Week 1 legal aspects
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Week1slides410320231.pptxLegal Aspects of Health Care
HLAD 4103
Instructor: Carol Schneider
Introductions
Please post a brief introduction of yourself on the Discussion Board entitled:
Introduction
Let us know why you are taking this course, a bit about your background, work place, interest in healthcare and anything else we should know about you
Syllabus
Class participation through discussion board participation- posts and replies for full credit -10%
Weekly readings and quizzes - 15%
Two written assignments -35%
Mid-term - 20%
Final exam - 20%
No late assignments- all assignments due by Thursday 11:00pm
Announcements
Check weekly for Announcements relating to:
assignment updates
grading
and other information to stay current on the class
It is your responsibility to stay informed of any changes or updates
Government, Law, and Ethics
The Law
A system of principles and processes by which people in a society deal with disputes and problems, seeking to solve or settle them without resorting to force.
Types and sources of law
Law and Public Policy
Public & Private Law
Public law
Laws that deal with the relationships between individuals and the government & relationships between individuals that are of direct concern to the public
Private Law
Laws that deal with the recognition and enforcement of the rights and duties of and between private individuals.
Public & Private Law Examples
Public law:
Criminal Law
Tax Law
Constitutional Law
Administrative Law
Private law:
Contracts
Torts
Labor law
Corporate law
Sources of Law
Common law
Derived from judicial decisions
Statutory law
Written laws
Administrative law
Public law, rules, and regulations issued by administrative agencies to direct the enacted laws of the federal and state governments
Common Law in the U.S.
Body of principles that has evolved and expanded from judicial decisions
Lower courts must follow decision from a higher state or federal court
Decision in one state is NOT binding in other states
Common Law Principles
Precedent
A judicial decision that may be used as a standard in subsequent similar cases
Res judicata
Means the thing is decided—refers to that which has been previously acted on or decided by the courts
Stare decisis
Common-law principle: let the decision stand
Based on similar cases and fact patterns (comparable rulings)
Principles of law are subject to change!
Federal Court System
U.S. District Court
94 district courts in 50 states, 1 in DC and 1 in Puerto Rico
Civil, criminal, admiralty, and bankruptcy cases
U.S. Court of Appeals
12 regional courts, 1 judicial circuit in DC
Reviews District court decisions and administrative agency decisions
U.S. Supreme Court
Only court created by federal constitution
Statutory Law
Written law emanating from a legislative body
Hierarchical order
U.S. Constitution
Highest in hierarchy of laws
State constitution
Federal laws take precedence over state laws
State laws are generally applicable when they are more rigid than federal laws
When state and federal laws conflict
Resolution sought in appropriate federal court
Article VI of the Constitution
This Constitution and Law of the United States
. . . Shall be the supreme Law of the Land;
and the Judges in every State shall be bound thereby . . .
Administrative Law
Extensive body of public law issued by administrative agencies to carry out the intent of enacted laws of the federal and state governments
Ex: Department of Health and Human Services (HHS) administers much of the federal health law enacted by Congress
Administrative Procedures Act
Describes different procedures under which federal administrative agencies must operate
Prescribes procedural responsibilities and authority of administrative agencies
Administrative Agencies have their own legislative, judicial and executive functions
Administrative Procedures Act
Provides legal remedies for those wronged by agency actions
Rules and regulations established by administrative agency must be administered within scope of authority delegated by Congress
Subject to judicial review by the courts, but usually must seek recourse within the agency first
Example of how it works
https://www.youtube.com/watch?v=ow5hZmU7Yfw
Public Policy: A Principle of Law
What government (any public official who influences or determines public policy, including school officials, city council members, county supervisors, etc.) does or does not do about a problem that comes before them for consideration and possible action.
Law that holds that no one can lawfully do that which tends to be injurious to the public or against the public good.
Government Organization
Legislative Branch: Write and Enact Laws
Executive Branch: Administer and Enforce the Laws
President can veto a bill
Congress can override veto with a 2/3 vote
Pocket veto: President prevents a bill from becoming law by avoiding any action when Congress is in session
Judicial Branch: Interpret and Apply Laws
How does a bill become law?
https://www.youtube.com/watch?v=66f4-NKEYz4&list=PL8dPuuaLjXtOfse2ncvffeelTrqvhrz8H&index=9
Separation of Powers
Under this model, government is divided into branches.
Each branch:
Has separate and independent powers
Has separate areas of responsibility
Is able to place limited restraints on the power exerted by the other branches
https://www.youtube.com/watch?v=0bf3CwYCxXw&list=PL8dPuuaLjXtOfse2ncvffeelTrqvhrz8H&index=3
Department of Health & Human Services
Responsible for carrying out national health and human services policy objectives
Administration on Aging
Improve the life of senior citizens
Centers for Medicare and Medicaid Services
Administer Medicare, Medicaid and State Children’s Health Insurance Program (CHIP)
Public Health Service
Promote the protection of the nation’s physical and mental health through various agencies
Public Health Service
National Institutes of Health
Principal federal biomedical research agency
Centers for Disease Control and Prevention
Prevention and control of infectious and chronic diseases and public health emergencies
Food and Drug Administration
Ensure the effectiveness, quality and security of drugs, medical devices and food
Substance Abuse and Mental Health Services Administration
Reduce the impact of substance abuse and mental illness
Public Health Service
Health Resources and Services Administration
Improve access to healthcare services and achieve health equity
Agency for Healthcare Research and Quality (AHRQ)
Provide evidence-based information on healthcare outcomes, cost, use and access
Agency for Toxic Substances and Disease Registry
Prevent or mitigate harmful exposures and related diseases
Indian Health Service
Provision of healthcare to Native Americans
Medicare
Medicare: federal health insurance covers adults 65+, disabled, certain diseases (ex: end stage rental disease)
Part A: Hospital, hospice, home health care and skilled nursing care (in-patient care)
Part B: Physician visits and medical procedures (out-patient care)
Part C: Medicare Advantage Plans (Medigap) (supplemental private insurance plans)
Part D: Prescription drug plans (also private)
Medicare
Premium: what you pay each month
Deductible: what you pay before the insurance company does
Copayments: what you pay for a service regardless of what the deductible is
Coinsurance: the percentage of the service the insurance company doesn’t cover
Out of Pocket Maximum: how much you will pay out of your pocket each year in an absolute worst-case-scenario situation
Medicaid
Medicaid: jointly sponsored/financed by the federal government and states
For those with very low incomes
Patients pay nothing except for a small-copayment on rare occasions
Varies from state to state
Ethics
Law and ethics are intertwined
Well-founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues.
The continuous effort of studying our own moral beliefs and our moral conduct, and striving to ensure that we, and the institutions we help to shape, live up to standards that are reasonable and solidly-based.
Government Ethics Committees
Executive Branch
Office of Government Ethics
Prevent and resolve conflicts of interest among government employees
Government Ethics Committees
U.S. House of Representatives
Committee on Ethics
U.S. Senate
Senate Select Committee on Ethics
U.S. Judicial Code of Conduct
Office of Congressional Ethics
Independent, nonpartisan office, governed by a board comprised of private citizens
Provides public review & insight into ethical conduct of members of the House of Representatives
OCE reviews allegations of misconduct against members, officers, and staff of the House and, when appropriate, refers matters to the House Committee on Ethics
Exercise 1 –Government Scandal
Research an ethics investigation or government/political scandal
´Can be domestic or international
´Share the facts with the class by posting on Discussion Board:
´Who was being investigated? And by whom?
´How did unethical allegations come to light?
´Outcome of investigation or scandal
´Why is this type of conduct a problem?
Format this assignment in full narrative form and include the questions above in your heading
State Ethics Committees
Hear complaints of ethics violations by legislators
Investigate complaints and impose penalties for ethics-related violations
Ethicists in Public Service
An independent, unbiased, professionally trained decision maker seen as an “outsider” may be more acceptable to councils, mayors, citizens, employees, or the press than one derived from inside the political process.
Political Malpractice
Negligent conduct by an elected or appointed political official
Duty
Breach
Injury
Causation
Exercise 2: Flint Water Crisis
Download from Blackboard and read Michigan Governor Rick Snyder’s remarks on the Flint Water Crisis.
Do you think there was political malpractice? Why? Walk us through the 4 elements – your post should be a minimum of four paragraphs
Reply to one other Discussion Board post with your comments and feedback- your reply post should be a minimum of two paragraph
