More health policy training in DC

Yesterday we heard about polling, federal budgeting, the role of the judiciary in health policy and a capstone panel with an overview of policymaking from beginning to end using regulation and rule making for electronic health information breach notification in the federal stimulus bill as a case study. The panel on the role of the judiciary was fascinating. We heard the differences (courts don’t care about data or statistics, it is all driven by individual cases or anecdotes) and similarities (politics decides alot) with policymaking in other branches. The bioethics underlying the law came up repeatedly – medical marijuana and assisted suicide cases. But the one that fascinated me most was a hospital in rural Maine that sued recently claiming that the requirement that hospitals treat everyone who enters their doors (at least to stabilize them) regardless of ability to pay was an unreimbursed “taking.” Something like when government takes your home to build a highway, they have to pay you a fair price. The hospital claimed that the government was requiring them to provide uncompensated care and not reimbursing them. This hospital provided only a very small amount of uncompensated care – 0.5% of revenue -- the national average is ten times that. The Courts found against them, but the reasoning was that the hospital’s trustees didn’t have to run a hospital. They could have chosen to convert it to another purpose (a hotel maybe?) and then nothing would be “taken”. I can’t wait to see what we’ll learn today.
Ellen Andrews