The Milbank quarterly
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Although applications of cost-benefit analysis (CBA) to the problem of drug policy are few in number and relatively primitive, they illustrate both the potential and limitations of CBA to produce critical insights that might improve drug policy making. But even the ideal CBA of drug policy could never produce a definitive conclusion about the desirability of drug legalization. Another tool of economics, analysis of price elasticity of demand, holds the potential to generate understanding of the likely effects of policy changes in the monetary and psychological prices associated with policy reforms.
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The specter of pediatric AIDS fundamentally challenges elements of the liberal ideological basis of women's reproductive freedom. Many public health officials hold that preventing transmission of HIV from mother to fetus requires efforts to discourage pregnancy by infected women. For over two decades, however, genetic counselors, feminists, and medical ethicists have stressed the importance of nondirective counseling in the context of reproductive choice. The question now confronted by American society is whether it will be possible to frame an ideology of reproductive choice that recognizes the limits of liberal individualism, while preserving the basic features of reproductive freedom.
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The Milbank quarterly · Jan 1990
Clinical TrialNew rules for new drugs: the challenge of AIDS to the regulatory process.
AIDS is systematically changing attitudes and practices regarding the regulation and use of drugs. The complex framework and rigorous research protocols developed by the Food and Drug Administration prior to the 1980s to minimize risk to subjects is shifting in the epidemic's wake to maximize innovation. The FDA has adopted new procedures hastening access to investigational drugs and easing drug importation for personal use, which, in effect, transfers decisions about the benefits and risks of drugs from the agency's staff to patients and their physicians. While the FDA's tilt toward embracing consumer rights may continue in the near future, disappointing results could prompt the agency to reassert its authority in controlling drug policy more restrictively.
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The Milbank quarterly · Jan 1989
Nonemergency visits to hospital emergency rooms: a comparison of blacks and whites.
Both blacks and whites go to hospital emergency rooms for nonemergency health problems. Age, marital status, and health conditions are significant sociodemographic determinants for blacks' visits on these occasions, while those for whites include sex, age, education, insurance, employment status, region of residence, and health conditions. Despite the significant differences in determinants, similar influences bear on the two groups' decision to utilize medical services generally. Discrete analyses are still needed of cultural and interracial variation affecting the use of health facilities, together with intensive assessment of community characteristics in which the facilities are located, especially among black populations.