Envelope from U.S. Citizenship and Immigration Services with the American flag on top/U.S. immigration concept.

Health Justice for Immigrants, Revisited

By Medha D. Makhlouf

A major contribution of health justice is that it provides a framework for understanding how universal access to health care protects collective, as well as individual, interests. The pandemic has underscored the collective nature of the health and wellbeing of every person living in the United States, regardless of immigration status.

In a 2019 article, Health Justice for Immigrants, I adopted and adapted the health justice framework to the problem of disparities in immigrant access to subsidized health coverage. I argued that, in future health care reforms, health justice requires that immigrants be included in the “universe” of universal access to health care. In this blog post, I revisit this argument in light of the COVID-19 pandemic.

This blog post applies the health justice lens to inequities in immigrant health and access to health care, drawing out lessons for the pandemic and post-pandemic eras. It describes three examples illustrating the utility of health justice for catalyzing cross-sector initiatives to improve health, reducing the role of bias in the design of interventions to address health disparities, and ensuring that such efforts are serving the needs of historically subordinated communities.

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illustration of person tracking his health condition with smart bracelet, mobile application and cloud services.

Expanded Reimbursement Codes for Remote Therapeutic Monitoring: What This Means for Digital Health

By Adriana Krasniansky

New reimbursement codes for virtual patient monitoring may soon be incorporated into Medicare’s fee schedule, signaling the continued expansion and reach of digital health technologies catalyzed by the COVID-19 pandemic.

In July 2021, the Centers for Medicare & Medicaid Services (CMS) proposed adding a new class of current procedural terminology (CPT) codes under the category of “remote therapeutic monitoring” in its Medicare Physician Fee Schedule for 2022 — with a window for public comments until September 13, 2021. While this announcement may seem like a niche piece of health care news, it signals a next-phase evolution for virtual care in the U.S. health system, increasing access possibilities for patients nationwide.

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Scales of justice and gavel on table.

Symposium Introduction: Health Justice: Engaging Critical Perspectives in Health Law and Policy

By Ruqaiijah Yearby and Lindsay F. Wiley

Public health scholars, advocates, and officials have long recognized that factors outside an individual’s control act as barriers to individual and community health.

To strive for health equity, in which everyone “has the opportunity to attain . . . full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance,” many have adopted the social determinants of health (SDOH) model, which identifies social and economic factors that shape health. Yet, health equity has remained elusive in the United States, in part because the frameworks that most prominently guide health reform do not adequately address subordination as the root cause of health inequity, focus too much on individuals, and fail to center community voices and perspectives.

The health justice movement seeks to fill these gaps. Based in part on principles from the reproductive justice, environmental justice, food justice, and civil rights movements, the health justice movement rejects the notion that health inequity is an individual phenomenon best explained and addressed by focusing on health-related behaviors and access to health care. Instead it focuses on health inequity as a social phenomenon demanding wide-ranging structural interventions.

This digital symposium, part of the Health Justice: Engaging Critical Perspectives in Health Law & Policy Initiative launched in 2020, seeks to further define the contours of and debates within the health justice movement and explore how scholars, activists, communities, and public health officials can use health justice frameworks to achieve health equity.

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illustration of person tracking his health condition with smart bracelet, mobile application and cloud services.

Reforming How Medicare Pays for Digital Health

By Robert Horne and Lucia Savage

The Fourth Industrial Revolution, also known as the digital revolution, leverages technology to blur the lines between products and services. In the health insurance sector, this revolution offers policymakers unique opportunities to improve coverage and payment efficiencies while providing meaningful benefits to beneficiaries.

Medicare could lead this charge. Congress has an opportunity to reform Medicare in 2024, when the Trust Fund will become insolvent. Policymakers expect Congress to address this problem legislatively to prevent interruptions in coverage for seniors.

If past behavior is any indication, the legislation will also include reforms to improve how the program operates and spends money. Reforms to Medicare’s traditional coverage and reimbursement approaches that harness the digital revolution can help the program secure additional value. We know this because other sectors of the U.S. economy that have fully embraced this revolution have realized additional value.

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Medical staff work in the Intensive Care Unit (ICU) for COVID-19 patients in University Hospital of Liege in Belgium on May 5th, 2020.

The Legality of Pandemic Detection and Prevention Technology

*This article is adapted from a longer paper published in the University of Michigan Journal of Law Reform. To access the original paper, please click here.

By April Xiaoyi Xu  

A test-and-isolate system for detecting and monitoring new pathogens could avert future pandemics, but may face legal challenges in implementation.

The test-and-isolate model is described in a 2020 Scientific American article by biochemist David Ecker. Ecker recommends strategically placing modern, high-speed metagenomic sequencing technology in urban hospitals across the United States to flag previously-unknown pathogens before the infectious agents have the opportunity to spread widely and potentially start a new pandemic.

Under this model, during a time period without any apparent pandemics, the 200 biggest metropolitan hospitals in the U.S. would automatically run diagnostic tests up-front for novel causative agents among patients who visit the emergency room with severe respiratory symptoms that are possibly infectious. If such a system detects a sufficiently serious pathogen, public health agencies will send out diagnostic tests to all residents in the affected geographical area(s) within weeks and isolate those who test positive. This system also will be integrated with contact tracing and more standard outbreak response.

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Top view of white cubicles in modern office with white walls and carpeted floor. 3d rendering.

Challenges Faced by Employees with Disabilities amid the Return to In-Person Work

By Doron Dorfman

Over a year into the COVID-19 pandemic, many employers are calling workers who had been fulfilling their roles remotely back into the office.

In May 2021, for example, Jamie Dimon, the CEO of JPMorgan Chase told employees that by July, they were expected to come back into their offices for at least a few days a week, adding that remote work “just doesn’t work for those who want to hustle. It doesn’t work for spontaneous idea generation. It doesn’t work for culture.” In July 2021, Apple announced its plan to require employees to be in the office at least three days a week.

These calls for getting back to the office raise particular quandaries for employees with disabilities, many of whom have disproportionally borne the brunt of pandemic layoffs.

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St. Paul, Minnesota /US - June 4, 2020: Police throand protestors during the protests following the murder of George Floyd.

Research and Regulation of Less-Lethal Projectiles Critically Needed

By Rohini Haar and Brian Castner

In 2020, the use of less-lethal weapons in the United States, already overused, took a sharp upturn during the police response to the Black Lives Matter protests. In response, last month, the U.S. House of Representatives formed a commission of inquiry to investigate the health effects of one such weapon: tear gas. Such research is welcome and badly needed. However, tear gas is only part of a larger story. While well-intentioned, the House missed an opportunity to address a wider and more dangerous issue: the use of “less-lethal” projectiles against crowds.

In protecting basic human rights and civil liberties, it is critical to better understand and regulate projectiles — they are dangerous and poorly studied weapons.

Regardless of their specific characteristics, all less-lethal projectiles work by the same principle: they inflict blunt trauma, pain, and intimidation on individuals, while attempting to limit the chances of death or disability as compared to live ammunition. While the weapons certainly do cause shock and pain, avoiding death and disability has not been so straightforward.

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Gloved hand holding medical rapid test labeled COVID-19 over sheet of paper listing the test result as negative.

How Long COVID Is Forcing a Reckoning with the Neglect of Post-Infectious Chronic Illnesses

By Colleen Campbell

While post-viral illnesses are not new, they have been considerably neglected by the public health, medical, and scientific communities. This invisibility has, in many ways, been constructed by institutional neglect and medical sexism.

The COVID-19 pandemic is now causing a reckoning with this institutional neglect. This is because COVID Long Haulers and patient advocates for the chronically ill are forcing an unprecedented recognition for these chronic complex diseases.

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Doctor working with modern computer interface.

To Set the Price Tag for Telehealth, First Understand Its Value

By Mary Witkowski, Susanna Gallani, and David N. Bernstein

As the economy reopens, a debate has emerged about whether to continue supporting telehealth and digital practices, or whether to return to pre-pandemic practices, practically relegating telehealth solutions and digital interactions to lower-value exceptions to traditional medical care.

The next set of regulatory and payment policies will likely set the trajectory for how digital health is integrated into the overall care model. We suggest that rather than making these policy decisions based on incremental thinking relative to historical pricing of in-person care, they ought to be based on an assessment of how they generate value for patients.

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President Joe Biden and Vice President Kamala Harris.

6 Actions the Federal Government Should Take in Response to the Delta Variant

By Jennifer S. Bard

Today, the U.S. Centers for Disease Control and Prevention took an important step in protecting the nation’s health by reinstating indoor masking for both vaccinated and unvaccinated alike, in particularly high-risk circumstances. That’s good. And so is the jump in institutions like the Veterans Health Administration requiring COVID-19 vaccination.

But we need to take more forceful action, and it needs to happen faster.

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