Georgetown University Law Center

About: Georgetown University Law Center is a based out in . It is known for research contribution in the topics: Supreme court & Public health. The organization has 585 authors who have published 2488 publications receiving 36650 citations. The organization is also known as: Georgetown Law & GULC.

Qualitative perspectives of the North Carolina healthy food small retailer program among customers in participating stores located in food deserts

Abstract: BACKGROUND The North Carolina Healthy Food Small Retailer Program (NC HFSRP) was established through a policy passed by the state legislature to provide funding for small food retailers located in food deserts with the goal of increasing access to and sales of healthy foods and beverages among local residents. The purpose of this study was to qualitatively examine perceptions of the NC HFSRP among store customers. METHODS Qualitative interviews were conducted with 29 customers from five NC HFSRP stores in food deserts across eastern NC. Interview questions were related to shoppers' food and beverage purchases at NC HFSRP stores, whether they had noticed any in-store efforts to promote healthier foods and beverages, their suggestions for promoting healthier foods and beverages, their familiarity with and support of the NC HFSRP, and how their shopping and consumption habits had changed since implementation of the NC HFSRP. A codebook was developed based on deductive (from the interview guide questions) and inductive (emerged from the data) codes and operational definitions. Verbatim transcripts were double-coded and a thematic analysis was conducted based on code frequency, and depth of participant responses for each code. RESULTS Although very few participants were aware of the NC HFSRP legislation, they recognized changes within the store. Customers noted that the provision of healthier foods and beverages in the store had encouraged them to make healthier purchase and consumption choices. When a description of the NC HFSRP was provided to them, all participants were supportive of the state-funded program. Participants discussed program benefits including improving food access in low-income and/or rural areas and making healthy choices easier for youth and for those most at risk of diet-related chronic diseases. CONCLUSIONS Findings can inform future healthy corner store initiatives in terms of framing a rationale for funding or policies by focusing on increased food access among vulnerable populations.

Forced Migration, the Human Face of a Health Crisis

Abstract: Nearly sixty million refugees, asylum-seekers and internally displaced persons (IDPs) fled their homes in 2014, predominately from war-torn Syria, Afghanistan and Somalia. The global response to assisting this vulnerable group has been wholly incommensurate with the need given the profound health hazards faced by forced migrants at each stage of their journey. The majority of forced migrants are housed in lower-income countries that do not have the infrastructure to assist the significant numbers of individuals who are crossing their borders and the humanitarian organizations who seek to assist in the response are grossly underfunded and under-resourced.Countries have varying responsibilities to protect different classes of forced migrants based in international law, however there are significant gaps in existing agreements, leaving many individuals without protection or hope of assistance. There is a need to strengthen existing international agreements to ensure that all classes of forced migrants are entitled to protection and to ensure the enforceability of existing agreements where governments refuse to honor their existing obligations.

Creating the Conditions for People to Lead Healthy, Fulfilling Lives: Law Reform to Prevent and Control NCDs

Abstract: 'Creating the Conditions for People to Lead Healthy, Fulfilling Lives' forms part of a book on non-communicable disease (NCD) prevention called Dancing in the Rain: Living with NCDs, which is published by Future Leaders (an Australian philanthropic initiative) and is intended for a general audience. This chapter describes the growing global governance framework for NCD prevention and the range of new initiatives that governments around the world are using to combat NCDs, including measures that draw upon law and regulation. The chapter contrasts this widespread global innovation with Australia’s failure to take decisive action in the areas of obesity prevention and alcohol control. It asks why Australia has ended up as a 'laggard' in these areas when it remains the world leader in tobacco regulation, particularly following the recent introduction of plain packaging legislation. The chapter concludes by challenging Australia’s political leaders to champion legislative reform that more comprehensively addresses the modifiable risk factors for NCDs (including consumption of unhealthy foods and beverages, alcohol and tobacco, and physical inactivity) so that all Australians are empowered to lead healthy, fulfilling lives.

A Regulatory Theory of Legal Claims

Abstract: Procedural law in the United States seeks to achieve three interrelated goals in our system of litigation: efficient processes that achieve “substantive justice” and deter wrongdoing, accurate outcomes, and meaningful access to the courts. For years, however, procedural debate, particularly in the context of due process rights in class actions, has been redirected toward more conceptual questions about the nature of legal claims — are they more appropriately conceptualized as individual property or as collective goods? At stake is the extent to which relevant procedures will protect the right of individual claimants to exercise control over their claims. Those with individualistic conceptions of legal claims tend to object to procedures that operate at the expense of claimant autonomy. Conversely, those who endorse collectivist views tend to downplay claimant autonomy. In the class action context, the debate between individualistic and collectivist views of legal claims has been waged as a proxy war between more fulsome and more limited availability of class procedures — a debate that has been rightly described as “intractable.” This Article does not seek to resolve that debate, but to broaden it. The individualistic versus collectivist debate about legal claims arises not just in the class action context but in other contexts as well — a point long overlooked in legal scholarship. Taking this broader view yields significant insights. It turns out that this conceptual debate has different implications for key normative questions in our litigation system and procedural law. For example, in the class action context, the individual-autonomy conception of legal claims is used as an argument for procedures that often frustrate access to justice. In litigation finance, individual-autonomy conceptions are critical to access. The debate between individualistic and collectivist conceptions of legal claims thus does not point consistently to any set of normative goals, but instead it cuts in precisely opposite directions. Two central insights emerge from this stalemate. First, formalist theories of legal claims provide a poor baseline for determining the scope of litigant autonomy and for guiding procedural law. Second, they should be replaced by a theory for legal claims that not only accounts for, but also better aligns with, foundational normative goals of our litigation system. This Article therefore proposes a regulatory theory of legal claims, which has three fundamental components. First, and drawing upon intellectual foundations of property, economic, and litigation theory literature, this Article posits that litigant autonomy over legal claims — though a strong norm — can be regulated in appropriate instances. Second, it provides a theoretical basis for the notion that the judiciary may appropriately regulate litigant autonomy over claims, including through procedural mechanisms. Third, it sets forth a key component of an overall theory of procedure itself — specifically, as appropriately directed toward regulating litigant autonomy to reduce transaction cost barriers to claiming. By then operationalizing this theory within various litigation contexts, this Article demonstrates in concrete ways how its regulatory theory of legal claims points a way forward on the resolution of numerous difficult questions in today’s litigation landscape.

Towards a New Moral Paradigm in Health Care Delivery: Accounting for Individuals

Abstract: For years, commentators have debated how to most appropriately allocate scarce medical resources over large populations. In this paper, I abstract the major rationing schema into three general approaches: rationing by price, quantity, and prioritization. Each has both normative appeal and considerable weakness. After exploring them, I present what some commentators have termed the "moral paradigm" as an alternative to broader philosophies designed to encapsulate the universe of options available to allocators (often termed the market, professional, and political paradigms). While not itself an abstraction of any specific viable rationing scheme, it provides a strong basis for the development of a new scheme that offers considerable moral and political appeal often absent from traditionally employed rationing schema. As I explain, the moral paradigm, in its strong, absolute, and uncompromising version, is economically untenable. This paper articulates a modified version of the moral paradigm that is pluralist in nature rather than absolute. It appeals to the moral, emotional, and irrational sensibilities of each individual person. The moral paradigm, so articulated, can complement any health care delivery system that policy-makers adopt. It functions by granting individuals the ability to appeal to an administrative adjudicatory board designated for this purpose. The adjudicatory board would have the expertise and power to act in response to the complaints of individual aggrieved patients, including those complaints that stem from the moral, religious, ethical, emotional, irrational, or other subjective positions of the patient, and would have plenary power to affirm the denial of access to medical care or to mandate the provision of such care. The board must be designed to facilitate its intended function while creating structural limitations on abuse of power and other excess. I make some specific suggestions on matters of structure and function in the hope of demonstrating both that this adjudicatory model can function and that it can do so immediately, regardless of the underlying health care delivery system or its theoretical underpinnings. I. INTRODUCTION Health care is not cheap. Far from it; in 2009, health care spending in the United States consumed a projected $2.5 trillion or 17-3% of the gross domestic product (GDP).1 In the same year, the average American spent $923 in "out of pocket" health care expenses.'2 While the cost of America's consumption is high relative to the rest of the world, the excessive and growing cost of health care is a global problem. In 2006, total health care spending amounted to 15.8% of the GDP of the United States, 10.0% of the Canadian GDP, 11.0% of the French GDP, and 8.1% of the Japanese GDP.3 Those numbers have been steadily climbing. In 1980, the respective percentages of GDP were 8.7%, 7-0%, 7-0%, and 6.5%.4 Recent estimates suggest that total health care spending in the United States will reach a staggering 19-3% of GDP, or nearly $4.5 trillion, by 2019-5 The same estimates suggest that 2019 per capita expenses will reach $13,387 and out of pocket consumer expenses will reach $1390 (a 50% increase from 2009 out of pocket levels).6 Many commentators have declared that if limits are not placed on access to health care (limiting access being the preferred or most direct means of limiting consumption), health care expenditures can easily reach 100% of GDP in industrialized nations, even without accounting for wasteful expenditures.7 Just as medical resources are costly, so are they scarce. This relationship between cost and scarcity is not merely coincidental; they each cause the other. As scarcity increases without a corresponding reduction in demand, rudimentary price theory dictates that price will increase. Multiplied over a population, these conditions result in decreased access to care and ultimately the death or suffering of individuals who are denied access. …