Journal of health politics, policy and law
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J Health Polit Policy Law · Oct 2010
Do provincial drug benefit initiatives create an effective policy lab? The evidence from Canada.
Although the costs of doctors' visits and hospital stays in Canada are covered by national public health insurance, the cost of outpatient prescription drugs is not. To solve problems of access, Canadian provinces have introduced provincial prescription drug benefit programs. This study analyzes the prescription drug policymaking process in five Canadian provinces between 1992 and 2004 with a view to (1) determining the federal government's role in the area of prescription drugs; (2) describing the policymaking process; (3) identifying factors in each province's choice of a policy; (4) identifying patterns in those factors across the five provinces; and (5) assessing the federal government's influence on the policies chosen. ⋯ The findings also highlight the importance of institutional factors, for example, in provinces' decision to compete rather than to collaborate. We conclude that, to date, Canada's federalism laboratory has only partly benefited the Canadian public. Cost pressures may, however, eventually overcome barriers to cooperation between the provincial and the federal governments, enabling them to capitalize on Canada's federal structure to improve the accessibility and affordability of drugs.
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J Health Polit Policy Law · Apr 2010
Federal trade commission regulation of food advertising to children: possibilities for a reinvigorated role.
Growing awareness of the role that food and beverage advertising plays in the epidemic of childhood obesity has prompted calls for stricter oversight of advertising practices. The food and beverage industries have taken voluntary steps in this direction, but many commentators have called for increased government regulation. The mission of the Federal Trade Commission (FTC) makes it an obvious candidate to lead a new regulatory effort. ⋯ The FTC has considerable latitude to regulate individual food advertisements more rigorously, either on the basis that they are deceptive or on the basis that they are unfair. Broader rule making under the unfairness authority would require congressional intervention to expand the FTC's scope of authority, but there exist possibilities for rule making under the deception doctrine. Finally, the FTC could strengthen its efforts to encourage the food industry to regulate its own advertising practices more stringently and could provide mechanisms for making voluntary initiatives more meaningful.
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J Health Polit Policy Law · Feb 2010
Medical licensing board characteristics and physician discipline: an empirical analysis.
This article investigates the relationship between the characteristics of medical licensing boards and the frequency with which boards discipline physicians. Specifically, we take advantage of variation in the structure of medical licensing boards between 1993 and 2003 to determine the effect of organizational and budgetary independence, public oversight, and resource constraints on rates of physician discipline. ⋯ Public oversight and political control over board budgets do not appear to influence the extent to which medical licensing boards discipline doctors. These findings are broadly consistent with theories of regulatory behavior that emphasize the importance of bureaucratic autonomy for effective regulatory enforcement.
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J Health Polit Policy Law · Dec 2009
Policy making on data exclusivity in the European Union: from industrial interests to legal realities.
After lengthening the duration of patents to twenty years in 1984, the pharmaceutical industry has turned to data exclusivity as a major vehicle for extending market protection, even after patents expire. Such protections give companies the power to tax consumers for innovation by charging above-market prices. ⋯ Several factors influenced the outcome, including the role of the pharmaceutical unit of the Directorate General for Enterprise of the European Commission in promoting the interests of the innovative branch of the industry, the time pressure to find a viable compromise before EU enlargement, and the heterogeneous preferences of the other actors. The case illustrates the inherent tension between the desire of both health care administrators and patients for high-quality, low-cost medicines and the objective of the innovator pharmaceutical industry to find and approve new drugs that are price protected and sell them in a way that maximizes revenues.
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J Health Polit Policy Law · Jun 2009
The landscape in 2009: a conversation with Bruce C. Vladeck, by Birnbaum Michael.
Michael Birnbaum interviews Bruce C. Vladeck about the landscape for national health reform in 2009. Vladeck, who worked under President Clinton directing Medicare and Medicaid as administrator of the Health Care Financing Administration, discusses some of the challenges and opportunities facing the Obama administration. ⋯ He explores the future of employer-based coverage; problems and solutions for America's aging workforce; poor customer service in Medicare; the "Medicaid Stigma"; the promise of immigration; and the trade-offs between access, quality, and cost in the American system. Finally, Vladeck offers a silver lining to the current economic catastrophe. As he sees it, common sense and results may be taking the place of ideology in policy making and policy analysis: "The intellectual hegemony of neoclassical economics has been blown out of the water."