The Invention of Health Law

By default, the courts are inventing health law. The law governing the American health system arises from an unruly mix of statutes, regulations, and judge-crafted doctrines conceived, in the main, without medical care in mind. Courts are ill-equipped to put order to this chaos, and until recently they have been disinclined to try. But political gridlock and popular ire over managed care have pushed them into the breach, and the Supreme Court has become a proactive health policy player. How might judges make sense of health law\u27s disparate doctrinal strands? Scholars from diverse ideological starting points have converged toward a single answer: the law should look to deploy medical resources in a systematically rational manner, so as to maximize the benefits that every dollar buys. This answer bases the orderly development of health care law upon our ability to reach stable understandings, in myriad circumstances, of what welfare maximization requires. In this Article, I contend that this goal is not achievable. Scientific ignorance, cognitive limitations, and normative disagreements yield shifting, incomplete, and contradictory understandings of social welfare in the health sphere. The chaotic state of health care law today reflects this unruliness. In making systemic welfare maximization the lodestar for health law, we risk falling so far short of aspirations for reasoned decision making as to invite disillusion about the possibilities for any sort of rationality in this field. Accordingly, I urge that we define health law\u27s aims more modestly, based on acknowledgment that its rationality is discontinuous across substantive contexts and changeable with time. This concession to human limits, I argue, opens the way to health policy that mediates wisely between our desire for public action to maximize the well being of the many and our intimate wishes to be treated non-instrumentally, as separate ends. I conclude with an effort to identify the goals that health law, so constructed, should pursue and to suggest how a strategy of accommodation among these goals might apply to a variety of legal controversies

Economic and environmental strategic water management in the shale gas industry: Application of cooperative game theory

In this work, a mixed‐integer linear programming (MILP) model is developed to address optimal shale gas‐water management strategies among shale gas companies that operate relatively close. The objective is to compute a distribution of water‐related costs and profit among shale companies to achieve a stable agreement on cooperation among them that allows increasing total benefits and reducing total costs and environmental impacts. We apply different solution methods based on cooperative game theory: The Core, the Dual Core, the Shapley value, and the minmax Core. We solved different case studies including a large problem involving four companies and 207 wells. In this example, individual cost distribution (storage cost, freshwater withdrawal cost, transportation cost, and treatment cost) assigned to each player is included. The results show that companies that adopt cooperation strategies improve their profits and enhance the sustainability of their operations through the increase in recycled water.The authors gratefully acknowledge the financial support by the Ministry of Economy, Industry, and Competitiveness from Spain, under the projects CTQ2016-77968-C3-1-P and CTQ2016-77968-C3-2-P (AEI/FEDER, UE)

Networks and Mechanisms of Interdependence: Theoretical Developments Beyond the Rational Action Model

There is interdependence when the actions of an individual influence the decisions (and later actions) of other individuals. This paper claims that social networks define the structure of that range of influence and unleash a number of mechanisms that go beyond those captured by rational action theory. Networks give access to the ideas and actions of other individuals, and this exposure determines the activation of thresholds, the timing of actions, and the emergence of contagion processes, informational cascades and epidemics. This paper sustains that rational action theory does not offer the necessary tools to model these processes if it is not inserted in a general theory of networks. This is especially the case in the context opened by new information and communication technologies, where the interdependence of individuals is acquiring greater empirical relevance

Happiness, Efficiency, and the Promise of Decisional Equity: From Outcome to Process

This article explains why outcome-oriented goals like efficiency, happiness, or well-being are ultimately of limited use as goals for law. Part II places happiness research in the context of past efforts to assess efficiency standards. Part III outlines the schism between efficiency and happiness and examines whether they can be reconciled. Part IV discusses the problems of relying on direct measures of happiness. The concept of decisional equity is described and examined in Part V

Post-Abyssal peacebuilding : thinking peace through the epistemologies of the South

Dissertação de mestrado em Relações Internacionais (Estudos da Paz e da Segurança), apresentada à Faculdade de Economia da Universidade de Coimbra, sob a orientação de Teresa de Almeida Cravo.Liberal peacebuilding, based on the ideology of liberal peace, became the hegemonic form of peace construction after the end of the Cold War. As performed by the United Nations (UN), liberal peacebuilding does not include endogenously developed answers to conflict in its formula for peace. The troubled relationship between the UN and the local has long been criticised by peace studies scholars, who have been exposing its hybrid character by recognising agency in local actors. My intention is to take these critiques further and draw attention to the importance of revealing the local understandings of peace that produced resistance to international intervention. For this, I suggest the integration by peace studies, of a new conceptual framework to deal with local epistemologies. The research question guiding this dissertation thus becomes: how can Boaventura de Sousa Santos’ conceptual framework of the epistemologies of the South further the knowledge and practice of peacebuilding? The argument set out is that the liberal peace concept, as part of modern western thinking, constitutes an abyssal line, radically excluding all other forms of social, political and economic organisation found in post-conflict spaces that do not conform to liberal values. The epistemologies of the South are able to confront this hegemony through the practice of the sociologies of absences and emergences and the work of translation, which reveal local epistemologies. Integrating this framework into peace studies constitutes a conceptual advancement since it helps to explain different visions of peace, thereby contributing to a broader understanding of this concept and enriching peaces that are already known. Thus, the dissertation makes a twofold contribution: first, it constitutes an epistemological critique of the liberal peace as associated with modern Western thinking; second, it constitutes a conceptual contribution, since it explores different tools to investigate endogenous forms of peace. Its main goal is to inspire new research into peace and peace construction that follow the epistemologies of the South framework and thus help to deepen the understanding of these concepts

Happiness, Efficiency, and the Promise of Decisional Equity: From Outcome to Process

Those who resist the teachings of law and economics are rightfully concerned that economic efficiency is largely based on the predictions of relatively acquisitive people about what will make them feel or be better off. Due to a variety of factors, these predictions often turn out to be wrong. The explosion in happiness research would appear to have the potential to close the link between choices and actual outcomes and, consequently, make the concept of efficiency more meaningful. This Article explores this promising advance. It concludes that direct focus on one concept or another of happiness or better-off-ness does not fully address the limitations of law and economics and may raise additional issues. For example, which is more important, feeling better off or being better off? In addition, when does happiness count? Is it at the time of the activity or as one remembers it? The Article explains why outcome-oriented goals like efficiency, happiness, or well-being are ultimately of limited use as goals for law. It then makes the case that law would be more usefully applied to the process of decision-making. To this end, it examines the extent to which law can be devoted to a decision-making idea or decisional equity. The ideal of decisional equity requires addressing three areas - information imbalances, psychic biases, and adaptations to social conditions

Information Feedback, Behaviour and ‘Smart Meters’: Using behavioural economics to improve our knowledge about the potential effectiveness of Smart Meters to use electricity efficiently

As part of the development of the European electricity grid, the EU has decided that ‘Smart Meters’ should be installed in 80% of the households of the EU by 2020. It is expected that this will lead to a reduction of energy use in the residential sector in the order of 10%. Driven by the so-called ‘Information-Deficit’ model, a critical assumption in this policy development is that provision of information, via ‘Smart Meters’, enables energy end-users to make more informed, and thus better, decisions in relation to their energy service demands (e.g. lighting). However, even if there is some evidence that feedback to consumers stimulate an efficient use of energy, the magnitude of this reduction is debated. In fact, findings from behavioural economics suggest that behavioural biases (e.g. loss aversion) and cognitive limitations restrict end-users from displaying purely rational behaviour, which in turn limits the effect (and policy expectations) of policies applying the information-deficit model. The thesis at hand addresses these issues explicitly and provides empirical analyses of how behavioural biases affects consumers’ response to energy-related information. To that end, experimental research covering eight field exercises and a Smart Meter experiment was conducted. The thesis aimed to generate knowledge about the applicability and implications of using behavioural economics to deliver feedback to electricity consumers. With due limitations, the experiments illustrate that a knowledge-gap exists, and that information can help correct consumer behaviour, but that the framing and salience of this information can affect the magnitude of the response. The Smart Meter experiment on loss aversion took place in a real-life setting where consumers actually used and paid for the electricity. Results show that the intervention group reduced its electricity use, and that those reductions were larger than those found for the reference group (for both daily and standby consumption). Compared to related research, findings revealed that reductions in electricity use were also larger than the average electricity reduction found in other studies of feedback on electricity use. As a whole, it is concluded that feedback information can contribute to efficient electricity use and thus contribute to meeting EU policy targets. However, the (expected) effects depend on how feedback is designed, framed and presented. The Smart Meter experiment indicates an enhanced effect on electricity use reduction as a result loss aversion, but further research (e.g. large scale trials) is needed for more conclusive and statistically significant results