{"title":"Data-sharing and data-withholding in genetics and the life sciences: results of a national survey of technology transfer officers.","authors":"Eric G Campbell, Eran Bendavid","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40839138","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}
This report is about how Medicare could improve care for beneficiaries with chronic conditions. During the mid-1960s, acute care - not chronic care - was the major focus of medicine. When Medicare was instituted in 1965, it was modeled after the health insurance system of that time. Medicare was to function primarily as a claims payer; its benefit package and reimbursement systems were not designed for chronic conditions; preventive services were excluded; and reimbursement was paid only for in-person visits and procedures to individual providers. Since then, good chronic care and comprehensive coverage have become crucial to Medicare beneficiaries. Though some improvements have been made to Medicare, major changes in the provision and financing of chronic care for Medicare beneficiaries are needed. Medicare has the potential to refocus its Medicare program - as well as the nation's health care system - and should take a leading role in improving chronic care. This report is the final product of the Medicare and Chronic Care in the 21st Century study panel, a panel convened by the National Academy of Social Insurance as part of its Making Medicare Restructuring Work project. The panel was charged with determining the health care and related needs of Medicare beneficiaries with chronic conditions, how well Medicare meets their needs, features of the current Medicare program that support or impede good chronic care, and the experience of other chronic care models. The study panel focused on original Medicare, Medicare's traditional fee-for-service program. It chose this focus because 35 million of Medicare's 40 million beneficiaries are covered under this system. The study panel also recommended changes to the Medicare+Choice (M+C) system, as changes to M+C may be easier to facilitate.
{"title":"Medicare in the 21st Century: Building a Better Chronic Care System","authors":"J. Eichner, D. Blumenthal","doi":"10.2139/SSRN.555632","DOIUrl":"https://doi.org/10.2139/SSRN.555632","url":null,"abstract":"This report is about how Medicare could improve care for beneficiaries with chronic conditions. During the mid-1960s, acute care - not chronic care - was the major focus of medicine. When Medicare was instituted in 1965, it was modeled after the health insurance system of that time. Medicare was to function primarily as a claims payer; its benefit package and reimbursement systems were not designed for chronic conditions; preventive services were excluded; and reimbursement was paid only for in-person visits and procedures to individual providers. Since then, good chronic care and comprehensive coverage have become crucial to Medicare beneficiaries. Though some improvements have been made to Medicare, major changes in the provision and financing of chronic care for Medicare beneficiaries are needed. Medicare has the potential to refocus its Medicare program - as well as the nation's health care system - and should take a leading role in improving chronic care. This report is the final product of the Medicare and Chronic Care in the 21st Century study panel, a panel convened by the National Academy of Social Insurance as part of its Making Medicare Restructuring Work project. The panel was charged with determining the health care and related needs of Medicare beneficiaries with chronic conditions, how well Medicare meets their needs, features of the current Medicare program that support or impede good chronic care, and the experience of other chronic care models. The study panel focused on original Medicare, Medicare's traditional fee-for-service program. It chose this focus because 35 million of Medicare's 40 million beneficiaries are covered under this system. The study panel also recommended changes to the Medicare+Choice (M+C) system, as changes to M+C may be easier to facilitate.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76091297","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":"The potential impact of genetic sequencing on the American health insurance system.","authors":"Frederick Levy, Joseph F Lawler","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40839140","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":"Reproductive genetics 1991-2002: a selected annotated legal bibliography of genetic testing, gene transfer and reproductive cloning.","authors":"Gail H Javitt","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40839135","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":"Public access versus proprietary rights in genomic information: what is the proper role of intellectual property rights?","authors":"Janice M Mueller","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40839139","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":"Biotechnology and human dignity, a necessary and compatible union.","authors":"Ella Judge Hayes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40839136","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}
The pharmaceutical industry presents many peculiarities. R&D are high and pose a high risk that they do not result in any marketable drug. The area is also very regulated by local governments, which, in many cases, control and limit the final price of drugs. The peculiarity of the pharmaceutical industry is reflected also in the area of transfer pricing since the vast majority of the transactions are carried out among companies of the same group in a worldwide basis. Innovative drugs are virtually unique and do not have any comparable in the market. In this sense, is difficult, or almost impossible to find comparables. The comparability analysis requires special attention, and maybe, special knowledge, when dealing with the pharmaceutical industry. If the concepts are applied in a general meaning, the comparability analysis is at risk of presenting misleading results, which do not fulfil the arm's length principle, and may cause double taxation.
{"title":"Comparability in the Pharmaceutical Industry for Transfer Pricing Purposes","authors":"Alexandre Siciliano Borges","doi":"10.2139/ssrn.400281","DOIUrl":"https://doi.org/10.2139/ssrn.400281","url":null,"abstract":"The pharmaceutical industry presents many peculiarities. R&D are high and pose a high risk that they do not result in any marketable drug. The area is also very regulated by local governments, which, in many cases, control and limit the final price of drugs. The peculiarity of the pharmaceutical industry is reflected also in the area of transfer pricing since the vast majority of the transactions are carried out among companies of the same group in a worldwide basis. Innovative drugs are virtually unique and do not have any comparable in the market. In this sense, is difficult, or almost impossible to find comparables. The comparability analysis requires special attention, and maybe, special knowledge, when dealing with the pharmaceutical industry. If the concepts are applied in a general meaning, the comparability analysis is at risk of presenting misleading results, which do not fulfil the arm's length principle, and may cause double taxation.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82213587","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}
This essay extends to adverse selection the critical attention provided in prior work to moral hazard. Like moral hazard, adverse selection is an old insurance concept that was adopted, formalized and generalized by economists developing the economics of information. As with moral hazard, insurance economics has addressed the phenomenon of adverse selection largely from the insurers' point of view. This essay examines how insurers create and shape adverse selection. At least in the context of insurance risk classification, there is much to be gained in thinking of adverse selection as a 'dual' problem (similar to moral hazard), meaning that actions to address adverse selection problems can lead to the de-pooling effect that motivated the actions in the first place. The first part of the essay sets forth the case for understanding adverse selection as a dual problem and highlights alternatives to insurance risk classification. The second uses three historical examples to explore moral justifications for insurance risk classification. The three examples are the 19th century controversy over age-based pricing in fraternal insurance, the mid 20th century controversy over experience rating in unemployment insurance, and the late 20th century controversy over efforts to exclude battered women from life, health and disability insurance pools. These examples demonstrate that, rather than being a neutral, technical solution to a structural dynamic inherent in the insurance relationship, risk classification reflects moral commitments.
{"title":"Containing the Promise of Insurance: Adverse Selection and Risk Classification","authors":"T. Baker","doi":"10.2139/ssrn.322581","DOIUrl":"https://doi.org/10.2139/ssrn.322581","url":null,"abstract":"This essay extends to adverse selection the critical attention provided in prior work to moral hazard. Like moral hazard, adverse selection is an old insurance concept that was adopted, formalized and generalized by economists developing the economics of information. As with moral hazard, insurance economics has addressed the phenomenon of adverse selection largely from the insurers' point of view. This essay examines how insurers create and shape adverse selection. At least in the context of insurance risk classification, there is much to be gained in thinking of adverse selection as a 'dual' problem (similar to moral hazard), meaning that actions to address adverse selection problems can lead to the de-pooling effect that motivated the actions in the first place. The first part of the essay sets forth the case for understanding adverse selection as a dual problem and highlights alternatives to insurance risk classification. The second uses three historical examples to explore moral justifications for insurance risk classification. The three examples are the 19th century controversy over age-based pricing in fraternal insurance, the mid 20th century controversy over experience rating in unemployment insurance, and the late 20th century controversy over efforts to exclude battered women from life, health and disability insurance pools. These examples demonstrate that, rather than being a neutral, technical solution to a structural dynamic inherent in the insurance relationship, risk classification reflects moral commitments.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79661819","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}
The risk of an unwanted pregnancy represents one of the major costs of sexual activity. When abortion was legalized in a number of states during the late 1960s and early 1970s (and nationally with the 1973 Supreme Court case of Roe v. Wade), this cost was reduced as women gained the option of terminating an unwanted pregnancy. We predict that abortion legalization led to an increase in sexual activity, accompanied by an increase in sexually transmitted diseases. Using CDC data on the incidence of gonorrhea and syphilis by state, we test the hypothesis that judicial and legislative decisions to legalize abortion lead to an increase in sexually transmitted diseases. We find that gonorrhea and syphilis incidences are significantly and positively correlated with abortion legalization. According to our estimates, abortion legalization might account for as much as one third of the average disease incidence.
{"title":"The Effect of Abortion Legalization on the Incidence of Sexually Transmitted Diseases","authors":"Thomas Stratmann, Jonathan Klick","doi":"10.2139/ssrn.306340","DOIUrl":"https://doi.org/10.2139/ssrn.306340","url":null,"abstract":"The risk of an unwanted pregnancy represents one of the major costs of sexual activity. When abortion was legalized in a number of states during the late 1960s and early 1970s (and nationally with the 1973 Supreme Court case of Roe v. Wade), this cost was reduced as women gained the option of terminating an unwanted pregnancy. We predict that abortion legalization led to an increase in sexual activity, accompanied by an increase in sexually transmitted diseases. Using CDC data on the incidence of gonorrhea and syphilis by state, we test the hypothesis that judicial and legislative decisions to legalize abortion lead to an increase in sexually transmitted diseases. We find that gonorrhea and syphilis incidences are significantly and positively correlated with abortion legalization. According to our estimates, abortion legalization might account for as much as one third of the average disease incidence.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90224593","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}
A major factor contributing to smoking initiation and experimentation by teenagers is the ability to 'bum' cigarettes. Yet research until now has ignored the impact of a lending/borrowing market on the smoking decisions of teenagers. In this paper, we develop a theoretical model where smoking decisions are determined by an individual's utility maximization process that includes an incentive to lend cigarettes. Predictions from this model are tested using data from the Youth Risk Behavior Surveys that can distinguish between teens who primarily buy and those who primarily bum their cigarettes. We show the ways in which price and restrictions on smoking will impact the decision to buy or bum cigarettes, as well as the impact on the allocation of purchased cigarettes between those self-consumed and those lent to others. Key results indicate that as prices and restrictions increase, teenagers are less likely to be regular smokers who purchase cigarettes and are more likely to consume smaller quantities obtained via the lending market. The basic conclusions are that anti-smoking policies have significant effects on the quantity of cigarettes consumed by teens and that these policies can help reduce the number of teens that escalate from experimental to regular smoking.
{"title":"The Impact of Lending, Borrowing, and Anti-Smoking Policies on Cigarette Consumption by Teens","authors":"Brett Katzman, S. Markowitz, K. McGeary","doi":"10.3386/W8844","DOIUrl":"https://doi.org/10.3386/W8844","url":null,"abstract":"A major factor contributing to smoking initiation and experimentation by teenagers is the ability to 'bum' cigarettes. Yet research until now has ignored the impact of a lending/borrowing market on the smoking decisions of teenagers. In this paper, we develop a theoretical model where smoking decisions are determined by an individual's utility maximization process that includes an incentive to lend cigarettes. Predictions from this model are tested using data from the Youth Risk Behavior Surveys that can distinguish between teens who primarily buy and those who primarily bum their cigarettes. We show the ways in which price and restrictions on smoking will impact the decision to buy or bum cigarettes, as well as the impact on the allocation of purchased cigarettes between those self-consumed and those lent to others. Key results indicate that as prices and restrictions increase, teenagers are less likely to be regular smokers who purchase cigarettes and are more likely to consume smaller quantities obtained via the lending market. The basic conclusions are that anti-smoking policies have significant effects on the quantity of cigarettes consumed by teens and that these policies can help reduce the number of teens that escalate from experimental to regular smoking.","PeriodicalId":73765,"journal":{"name":"Journal of health care law & policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77005608","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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