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Improvements in technology and medical care have increased life expectancy by a considerable amount. Alongside these improvements, health care costs have risen dramatically. Because the health of the people in a nation reflects the health of the nation itself, health care law is vital for the stability of the Unites States.
Preserving public health is a primary duty of the state. Health regulations and laws are therefore almost all state based. Many states delegate authority to subordinate govermental agencies such as boards of health. These boards are created by legislative acts.
Federal health law focuses on the activity of the Department of Health and Human Services. It administers a wide variety of agencies and programs, like providing financial assistance to needy individuals; conducting medical and scientific research; providing health care and advocacy services; and enforcing laws and regulations related to human services. An important part of the HHS are the Centers for Medicare and Medicaid Services which oversee the Medicare and Medicaid Programs. Their goal is to ensure that elderly and needy individuals receive proper medical care.
Private health insurance originated with the Blue Cross (http://www.bcbs.com) system in 1929. The underlying principle was to spread the risk of high hospitalization bills between all individuals. Whether sick or healthy, all school teachers and hospital employees in the Dallas area had to join, ensuring that the risk was spread through a large numberof individuals. Blue Shield was later developed under the same principle.
Today, many people receive health care through health maintenance organizations (HMO's). Managed care essentially creates a triangle relationship between physician, patient, and payer. Physicians are paid a flat per-member per-month fee for basic health care services, regardless of whether the patient seeks those services. The risk that a patient is going to require significant treatment shifts from the insurance company to the physicians under this model. Because of the importance of the industry, HMO's are heavily regulated. On the federal level the Health Maintenance Organization Act of 1973
Public health law focuses on legal issues in public health practice and on the public health effects of legal practice. Public health law typically has three major areas of practice: police power, disease and injury prevention, and the law of populations.
Police power
This area of are employed by governmental agencies. Bioterrorism is a growing focus of this practice area, and public health lawyers have worked in the creation of the Model State Emergency Health Powers Act and the Model State Public Health Act.
Disease and injury prevention
This broader area of public health law applies legal tools to public health problems associated with non-communicable diseases and injury. Practitioners apply legislation, regulation, litigation (private enforcement), and international law to public health problems using the law as an insturment of public health. Litigation against tobacco companies in the United States provides an excellent example.
Law of populations
Population-based legal analysis is the theoretical foundation of public health law. The law of populations is a relatively new theoretical framework in jurisprudence that seeks to analyze legal problems using the tools of epidemiology. Population-based legal analysis can be applied to traditional public health problems but also has application in environmental law, zoning, evidence, and complex tort. |
