Health Law - Bill of Health

Following the Yellow Brick Road Toward Hospital Price Transparency

September 23, 2020September 22, 2020 Laura Karas Leave a comment

By Laura Karas

The Center for Medicare and Medicaid Services (CMS) scored a victory on the price transparency front in June of this year with the D.C. Circuit decision in American Hospital Association v. Azar, No. 1:19-cv-03619-CJN.

The CMS final rule at issue in the suit requires price transparency for hospital items and services. The legal victory will begin to remedy the information asymmetry that has kept patients in the dark about hospital prices for far too long.

As the final rule states, its aim is to empower patients to become “active consumers” of health care “so that they can lead the drive towards value.” The rule is part of a federal effort to improve the ability of patients to make informed choices based on price and gain leverage to negotiate unreasonable hospital charges.

The American Hospital Association, the Association of American Medical Colleges, and several other groups brought suit to contest the CMS final rule mandating that hospitals make public and update annually certain “standard charges” for hospital “items and services.”

Santiago, Chile - Crosswalk in long-exposure.

Chile’s New Constitution, the Right to Health, and Health System Reforms

September 18, 2020September 18, 2020 The Petrie-Flom Center Staff Leave a comment

By Marco Antonio Nuñez

During these months of the COVID-19 pandemic in Chile, the need to align the constitutional process with long-postponed structural reforms to the health system has become evident among public health experts.

Capitalizing on this moment might avoid the possibility of a constitutional right to health becoming a dead letter or being reduced only to the prosecution of particular cases, postponing again the aspirations of the majority of Chileans.

Although the Chilean Constitution promulgated under the dictatorship in 1980 and subsequently reformed in several of its chapters recognizes “The right to the protection of health,” it has been tainted by authoritarianism from its origin, and promotes a subsidiary role of the state in health.

gavel and stethoscope on white background

The Right to Health in the Upcoming Constitutional Debate in Chile

September 18, 2020September 17, 2020 The Petrie-Flom Center Staff Leave a comment

By Veronica Vargas

At this unprecedented COVID moment, health has been revealed as one of our most precious possessions and protecting it has become imperative. The right to health was articulated by the WHO in the Declaration of Alma-Ata of 1978. The upcoming constitutional debate in Chile is an opportunity to re-examine this concept.

The Chilean constitution specifies the right to “free and egalitarian access” to health care. Simultaneously, the constitution guarantees that “each person has the right to choose the health system they wish to join, either public or private.”

These provisions have championed a prospering private health sector, with corporate clinics and a private insurance system that represents almost half of total health spending.

However, this private sector serves less than 20 percent of the population. Nearly 80 percent of the population utilizes public sector insurance. Although the public sector has been expanding its coverage of health services, and health indicators for those with public insurance have been improving, the public sector is chronically underfunded. Public sector health care spending represents only 4% of the GDP.

Pragmatism and the Chilean Constitutional Moment

September 16, 2020September 15, 2020 The Petrie-Flom Center Staff Leave a comment

By Sebastián Soto

Chile is heading into a constitutional change.

After 40 years, the Chilean 1980 Constitution, enacted under Pinochet’s rule, but subsequently amended over fifty times, will probably be replaced. On October 25^th, a referendum will decide whether or not to call a constitutional convention to change the Constitution.

If the referendum passes, in April 2021 the convention will be called and will have nine months (extendable for three more, if needed) to write a new constitution. If the convention reaches an agreement on a new constitution by 2/3 of its members, a new referendum to approve it will be called during the first semester of 2022.

Social rights are expected to be one of the most contested topics discussed during the process.

Concerns Mount About Rule of Law in Argentina During COVID-19

September 15, 2020September 15, 2020 The Petrie-Flom Center Staff Leave a comment

By Roberto Gargarella

From the first time that I wrote about the COVID-19 situation in Argentina, June 8, until the date I am writing this, September 7, things have changed significantly.

First, the number of people who have died of COVID-19 in Argentina has risen to nearly 10,000; the 16^th highest death toll in the world. The total number of cases is 500,000; which places Argentina among the top 10 countries for infections worldwide.

These alarming statistics are particularly worrying in Argentina, given a number of additional facts mentioned in my original blog.

Who’s to Blame for COVID-19 Outbreaks at Colleges and Universities?

September 15, 2020September 15, 2020 Sravya Chary Leave a comment

By Sravya Chary

For many U.S. colleges and universities that opted for in-person instruction this fall, the return to campus during the COVID-19 pandemic has proven disastrous, and prompted the question: who’s to blame for these new outbreaks?

Although administrators are quick to blame student behavior, in this post, I will argue that the administrations are ultimately at fault – their negligence has put students’ health at risk and exacerbated the public health catastrophe.

Protest against Brazil's President Jair Bolsonaro.

Between Gross Negligence and Genocide: Brazil’s Failed Response to COVID-19

September 14, 2020September 14, 2020 The Petrie-Flom Center Staff Leave a comment

By Octávio Luiz Motta Ferraz

When my first piece in this series was published on May 12^th, Brazil counted 11,000 deaths caused by COVID-19. A new health secretary had just been appointed to replace Dr. Luiz Henrique Mandetta, who was sacked for disagreeing with President Jair Bolsonaro’s views that the pandemic (which he infamously called a “little flu”) was a conspiracy of the media and that public health measures should be immediately lifted to avoid damage to the economy.

Fast forward to September 10^th and the situation, predictably, has gotten significantly worse. Brazil now counts 128,539 deaths, the second highest number in absolute terms (after the U.S., where the death toll is 190,872), and the sixth in per capita terms, with just over 60 deaths per 100,000 population. When Brazil reached the 100,000 deaths mark in early August, the president thought it more appropriate to use his Twitter account to celebrate his football team’s win at the local tournament than to make any statement on the health crisis.

The Novel Coronavirus and Civil Rights: An Update from Chile

September 14, 2020September 11, 2020 The Petrie-Flom Center Staff Leave a comment

By Lidia Casas Becerra

As the COVID-19 pandemic continues apace in Chile, a test of the country’s commitment to democracy and the rule of law looms close – in just over a month, a historic referendum will be held on the possibility to change the Constitution.

The plebiscite was a key political demand during the social mobilization after October 19, 2019. But since March 18, 2020, Chile has been under the state of constitutional catastrophe or calamity due to the COVID-19 pandemic, which will continue at least through September 24, 2020.

Due to the pandemic, the date of the plebiscite was moved from April to October 25th after a political agreement between Congress and the executive. Chile does not have a system allowing for either electronic voting or voting by mail.

Senior citizen woman in wheelchair in a nursing home.

COVID-19 and Nursing Homes: The New York State Experience

September 9, 2020September 8, 2020 The Petrie-Flom Center Staff Leave a comment

By James W. Lytle

While New York State has generally earned high marks for its response to the COVID-19 pandemic, nagging questions continue over whether more might have been done to protect patients in nursing homes and other congregate settings — and whether some of the state’s policies even may have made matters worse.

Lessons from the New York State experience may prove helpful to those regions that have displaced New York as the epicenter of the American pandemic, and may help ensure that adequate steps are taken to protect the most frail and vulnerable among us from any resurgence of COVID-19 or from some future disease.

Although New York was among the hardest hit states, with the highest number of deaths thus far (over 32,000, more than twice as many as California), the aggressive steps taken by Governor Andrew Cuomo and his administration have been widely credited with reducing the spread of the disease in the State.

But a key, sustained criticism of the Governor’s handling of the pandemic focuses on the state’s nursing homes.

The Case for Face Shields: Improving the COVID-19 Public Health Policy Toolkit

September 2, 2020September 2, 2020 The Petrie-Flom Center Staff 1 Comment

By Timothy Wiemken, Ana Santos Rutschman, and Robert Gatter

As the United States battles the later stages of the first wave of COVID-19 and faces the prospect of future waves, it is time to consider the practical utility of face shields as an alternative or complement to face masks in the policy guidance. Without face shields specifically noted in national guidance, many areas may be reluctant to allow their use as an alternative to cloth face masks, even with sufficient modification.

In this post, we discuss the benefits of face shields as a substitute to face masks in the context of public health policy. We further discuss the implications and opportunity costs of creating policy guidance with only a small subset of scientific data, much of which is limited. We conclude by arguing that existing federal guidance should be expanded to include face shields as a policy option.

Tag: Health Law