Who Pays? Who Benefits? Unfairness in American Health Care

American-style health insurance greatly amplifies price-gouging opportunities for health care providers, who inflate prices both to enrich themselves and to subsidize and expand the nation’s health care enterprise. To the extent that lower- and middle-income Americans with private health coverage pay premiums that go to support and expand the system, they are subject to an unfair (regressive) “head tax” levied by unaccountable entities for ostensibly public but also private purposes. Lower-income premium payers also often pay for costly health coverage designed to suit the economic interests and values of professional and other elites rather than their own. They also appear to get less as a group out of their employers’ health plans than their higher-income coworkers. How the cost burdens and benefits of Americans’ health care are distributed has not been sufficiently recognized as the fundamental issue of social justice that it is - even after the major reform legislation of 2010

Distributive Injustice(s) in American Health Care

Havighurst and Richman seek to show the nature--and to suggest the cumulative attitude--of the many regressive tendencies of the financing, regulatory and legal regime governing the private side of US health care

Dilated Floor Functions That Commute

We determine all pairs of real numbers $(\alpha, \beta)$ such that the dilated floor functions $\lfloor \alpha x\rfloor$ and $\lfloor \beta x\rfloor$ commute under composition, i.e., such that $\lfloor \alpha \lfloor \beta x\rfloor\rfloor = \lfloor \beta \lfloor \alpha x\rfloor\rfloor$ holds for all real $x$.Comment: 6 pages, to appear in Amer. Math. Monthl

The Past, Present, and Future of Violent Crime Federalism

The history of the federal involvement in violent crime frequently is told as one of entrepreneurial or opportunistic action by presidential administrations and Congress. The problem with this story, however, is that it treats state and local governments as objects of federal initiatives, not as independent agents. Appreciating that state and local governments courted and benefited from the federal interest is important for understanding the past two decades, but also for understanding the institutional strains created by the absolute priority the feds have given to counterterrorism since September 11, 2001. Intergovernmental relations are at a crossroads. For two decades, the net costs of the federal interaction with state and local governments on crime have been absorbed nationally, with the benefits felt locally. The federal commitment to terrorism prevention and the roles federal authorities envision for state and local agencies portend a very different dynamic, with reduced federal funding for policing and an inherent tension between domestic intelligence collection and street crime enforcement, particularly in urban areas with a high proportion of immigrants

Cooperating Clients

Indicted on serious narcotics charges, Jose Lopez retained Barry Tarlow to “vigorously defend and try the case.” Tarlow was up to the task but warned Lopez that it was “his general policy not to represent clients in negotiations with the government concerning cooperation,” and that he did not plan to make any exception for Lopez. As Tarlow later explained, he found such negotiations “personally[,] morally and ethically offensive.” This arrangement suited Lopez just fine, until he wavered in his resolution. Encouraged by a co-defendant, worried about his children, and hoping to obtain an early release from prison in order to be with them, Lopez asked his co-defendant\u27s lawyer to initiate discussions with the government. He told his own lawyer nothing about this overture, calculating that Tarlow would serve him well if negotiations broke down and the case ended up going to trial. Sensitive to the constitutional and ethical issues raised by a defendant\u27s efforts to go behind his lawyer\u27s back but relying on a memorandum from Attorney General Thornburgh authorizing pre-indictment contacts with represented defendants, the prosecutor had Lopez brought before a magistrate, who advised Lopez of the dangers of proceeding without the assistance of counsel. Undeterred, Lopez signed a written waiver avowing his belief that Tarlow did not represent his best interests in the matter. He then met with the prosecutor and revealed the names of several alleged drug traffickers. Upon learning of Lopez\u27s meetings with the prosecutor, Tarlow withdrew from the case. Not long thereafter, Lopez, now with new counsel and evidently dissatisfied with the progress of his plea negotiations, moved to dismiss the indictment, alleging that the government had violated his Sixth Amendment right to counsel and DR 7-104(A)(1) of the American Bar Association\u27s Model Code of Professional Responsibility, which bars an attorney from communicating with a represented party without the knowledge and consent of opposing counsel. The district court found no Sixth Amendment violation,6 but it concluded that the “prosecutor\u27s actions constituted an intentional violation of the long-standing ethical prohibition” expressed in DR 7-104 and that dismissal of the indictment was the appropriate sanction for the government\u27s “flagrant and egregious misconduct.” Although the Ninth Circuit later vacated the district court\u27s order, it found fault only with that court\u27s choice of remedy and agreed with the court\u27s condemnation of the prosecutor\u27s decision to deal with Lopez behind the back, and without the knowledge, of his lawyer

Corporate Headhunting

A wide range of commentators – including some pretty sophisticated ones – have raked through the ruins of the 2008 financial collapse, confident that there are significant criminal prosecutions to bring against individuals and that the Justice Department should be faulted for its failure to bring them. Their confidence that blockbuster criminal cases could have been made rests on shaky grounds. So, too, does their faith that the hunting of heads is a socially productive response to the collapse. If anything, a focus on headhunting will only distract from, and reduce the pressure for, efforts to explain the collapse and prevent its recurrence. In a country where to make a federal case out of something is simply to treat it seriously, one can hardly quarrel with the instincts of laypeople who think that federal prosecutions are a fitting answer to – even a solution for – massive institutional failures over which extravagantly paid chieftains presided. All too frequently absent from current debates has been sustained engagement with realities of federal criminal law enforcement – realities that even Judge Jed Rakoff, a masterful Southern District of New York trial judge and one of the nation\u27s leading white collar crime experts, gave short shrift to in a recent article. The goal of this essay is to bring somewhat prosaic considerations of law and institutional capacity back into the conversation. While I offer little in the way of regulatory or architectural reform, I simply seek to clear away broad rhetoric that can only impede such efforts

Expanding the Evidentiary Frame for Cooperating Witnesses

One telling feature of this conference as a whole has been the extent to which speakers have focused on the cooperation dynamic outside the courtroom. Prosecutors should take more pains to avoid suborning or even unconsciously encouraging perjury by the cooperator who is looking for a lower sentence. Courts and disciplinary authorities should ensure that such pains are taken. What\u27s interesting is how little attention has been given to changing what happens in front of the jury. Since our assignment has been to think outside of the box (which usually means proposing something interesting but really wrong or dangerous), I\u27d like to broach the question of whether we should do more to align the zealous prosecutor\u27s interest in winning with an institutional interest in justice, by expanding the range of proof that a jury ordinarily considers when it comes to cooperation. Trials of course are a rarity in our system. But interactions with prospective witnesses do take place in the shadow of evidentiary rules. In our effort to structure the interaction between prosecutors and cooperators, it is worth considering the incentives, or more precisely the lack of incentives, that prevailing evidentiary rules give to prosecutors

Comments on the Symposium: Expanding Research Opportunities on the Federal Criminal Justice System

A full understanding of how the federal enforcement bureaucracy will elude us without a rich understanding of what makes prosecutors (or agents) tick. However, I suspect that the best way to reach that goal is not to start with this ultimate question. After all, to look closer to home, what do professors “maximize” when they grade papers? Progress is much more likely to be made if we follow Jim Eisenstein and focus on, first, identifying the most salient features of the bureaucratic environment, and, second, getting a handle on their relative influences