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Quick background of U.S. health care system
Clip from Sicko
Research Resources
› Getting started - Health Sites v. Health Law Sites
› Health Statistics
› Federal Health Care Laws – pending, current, and
past
› State Health Care Laws
› Health Law Practice-Oriented Resources
Guest Lecture by Mirya Holman, Associate in
Research
 In-class Exercise

Traditionally, focus of health care policy
was advancing medical science
 Shift in the 1980s:
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› Cost of medical treatment
› Access to medical treatment
Today, you often hear the term “health
care” used synonymously with “health
insurance”
 Legal doctrine now must take into account
current public policy to limit or allocate
governmental and private health care
spending
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U.S. Dept. of Health & Human Services HIPAA site:
http://www.hhs.gov/ocr/privacy/
National Health Information Center:
http://www.health.gov/nhic/
Health & Human Services Centers for Medicare & Medicaid
Services: http://www.cms.hhs.gov/
HealthReform.Gov: http://www.healthreform.gov/
Academy Health: http://www.academyhealth.org/
Management Resources for Healthcare & Medical
Professionals: http://www.pohly.com/admin.html
American Medical Association’s Doctor Finder:
http://webapps.ama-assn.org/doctorfinder/home.jsp
American Association of Family Practitioners:
http://www.aafp.org/online/en/home/aboutus.html
Federation of State Medical Boards DocInfo:
https://s1.fsmb.org/Docinfo/Default.aspx
Health & Human Services Centers for Medicare & Medicaid Services:
http://www.cms.hhs.gov/
http://www.cms.hhs.gov/home/regsguidance.asp
http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAc
countsHistorical.asp#TopOfPage
http://www.cms.hhs.gov/NationalHealthExpendData/05a_NationalHealthAcco
untsStateHealthAccountsProvider.asp#TopOfPage
http://www.healthreform.gov/
This is a government site, so
we need to keep in mind that
there is an agenda behind it.
Scroll down the page…
Click on NC to see what
we can find out about how
the proposed health care
legislation might affect our
state.
Can use the footnotes to
confirm the information
provided, and to get to
other, perhaps more
objective, resources
American Association of Family Practitioners:
http://www.aafp.org/online/en/home/aboutus.html
Federation of State Medical Boards DocInfo:
https://s1.fsmb.org/Docinfo/Default.aspx
Provides public access to disciplinary
records. Maintained by the Federation of
State Medical Boards.
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Georgetown University Law Library Research Guide - Health Law
http://www.ll.georgetown.edu/guides/health.cfm
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University of Houston Health Law & Policy Institute - Health Pathfinder
http://www.law.uh.edu/healthlaw/pathfinder/HealthLaw.html
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SMU Professor Tom Mayo’s Health Law & Medicine Law Page
http://faculty.smu.edu/tmayo/twmlinkshealthmedicine.htm
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ABA Health Law Section
http://www.abanet.org/health/
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American Health Lawyers Association (AHLA)
http://www.healthlawyers.org/Pages/Default.aspx
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Guide to Health Law, Hieros Gamos
http://www.hg.org/health.html
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Cornell Legal Information Institute – Health Law
http://topics.law.cornell.edu/wex/health
University of Houston Health Law & Policy Institute- Health Pathfinder:
http://www.law.uh.edu/healthlaw/pathfinder/HealthLaw.html
Provides
hundreds of
annotated links
from the UHLC
Health Law and
Policy Institute’s
web page. Covers
health law, health
policy, and
general health.
SMU Professor Tom Mayo’s Health Law & Medicine Law Page:
http://faculty.smu.edu/tmayo/twmlinkshealthmedicine.htm
ABA Health Law Section: http://www.abanet.org/health/
Annotated list of healthrelated resources including
foreign and international
health law sources
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Goodson Law Library Empirical Research Data Sources
> Health:
http://www.law.duke.edu/lib/facultyservices/empirical/l
inks/miscellaneous
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CDC’s National Center for Health Statistics
http://www.cdc.gov/nchs/default.htm
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Centers for Medicare & Medicaid Services’
Research, Statistics, Data & Systems
http://www.cms.hhs.gov/home/rsds.asp
Annotated list of healthrelated resources
Where you might to go get a
sense of health care legislation
on the horizon, and the relevant
conversations/debates
A site like this could offer tools to
evaluate rumors over pending legislation,
and to get started sorting out truth from
fiction…though it is NOT something to
cite to/rely wholly upon.
Ultimately
you need to
read the
legislation
itself, which
you can do for
free on LOC’s
Thomas
website
Can search
or browse
Congressional
Bills and
Public Laws
Here, we get
a shortcut as
this is a hot
topic!
Clicking on H.R. 3200 (the
Congressional Bill number of this piece of
this act) brings us to this page, where we
can link to all kinds of information about
this bill
The Subjects page provides a list of
CRS (Congressional Research Service)
Index Terms
The Summary provides a nice overview
of the bill
Congressional Actions lets
us see what has happened
with this bill since it was
introduced
The text of the bill in html
(can also link to PDF, which
routes you to GPO Access site)
Freely available, but only
goes back about 15 years
for Public Laws and
Congressional bills
Also, not the most searchfriendly resource
What if we wanted to look
at the Health Care Reform
legislation under Clinton?
Might start with Google or
Wikipedia to get a
year/title/etc.
Scroll down to scout for
references to primary
sources
Bingo! Footnote 16 leads
us to the Congressional Bill
Links us into the bill in
Thomas, which we know is
a legitimate and reliable site
Click on “Bill Summary &
Status”
Now we can read the text
of the proposed legislation,
see all Congressional
actions on the bill, see
related bills, etc. – all for
FREE!
So we know it never
became a Public Law, which
means the Popular Names
Table won’t work…
What about in the
Congressional Bills
database?
Nope – only goes back to
1994
We could also search
the Federal Bill
Tracking Archives (USBILLTRK-OLD)
Searching this is
awkward and display is
not nearly as userfriendly as on Thomas
Reminds us that Lexis
and Westlaw aren't’
always the resource of
choice
guide to healthcare legal forms
guide to healthcare legal forms
http://www.thefacultylounge.org/2009/08/death-taxes-and-medical-bills-.html
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1425814

Scholars, politicians, and pundits have
been fighting over the relationship
between medical bills and bankruptcy
› Warren’s 2005 and 2009 studies found that
medical bills contribute to a substantial
number of bankruptcies
› Department of Justice study that found that
bankruptcy filers had limited medical debt
In 2005, Senators Grassley and Sessions used
the DOJ analysis to disparage the Warren
study as “myth,” “misrepresentation,” and
“fiction.”
 Recently, Rep. Conyers cited the Warren
studies
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› But a witness at the hearing from the American
Enterprise Institute cited the DOJ analysis, which
was referred to as the “closest comparable
study,” to cast doubt on the Warren studies’
findings
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Our paper is the first to use both methods
› survey question analysis like the Warren study
› court record analysis like the DOJ
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A single nationally representative
dataset of bankruptcy filers.
 Random
National Sample of
Chapter 7 and 13 cases (n=2438)
› Written Questionnaires (50% response rate)
› Court records
› (Telephone Surveys)

Funders: Robert Wood Johnson
Foundation, FDIC, AARP (& universities)
60%
48%
50%
Percentage
40%
34%
30%
24%
20%
20%
10%
9%
8%
18%
22%
11%
5%
0%
More than
$10,000
$5,001 to $10,000 $1,001 to $5,000
Questionnaire
$1,000 or Less
Schedule F
Zero
Medical Bill Management
80%
70%
76%
69%
Percentage
60%
50%
40%
34%
34%
30%
20%
10%
21%
16%
16%
8%
2%
2%
7%
2%
0%
Cash,
Regular
Medical Home Equity
Check,
Credit Card Credit Card Loan or Line
Debit Card
of Credit
Medical Bill Reason for Filing
Provider
Payment
Plan
Something
Else
No Medical Bill Reason for Filing
More than $10,000 in expense (and perhaps
much more) and zero schedule F medical
debt
 At least $5,000 more expense than
schedule F medical debt
 At least $1,000 more expense than
schedule F medical debt
(20% of sample in prior 3 categories)
 1 “category” more expense than schedule
F medical debt
 Same category for both measures
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90%
80%
83%
81%
76%
74%
67%
70%
60%
50%
50%
10%
27%
25%
30%
20%
39%
39%
40%
19%
13%
4%
6%
6%
0%
Same category One category Two categories Three categories $10,000+ more of
amount of OOP more of OOP ($1,000+) more of ($5,000+) of OOP
OOP than
and schedule F than schedule F
OOP than
than schedule F
schedule F
schedule F
Cash or Cash Equivalent
Regular Credit Card
Home Equity Loan
$40,000
$34,523
$35,000
$30,000
$27,334
$28,891
$25,000
$19,893
$20,000
$15,000
$15,076
$10,000
$5,000
$-
Same category One category Two categories Three categories $10,000+ more
amount of OOP more of OOP ($1,000+) more
($5,000+) of
of OOP than
and schedule F than schedule F of OOP than
OOP than
schedule F
schedule F
schedule F
80%
67% 67%
70%
60%
53%
47%
50%
40%
30%
32%
31%
28% 29%
25%
24%
20%
10%
37%
9%
11%
25%
13%
0%
Same category One category more Two categories
amount of OOP and
of OOP than
($1,000+) more of
schedule F
schedule F
OOP than schedule
F
Three categories
($5,000+) of OOP
than schedule F
Medical Bills
Medical Problems (Self or Spouse)
Medical Problems (other family members)
$10,000+ more of
OOP than schedule
F
Setting up our In-Class Exercise:
http://www.hulu.com/watch/2340/saturday-night-live-old-glory

A long-time client of ours, Mr. Stevens, has heard a number of
rumors about the new healthcare legislation, and is very
concerned for himself, his family, and his business. He has
asked for our counsel as to whether the rumors are true or
not.

Specifically, he wants to know:
› Whether he might have to change doctors
› How it will affect his small business
› If his elderly parents will be forced into end-of-life
decisions
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As you consider these questions, think
about possible health sites and health law
sites, as well as other informative current
awareness sites that can get you started