Certification mark law — a branch of trademark law — itself enables consequences that undermine the law’s own goals through inadequate regulation or oversight. Because the law allows certification standards to be kept vague, high-level, and underdeveloped, a certifier can choose to exclude certain businesses inconsistently or arbitrarily, even when those businesses’ goods or services would seem to qualify for the certification mark (particularly to consumers). Moreover, even when a certification standard is clear and complete, certifiers can wield their marks anticompetitively. They can do so through redefinition — something certification mark law currently allows without oversight — to ensure that certain businesses’ goods or services will not qualify for the mark. Both of these forms of certification mark manipulation undermine the goals of certification marks: to protect consumers by providing them with succinct information on goods’ or services’ characteristics and to promote competition by ensuring that any businesses’ goods or services sharing certain characteristics salient to consumers qualify for a mark certifying those characteristics. The law should be restructured to curb this conduct. I advocate for robust procedural regulation of certification standardmaking and decisionmaking that would detect and punish poor certification behavior. Moreover, for anticompetitive behavior that nonetheless slips through the regulatory cracks, I suggest that attentive antitrust scrutiny be arrayed to catch it.
Starting January 1, 2017, the Ohio Healthcare Price Transparency Law requires that patients in Ohio must receive a good-faith estimate of the cost for anticipated healthcare services they are scheduled to receive. Emergencies are obviously excluded, including hospital admissions for acute issues. The estimate must provide the amount to be charged, the insurance share and the patient share.
Non-pecuniary sources of motivation are a strong feature of the health care sector and the impact of competitive incentives may be lower where pecuniary motivation is low. We test this hypothesis by measuring the marginal utility of income of physicians from a stated-choice experiment, and examining whether this measure influences the response of physicians to changes in competition on prices charged. We find that physicians exploit a lack of competition with higher prices only if they have a high marginal utility of income.
Health Complaints and Regulatory Reform: Implications for Vulnerable Populations? by Terry Carney, Fleur Aileen Beaupert, Mary Chiarella, Belinda Bennett, Merrilyn Walton, Patrick Kelly, Claudette Satchell :: SSRNFebruary 1, 2017
Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta regulation, responsive (risk–based) regulation, and “networked governance”. Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants’ motivations and experiences, the impact of complaints processes on health professionals and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This paper concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.
Source: Health Complaints and Regulatory Reform: Implications for Vulnerable Populations? by Terry Carney, Fleur Aileen Beaupert, Mary Chiarella, Belinda Bennett, Merrilyn Walton, Patrick Kelly, Claudette Satchell :: SSRN
Comparing International and United States Undergraduate Medical Education and Surgical Outcomes Using a Refined Balance Matching Methodology | LDIJanuary 23, 2017
In Annals of Surgery, Salman Zaheer and colleagues, including LDI Senior Fellow Rachel Kelz, compare surgical outcomes of international medical graduates (IMGs) and United States medical graduates (USMGs). Medical education outside of the US is substantially different from that in the US and usually begins right after high school and lasts for 5 to 7 years. This is the first study to examine differences in surgical outcomes of patients treated by IMGs and USMGs. The authors used a unique dataset linking AMA Physician Masterfile data with hospital discharge claims from Florida and New York (2008-2011). The authors compared mortality, complications and prolonged length of stay between IMGs and USMGs using optimal sparse network matching with balance, in which each patient who underwent an operation by an IMG was matched to a patient of a USMG who underwent the same operation in the same hospital. The authors identified 972,718 operations performed by 4,581 surgeons (72% USMG, 28% IMG). IMG and USMG surgeons differed significantly in demographic (age, gender) and baseline training charecteristics (years of training, university affiliation of training hospital). USMG surgeons were more likely to perform complex procedures and practice in urban settings while IMG surgeons performed a higher volume of studied operations. In the matched cohort analysis of 396,810 patients, the authors find rates of mortality, complications and prolonged length of stay between IMGs and USMGs were not significantly different. Despite differences in educational background, surgical training characteristics and practice patterns, IMG and USMG surgeons deliver equivalent surgical care to their patients.
Medical Malpractice Arbitration: Not Business As Usual by David Allen Larson, Dr. David Dahl, MD :: SSRNJanuary 21, 2017
There is an interesting exception to businesses’, employers’, and service providers’ seemingly universal embrace of arbitration processes, particularly mandatory pre-dispute arbitration. Although it may be difficult to believe given arbitration’s current popularity, not everyone requires his or her clients to sign mandatory pre-dispute arbitration agreements. In fact, some service providers prefer to avoid arbitration regardless of whether it is arranged pre- or post-dispute. So which merchants or service providers are choosing to forgo arbitration and, more importantly, why do they dislike arbitration? And do politics have anything to with their choices? Physicians are not, shall we say, the world’s greatest fans of arbitration. It turns out that regulatory policies and practices, in other words politics, provide one important reason why physicians prefer to avoid arbitration. And there are additional reasons that explain why this particular group of service providers has not followed the “mad rush” to arbitration. This article will explain why at least one group of service providers, physicians, do not regard arbitration as the answer to all of their prayers.