- “Unthinkable”: Cuomo executive order protects New York medical professionals from liability for much care extended during the emergency [Robert Gavin, Albany Times-Union] Will liability capsize the nursing home business? [AP/WBFF, Maggie Flynn/Skilled Nursing News; Lydia Wheeler and Valerie Bauman, Bloomberg]
- To raise hospital capacity, flatten certificate-of-need laws [Matthew D. Mitchell, Thomas Stratmann, and James Bailey, Mercatus, earlier]
- Cato Daily Podcasts with Will Rinehart on regime uncertainty for developers of COVID-19 tests and Jeffrey Singer on telemedicine, hosted by Caleb Brown;
- As virus cut swath through nursing home population, states like Virginia and Maryland cited health privacy laws as reason not to release data breakdowns [Kate Masters, Virginia Mercury] “And, despite not knowing what threat the [info would be used] for, the group had pre-emptive ethical clearance to immediately gather samples from patients – something which would take weeks or months in other countries.” Seems to have served Australians well [Tyler Cowen]
- From early in crisis: ways in which feds relaxed hospital rules [Valerie Bauman and Lydia Wheeler, Bloomberg Law]
- Some pre-crisis links: “Must an employer pay for medical marijuana? Apparently yes – at least in New Jersey.” [Alexander Castelli, LexBlog] “The ACA Expanded Insurance Coverage of Contraceptives. Prices Soared.” [Michael Cannon, Cato at Liberty] Vaccines, birth control, Accutane: as plaintiff’s lawyers kept winning, the public kept losing [Beck]
- As country eyes path to reopening, restart of non-COVID-19 medical care, including postponed surgeries, is desperately needed [Hans Bader, James Bacon (Virginia governor’s “statewide ban on elective surgery is a sledgehammer which may be appropriate for the hardest-hit parts of the state but is wildly inappropriate for others.”]
- Michigan’s Gov. Whitmer rolls back some of the more arbitrary and controversial restrictions in her stay-at-home order [Billy Binion, Reason]
- Tech firms among the first to respond when the virus appeared here: “So, the approximate order of events was: private sector response, then local government response in the west, then response in the east and by the Federal government.” [Arnold Kling]
- We previously linked our Cato online panel on the pandemic and the Constitution; now our friends at Competitive Enterprise Institute have written a very nice review and summary of it [Richard Morrison, CEI]
- Especially given its conduct during this outbreak, expenditures on the World Health Organization deserve top-to-bottom reevaluation [Lyman Stone, The Dispatch; Anish Koka]
- “COVID-19 Exposes the Shallowness of Our Privacy Theories” [Jane Bambauer, Truth on the Market]
- Telemedicine has become a crucial tool during the crisis. 2017 paper discusses the regulatory barriers that had constrained it [Shirley Svorny, Cato Policy Analysis; earlier here, here, and here]
- “Wondered why it’s been so hard to ramp up production of surgical masks and respirators? Why haven’t private companies flooded into the market to meet peak demand? Because they are regulated medical devices and new versions require FDA approval which can take months to obtain.” [Paul Matzko thread on Twitter]
- Asking former health care workers to “dust off their scrubs” and return for the emergency raises possible liability exposures [Lori Rosen Semlies, Wilson Elser] “Coronavirus could affect med mal rates: Experts” [Judy Greenwald, Business Insurance]
- A closer look at certificate of need laws, which suppress hospital bed supply [Eric Boehm, related audio clip with Jeffrey Singer, earlier and more]
- More on the relaxation of occupational licensure in medical jobs during the emergency [Michael Abramowicz, Jeffrey Singer, earlier]
- Return with us now to those days not so long ago when public health specialists seemed to be in the paper every day inveighing against alcohol, dietary choices, and such like [Elaine Ruth Fletcher, Health Policy Watch last year on World Health Organization (WHO) rumblings against alcohol; JAMA on furious fight over red-meat recommendations]
So as to deploy medical services more effectively during the COVID-19 emergency, the Department of Health and Human Services has announced that it will forgo enforcement of rules restricting telemedicine, both by waiving HIPAA prohibitions on the use of everyday communications technologies like Skype and FaceTime, and by removing a requirement that reimburseable services be provided by the holder of an in-state license. At the same time, as I noted last week, many states have been relaxing rules prohibiting practice by out-of-state medical professionals (partial list here).
That’s part of a pattern in which governments are slashing many old regulations that they realize get in the way of crisis response and complicate the lives of ordinary citizens trying to work and shop under difficult conditions. My Cato colleague Chris Edwards links some of them in this post, including compilations by the Competitive Enterprise Institute and Americans for Tax Reform. (More: R Street Institute; Katherine Timpf, National Review. Hospitals and medical professionals aside, suspended rules include hours of service rules for truckers driving emergency medical supplies, requirements that Florida insurance agents keep public offices, rules forbidding the combined transport of food and liquor in Texas trucks, and federal standards restricting universities’ use of online classes. How many of these rules were unnecessary or unwise in the first place?
While movement of persons between communities may pose a danger during epidemics, movement of goods remains vital to prosperity and mutual exchange. Simon Lester points out in a Cato podcast that easing trade restrictions is a direct way to address difficult bottlenecks in emergency medical supplies. Relatedly, recent tariffs on medical supplies haven’t been helpful, encouraging large factories overseas to prioritize customers outside the U.S. (earlier).
In a reaction to the financial strains caused by the outbreak, the feds have been flooding the banking system with liquidity, both by relaxing regulations and through central bank operations. Cato’s Diego Zuluaga in a podcast distinguishes between liquidity objectives and (what is rightly more controversial) bailout objectives.
- Certificate-of-need laws in 38 states restrict hospital bed capacity by giving competitors a lever to object. More beds would have helped with emergency preparedness [Jeffrey Singer; more from Eric Boehm; bed crisis feared within weeks]
- White House, Congress negotiate on liability-limit measure aimed at freeing up 31 million expired but usable masks; “3M and Honeywell don’t feel comfortable providing them without assurances they won’t be sued.” [Michael Wilner, McClatchy; latest on HHS proclamation] Between death, business interruption, and enormous disruption to business practice, a landscape of litigation opens up [Bob Van Voris et al., Fortune]
- Proposed executive order would bar import of critical medical supplies from China, closing supposed “loophole” that could save your loved one’s life as shortages of ventilators loom [Ana Swanson, New York Times; Greta Privitera, Politico Europe on triage decisions at Italian hospitals reeling under equipment shortages]
- Courts canceling jury trials as virus spreads [Eric Turkewitz] Supreme Court building closes to public until further notice;
- Newark, N.J. threatens to prosecute persons who make false statements about the pandemic [Mike Masnick, TechDirt (“a masterclass in how not to deal with the problem of misinformation about the coronavirus”); Eugene Volokh (while some kinds of lies can be criminalized consistent with the First Amendment, many of those relevant here cannot]
- Memo to HR: EEOC has advised “that taking the temperature of all employees may violate the ADA under some circumstances, but has indicated that the rules may change during a pandemic” [Daniel Schwartz; employee temperature checks in Singapore]
Lawyers in suits and ties ransacked the Punjab Institute of Cardiology in Lahore, Pakistan, “beating up staff and smashing equipment…. The lawyers had been protesting over the alleged mistreatment of some of their colleagues by hospital staff last month. But the final trigger for the violence appears to have been a video posted on social media by a doctor on Tuesday night in which he poked fun at the lawyers.” Three patients died during the riot as medical staff could not care for them. [BBC]
“Maria Cvach, an alarm expert and director of policy management and integration for Johns Hopkins Health System, found that on one step-down unit (a level below intensive care) in the hospital in 2006, an average of 350 alarms went off per patient per day—from the cardiac monitor alone….
“Bed alarms have proliferated since 2008 when the Centers for Medicare and Medicaid Services declared hospital falls should ‘never’ happen and stopped paying for injuries related to those falls. After that policy change, the odds of nurses using a bed alarm increased 2.3 times, according to a study led by Dr. Ronald Shorr, director of the Geriatric Research, Education and Clinical Center at the Malcom Randall Veterans Affairs Medical Center in Gainesville, Fla. The alarms have become a standard feature in new hospital beds.” Meanwhile, in 2017 the same federal agency “began discouraging their widespread use in nursing homes, arguing that audible bed or chair alarms may be considered a ‘restraint’ if the resident ‘is afraid to move to avoid setting off the alarm.'” [Melissa Bailey, Kaiser Health News via Virginia Postrel; earlier here, here, and here]
From Institute for Justice’s Short Circuit newsletter: “How many times can an eye surgeon accidentally operate on the wrong eye before his surgical privileges are revoked? Three is the magic number at the Murfreesboro, Tenn. Veterans Affairs hospital. Sixth Circuit: And the revocation does not violate the due process of law.” [or constitute retaliation under employment discrimination law; Ahad v. Wilkie]
It is forbidden to save lives except in the prescribed location and manner: “In an effort to protect rural hospitals in Louisiana, state lawmakers have passed a bill that bans the creation of most freestanding emergency rooms.” [Alia Paavola, Becker’s Hospital Review]
- “How the Reformulation of OxyContin Ignited the Heroin Epidemic” [William N. Evans and Ethan Lieber, Cato Research Briefs in Economic Policy] Antiquated regulations on methadone need revision [Jeffrey Singer, Cato] Concept of addiction is constantly run together with that of dependence, and applied in such dubious areas as “social media addiction” [Singer]
- EEOC sues Tennessee hospital over lapse of religious accommodation in its mandatory flu shot policy (but is a mask as effective as the vaccine?) [EEOC press release]
- Free to Choose Medicine: a review [Thomas Hemphill, Cato Regulation magazine]
- Texas law limiting med-mal suits: “Fifteenth Anniversary of Proposition 12” [Texans Against Lawsuit Abuse]
- Time to include electronic components in the BAAA: “Biomaterials Access for the 21st Century” [Jim Beck]
- Affordable Care Act’s incentive program punishing hospitals for readmissions had unintended consequences, we know now. Were some of them lethal? [Tyler Cowen on Rishi K. Wadhera, Karen E. Joynt Maddox and Robert W. Yeh, New York Times]