PLS 347-01

regulation of healthcare via Commerce clause, cont’d

  • things
  • channel
  • substantial effect
  • rational connection
  • Wickhard v. Filburn (wheat)
    • home garden
    • cumulative impact
  • Gonzales v. Raich (weed)
    • Controlled Substances Act

Healthcare: 16% GDP

  • Lopez
    • state v. federal
    • trade area / state sovereignty
    • economic activity direct or national regulatory scheme

healthcare cost drivers

  • aging population
    • end-of-life care
  • poor lifestyle
    • diet, exercise, STD’s, etc
  • doctors & AMA interests (profit motive)
  • urban v. rural
  • medical specialization
  • tech/R&D/advertising
  • competition
  • third party providers
  • tort law
    • reduce malpractice awards
    • defensive medicine

potential cost controls

  • limits on elder care (rationing)
    • long-term care
    • CLASS Act
  • certificate of need
  • tort reform
    • cap non-compensatory damages (punitive/P&S)
      • OH non-comp $250k, pun. $350k
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