The only part of the Patient Protection and Affordable Care Act (hereafter, ‘the ACA’) struck down in National Federation of Independent Business (NFIB) et al. v. Sebelius, Secretary of Health and Human Services, et al. was a provision expanding Medicaid. We will argue that this was a mistake; the provision should not have been struck down. We’ll do this by identifying a test that C.J. Roberts used to justify his view that this provision was unconstitutional. We’ll defend that test against (...) some objections raised by J. Ginsburg. We’ll then go on to argue that, properly applied, that test establishes the constitutionality of the Medicaid provision. (shrink)

The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither (...) uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the health care system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry. (shrink)

To have a well-functioning principle of academic freedom, we need to distin-guish critique from an infringement of academic freedom. To achieve this goal, this paper presents three necessary conditions for something to be an infringe-ment of academic freedom. These conditions allow to delineate cases in which at least one of the three conditions is not fulfilled. These are contrast cases that might – at first glance – look like infringements of academic freedom but are, in fact, not so. I will (...) refer to five such kinds of contrast cases: (1) discrimination and thus a more general kind of unjust treatment of a person engaged in aca-demic affairs, (2) infringement of freedom of speech or other non-academic intel-lectual freedoms, (3) mere critique, (4) justified critique that leads to justified limitations of someone’s academic freedom, and (5) cases of deep disagreement. Special attention will be given to vulnerabilities concerning unjustified silencing of critique, which haunt fields that lack clear and agreed-on ethical or academic standards. (shrink)

Under the UDHR, all persons have the right to "seek and to enjoy . . . asylum from persecution." From this designation as fundamental followed codification of the right in the 1951 Convention relating to the Status of Refugees and the 1967 Protocol Relating (collectively 'the Convention'), the "centrepiece" of treaties and customary norms that make up international refugee law. It defines and regulates the status and rights of refugees; its purpose is to safeguard the basic rights of persons "outside (...) their country of origin," who have fled due to a legitimate fear of persecution. Fundamentally, it guarantees that asylees and refugees enjoy rights without discrimination; without penalization for illegal territorial entry; and, without expulsion or return to "territories where . . . life or freedom would be threatened on account of . . . race, religion, nationality, membership of a particular social group or political opinion," —or 'non-refoulement'. What follows is background on development of the principle of non-refoulement, evasive US Asylum Cooperative Agreements ('ACAs') and implementing legislation, and the resulting erosion to the right to asylum. (shrink)

William Smith’s recent article criticises the so-called orthodox approaches to the normative analysis of healthcare resource allocation, associated to the requirement that decision-makers should abide by strictly procedural principles of legitimacy defining a deliberative democratic process. Much of the appeal of Smith’s argument goes down to his awareness of real-world processes and, in particular, to the large gap he identifies between well-led democratic deliberation and the messiness of the process through which the intuitively legitimate Affordable Care Act (ACA) was created. (...) This reply aims to demonstrate that the ACA provides no counterexample to orthodox views, seizing this opportunity to explore the specific space that the procedural principles populating orthodox accounts are meant to regulate. Neither general questions of healthcare justice concerning, for example, universal access nor, relatedly, the activity of elected politicians falls within the natural scope of application of such principles, revealing a much more complex picture of the interactions between justice and legitimacy as well as substantive and procedural considerations than acknowledged by Smith. In the end, orthodox accounts of healthcare resource allocation turn out to provide a precious fund of theoretical resources for the normative study of administrators, which might be useful well beyond bioethics and health policy. (shrink)

L'esistenza del commento di Alessandro di Afrodisia al De generatione aristotelico, perduto nella versione greca e nella traduzione araba, è attestata da numerose fonti arabe, tra le quali Averroè, nel suo commento alla stessa opera. L'A. rintraccia la presenza, la tipologia e la distribuzione delle citazioni tratte dal commento di Alessandro nel Kitab al-Tasrif, un'opera del corpus alchemico attribuita a Gabir ibn Hayyan. Secondo l'A., la sezione interessata dalle citazioni assembla tre diversi tipi di testi: 1) lemmi del De generatione (...) in traduzione araba; 2) frammenti lacunosi della traduzione araba del commento di Alessandro; 3) interventi di collegamento. Una più ampia discussione si trova in un saggio visibile sulla pagina "publicationslist" dell'autore: "Alessandro di Afrodisia sulle 'contrarietà tangibili' (De gen. et corr. II.2): fonti greche e arabe a confronto" in: Aristotele e Alessandro di Afrodisia nella tradizione araba, a c. di C. D'Ancona e G. Serra, “Il Poligrafo”, Padova 2002, pp. 151-189. Notasi che il testo ricostruito di Alessandro in GC 2.2-5 è stato pubblicato da E. Gannagé nella serie ACA, che però non menziona il contributo di SF, dalla cui iniziativa, dalle cui analisi e dalla cui ricostruzione integrale, svolta sul manoscritto arabo Paris. 5099, la ricerca prese l'avvio. (shrink)

This dissertation aimed to examine the consequence of health-induced poverty and two policy responses to address this issue among older adults in the United States and China. Specifically, Paper I investigates whether public transfers crowded out private transfers among rural and urban Chinese older families and if this dynamic would change when health care expenses were high. Paper II examines the effect of New Rural Cooperative Medical Insurance, a national health insurance program for rural residents in China, on changing the (...) incidence of health-induced poverty among middle-aged and older beneficiaries. Paper III tests the effects of closing the Medicare Part D donut hole (coverage gap) through the Affordable Care Act (ACA) on changing prescription drug cost-induced poverty. Overall, the findings obtained from these three papers provide empirical evidence that health-induced poverty is prevalent among older adults in both China and the United States and the current public transfers and health policies are either ineffective or insufficient to reduce health-induced poverty as intended. (shrink)

El tema de la importancia de la filosofía puede ser abordado desde muy diversas plataformas teóricas. Nos interesa en este ensayo, sobre todo, tratar el tema de la relación entre vida y filosofía. La idea básica que deseamos desarrollar acá es que la filosofía forma parte inalienable de la vida humana misma. Partimos de la idea de que a la filosofía la necesitamos porque nos es vitalmente necesaria, es decir, porque es necesaria para la vida.

El trabajo aborda el tema de la democracia desde una perspectiva axiológica, tratándola como valor político. Aunque se singulariza el análisis para el caso de la sociedad cubana, el texto desarrolla ideas metodológicas aplicables al estudio de la democracia como valor en otras sociedades. A diferencia de otros estudios sobre el tema, el presente trabajo aplica al estudio de la democracia una concepción pluridimensional de los valores, buscando delimitar el contenido del valor democracia en las dimensiones instituida, subjetiva y objetiva. (...) Para el estudio de la democracia en esta última dimensión se apela a tres modelos que permiten metodológicamente analizarla y que acá se designan con los conceptos: ser real, deber ser ideal y deber ser actual. (shrink)