Month: March 2017

PANEL MONDAY (4/3)! Opiate Regulation Policies – Balancing Pain and Addiction

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NEW EVENT! Opiate Regulation Policies image

Opiate Regulation Policies: Balancing Pain and Addiction 

April 3, 2017 12:00 PM

Austin Hall, West Classroom (111)
Harvard Law School, 1515 Massachusetts Ave., Cambridge, MA

Description

The current opiate epidemic has spurred long-overdue scrutiny on the pharmaceutical production and distribution of opiate medication, but it also raises questions of public policy and law regarding the regulation of medical access to and use of opiate medications with high potential for addiction. Expert panelists will address the challenges that arise from efforts to balance restrictions on access to opiates to limit addiction while also preserving sufficient access for legitimate medical management of pain.

Panelists

  • Monica Bharel, MD, MPH, Commissioner, Massachusetts Department of Public Health
  • David Borsook, MD, PhD, Professor in Anesthesiology, Harvard Medical School; co-director, Center for Pain and the Brain at Boston Children’s Hospital, Massachusetts General Hospital, and McLean Hospital; and affiliated faculty, Center for Law, Brain & Behavior at Massachusetts General Hospital
  • Rita Nieves, Deputy Director, Boston Public Health Commission
  • Moderator: Amanda C. Pustilnik, JD, Professor of Law, University of Maryland Carey School of Law; affiliated faculty, Center for Law, Brain & Behavior at Massachusetts General Hospital; and 2014-2015 Senior Fellow in Law and Applied Neuroscience as part of the Project on Law and Applied Neuroscience, a collaboration between the Center for Law, Brain & Behavior at Massachusetts General Hospital and the Petrie-Flom Center

This event is free and open to the public. Lunch will be provided.

Learn More

Check out the new EdX course “The Opioid Crisis in America,” developed by faculty at Harvard Medical School, to learn more about opioid addiction, evidence-based treatment models, harm reduction approaches that law enforcement and public health officials are using to reduce opioid overdose deaths, and non-opioid alternatives for medical pain management. This online course is free and self-paced; the first session will be available online on March 27, 2017.

Part of the Project on Law and Applied Neuroscience, a collaboration between the Center for Law, Brain & Behavior at Massachusetts General Hospital and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.

New Drug Pricing Bill from Democrats Balances Innovation, Access

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By Rachel Sachs

Yesterday, a group of 20 Democrats in both the House and Senate introduced the Improving Access to Affordable Prescription Drugs Act, a 129-page bill designed to lower drug costs while increasing innovation and promoting transparency.  The bill aims to accomplish a number of different goals, and in this post I’ll go through the different functions it serves and consider some notable provisions.  For those who are interested, here’s a provision-by-provision summary.  This is going to be a very long post, so I apologize in advance.

On the whole, I think there’s a lot to like in this bill, particularly in its promotion of innovation and in the way in which it seeks to curtail bad actors within the industry.  However, I don’t agree with all of its provisions (as you’ll see) and I view some of its proposals as kludge-y solutions to kludge-y problems our complex system has created.  I’m not yet sure whether I see that as a bad thing, to be clear – it works to create meaningful change within a system that was cobbled together over decades, mostly accidentally.  But it isn’t the platonic ideal of a value-based pricing system, or anything similar.

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Andrea Matwyshyn on ‘The Week in Health Law’ Podcast

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By Nicolas Terry and Frank Pasquale

Subscribe to TWIHL here!

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This week’s conversation featured Northeastern University School of Law Professor, Andrea Matwyshyn. In addition to her appointment on the law faculty, she is a professor of computer science (by courtesy), and co-director of the law school’s Center for Law, Innovation, and Creativity (CLIC).

An expert on cybersecurity and healthcare, Andrea helped us understand the changing approaches of federal regulatory agencies. We discussed the range of cybersecurity threats, from the science fictional to the all-too-factual scourge of ransomware. We also covered the continued threats from the Internet of Health Things and how the market and policymakers must find ways to reward developers for producing safe and secure code. We ended with a brief discussion (unlikely to be our last) of Blockchain as a security model, given current enthusiasm for algorithmic data management and smart contracts in the health policy space.

The Week in Health Law Podcast from Frank Pasquale and Nicolas Terry is a commuting-length discussion about some of the more thorny issues in Health Law & Policy. Subscribe at iTunes, listen at Stitcher Radio, Tunein and Podbean, or search for The Week in Health Law in your favorite podcast app. Show notes and more are at TWIHL.com. If you have comments, an idea for a show or a topic to discuss you can find us on twitter @nicolasterry @FrankPasquale @WeekInHealthLaw

What Happens Next for the ACA?

The Petrie-Flom Center Staff 1 Comment

Cross-posted from the Take Care blog.

By Rachel Sachs and Nick Bagley

In his speech after withdrawing the Republican health care bill from consideration on Friday, Speaker of the House Paul Ryan said that “Obamacare is the law of the land” and will remain so “for the foreseeable future.”  But law professors who have followed the Affordable Care Act (ACA) for the past seven years ago know that its future is not yet secure.  President Trump has said that “the best thing we can do politically speaking is let Obamacare explode,” and there’s a lot he can do to make that explosion a reality.

It doesn’t have to come to that.  Contrary to GOP reports, the ACA is not collapsing.  The Medicaid expansion will continue chugging along and we’re even seeing other states—Kansas and North Carolina most recently—move toward their own expansions.  The individual markets in some states are fragile, but they are not in a death spiral.  As the Congressional Budget Office noted in its first score of the GOP bill just two weeks ago, the marketplaces would “probably be stable in most areas” under current law.

Without question, however, President Trump and HHS Secretary Price have the ability to radically destabilize the individual marketplace.  The only question is whether they attempt to do so through active sabotage, incompetence, or purposeful ambivalence.

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Housing Equity Week in Review

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Our weekly update of the latest news in housing law for health and equity, for the week of March 20-27, including one piece written by our own Abraham Gutman:

  • Philadelphia city council held a hearing to evaluate the impact of the evictions on the lives of Philadelphians. One solution of for the eviction crisis is extending the right to counsel to housing courts. We, at the Temple University Center for Public Health Law Research, believe that evidence-based legal solutions are always worth considering, via Huffington Post
  • At a time when large budget cuts are looming over affordable housing programs, an audit of the largest affordable housing funder in Washington D.C., found inefficiencies, via NextCity
  • Some warn that reducing corporate taxes would lead to reduce use of the Low Income Housing Tax Credits
  • The proposed budget cuts to HUD are still the main story in the housing world. In Chicago dozens of affordable housing advocates took to the street to demand protection of affordable housing programs.
  • According to FiveThirtyEight, suburbanization in America is increasing in a faster rate.

TODAY, 3/27 at 5 PM! Health Law Workshop with Kathryn Zeiler

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March 27, 2017, 5-7 PM
Hauser Hall, Room 104
Harvard Law School, 1575 Massachusetts Ave., Cambridge, MA

Presentation: “Communication-And-Resolution Programs: The Numbers Don’t Add Up”

This paper is not available for download. To request a copy in preparation for the workshop, please contact Jennifer Minnich at jminnich at law.harvard.edu.

Kathryn Zeiler is Professor of Law and Nancy Barton Scholar at the BU School of Law. Prior to joining the BU faculty, Zeiler was Professor of Law at the Georgetown University Law Center (2003–2015). She has held visiting professorships at Harvard Law School, NYU School of Law, and Boston University School of Law. In Fall 2010 she was a Senior Fellow at the Petrie-Flom Center.

Zeiler’s scholarship applies economic theory and empirical methods to the study of legal issues and research questions. Her main scholarly interests include the importation of experimental economics results and behavioral economics theories into legal scholarship, the impact of state legislative tort damages caps on the price of medical malpractice insurance premiums, the impacts of communication and resolution programs implemented by hospitals to resolve medical malpractice claims, and the role of medical malpractice insurers in patient safety.

Zeiler serves as a fellow and member of the board for the Society of Empirical Legal Studies (2015–present). She currently holds positions on the editorial board of the American Law and Economics Review and Behavioral Science and Policy. She is a member of the Max Planck Institute’s Scientific Review Board for Research on Collective Goods. She has served as a member of the board of directors of the American Law and Economics Association (2010–2012). She is a regular peer-reviewer for a number of economics journals and law and economics journals.

Her recent publications include “Against Endowment Theory: Experimental Economics and Legal Scholarship” (UCLA Law Review), “Do Damages Caps Reduce Medical Malpractice Insurance Premiums?: A Systematic Review of Estimates and the Methods Used to Produce Them” (Research Handbook on the Economics of Torts), “The Willingness to Pay-Willingness to Accept Gap, the “Endowment Effect,” Subject Misconceptions, and Experimental Procedures for Eliciting Valuations: Reply” (American Economic Review), “Cautions on the Use of Economics Experiments in Law” (Journal of Institutional and Theoretical Economics), and “Medical Malpractice Liability Crisis or Patient Compensation Crisis? (DePaul Law Review, Rising Stars Symposium).

No Seat at the Table: The Legal Status of Players at the NFL Scouting Combine

The Petrie-Flom Center Staff Leave a comment

This post is part of our Blog Symposium “Applying the Americans with Disabilities Act and Genetic Information Nondiscrimination Act to the NFL Workplace.” Background on the symposium and links to other blog posts are here. 

By Michael McCann

In Evaluating NFL Player Health and Performance: Legal and Ethical Issues 165 U. Pa. L. Rev. 227 (2017), the authors (Jessica L. Roberts, I. Glenn Cohen, Christopher R. Deubert and Holly Fernandez Lynch) compellingly explain why the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act supply legal protections to football players at the NFL Scouting Combine (“Combine”). In this blog post, I stress the need for such protections in light of the unusual—and vulnerable—legal status of players at the Combine.

The Combine and its relationship to the NFL Draft

Held in late February and early March, the Combine is the annual scouting spectacle for NFL teams. Over seven days, NFL teams evaluate college football players who are eligible for the NFL Draft. The NFL Draft, of course, is the exclusive method of entry for players into the NFL: only players who are either drafted or who are exposed to NFL Draft and not selected are eligible to play in the NFL.

Held each April, the NFL Draft is ostensibly designed to promote parity in the NFL. For teams that fail to make the playoffs, draft order is based on inverse order of teams’ records. This means that the very worst team obtains the first overall pick and thus the chance to draft the best available player. Read More

Playing the Long Game: Epigenetics and Public Health

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By Seán Finan

Good investing takes time, foresight and patience. You have to thoughtfully spend now for a big return in ten years. But when it comes to investments in public health, everybody wants to make a quick and easy buck. I’ve written before about the need for more emphasis on preventive care over “heroic medicine”: it costs less, it’s easier to administer and it leads to better outcomes. But fully realizing the potential of preventive care and public health initiatives takes more than vaccines and check-ups. The government could invest in an unlimited buffet of hospital examinations and laboratory tests for all, but if people can only afford food that leaves them obese and diabetic or if they live in neighborhoods where crack dens and meth labs outnumber the schools, the investment is not going to pay off. Addressing the social determinants of health has incredible potential to improve outcomes on a population level.

Efforts are already being made. The government aims for “Health in All Policies” by promoting holistic education programs for poor youths and funding better food in stores in neglected communities. Other initiatives focus on fighting food insecurity among families or homelessness among pre and post natal mothers. The topic was covered well in this article from the Kaiser Family Foundation. They break the social determinants of health into the broad categories of social, economic and environmental factors. Things like economic stability, neighborhood and physical environment, education, food and social context play a massively underappreciated role in health outcomes. The article contains a graphic on the impact of different factors on the risk of premature death. Apparently, healthcare has the smallest impact at 10%. Individual behaviors carry the biggest single impact at 40%. The social and environmental factors that the article focuses on contribute 20%. The last factor was genetics, at 30%. As I was reading, I remembered seeing this article on epigenetics and it struck me that the separation of genetics from behavior and environmental factors might be a little artificial.

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Reforming the approach to clinical negligence in the National Health Service (NHS)

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By John Tingle

The Department of Health in England  have just published a consultation paper on the Governments proposal to introduce a Rapid Resolution and Redress Scheme (RRR) – a voluntary administrative compensation scheme for families affected by severe avoidable birth injury. Action against Medical Accidents (AvMA) the UK charity for patient safety and justice cautiously welcomes the stated intentions of the scheme but state that more thought needs to be given to the proposals. There needs to be more detail of the scheme and  some serious concerns are expressed.

The case for change

There are central three policy objectives behind the (RRR) scheme:

  • Reducing the number of severe avoidable birth injuries by encouraging a learning culture.
  • Improving the experience of families and clinicians when harm has occurred; and
  • Making more effective use of NHS resources.

In the consultation paper, a leading policy justification for the (RRR) scheme is the success of a Swedish initiative called, ‘The Safe Delivery Care Project’ which shows evidence of a reduction of claims for severe neurological birth injury. Read More

JOB OPPORTUNITY: The Petrie-Flom Center is searching for a new Executive Director!

The Petrie-Flom Center Staff Leave a comment

PFC Logo-New-Horizontal_slideExecutive Director

The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics

Harvard Law School, Cambridge, MA

Learn more and apply now online!

Duties & Responsibilities

The Executive Director works in partnership with the Faculty Director on strategic planning and vision for the Center, and oversees the Center’s staff, activities, and collaborations, including sponsored research, fundraising, events and conferences, publications, programs for students, administration, finance, communications, and other programmatic activities.  S/he also engages in independent scholarly activities, including research and writing, lecturing, and occasional teaching, as appropriate.

Essential Functions

The Executive Director works with the Faculty Director and independently to build the Center and advance its public profile and impact among policymakers, academics, practitioners, and students.  Primary responsibilities include:

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