Health care reform has been a dominant theme in public discourse for decades now. The passage of the Affordable Care Act was a major milestone, but rather than quell the rhetoric, it has sparked even more heated debate. In the latest edition of Introduction to US Health Policy, Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today. Barr's comprehensive analysis explores the various organizations and institutions that make the US health care system work-or fail to work. He describes in detail the paradox of US health care-simultaneously the best in the world and one of the worst among developed countries-while introducing readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. Barr also discusses specific elements of US health care with depth and nuance, including insurance, especially Medicare and Medicaid. He scrutinizes the shift to for-profit managed care while analyzing the pharmaceutical industry, issues surrounding long-term care, the plight of the uninsured, the prevalence of medical errors, and the troublesome issue of nursing shortages. The thoroughly updated edition of this widely adopted text focuses on the Affordable Care Act. It explains the steps taken to carry out the Act, the changes to the Act based on recent Supreme Court decisions, the success of the Act in achieving the combined goals of improved access to care and constraining the costs of care, and the continuing political controversy regarding its future. Drawing on an extensive range of resources, including government reports, scholarly publications, and analyses from a range of private organizations, Introduction to US Health Policy provides scholars, policymakers, and health care providers with a comprehensive platform of ideas that is key to understanding and influencing the changes in the US health care system.

What our health data tell American capitalism about our value-and how that controls our lives. Afterlives of Data follows the curious and multiple lives that our data live once they escape our control. Mary F. E. Ebeling's ethnographic investigation shows how information about our health and the debt that we carry becomes biopolitical assets owned by healthcare providers, insurers, commercial data brokers, credit reporting companies, and platforms. By delving into the oceans of data built from everyday medical and debt traumas, Ebeling reveals how data about our lives come to affect our bodies and our life chances and to wholly define us. Investigations into secretive data collection and breaches of privacy by the likes of Cambridge Analytica have piqued concerns among many Americans about exactly what is being done with their data. From credit bureaus and consumer data brokers like Equifax and Experian to the secretive military contractor Palantir, this massive industry has little regulatory oversight for health data and works to actively obscure how it profits from our data. In this book, Ebeling traces the health data-medical information extracted from patients' bodies-that are digitized and repackaged into new data commodities that have afterlives in database lakes and oceans, algorithms, and statistical models used to score patients on their creditworthiness and riskiness. Critical and disturbing, Afterlives of Data examines how Americans' data about their health and their debt are used in the service of marketing and capitalist surveillance.

Some have described the Food and Drug Administration (FDA) as a scientific bureaucracy with police powers. Does a "cult of infallibility" exist within the FDA, leading to decisions that are contrary to the best interests of patients and their physicians? The Food and Drug Administration (FDA) is one of the most powerful of federal regulatory agencies, if not the most powerful. It regulates over 25% of all consumer goods sold in the United States. It makes decisions on a daily basis that affect the lives of millions of people. While the FDA was created to protect the public, how well is it fulfilling this mission and whose interests is it actually protecting? In this book, four outstanding scholars examine how the FDA accumulated its enormous power and what effects it has had on the public. It also explores who actually benefits and loses from FDA actions, and whether alternatives exist to safeguard the health of Americans. This book raises serious questions about the wisdom of giving policing power to scientists with little oversight or appeal process, as the FDA currently does. It also argues forcefully that the FDA unnecessarily delays beneficial medicines and medical devices, many of which are routinely available in Europe, from being available to Americans.

The staggering toll of gun violence - which claims 31,000 U.S. lives each year - is an urgent public health issue that demands an effective evidence-based policy response. The Johns Hopkins University convened more than 20 of the world's leading experts on gun violence and policy to summarize relevant research and recommend policies that are both constitutional and have broad public support. Collected for the first time in one volume, this reliable, empirical research and legal analysis will help lawmakers, opinion leaders, and concerned citizens identify policy changes to address mass shootings, along with the less-publicized gun violence that takes an average of 80 lives every day. Selected recommendations include: Background checks: establish a universal background check system for all persons purchasing a firearm from any seller; High-risk individuals: expand the set of conditions that disqualify an individual from legally purchasing a firearm; Mental health: focus federal restrictions on gun purchases by persons with serious mental illness on the dangerousness of the individual; Trafficking and dealer licensing: appoint a permanent director to ATF and provide the agency with the authority to develop a range of sanctions for gun dealers who violate gun sales or other laws; Personalized guns: provide financial incentives to states to mandate childproof or personalized guns; Assault weapons and high-capacity magazines: ban the future sale of assault weapons and the future sale and possession of large-capacity ammunition magazines. It also include Research funds: provide adequate federal funds to the Centers for Disease Control and Prevention, National Institutes of Health, and National Institute of Justice for research into the causes and solutions of gun violence. The book includes an analysis of the constitutionality of many recommended policies and data from a national public opinion poll that reflects support among the majority of Americans - including gun owners - for stronger gun policies.

Noncommunicable diseases (NCDs) - including cardiovascular disease, diabetes, asthma and other chronic respiratory conditions, and cancers - are the leading causes of death worldwide. An estimated 36 million people die from such diseases each year; this represents roughly two out of three deaths globally. Eighty percent of these fatalities occur in developing countries. The statistics are staggering, yet millions of these deaths are preventable. This is an urgent global health issue that demands analysis of gaps in NCD research, new policies and practices, and actionable recommendations to close the gaps. The Johns Hopkins Institute for Applied Economics, Global Health, and the Study of Business Enterprise convened an NCD Working Group of leading scholars to examine a wide range of issues that both the private and public sectors must address to make sustainable progress in NCD prevention and treatment in lower- and middle-income countries. Collected in this volume are essays on five key areas where strengthened policies and health systems can have the most impact in the near future. Features: accelerating regulatory harmonization; structuring supply chains; improving access to interventions; restructuring primary care; and promoting multisectoral and intersectoral action. While there is a growing literature on the problem of NCDs, none of the available studies provides background on the range of challenges matched with specific steps that can be taken by the public sector, private sector, and civil society working together. Noncommunicable Diseases in the Developing World presents a framework for understanding the salience of specific policy recommendations and detailed steps that can be taken now to move forward in the global campaign against NCDs. This book will be of interest to practitioners, scholars, and students in public health as well as those framing and implementing health policies in the private and public sectors.

The story of a small healthcare startup and its fight for survival against the very federal agencies responsible for its launch as part of the ACA. In the contentious run-up to the passage of the Affordable Care Act, Congress passed a law to make nonprofit health insurance CO-OPs (formally known as Consumer Operated and Oriented Plans) a viable alternative to the public option. The idea was to create new competition in order to lower health insurance premiums and encourage innovation. Nearly two dozen such low-cost CO-OPs were launched in the wake of the ACA's passage; only four are in operation today. In Death by Regulation, Dr. Peter L. Beilenson tells the story of a group of Maryland-based public health professionals who launched the Evergreen Health Cooperative, only to discover that the ACA law encouraging CO-OPs was a "plastic plant"-a piece of legislation created for optics but never intended to be functional. Over most of its four years of existence, Evergreen succeeded against all odds, prevailing over naysayers, big insurance companies, Congress, and its founders' naivete. But in an ironic twist, it was bureaucratic hostility from the Centers for Medicare and Medicaid Services-the very Obama administration agency responsible for the CO-OPs-that led to their collective demise. Beilenson traces the huge impact of seemingly small policy decisions on the work of his team and the people their CO-OP was built to serve. He recounts the excitement and satisfaction of launching such a valuable healthcare company, as well as the damage done to scores of employees and tens of thousands of satisfied healthcare customers when bureaucrats ran amok. The only book about these idealistic Obamacare CO-OPs and the obstacles they all faced, Death by Regulation offers an insider view of health policy and the reality of starting an insurance company from scratch.

While sex work has long been controversial, it has become even more contested over the past decade as laws, policies, and enforcement practices have become more repressive in many nations, partly as a result of the ascendancy of interest groups committed to the total abolition of the sex industry. At the same time, however, several other nations have recently decriminalized prostitution. Legalizing Prostitution maps out the current terrain. Using America as a backdrop, Weitzer draws on extensive field research in the Netherlands, Belgium, and Germany to illustrate alternatives to American-style criminalization of sex workers. These cases are then used to develop a roster of "best practices" that can serve as a model for other nations considering legalization. Legalizing Prostitution provides a theoretically grounded comparative analysis of political dynamics, policy outcomes, and red-light landscapes in nations where prostitution has been legalized and regulated by the government, presenting a rich and novel portrait of the multifaceted world of legal sex for sale.

En este libro la Dra. Georgina Chan Perdomo y su hija Melisa Perdomo Roy exploran lo que el mundo cientifico recomienda para prevenir las causas principales de muerte en el nacimiento de este milenio: Infartos Cardiacos, Infartos Cerebrales., SIDA/VIH, Cancer y Enfermedades Infecciosas. Hace 3,500 anos, se le dieron cinco libros de leyes, La Tora, a un grupo de esclavos perseguidos, para que aprendieran como sobrevivir. En estas primitivas escrituras, podemos encontrar consejos que si los seguimos, previenen o retrazan las cinco causas de muerte mas comun en el presente. Estos escogidos debian compartir esa informacion con el resto de la humanidad. Las similitudes entre las guias de Las Organizaciones Mundial de la Salud del siglo XXI y las antiguas leyes de La Tora son impresionantes. Ellas fueron dadas como Leyes, pero en realidad son una reflexion del amor del Creador por su creacion, la humanidad, para que pudieramos vivir largas vida llenos de felicidad y salud. Que mas tienen Las Escrituras Sagradas que nos pueden ayudar hoy en dia? Discutimos al final del libro el impacto que tuvieron Las Palabras de Dios no solo en nuestra vida fisica sino tambien espiritual.

The second and thoroughly revised edition of the 1999 reference provides substantially expanded citations in vital areas such as institutional liability, genetics, managed care, integrated delivery systems, professional regulation, and antitrust law. This comprehensive reference work is unique in its scope, accuracy, timeliness, and viability. It is endorsed by the American Health Lawyers Association and the American Hospital Association.

Health is indispensable for living a life of dignity. Currently, there is an almost universal commitment to the right to health (care). However, despite the growing legal recognition of this right, empirical evidence suggests that, as a whole, the implementation of the right to health (care) remains largely rhetorical at the domestic level. For example, although China ratified the International Covenant on Economic, Social and Cultural Rights in 2001, relatively little attention has been paid to the domestic implementation of the right to health (care). Violations of this right were also identified in reality. Given that China's health care reform is entering the so-called 'deep-water' zone, it is essential for the Chinese government to investigate how to guarantee everyone equal access to health care.Advancing the Right to Health Care in China analyses the role of accountability, a Western concept that has recently been introduced to China, in advancing the right to health care in light of China's unique political, legal and social background. In doing so, this book synthesises two different concepts: (1) the right to health; and (2) accountability, and integrates them into an analytical framework for 'right to health-based accountability'. It further provides a greater understanding of accountability and the various forms of accountability mechanisms that should be established by States. More specifically, it establishes a constructive accountability model that can be applied to specific health concerns in China, as well as in other countries, particularly those with non-electoral regimes.This book first systematically evaluates the status quo of the legislative and policy measures China has taken to give effect to the right to health care within its jurisdiction. It then identifies the shortcomings in Chinas domestic implementation of this right and seeks to address the remaining challenges through the lens of accountability. This book concludes with a set of recommendations for Chinese law- and policy-makers for implementing China's obligations under the right to health care through its draft Basic Health Law.

The International Survey of Family Law is the annual review of the International Society of Family Law. It brings together reliable and clearly structured insights into the latest and most notable developments in family law from all around the globe. Chapters are prepared by an international team of selected experts in the field, usually covering 20 or more jurisdictions in each edition. The International Society of Family Law (ISFL) is an independent, international, and non-political scholarly association dedicated to the study, research and discussion of family law and related disciplines. The Society's membership currently includes professors, lecturers, scholars, teachers, and researchers from more than 50 different countries, offering a unique opportunity for networking within a truly international family law community.

Dukes, Braithwaite and Moloney reach the depressing conclusion that 'corporate crime in the pharmaceutical industry appears to be on the rise.' Their approach to this problem is much more nuanced than just throwing people in jail. They advocate for a pyramid of regulatory strategies including qui tam legislation and equity fines. There is an opportunity for a radical transformation of the pharmaceutical industry and the authors offer us a road map to begin that journey.' - Joel Lexchin MD, York University, CanadaThe pharmaceutical industry must exist to serve the community, but over the years it has engaged repeatedly in corporate crime and anti-social behavior, with the public footing the bill. This readable study by experts in medicine, law, criminology and public health, with deep experience of the industry, documents problems ranging from false advertising and counterfeiting to corruption, fraud and overpricing. It is a fresh and revealing look at the unacceptable pressures brought to bear on doctors, politicians, patients and the media. Uniquely, the book presents realistic and worldwide solutions for the future, with positive policies encouraging honest dealing, as well as partial privatization of enforcement and a transformation of science policy to develop the medicines that society needs most. The authors examine in turn each of the main facets of the pharmaceutical industry's activities - research, manufacturing, information, distribution and pricing - as well as some questionable aspects of its relationship with society. Offering a considered analysis of pharmaceutical rights and wrongs as they have developed, particularly over the last half-century, this book is rich in new insights for managers in the pharmaceutical industry, regulatory agencies and health agencies. Contents: Essay Part I: Setting the Scene Introduction Part II: A View of Rights and Wrongs 1. Creating a Medicine: Why, How and How Not 2. Safe, Unsafe and Improper Manufacturing Practices 3. Aggressive or Misleading Promotion 4. The Dark Art of Manipulation: The Industry and its Puppets 5. Corruption, Counterfeiting and Fraud 6. Prices, Monopolies, Abuses and the Law Part III: Transforming the Way Ahead 7. A Criminological Perspective on a Worsening Crisis 8. Positive Regulation: The Complementary Role of Supports and Sanctions 9. A Responsive Criminal Law of Pharmaceuticals 10. Privatising Enforcement 11. A New Capitalism: A New Drug Diplomacy Index

This innovative book examines the role an automobile emissions tax could play in reducing emissions in the United States. The author concludes that an emissions tax has the potential to reduce emissions from households vehicles significantly, even when travel demand is relatively price inelastic. Beginning with a theoretical discussion of a first-best tax, a second-best tax on passenger vehicles is developed. This study contains detailed analyses of: * the design of the tax * behavioural responses that lead to emissions reductions, including reductions in the household's vehicle miles of travel and the scrapping of low-value, high emitting vehicles * the effect of the tax on the reduction of emissions * the effect of the tax on households in different income quintiles * the emissions reducing potential of a gasoline tax compared to an emissions tax This study uses a simulation model to analyse the sensitivity of travel demand and the resulting emissions, to different tax rates and demand elasticities. The author concludes that an emissions tax has the potential to reduce emissions from household vehicles significantly, even when travel demand is relatively price inelastic. Taxing Automobile Emissions for Pollution Control will prove invaluable to policymakers and academics in the field of environmental management and environmental economics and policy.

Regulating Obesity?: Government, Society, and Questions of Health explores the effectiveness of legal interventions aimed at promoting healthier lifestyles. In it, W.A. Bogart suggests that the government's emphasis on encouraging weight loss and preventing excess gain have largely failed to resolve obesity and have instead fueled prejudice against fat people. He suggests that a major challenge lies in shifting norms away from stigmatization of the obese and towards more nutritious and healthy lifestyle habits in addition to the acceptance of bodies in all shapes and sizes. Part of this challenge lies in the complex effects of law and its relationship with norms, including the unintended consequences of regulation. Regulating Obesity? begins by arguing for the protection of the overweight and obese from discrimination through human rights laws. It then examines three other areas of interventions-marketing, fiscal policy, and physical activity-and how these interventions operate within the context of "health equity." Professor Bogart evaluates the effectiveness of legal regulation in addressing obesity and concludes that a healthier population is more important than a thinner population. Regulating Obesity? is the first book to engage in the comprehensive evaluation of this role for law and the implications of society's fascination with regulating consumption.

Why do law reforms spread around the world in waves? In the dominant account of diffusion through technocracy, international networks of elites develop orthodox policy solutions and transplant these across countries without regard for the wishes of ordinary citizens. But this account overlooks a critical factor: in democracies, reforms must win the support of politicians, voters, and interest groups. This book claims that laws spread across countries in very public and politicized ways, and develops a theory of diffusion through democracy. I argue that politicians choose to follow certain international models to win domestic elections, and to persuade skeptical voters that their ideas are not radical, ill-thought-out experiments, but mainstream, tried-and-true solutions. This book shows how international models generated domestic support for health, family, and employment law reforms across rich democracies. Information that international organizations have endorsed certain reforms or that foreign countries have adopted them is valuable to voters. Public opinion experiments show that even Americans respond positively to this information. Case studies of election campaigns and legislative debates demonstrate that politicians with diverse ideologies reference international models strategically, and focus on the few international organizations and countries familiar to voters. Data on policy adoption from many rich democracies document that governments follow international organization templates and imitate the policy choices of countries heavily covered in national media and familiar to voters. Benchmarks from Abroad provides a direct defense to a major criticism international organizations and networks face: that they conflict with domestic democracy. Even presumptively weak international efforts, such as the development of soft law and best practices, can increase voter support for major reforms. Instead, international and European Union negotiations to establish binding legal obligations can be costly and protracted, resulting in "too little, too late. " However, the book also explains how electoral calculations do not favor the spread of successful policies that happen to originate in small and remote states.

What do we mean when we talk about rights in relation to health? Where does the language of health rights come from, and what are the implications of using such a discourse? During the last 20 years there have been an increasing number of initiatives and efforts - for instance in relation to HIV/AIDS - which draw on the language, institutions and procedures of human rights in the field of global health. This book explores the historical, cultural and social context of public health activists' increasing use of rights discourse and examines the problems it can entail in practice. Structured around three interlinked themes, this book begins by looking at what health as a right means for our understandings of citizenship and political subjectivities. It then goes on to look at how and why some health problems came to be framed as human rights issues. The final part of the book investigates what happens when health rights are put into practice - how these are implemented, realised, cited, ignored and resisted. Assembling Health Rights in Global Context provides an in-depth discussion of the historical, anthropological, social and political context of rights in health and develops much needed critical perspectives on the human rights approach to global health. It will be of interest to scholars of public health and human rights within health care as well as sociology and anthropology.

Public service authorities are required to solicit bids for architectural and engineering services. This work helps to structure the bidding process. It offers procedural recommendations, discusses options for awarding contracts when specific thresholds have not been met by bids, makes specific suggestions for coordinating bidding with the planning process, and presents typical problems that arise in architectural and engineering contracts.

Attention deficit-hyperactivity disorder (ADHD) has been a common psychiatric diagnosis in both children and adults since the 1980s and 1990s in the United States. But the diagnosis was much less common-even unknown-in other parts of the world. By the end of the twentieth century, this was no longer the case, and ADHD diagnosis and treatment became an increasingly widespread global phenomenon. As the diagnosis was adopted around the world, the definition and treatment of ADHD often changed in the context of different psychiatric professions, medical systems, and cultures. Global Perspectives on ADHD is the first book to examine how this expanding public health concern is diagnosed and treated in 16 different countries. In some countries, readers learn, over 10% of school-aged children and adolescents are diagnosed with ADHD; in others, that figure is less than 1%. Some countries focus on medicating children with ADHD; others emphasize parent intervention or child therapy. Showing how a medical diagnosis varies across contexts and time periods, this book explains how those distinctions shape medical interventions and guidelines, filling a much-needed gap by examining ADHD on an international scale. Contributors: Madeleine Akrich, Mari J. Armstrong-Hough, Meredith R. Bergey, Eugenia Bianchi, Christian Broer, Peter Conrad, Claire Edwards, Silvia A. Faraone, Angela M. Filipe, Alessandra Frigerio, Valeria Portugal Goncalves, Linda J. Graham, Hiroyuki Ito, Fabian Karsch, Victor Kraak, Claudia Malacrida, Lorenzo Montali, Yasuo Murayama, Sebastian Rojas Navarro, Orla O'Donovan, Francisco Ortega, Monica Pena Ochoa, Brenton J. Prosser, Vololona Rabeharisoa, Patricio Rojas, Tiffani Semach, Ilina Singh, Rachel Spronk, Junko Teruyama, Masatsugu Tsujii, Fan-Tzu Tseng, Manuel Vallee, Rafaela Zorzanelli

This book presents the health reform experiences over the past three decades of twelve small and medium-sized nations that are not often included in international comparative studies in this field. The major conclusion of the study is that despite many similarities in policy goals, policy challenges and in the menu of policy options for countries that seek to offer universal coverage to their population, the health reforms of the nations in this book did not converge into one direction or model. However, we found several widespread policy experiences that are relevant for others, too.For example, user fees are unpopular everywhere. Governments often try to soften the consequences by exempting large groups of users, thus largely defeating the very purpose of those fees.As a second example, the introduction of new payment modes for medical care - like the shift from fee for service to case-based payment - took much longer than originally expected everywhere, and also failed to deliver their promises of improved transparency or efficiency gains A third example is that proposals are for universal coverage often ignore the challenges of implementing new financing models that elsewhere took decades if not centuries to develop.The conclusions contain both empirical findings and theoretical conclusions of interest to policy-makers and scholars of international comparison. It is accessible for academics, healthcare managers and students as well as a wider audience of readers interested in the changes in healthcare across the world.

In the last half-century, radical changes have rippled through the workplace and the home from Boston to Bombay. In the face of rapid globalization, these changes affect us all, and we can no longer confine ourselves to addressing working and social conditions within our own borders without simultaneously addressing them on a global scale. Based on over a thousand in-depth interviews and survey data from more than 55,000 families spanning five continents, Forgotten Families is the first truly global account of how the changing conditions of work threaten children, women and men, and the infirm. It addresses problems faced by working families in industrialized and developing countries alike, touching on issues of child health and development, barriers to parents getting and keeping jobs, problems families confront daily and in times of crisis, and the roles of growing inequalities. Rich in individual stories and deeply human, Heymann's book proposes innovative and imaginative ideas for solving the problems of the truly belabored together as a global community.

In the 1960s and 1970s, Congress enacted a vast body of legislation to protect the environment and individual health and safety. Collectively, this legislation is known as "risk regulation" because it addresses the risk of harm that technology creates for individuals and the environment. In the last two decades, this legislation has come under increasing attack by critics who employ utilitarian philosophy and cost-benefit analysis. The defenders of this body of risk regulation, by contrast, have lacked a similar unifying theory. In this book, the authors propose that the American tradition of philosophical pragmatism fills this vacuum. They argue that pragmatism offers a better method for conceiving of and implementing risk regulation than the economic paradigm favored by its critics. While pragmatism offers a methodology in support of risk regulation as it was originally conceived, it also offers a perspective from which this legislation can be held up to critical appraisal. The authors employ pragmatism to support risk regulation, but pragmatism also leads them to agree with some of the criticisms against it, and even to level new criticisms of their own. In the end, the authors reject the picture-painted by risk regulation's critics-of widely excessive and irrational regulation, but the pragmatic perspective also leads them to propose a number of recommendations for useful reforms to risk regulation.

We invest more in health care than ever before, yet we are more anxious about doctors, hospitals, and the NHS in general. As perceptions of patients' rights have expanded, so has the transparency of the difficult choices that are routine. Government has become more critical of the NHS and the public less willing to wait for treatment. Why does demand for health care consistently exceed supply and how should Government manage the problem? There is a danger that improved rights for the strong and articulate will ignore less visible, or unpopular interests. How should the rights of elderly patients, or children, or those with terminal illnesses be balanced? Who should decide: the government, doctors, NHS managers, citizens, or the courts? How should decision-makers be held accountable, and by whom? How should governance regulate the NHS? As patients become 'consumers' of medical care, what choice do they have as to how, where, and when they will be treated; and should this include hospitals abroad? This completely revised new edition puts patients' rights into their political, economic and managerial contexts. It considers the implications of the Bristol Inquiry and the rhetoric of patients as 'consumers' of care. In balancing the rights of individuals with those of the community as a whole, it deals with one of the most pressing problems in contemporary society.