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BACKGROUND Since the 1990s, nationwide rates of vaginal birth after cesarean section (VBAC) have decreased sharply and rates of cesarean section have increased sharply. Both trends are consistent with clinical behavior aimed at reducing obstetricians' exposure to malpractice litigation. OBJECTIVE To estimate the effects of malpractice pressure on rates of(More)
Caps on damages have emerged as the most controversial legislative response to the new malpractice crisis. We analyzed a sample of high-end jury verdicts in California that were subjected to the state's dollars 250,000 cap on noneconomic damages. We found strong evidence that the cap's fiscal impact was distributed inequitably across different types of(More)
Mobile health (mHealth) technology has facilitated the transition of care beyond the traditional hospital setting to the homes of patients. Yet few studies have evaluated the legal implications of the expansion of mHealth applications, or "apps." Such apps are affected by a patchwork of policies related to medical licensure, privacy and security protection,(More)
BACKGROUND This paper summarizes a new report presenting the best available research about the impact of the liability environment on maternity care, and policy options for improving this environment. Improved understanding of these matters can help to transcend polarized discourse and guide policy intervention. METHODS We used a best available evidence(More)
The Affordable Care Act (ACA) attempts to reduce healthcare costs while simultaneously providing the means for more Americans to obtain health insurance. Among other things, the ACA expands preventative care for obesity by mandating screening and counseling. However, it permits the states to determine whether to mandate treatments for inclusion in plans(More)
BACKGROUND The present liability system is not serving well childbearing women and newborns, maternity care clinicians, or maternity care payers. Examination of evidence about the impact of this system on maternity care led us to identify seven aims for a high-functioning liability system in this clinical context. Herein, we identify policy strategies that(More)
Following a multistate measles outbreak that began in Disneyland, California legislators responded to the outbreak by passing legislation repealing exemptions for philosophical and religious beliefs.1 Although the legislation retains medical exemptions, it makes California the largest state to have such strict childhood vaccination requirements, joining(More)
preventable illness without violating the family’s constitutional rights? If parents refuse to vaccinate their children, what can physicians legally and ethically do to protect other patients in their practice from exposure to vaccinepreventable illnesses? In January 2015, a federal appeals court answered the former question with regard to New York State(More)
During2014,numerouscommunitiesacross theUnited States have been affected by significant, largely avoidable outbreaks of vaccine-preventable illnesses (VPIs), such as measles, mumps, and pertussis.1 These outbreaks have been associated with increasing numbers of familiesactivelydeclining immunizationsagainstVPIs for their children.2 States can require that(More)