemic in comparison to a severe, 1918 Spanish Flu type pandemic respectively. Both of these statistical models reveal significant resource deficiencies that many local communities may face. Additionally, we discuss some negative consequences that pandemic policy implementation itself may have on local communities and healthcare systems. Some recommendations for pandemic planning are suggested.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89404570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We examine the determinants of claims for a group health care plan. Since all persons in the group are covered, the premium does not enter the consideration of demand in this case. Hence, we are able to isolate other variables that affect the demand for health insurance. We show that income of the employees affect the claims in an unexpected way.
{"title":"Determinants of Group Health Insurance Demand","authors":"J. Munoz Perez, Tapen Sinha","doi":"10.2139/ssrn.947345","DOIUrl":"https://doi.org/10.2139/ssrn.947345","url":null,"abstract":"We examine the determinants of claims for a group health care plan. Since all persons in the group are covered, the premium does not enter the consideration of demand in this case. Hence, we are able to isolate other variables that affect the demand for health insurance. We show that income of the employees affect the claims in an unexpected way.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76058156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Byrne, M. S. Goeree, B. Hiedemann, Steven Stern
We use the 1993 wave of the AHEAD data set to estimate a game-theoretic model of families' decisions concerning the provision of informal and formal care for elderly individuals. The outcome is a Nash equilibrium where each family member jointly determines his or her consumption, transfers for formal care, and allocation of time to informal care, market work, and leisure. We use the estimates to decompose the effects of child characteristics into wage effects, quality of care effects, and burden effects. We also simulate the effects of a broad range of policies of current interest.
{"title":"Formal Home Health Care, Informal Care, and Family Decision-Making","authors":"D. Byrne, M. S. Goeree, B. Hiedemann, Steven Stern","doi":"10.2139/ssrn.907349","DOIUrl":"https://doi.org/10.2139/ssrn.907349","url":null,"abstract":"We use the 1993 wave of the AHEAD data set to estimate a game-theoretic model of families' decisions concerning the provision of informal and formal care for elderly individuals. The outcome is a Nash equilibrium where each family member jointly determines his or her consumption, transfers for formal care, and allocation of time to informal care, market work, and leisure. We use the estimates to decompose the effects of child characteristics into wage effects, quality of care effects, and burden effects. We also simulate the effects of a broad range of policies of current interest.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84235546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In an era filled with fears of bioterrorism, Congress approved the Public Readiness and Emergency Preparedness Act (PREPA) to encourage development of vaccines and other countermeasures. By providing pharmaceutical manufacturers with protection from liability for potential side effects, Congress has attempted to motivate manufacturers to produce a national stockpile of countermeasures. As part of PREPA, the government established a compensatory system intended to provide compensation to persons injured by countermeasures used during a public health emergency. Although the Act provides for a compensation fund, it fails to allocate monies for that fund. Thus, in the absence of further congressional action, PREPA will not provide compensation to those injured by countermeasures. Failing to assure the American public of a compensation program constitutes bad public policy and risks inspiring potential vaccinees to refuse necessary drugs. Additionally, arguments as to the constitutionality of the Act exist should Congress fail to adequately fund the program, and the existence of those arguments undermines the purpose of the Act--namely to assure pharmaceutical manufacturers that they will not be sued into oblivion should they attempt to aid national pandemic protection. In addition to detailing both the Act and the statutory precedent for congressional attempts to spur biodefense, this Article addresses important issues of healthcare, tort, and constitutional law that will continue to manifest themselves in this new era of bioterrorism.
{"title":"High and Dry? The Public Readiness and Emergency Preparedness Act and Liability Protection for Pharmaceutical Manufacturers","authors":"Brian Kurt Copper","doi":"10.2139/SSRN.896299","DOIUrl":"https://doi.org/10.2139/SSRN.896299","url":null,"abstract":"In an era filled with fears of bioterrorism, Congress approved the Public Readiness and Emergency Preparedness Act (PREPA) to encourage development of vaccines and other countermeasures. By providing pharmaceutical manufacturers with protection from liability for potential side effects, Congress has attempted to motivate manufacturers to produce a national stockpile of countermeasures. As part of PREPA, the government established a compensatory system intended to provide compensation to persons injured by countermeasures used during a public health emergency. Although the Act provides for a compensation fund, it fails to allocate monies for that fund. Thus, in the absence of further congressional action, PREPA will not provide compensation to those injured by countermeasures. Failing to assure the American public of a compensation program constitutes bad public policy and risks inspiring potential vaccinees to refuse necessary drugs. Additionally, arguments as to the constitutionality of the Act exist should Congress fail to adequately fund the program, and the existence of those arguments undermines the purpose of the Act--namely to assure pharmaceutical manufacturers that they will not be sued into oblivion should they attempt to aid national pandemic protection. In addition to detailing both the Act and the statutory precedent for congressional attempts to spur biodefense, this Article addresses important issues of healthcare, tort, and constitutional law that will continue to manifest themselves in this new era of bioterrorism.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83663203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In a paper published by Ma (1994) it was argued that the prospective payment system in the hospital industry was superior to the cost based reimbursement system to achieve both cost reduction and quality improvement objectives. In the analysis, it was assumed that quality and costs decisions were made by a single agent. Our paper compares these two financing systems assuming that the main decisions taken within the hospital are shared between physicians (quality of treatment) and hospital managers (cost reduction). If Ma's conclusions hold in the US context (where the hospital managers bear the whole cost of treatment), we show that the ability of a prospective payment system to achieve both objectives is very depending of the type of interaction between the agents when physicians bear a part of the treatment cost as it is the case in many European countries.
{"title":"The Optimality of Hospital Financing System: The Role of Physician-Manager Interactions","authors":"D. Crainich, Hervé Leleu, A. Mauleon","doi":"10.2139/ssrn.912673","DOIUrl":"https://doi.org/10.2139/ssrn.912673","url":null,"abstract":"In a paper published by Ma (1994) it was argued that the prospective payment system in the hospital industry was superior to the cost based reimbursement system to achieve both cost reduction and quality improvement objectives. In the analysis, it was assumed that quality and costs decisions were made by a single agent. Our paper compares these two financing systems assuming that the main decisions taken within the hospital are shared between physicians (quality of treatment) and hospital managers (cost reduction). If Ma's conclusions hold in the US context (where the hospital managers bear the whole cost of treatment), we show that the ability of a prospective payment system to achieve both objectives is very depending of the type of interaction between the agents when physicians bear a part of the treatment cost as it is the case in many European countries.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90230677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Closing the health care disparities gap: turning evidence into action.","authors":"Carolyn M Clancy","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26439362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing access to health care and eliminating racial and ethnic disparities in health status: a compelling case for health professions schools to implement race-conscious admissions policies.","authors":"Thomas E Perez","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26439358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although the existence of racial and ethnic disparities is increasingly recognized, a complete understanding of the causes and solutions to these problems remains elusive. Part One of this paper provides a historical overview of the origins of these disparities. Part Two outlines fundamental challenges to achieving a clear understanding of the problem and briefly discusses current policy strategies espoused by conservative and liberal proponents. Finally, Part Three provides an in-depth discussion of one promising approach with significant bipartisan support.
{"title":"Common ground: exploring policy approaches to addressing racial disparities from the left and the right.","authors":"M C Gibbons","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although the existence of racial and ethnic disparities is increasingly recognized, a complete understanding of the causes and solutions to these problems remains elusive. Part One of this paper provides a historical overview of the origins of these disparities. Part Two outlines fundamental challenges to achieving a clear understanding of the problem and briefly discusses current policy strategies espoused by conservative and liberal proponents. Finally, Part Three provides an in-depth discussion of one promising approach with significant bipartisan support.</p>","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26439356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neil S Calman, Maxine Golub, Charmaine Ruddock, Lan Le, Diane Hauser
{"title":"Separate and unequal care in New York City.","authors":"Neil S Calman, Maxine Golub, Charmaine Ruddock, Lan Le, Diane Hauser","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26439360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Human experimentation in developing countries: improving international practices by identifying vulnerable populations and allocating fair benefits.","authors":"Kristen Farrell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26439364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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