Equitable Subordination- where is applies, what it does, and the Implications that result

(Excerpt) Equitable subordination, as permitted under section 510(c)(1) of the Bankruptcy Code, provides the court the ability to reorganize creditor’s debt in the light of any inequitable conduct. The code gives courts the ability to subordinate the level of priority of a creditor’s claim in light of any inequitable conduct committed by that creditor. This remedy is applied in cases where the creditor has acted in an inequitable manner, causing injury or creating unjust positions for other creditors. This remedy is remedial, not punitive, and limited only to the extent necessary to remedy the damage caused by the wrongdoing creditor. Traditionally, equitable subordination was only applied in cases where the wrongdoing creditor was an insider, however, recently this remedy has been applied to all creditors. In addition, equitable subordination was only applied in instances of fraud, but in recent years has been expanded to remedy all unfair and unjust conduct by creditors. Recently a creditor who breached the implied contract of good faith was found to have risen to the level of equitable subordination. Specifically, in In re LightSquared, Inc., a bankruptcy court equitably subordinated the claim of an entity that the founder, chairman of the board, and controlling shareholder of a competitor of the debtor created in order to circumvent a credit agreement’s restrictions on transferring the debt to certain parties. In particular, the court determined that the entity acted in bad conduct by breaching the implied covenant of good faith by (1) circumventing the credit agreement’s restrictions and (2) delaying the closing of the entity’s purchases of debt from other creditors. Further, the court concluded that this conduct resulted in damage to the other creditors. Accordingly, the court decided to equitably subordinate the entity’s claim to the extent necessary to place the other creditors in the position they would have been in if not for the wrongdoing

Guidelines to shape clinical practice. The role of medical societies: The Dutch experience on comparison with recent developments in the American approach

Abstract In the last few years there has been a growing interest in the development of guidelines for care. The most important aim of these guidelines is to improve the quality of care by changing the daily practice of physicians in the desired direction. Therefore besides the scientific basis of guidelines, emphasis should be placed on the implementation of guidelines. Experiences in the Netherlands, where medical societies contribute significantly to the procedure of consensus guidelines development, are described in comparison with new ideas in the U.S.A. regarding criteria setting. Involvement of physician organisations to the development procedure is a necessary requirement for guidelines to shape clinical practice. Furthermore, some interventions used in The Netherlands for improving implementation of guidelines in daily practice are mentioned

Quality systems in Dutch health care institutions

The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived from the European Quality Award-was sent to 1594 health care institutions; the response was 74%. The results showed that in 13% of the institutions a coherent quality system had been implemented. These institutions reported, among other effects, an increase in staff effort and job satisfaction despite the increased workload; 59% of the institutions had implemented parts of a quality system. It appeared that management pay more attention to human resource management compared to documentation of the quality system. The medical staff pay relatively more attention to protocol development than to quality-assurance procedures. Patients were hardly involved in these quality activities. The research has shown that it is possible to monitor the progress of implementation of quality systems on a national level in all subsectors of health care. The results play an important role in the discussions and policy on quality assurance in health care. (aut.ref.

Lifetime health effects and costs of diabetes treatment

BACKGROUND: This article presents cost-effectiveness analyses of the major diabetes interventions as formulated in the revised Dutch guidelines for diabetes type 2 patients in primary and secondary care. The analyses consider two types of care: diabetes control and the treatment of complications, each at current care level and according to the guidelines. METHODS: A validated probabilistic diabetes model describes diabetes and its complications over a lifetime in the Dutch population, computing quality-adjusted life years and medical costs. Effectiveness data and costs of diabetes interventions are from observational current care studies and intensive care experiments. Lifetime consequences of in total sixteen intervention mixes are compared with a baseline glycaemic control of 10% HBA1C. RESULTS: The interventions may reduce the cumulative incidence of blindness, lower-extremity amputation, and end-stage renal disease by >70% in primary care and >60% in secondary care. All primary care guidelines together add 0.8 quality-adjusted life years per lifetime. CONCLUSION: In case of few resources, treating complications according to guidelines yields the most health benefits. Current care of diabetes complications is inefficient. If there are sufficient resources, countries may implement all guidelines, also on diabetes control, and improve efficiency in diabetes care

Het Witterveld bij Assen : een schets van de natuurlijke gesteldheid en een evaluatie van de gevolgen van intensivering van het militair gebruik

RIN vegetatieonderzoek militair oefenterrei