healthcare law

Question One

 

It surprises people (especially international students) to learn that the U.S. Constitution does not provide for a right to health care for American citizens.   A key exception to that is prisoners, as Justice Marshall explains in the Gamble case excerpt.  They do have a right to minimum health care, because of the Eight Amendment.  

 

Do you think, as a policy matter, that  all Americans should have a right to minimum health care?  This is the first discussion question for the week.

 

Question Two

 

Your book talks about another type of financial concern we might have with physicians, namely, physician ownership of treatment facilities.  If a physician owns a treatment facility, you can see why he might be more eager to recommend patients use it—or to recommend less lucrative patients use his competitor’s facilities.  The flip side is that not allowing physicians to refer to their facilities might create extra administrative cost and inefficiency.  The law polices physician ownership in several ways and bars it in many instances.  One place it does not bar ownership is with respect to facilities known as ambulatory service centers, which are in essence a kind of lower cost treatment alternative to hospitals.  The study in the book shows how it does indeed look like physicians, in making referrals to ASCs they own or do not own, seem to take into account their own financial returns. 

 

Do you think that is a problem?  If so, is a better solution an outright bar of the practice or merely requiring doctors to disclose to their patients their ownership interests in treatment facilities?  This is the second discussion question for the week.

 

Question Three

  www.sciencedirect.com/science/article/pii/B9780122148507500280

Do Kenneth Arrow’s insights suggest health insurance is best provided by the government, private payers, or a combination of both?  This is the third discussion question of the week.

 

Question Four

 

If we could have a system where anyone of any age could opt-in to Medicare by paying a modest premium, would you prefer that system?  Why or why not?  This is the fourth discussion question of the week.