The Impact of the Bayh-Dole Act on Genetic Research and Development: Evaluating the Arguments and Empirical Evidence by Charles McManis, Sucheol Noh :: SSRN

July 28, 2011

This book chapter summarizes the theoretical arguments for and against patenting upstream genetic research and vesting presumptive patent ownership in the recipients of federally funded genetic research, with a view to determining who should bear the burden of proof on specific aspects of these two questions. The chapter also evaluates the weight of the empirical evidence concerning each question made available between 2004 and 2007, with a view to determining how that evidence seems to preponderate. While neither the theoretical arguments nor the empirical evidence are likely to put an end to the fractious debate over these issues, both the theoretical arguments and the empirical evidence to date clearly seem to preponderate in favor of the proponents of patenting upstream genetic research and vesting presumptive patent ownership in the recipients of federally funded genetic research. Indeed, very little empirical evidence has been produced to date to support the argument that granting patents on the results of “upstream” genetic research undermines the norms of the biological research community or retards biomedical innovation, technology transfer, or the development of downstream commercial products and processes. To the contrary, the preponderance of the empirical evidence produced to date seems to suggest that, by vesting presumptive patent ownership in the recipients of federally funded genetic research, the Bayh-Dole Act is indeed achieving not only its statutory purpose but also the larger, constitutionally mandated requirement that the U.S. patent system “promote the Progress of Science and the useful Arts.”

More at The Impact of the Bayh-Dole Act on Genetic Research and Development: Evaluating the Arguments and Empirical Evidence by Charles McManis, Sucheol Noh :: SSRN.


On the Determinants of Happiness by Aravind Eyunni :: SSRN

July 28, 2011

In the most rational sense, the pursuit of happiness is the end goal of all our actions. Utility, a word used extensively by economists, can be understood as a synonym for life satisfaction or happiness.

Industrial societies and contemporary economics have overemphasized the role income plays in increasing a person’s well-being. Although this theory is generally true, income is merely a means to an end rather than an end in itself, as socio-economic determinants such as health, good governance, social capital, as well as the impact of unemployment, inequality and other important factors are either taken for granted or not considered at all in current Economic methodology. Part of this problem stems from the use of revealed preferences which are both limited in the information that they contain as well as misleading. I use data from the European Social Survey and the World Value survey, two data sets that contain expressed preferences, to bring to light some of the other determinants of happiness. I find that although income is a substantial contributor to well being, qualities such as social capital, good health, and good governance are either more important than or as important as income in itself.

Accepting that the methodology is not completely sound by any means, this work attempts to provide further support to a growing number of Economists that are using valuable information contained in expressed preferences. I believe that such data can contribute a great deal to the policy arena and be a useful complement to already existing tools of research.

More at On the Determinants of Happiness by Aravind Eyunni :: SSRN.


The Effects of Health Shocks on Employment and Health Insurance: The Role of Employer-Provided Health Insurance by Cathy Bradley, David Neumark, Meryl Motika :: SSRN

July 28, 2011

We study how men’s dependence on their own employer for health insurance affects labor supply responses and loss of health insurance coverage when faced with a serious health shock. Men with employment-contingent health insurance (ECHI) are more likely to remain working following some kinds of adverse health shocks, and are more likely to lose insurance. With the passage of health care reform, the tendency of men with ECHI as opposed to other sources of insurance to remain employed following a health shock may be diminished, along with the likelihood of losing health insurance.

More at The Effects of Health Shocks on Employment and Health Insurance: The Role of Employer-Provided Health Insurance by Cathy Bradley, David Neumark, Meryl Motika :: SSRN.


Dropped Medical Malpractice Claims: Their Surprising Frequency, Apparent Causes, and Potential Remedies by Dwight Golann :: SSRN

July 28, 2011

Most medical malpractice claims are not won or lost in court, or settled. Instead, they disappear, abandoned by the plaintiffs who bring them.

A study of 3,605 malpractice claims closed in Massachusetts between 2006 and 2010 showed that in 45.4 percent of malpractice cases and 56.8 percent of claims against individual doctors, plaintiffs eventually dropped the case or claim without a decision or recovery. This did not occur, however, until defendants had incurred defense costs of more than $25,000 per claim and $44,000 per case; there was also significant stress and other non-monetary costs for both patients and doctors. Defense costs escalated rapidly between the second and fourth year a claim was pending; abandoned claims in the study were pending for an average of 2.7 years before being closed.

Most of the abandoned malpractice claims in the study were not frivolous. Sixty percent of abandoned claims had gone through the state’s medical malpractice tribunal, and of those 27 percent were rejected as inadequately supported.

The study included interviews of plaintiff lawyers, which show numerous reasons for plaintiffs’ decisions to abandon a claim. The most common is that malpractice cases are complex and their validity is therefore difficult to ascertain before discovery processes occur. Unfortunately the legal system is adversarial and inefficient, with both plaintiffs and defendants commonly withholding information and avoiding serious discussion about settlement, often for years.

The article argues that patients and doctors have a joint interest in finding a better process, and notes that there are models for how this could be done. One is the Toro Company, maker of power tools, which reformed its claims process and realized large savings as a result. The University of Michigan hospital system has taken a similar approach to allegations of medical malpractice. It investigates adverse outcomes, explains its findings to patients and their lawyers, commits to using what it has learned to improve patient care and, when appropriate, offers fair compensation.

Traditionally insurers have expressed concern that if the litigation process is streamlined plaintiffs will assert more weak claims. In fact after the University of Michigan changed its approach its malpractice cases declined by 36 percent, and the average cost of resolving a case dropped 44 percent, from $410,000 to $228,000. Some of this improvement was likely due to the fact that the Michigan program improved its quality of care as well as changing how it handled claims.

The article suggests that plaintiff malpractice specialists, who accounted for a large proportion of the abandoned claims in the study, work with insurers and hospitals to develop ways to exchange information and discuss settlement efficiently. Such reforms would substantially reduce the frequency and duration of dropped claims and substantially reduce the cost of medical malpractice litigation.

More at Dropped Medical Malpractice Claims: Their Surprising Frequency, Apparent Causes, and Potential Remedies by Dwight Golann :: SSRN.


Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage, July 27, 2011, McWilliams et al. 306 (4): 402 — JAMA

July 27, 2011

Implementation of Part D was associated with significant differential reductions in nondrug medical spending for Medicare beneficiaries with limited prior drug coverage.

More at Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage, July 27, 2011, McWilliams et al. 306 (4): 402 — JAMA.


The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes – The Commonwealth Fund

July 27, 2011

In this Commonwealth Fund–supported study, researchers found that an increase in nurse staffing hours was associated with lower deficiency scores—and thus improved quality of care—in Florida nursing homes. Such findings, when reported on public Web sites, can help families make informed decisions when shopping for long-term care.

More at The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes – The Commonwealth Fund.


Promising Payment Reform: Risk-Sharing with Accountable Care Organizations – The Commonwealth Fund

July 27, 2011

The Medicare Shared Savings Program, a component of the Patient Protection and Affordable Care Act, has accelerated the creation of accountable care organizations (ACOs), payer–provider alliances meant to deliver lower-cost but still high-quality health care via new payment models, particularly ones that reward efficiency. This paper describes and reports on the implementation of eight private ACOs that use, or are planning to deploy, a shared payer–provider risk payment model. Still in an early developmental phase, these payment models vary not only in their design and in how they define shared risk. The authors note that providers currently lack the infrastructure required to take on and manage risk successfully, though some payers are providing such support. Providers will need more data and analytic capabilities to manage the patient populations for which they take on financial risk and to negotiate appropriate risk-sharing arrangements with payers.

More at Promising Payment Reform: Risk-Sharing with Accountable Care Organizations – The Commonwealth Fund.