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PubMed1998

Impact of the 1970 legal BAC 0.05 mg% limit legislation on drunk-driver-involved traffic fatalities, accidents, and DWI in Japan.

Official statistics of motor vehicle fatality data have indicated that alcohol involvement in fatal crashes has declined substantially in Japan since 1970. The national campaign against drunken driving in Japan provides a natural experiment in which to test the predictions of deterrence theory. Utilizing official data over the 1960-1995 period, we report conclusive evidence that 1970s legislation is having a measurable and long-term effect on alcohol-related motor vehicle fatalities. Enactment of the lower legal blood alcohol limit with a combination of other severe sanctions has been more desirable in the prevention of alcohol-related fatalities in the long term as shown in this study. Further extensive research is necessary to investigate performance at the lower legal limit in other societies in order to inspire a strong "international lobby" to support the reduced legal blood alcohol limit for drivers all over the world, as there is no doubt that a reduction in alcohol-impaired driving will result in a substantial savings of human lives and resource worldwide.

Accidents, Traffic↗
PubMedDate not supplied

Data security in medical information systems: technical aspects of a proposed legislation.

This paper analyses the results of a recent survey performed among medical establishment personnel in Greece, evaluates information security legislation existing in other countries and incorporates guidelines of international societies to propose principles governing a future legal framework. Furthermore, it presents a design methodology for designing secure information systems and provides an example of the use of this methodology in designing a database oriented secure medical information system with access rights incorporated.

Computer Security↗
PubMed1998

Genetic testing for the BRCA1 gene and the need for protection from discrimination: an evolving legislative and social issue.

Genetic testing for the BRCA1 gene is available commercially and clinically. The information gained from this test impacts not only on the individual tested, but on family members as well. The test can offer an individual and their family the opportunity to gain valuable information about their risks of developing certain forms of inherited breast cancer and other inherited cancers. In addition to its emotional and psychological impact, this information is associated with significant social and economic issues. This includes the potential for denial, loss, or increased rates for health insurance as well as denial and loss of employment based on genetic test information. The risk for such discrimination can lead to fear of seeking testing and can discourage participation in and potential benefit from prevention, screening, and treatment programs. Therefore, misuse of this information carries significant risk for the individual being tested and for their family members. It is imperative that the potential benefits of genetic testing and genetic information be afforded to all without this risk and fear. In addition to protecting all individuals from genetic discrimination, there is a need to protect the confidentiality of genetic information and an individual's right to privacy. This article discusses protection currently available through legislation at the federal and state level, focusing on the experience in North Carolina in developing and passing a genetic antidiscrimination bill. Although progress has been made, troublesome issues still remain.

Journal Article↗
PubMed2002

Legislative perspectives on diabetes in America.

PURPOSE: To highlight the ongoing legislative activity in support of diabetes management. FINDINGS: Efforts of the Senate Diabetes Caucus have been instrumental in increasing the budget of the National Institutes of Health from $13.6 billion to $20.4 billion during the past 3 years, including more than doubling of the funding for diabetes research (from $319 million to $690 million). The demonstrated effectiveness of the Diabetes Prevention Program in delaying or preventing the development of type 2 diabetes by use of diet and exercise or metformin emphasizes the importance of diabetes educational programs for high-risk persons. CONCLUSION: Government funding of diabetes educational and research programs improves the quality of life for patients with diabetes and ultimately saves money.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Research, ethics and the data protection legislation.

As nursing research becomes more common, so does the issue of whether or not patients should be involved and, if so, to what extent. This article examines how the data protection legislation helps to protect patients, and whether they have the capability to decide to participate, or not.

Clinical Nursing Research↗
PubMed1991

Special report on taxation. Prepare for impending legislation that could threaten your tax-exempt status!

With impending federal action, and the likelihood of "copycat" legislation at the state and local levels if a federal statue is adopted, nonprofit hospitals need to ensure that they will be in compliance if a mandatory charity care bill were to become law. Such facilities should take the initiative now, by clearly articulating their charity care policies and by describing their other undercompensated or uncompensated activities that are maintained in order to benefit their communities. They should also ensure that all of their activities that could be counted as charity care or community benefit are fully documented and quantified. Financial consultants and counsel may be helpful in this process. Exempt facilities also should, of course, closely monitor the progress of the bills discussed above. Most importantly, they should continue to test their charity care and community benefit statistics on a regular basis to determine if their facilities meet the thresholds specified in the bills as they proceed through Congress.

Charities↗
PubMed1992

State legislators calling for more, less in pursuit of universal access to care.

In what may be partly the result of election-year politics, state legislators are following somewhat schizophrenic paths in pursuit of universal access to healthcare. While more states are expected to allow "bare bones" health coverage, thus lowering premiums and making insurance more affordable, lawmakers also continue adding to the mandated benefits many say boost costs and increase the uninsured.

Health Services Accessibility↗
PubMed1992

Two measures for hospitals included in panel's legislation.

Health care reform legislation that recently cleared the House Ways and Means health subcommittee includes two measures that have been sought by hospitals--the restoration of separate payments to physicians for interpretation of electrocardiograms and the reauthorization of the federal grant program aimed at developing networks of primary-and acute-care hospitals in rural areas, known as the "each/peach" program.

Bed Conversion↗
PubMed1993

Nursing home reform: its legislative history and economic impact upon nursing homes.

This article presents a legislative history of Subtitle C of the Omnibus Budget Reconciliation Act of 1987 (OBRA '87). It articulates the philosophy behind the act and describes the economic and organizational impact on the nursing home industry. Additionally, data from Connecticut nursing homes are analyzed to determine the factors that affect the costs of complying with OBRA.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1994

State legislative approaches to regulating coverage for experimental procedures.

As addressed in past issues of the Newsletter, the Employment Retirement Income Security Act ("ERISA"), 29 U.S.C. sections 1001 et seq., limits the ability of states to regulate the terms and conditions of group health plans. See Newsletters, Vol. 8, No. 6, June 1993, at 6 and 23; Vol. 8, No. 1, January 1993, at 7; Vol. 7, No. 2, February 1992, at 13; Vol. 6, No. 11, November 1991, at 3. Under ERISA, states cannot mandate that self-insured group health plans or employers provide specific types of coverage. Metropolitan Life Ins. Co. v. Massachusetts, 471 U.S. 724, 105 S.Ct. 2380 (1985). Such mandates are enforceable only as to insurance companies and HMOs, and only to the extent that they are deemed to "regulate insurance." Id. As a result, state legislative attempts to regulate experimental treatment insurance coverage have largely been limited to health plans that are not self insured. Given the inconsistent handling of experimental treatment insurance coverage by both insurance companies and courts across the nation, state legislatures have demonstrated that they are ready to address this matter themselves. However, unless ERISA is amended to afford employees with self-insured plans the same protections as those with insured plans, such state efforts will not be able to resolve the problem for all citizens.

Bone Marrow Transplantation↗
PubMedDate not supplied

Recent developments in 'any willing provider' legislation.

Because of recent state-level legislation, many health care networks may not be allowed to choose between qualified member providers. Gerald A. Neiderman, J.D., Jay D. Christiansen, J.D., and Kelly Phillips, J.D., of the health care practice group of Fagre & Benson, update the background, trends and potential impacts of any willing providers laws.

Medical Staff Privileges↗
PubMedDate not supplied

Key state legislative provisions on purchasing alliances.

In order to function effectively in post-reform healthcare markets, behavioral healthcare professionals must understand and interact with health purchasing alliances. Healthcare reform initiatives based upon the principles of managed competition envision an important role for cooperative health purchasing organizations, or "health alliances," that collect premiums and contract with health plans for the provision of comprehensive health services delivered within the framework of a standardized benefit package. Health purchasing alliances have already been implemented in eight states, and this trend is expected to grow. The following article illustrates the structure and authority of the health alliances that are already in operation, and is presented here to give Behavioral Healthcare Tomorrow journal readers an up-to-date overview of reforming healthcare markets. This matrix arrays recent state laws which we identify as clearly including components of managed competition or purchasing alliances. Other states undoubtedly have elements of reform that include some aspects of these concepts. For example, under legislation, a Vermont health care authority was established and, among other things, charged with developing two comprehensive reform proposals, one of which will involve multipayors and the other a single-payor system. Options will likely embody many of the activities of alliances. Vermont is not included in this matrix because these provisions are still in the developmental stage.

Group Purchasing↗
PubMed1995

State legislative approaches to regulating the use of genetic information.

As genetic testing becomes more prevalent and the uses for genetic information multiply, we are likely to witness more demand for comprehensive state legislation on the order of the Oregon law regulating the procedures for obtaining and using genetic information. In addition, the United States Senate has expressed an interest in the subject. The Senate Labor and Human Resources Committee reportedly agreed on August 2, 1995 to include in a health insurance reform bill (S. 1028) language prohibiting health plans from using genetic information when determining eligibility, continuation, enrollment, or contribution requirements. 4 BNA's Health Law Rep. at 1218 (Aug. 10, 1995). Insurance companies continue to maintain that genetic test results are simply another factor that should rightfully be used during underwriting, much as age, medical history, and physical examinations are routinely used today. Right to privacy advocates argue that genetic testing provides employers and insurance companies with too much information and offers a great potential for discrimination. As more states wrestle with this issue, these competing interests are likely to be debated in public forums throughout the country.

Confidentiality↗
PubMed1996

Legislative responses to managed care pressures.

Changes brought about by the increasing presence of managed care have sparked responses in a number of states. While proponents of managed care contend that it fosters competition and allows the market to influence its nature and functioning, the legislators' responses call into question the notion that managed care will bring greater freedom to insurers and providers and, at the same time, will benefit health care consumers.

Decision Making, Organizational↗
PubMed1996

Medigap reform legislation of 1990: have the objectives been met?

The 1990 medigap reform legislation had multiple objectives: To simplify the insurance market in order to facilitate policy comparison, provide consumer choice, provide market stability, promote competition, and avoid adverse selection. Based on case study interviews with a cross-section of individuals and organizations, we report that most of these objectives have been achieved. Consumers of medigap plans are able to make more informed choices, largely because they can adequately compare policies based on standard benefits. Marketing abuses have apparently declined, as evidenced by a decrease in the number of consumer complaints. Finally, no major detrimental impact on the insurance industry was detected. Beneficiaries still face some confusion in this market, however, such as understanding the rating methodologies used to set premiums and how this may affect their choices. Confusion could increase with the growth of managed care options.

Aged↗
PubMed1996

A compilation of state activities in legislatively mandated reporting of health services data.

The health care crisis and efforts for reform have taken a variety of forms. Apparently a majority of states have decided that the federal government will develop solutions to this problem slowly, if at all, and have undertaken a variety of activities on their own to address the problem. One state response has been to mandate the collection of data related to health services in an effort to assist purchasers of health care to make more prudent buying decisions. This article contains the results of a survey conducted among the states that have legislatively mandated the collection of health-related data and presents a compilation and discussion of their activities.

Data Collection↗
PubMedDate not supplied

Managed care matures. What's behind the wave of anti-HMO legislation?

At first glance, it may appear as if managed care itself may be doomed. The avalanche of bills, measures, initiatives, Federal regulations, etc., seemed overwhelming in late 1996. Did this, in fact, portend a national shift away from managed care? What does the consumer protection and regulatory activity really mean? What directions for the future can be identified? This article seeks to answer those questions and highlights a case study of "reform gone awry" that may hold lessons for the national scene. The anti-HMO legislation activity does not represent a repudiation of managed care. Rather, it may be seen as a maturing of the entire process of redefining our medical delivery and financing system.

Health Care Reform↗