The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics
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Historical Article
Surviving wartime emancipation: African Americans and the cost of Civil War.
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Comparative effectiveness research (CER) is one of the Patient Protection and Affordable Care Act's significant initiatives that aims to improve treatment outcomes and lower health care costs. This article takes CER a step further and suggests a novel clinical application for it. ⋯ A treatment comparison for a given patient would be based on data from electronic health records of a cohort of clinically similar patients who received the treatments previously and whose outcomes were recorded. This framework has unique potential to simultaneously improve the quality of health care, reduce its cost, and alleviate public concerns about rationing and "one size fits all" medicine.
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The Patient Protection and Affordable Care Act (ACA) sets in motion a wide range of programs that substantially affected the health system in the United States and signify a moderate but important regulatory shift in the role of the federal government in public health. This article briefly addresses two interesting policy paradoxes about the ACA. First, while the legislation primarily addresses health care financing and insurance and establishes only a few initiatives directly targeting public health, the ACA nevertheless has the potential to produce extensive public health benefits across the United States population by improving access to health care and services and reducing cost. ⋯ Despite these dual paradoxes and the upside potential for public health improvements resulting from the ACA, the public health impact of the law remains uncertain and will be decided by numerous subsequent regulatory and implementation decisions. The ACA authorizes multiple federal agencies to engage in rulemaking, a process that will largely dictate the systemic and health impacts that will become its legacy. This reality opens up ample opportunity to bolster public health aspects and interpretations of the law, and to simultaneously augment the corresponding components of the right to health.
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The Affordable Care Act (ACA) transforms the U. S.'s public and private health care financing systems into vehicles for promoting public health by making evidence-based preventive services available nationwide through individual and group health plans, Medicare, and Medicaid. ⋯ S. population through individual and group health plans. As a result, prevention measures with proven effectiveness will now be provided on a national and uniform basis to a majority of Americans, with the potential to improve health outcomes and reduce costs.