Author Archive for Janice Lim

Why the ACLU’s Fight Against Catholic Hospitals Will Fail

Recently, Catholic hospitals have come under fire when former female patients came forward claiming that they were denied important reproductive treatments and procedures. The American Civil Liberties Union (“ACLU”) came forward on their behalf and sued the Catholic health system for refusing to provide the necessary treatments, such as abortions. us supreme court

Yet every suit brought forward by the ACLU was dismissed by the courts. At the moment, no law can force or coerce a medical officer to perform a procedure that goes against their faith and conscience. In this case, the procedures are abortions and sterilization.

Why does the law protect medical personnel like this? Is there anything we can do to make sure female patients get their necessary medical treatment?

Constitution 101: Negative Rights and Positive Rights

To best understand the situation, it will help to have a brief overview of a special aspect of the Constitution. It is important to know that the Constitution is made up of positive rights and negative rights.

A positive right is when the government owes its citizens a right or an action, such as a right to an attorney in a criminal trial. In contrast, a negative right is when the government owes its citizens the duty of not acting, such as not suppressing speech or religion. In this case, doctors have the negative right of freedom from the government forcing them to perform abortions against their conscience and/or religion.

Why are the Courts Dismissing the ACLU’s Claims?

In 2015, the 6th circuit court of appeals dismissed the ACLU’s claims against a hospital. The claim was that the “Religious and Ethical Directive” made a physician deny “appropriate medical care” to a woman suffering from a natural miscarriage. The court dismissed the case for several reasons, but mainly because the court did not think they had jurisdiction over the issue since it concerns “ecclesiastical matters.”

The courts refuse to step in because they believe that the Catholic hospital system should have complete control over their services and operations. But, what if Catholic hospitals refuse to perform heart surgery or dialysis, a necessary treatment for people with diabetes? What if Catholic hospitals refuse to give what is considered to be a necessary treatment?

Medical Abortions are Not Considered to be Necessary Treatment

At the moment, the law thinks a medical abortion is not a necessary treatment for women. Even though medical organizations and groups recommend that a medical abortion should be performed once the patient begins to show signs of infection or excessive blood loss.

But anti-abortion groups still maintain that advances in science have made abortions unnecessary to save a woman’s life. A large part of our nation thinks abortion is not a medical procedure, but a moral evil that violates a sincerely held religious belief. Since our nation cannot decide if abortion can ever be necessary, it is not surprising that our legal system refuses to force physicians to perform it against their conscience.

There is a Lot to Do Before We Try to Make Catholic Hospitals Perform Necessary Abortions.

Right now, the ACLU’s efforts might be in vain. The legal system refuses to hear or decide on any issues they deem to be about religion, and abortion seems to remain a question of morality and not medicine. Until there is a change, it is unlikely that any of the ACLU’s lawsuits and claims on behalf of patients will succeed.

Given the political climate, it seems unlikely our nation will stop using abortion as a political platform. Until then, the ACLU’s efforts will keep bringing Catholic hospitals’ Ethical and Religious Directive into the spotlight and remind us that we have a long way to go.

What Happened to Our Healthcare System?

On October 4, 2016, former President Bill Clinton had some choice words for the Affordable Care Act (ACA), also known as Obamacare. He pointed out that the ACA has failed to help small business owners or individuals who make just over the ACA requirement for discounted insurance.

For example, in 2015, if a single individual made $47,000 a year, then they would not qualify for a subsidy. To qualify for a subsidy, a single individual must make less than $46,680 a year. But if you happen to make $46,680 or more, like $47,000, then does that mean you can afford an individual healthcare plan? No, probably not.

The ACA was supposed to fix the healthcare system and make insurance affordable for everyone, so every person can be covered. Yet, studies show that around 29 million individuals are still uninsured and the price of health insurance is still unaffordable for a large number of the U.S. population.

How did we get here? Where did we go wrong?

The 2008 Recession and How It Got Us Here, Today

In 2000, 83% of employees in the work force worked +35 hours and were considered to be full-time employees and 17% were part-time employees. But after the 2008 recession, full-time employment dropped to 80% and part-time employment went up to 20.1%. While the change in percentage does not seem significant, it was the start of a massive shift in the job market.

But why did this shift occur? After the recession, companies that were still in business had to find ways to cut costs in order to stay open. Under federal law, businesses with a certain number of employees must offer certain benefits, like health insurance. On average, employers cover 83% of the cost of the premium of an individual and 72% of the premium for a family. Employees still need to cover a portion of the health insurance premium, but how can they afford the cost if the price of insurance is rising and personal income remains the same, or drops?

In 2008, the cost of individual insurance rose by 5% and family insurance rose by 4.7%, while personal income dropped by 0.4%. But in 2009, the cost of individual insurance rose by 2.6% and family insurance rose by 5.5%, yet personal income dropped by 5.6%.

Health insurance companies need to make a profit, even though most citizens cannot afford to purchase health insurance. During the recession, the cost of healthcare coverage either remained the same or increased. Whereas earned income during the recession dropped, by 5.6%. A person who earned $47,000 a year in 2007 would have found their income drop to around $44,400 in 2009. But only if they were lucky enough to keep their job, since the unemployment rate in 2007 was 4.6% and in 2009 it rose to 9.3%.

But Where Does This Leave Us?

Recent numbers show that in 2017, insurance premiums under Obamacare will go up 25%. Despite the 2008 Recession, health insurance companies are managing to make record profits.

While the majority of U.S. citizens were losing their jobs, making less money, and/or losing their savings, the U.S. healthcare insurance companies were making record profits. The five largest insurance companies made $12.2 billion in profit in 2009, compared to the $4.4 billion they made in 2008. In 2009, 2.7 million Americans lost their health coverage.

Obamacare was enacted in 2010, with the goal of expanding Medicaid and giving federal subsidies to help middle and lower-class Americans buy private coverage. It began with the belief that, in 2014, around 3.5 million Americans will enroll in Medicaid, but in reality 6.8 million individuals enrolled.

To enroll in Medicaid, an individual has to make less than $16,243 a year, just $4,363 above the federal poverty level of $11,880. So in 2014, 6.8 million Americans hover just above, or below, what is considered to be absolute poverty.

But, in times of wealth or poverty, people will continue to get sick. When healthcare is indispensable, yet unaffordable, then health insurance is just as necessary. When our system is over-burdened and our economy is recovering from a recession, it is not surprising that the Affordable Care Act has yet to meet expectations.

Can a Catholic Hospital Refuse Medical Treatment For Religious Reasons?

What happens when a hospital refuses vital medical treatment due to the hospital’s religious beliefs?

In the United States, Catholic hospitals have come under scrutiny when reports emerged of women denied treatment due to their “ethical and religious directive.” In almost every case, it was a woman who was either pregnant and/or wished to prevent pregnancy.

How can hospitals, especially Catholic hospitals, deny necessary treatment? Regardless of religious affiliation, hospitals are there to treat and serve their community. How can the hospital be allowed to operate if they refuse necessary, life-saving treatment for those in need?

What Does the “Ethical and Religious Directive” Say?

In the United States, Catholic hospitals must follow the “ethical and religious directive” set by the Church. The Directive instructs that hospitals should treat all patients, including (but not limited to): the poor, those without insurance, single parents, the elderly, children, and “the unborn.”

The Directive states that a pregnant woman can undergo treatment or care, even at the risk of the fetus’s life, so long as their illness is “proportionately serious” in comparison to the loss of the fetus. In fact, the Directive uses the term “proportionately serious” when describing the health of a pregnant woman and an unborn fetus.

For these hospitals, the life of the unborn fetus is as important as the life of the pregnant woman in distress. In essence, the fetus is as much a patient as the mother. In fact, the directive also forbids the hospitals from sterilizing women, so they also treat the hypothetical “unborn.”

The doctors at the Catholic hospitals refused to perform an abortion, since the fetus’ heart was beating. Even after the women were bleeding heavily, in excruciating pain, developing an infection, and were told that their is no way for their child to survive.

Can a Hospital Refuse to Give Necessary Treatment?

No, a hospital cannot refuse to give a patient necessary treatment. However, the question is whether the treatment is necessary.

An abortion is not always necessary if the pregnancy would become a miscarriage. However, it is a common medical practice in the United States to perform a medically necessary abortion when a patient begins to show signs of infection and/or severe pain.

Many of the women in the report were experiencing severe pain and showing signs of infection. Instead, the Catholic hospitals turned away each patient and told them to wait in pain, discomfort, and fear until the fetus no longer had a heartbeat. In fact, to fight the pain and infection, they were given some aspirin and sent home.

It is easy to say that these women should have gone to a different hospital or facility; someplace that does not follow the Ethical and Religious Directive. But Catholic hospitals are growing in number, and in some states they account for 40% of available hospital beds. This means that for many of these women, finding a place that is not a Catholic hospital may mean hours of travel to receive treatment.

So Why is This Still Going On?

The state and federal government have not addressed the gap in treatment options that are due to religious directives. The government wants to encourage the creation and running of non-government run hospitals, but they cannot tell these hospitals how to operate.

Currently, hospitals may be required to have emergency services and not turn away impoverished patients. But women’s health and abortion issues are still heavily debated, in the government and around the dinner table. If the government cannot take a stand on abortion, then it would be hard to impose any requirement on hospitals.

But what can we do about women who are falling through the cracks of the system? These women are not seeking an abortion to end a healthy and viable fetus. They are seeking an abortion to help end the agony of a miscarriage after being told that their child will not survive.

Given the current landscape of women’s health, it seems like this issue will not be resolved any time soon. But for the health and safety of 50.8% of the United States population, we can only hope that it will stop being a question of politics and instead a question of public health and well-being.

How the EpiPen Price Hike is Not the Last of Its Kind

In 2015, the head of Turing Pharmaceuticals, Martin Skhreli, became the man that everyone loved to hate. After Turing acquired a patent for Daraprim, an older medication, they increased the price of the drug from $13.50/pill to $750/pill.

In August of 2016, Mylan Pharmaceuticals increased the price of the EpiPen from $56 to over $317. The EpiPen contains vital medication to counteract life-threatening allergic reactions. Soon, the media began to cover stories of parents struggling to afford EpiPens for their children.

After the price hikes, the CEO’s of Turing and Mylan faced heavy criticism. Public outcry demanded the reason for such an outrageous price increase, but the response seemed to be “because we can.” Unsatisfied by the logic, the nation questioned if the laws of the free-market should still apply when it concerns matters of life and death.

Yes, Martin Skhreli was Indicated, But It Was Not Because of the Price Hike

Martin Skhreli, Turing’s CEO, faced charges and was indicted of securities fraud in December 2015. As of September 2016, Skhreli is free on bail until his case heads to court. But his indictment of securities fraud comes from his time as a hedge fund manager and the CEO to a different company. During that time, Skhreli took the money from his company to make up for the money his investors lost in his hedge fund. His criminal charge have nothing to do with the price hike at Turing.

In fact, Skhreli, or any other CEO or company that increases the price of a necessary medication, cannot face criminal charges for the price increase. There is no law that criminalizes a drastic price increase.

It Is Not Illegal to Raise the Price of Drugs, In Fact It’s Good Business

Every discussion about the economy usually relies on the fact that the U.S. economy relies on capitalism. Capitalism can be a difficult concept, but the key point to understand is that a capitalistic economy relies on private ownership and is driven by profit. supreme court generic drugs

Companies like Turing and Mylan that produce life-saving and vital medications can adjust the price to whatever would give them the most profit. If there are no alternatives to the medications supplied by those companies, then they have no competition and can set the drugs at the highest possible price.

This was the case for the price hikes by Turing and Mylan. Where there is a drastic price hike, capitalism says that other companies will create their version to undermine a competitors’ profits.

For Daraprim, the drug created by Turing, other corporations were able to create a generic version which costs only $1 per pill. But for the EpiPen, the price increase applies to the medication sold in the auto-injector and not the actual medication itself. The auto-injector is patented by Mylan.

After Mylan offered a “generic” version at $300 per box instead of $600, the nation was not convinced. To avoid paying such an outrageous price, some users of the EpiPen have resorted to buying the drug in the auto-injector (epinephrine), and injecting it themselves.

But is that the only solution? Do we need to wait until another corporation decides to create a profit?

If We Ask for the Government to Step In, It Will Be a Long Wait

Healthcare seems to be heavily regulated by the U.S. government. But out of all possible aspects of healthcare, the pharmaceutical industry faces the least amount of regulation. In fact, Daraprim and EpiPen are not the only drugs that have increased by over 100%.

In 2002, a drug called “Abilify” entered the market to treat acute psychiatric disorders like schizophrenia. It soon proved to be effective in treating other disorders, but the other treatments were not approved by the Food and Drug Administration (“FDA”). So insurance companies refused to cover the cost for “off-label” use.

Currently, the price of ability without insurance can range from $700 to $1,000 for 30 pills. It was only in 2015 that the FDA approved a generic version of Abilify. For 13 years, patients were spending hundreds and thousands of dollars on a medication that was necessary to their daily function.

In short, what has happened with Turing and Mylan is not something new, and it’s also not something that will go away. Drug companies have been doing this for a long time, and the U.S. government makes no attempt to stop them.

If you feel like drug companies need to be regulated, then 3 out of 4 Americans agree with you. The majority of the nation are beginning to feel like pharmaceutical industries need to be regulated and stopped. It is hard not to want regulation when a person needs to decide between financial ruin to survive a treatable illness, or death. It is time for each citizen to tell lawmakers and the pharmaceutical industry that enough is enough.

Alligator Attack at Walt Disney World: How Wild Animals Can Change the Claim

On June 14, 2016, Lane Graves, a 2 year-old boy, was dragged from the shallows of a lagoon near the Walt Disney World Resort. He was later found dead, after the alligator dragged him away from his family and killed the child. The attack shocked park-goers and families throughout the nation. Soon, the news was filled with stories of parents sharing pictures of their children playing at the exact spot where the little boy lost his life.

Since then, The Walt Disney Company has taken every step to show remorse, sympathy, and compassion for the Graves family and visitors. But despite good will and efforts to remedy the situation, Lane’s family has a possible cause of action against the Happiest Place on Earth.

But what is the possible cause of action, or claim, they can file? Most importantly, what does this mean for Disney and other landowners who may face the same problems? What does it mean for their guests?

A Strict Liability Claim

Under strict liability, an owner of a wild animal can be held strictly liable for any injuries or damages caused by the animal, even if the owner took precautions or was not at fault. Wild animals are considered abnormally dangerous and ultra-hazardous due to their very nature. Alligator

But, here Disney can argue that they do not own the alligators on their property. In fact, Disney has removed 244 alligators from 2006 to 2016. After the attack on June 14, they removed six more from the area. If the alligators return enough to be a “nuisance”, they are euthanized. So in this case, Disney does not want the alligators on their property and do not own them. So in the end, Disney cannot be held liable under a strict liability claim, but can only be held liable under a negligence claim.

A Negligence Claim

Under Tort law, the Graves family can sue Disney for failing in their duty to protect their guests from known, dangerous wildlife on property. To establish their claim, the Graves family will need to prove that Disney had:

  • a duty to keep the area safe;
  • they breached the duty;
  • the breach was the cause of the child’s death; and
  • the family suffers measurable damages due to the death.

While the analysis may seem obvious in cases like these, each aspect must be proven in turn. Disney World Resort is a commercial property, owned and operated by The Walt Disney Company. It invites people onto their land for a fee, and once they pay the fee, the guests are legally considered “invitees”, or more specifically “business invitees” or guests. The legal status of the Graves family is important, as it will determine the level of due care that Disney owes in the situation.

In this case, it is clear that the Grave family are guests of Walt Disney Resort. Disney did not put up adequate signs to warn guests about the real danger of alligator attacks. Their failure to put up proper signs should have been foreseeable to them that their guests may be hurt by an alligator, and that their guests would not have gone near or into the water if there was an adequate warning sign. Finally, it is undeniable that the Graves family suffered a terrible injury from the attack.

In this case, it is unlikely that Disney will be able to defend against a wrongful death claim from the Graves Family. But is it fair for Disney and other property owners to not face strict liability?

Landowners Get Additional Protection from the Law, So They Must Give Additional Protection to Their Guests.

As discussed earlier, landowners are held strictly liable for any injuries caused by a wild animal they own on their property. This includes pet tigers, lions, bears, and any other animal that is not domesticated. But it does not include wild animals that happen to roam the property.

The law was written with the understanding that wild animals are uncontrollable, especially animals that enter private property without knowledge of the owner. The law does not hold landowners responsible for the actions of a random, wild animal on their land.

But it does not mean landowners, like Disney, won’t face punishment for injury or death of a guest. The law declares that landowners like Disney have a duty to repair and correct known dangers, as well as a duty to reasonably inspect, discover, and correct unknown dangers in areas that guests are able to access.

What is “reasonable” is decided by the court, and it is often based on what the landowner is capable of doing. For example, Disney is a multi-billion dollar and they are known for exercising great control over the quality and safety of their parks. So the court may order Disney to do far more than an average landowner who also has alligators on their property.