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Numerous consumer protection regulations (e.g., No Surprises Act, Transparency in Coverage) have been implemented recently in the United States that could impact private health insurance prices and patient cost-sharing for many health care services. We use a large multi-payer database of health insurance claims for employer-sponsored health plans in the U.S. to describe the trajectory of prices and patient cost-sharing for the services of clinicians that are likely most affected by these regulatory changes: emergency physicians, radiologists, pathologists, and neonatologists. We find that in-network prices and patient cost-sharing generally increased for all four specialties between 2012 and 2022. However, all four specialties experienced periods of decline in out-of-network prices and cost-sharing, with different starting points, and substantial reductions in prices and cost-sharing from 2021 to 2022, particularly for self-funded health plans. Although we cannot isolate the causal impact of any law or regulation, our results suggest that out-of-network prices and cost-sharing decreased when the NSA and TIC were implemented in 2022, especially for the previously less regulated self-funded health plans. Our results imply that patients who previously struggled with the financial burdens of surprise out-of-network medical bills may have benefited significantly from the recent regulatory changes.
This article identifies and analyzes a select body of climate litigation, framing such litigation as a decolonial approach to legal mobilization. Drawing on 58 cases filed between 2003 and 2023, we examine how certain climate lawsuits – spanning diverse jurisdictions, legal claims, and forums – articulate political projects grounded in historical struggles against colonialism, racial capitalism, and extractivism. Instead of adopting conventional typologies based on rights, torts or procedural elements, we propose a political lens attentive to the subaltern voices, contexts, and narratives that animate these cases. We identify commonalities across this litigation: racialized plaintiffs, three contexts of decolonial struggle (settler colonies, metropoles/(post)colonies, and global peripheries), and four distinctive types of decolonial claim. While these cases remain partially entangled with liberal legal frameworks, they nonetheless contest dominant climate governance paradigms and advance emancipatory visions of justice. We argue that these cases represent a tactical, albeit imperfect, intervention in the struggle for decolonial climate justice.
This article presents a preliminary study of the judicialization of unequal health impacts of climate change in climate litigation. Reviewing cases addressing unequal health impacts of climate change, the sample reveals that 60% of health-related cases involve intersectional dimensions, addressing health inequalities tied to gender, race, ethnicity, Indigeneity, or age. This serves as a departure point for a systematic content analysis of six transnational climate cases, analysing how plaintiffs use health-related scientific evidence and how judges respond to it in the first stage of judicial decisions. Results show that plaintiffs often present general scientific knowledge rather than specific evidence of intersecting vulnerabilities. While judges acknowledge these scientific claims, procedural dismissals limit opportunities for substantive engagement with intersectional health claims. These findings raise questions about the availability and strategic use of scientific evidence on intersecting vulnerabilities, and call for further research on the emerging phenomenon of health narratives and their normative and evidentiary value.
This article brings a critical feminist phenomenological lens to a central pillar of the international humanitarian law regime – the proportionality rule – and reflects on how the narrow, masculine orientation of the norm fails to accommodate women’s experiences of incidental mental harm. While women disproportionately experience double the rates of post-traumatic stress disorder in response to trauma events than do men, the proportionality rule does not expressly include mental harm within its ambit, exposing the rule to conservative interpretation and exclusionary applications for gendered mental harm. Some interpretations of the temporal constraints of the rule (concerned with the legality of single strikes, absent their latent, reverberating effects) reflect a dominant event-based legal model at odds with women’s experiences of mental harm that are protracted, cumulative and repercussive. Studies reveal women’s fear as a product of constructions of masculinity and femininity, structural inequity, and fear conditioning. This article offers a reparative response through a gendered and temporal alignment of the principle of proportionality with women’s experiences of mental harm in armed attacks.
The genre of Islamic juristic opinions (fatāwā or nawāzil) provides a fascinating window into how Muslim jurists—both medieval and modern—have applied theoretical sharī‘a guidelines to actual problems facing their communities. Because Muslim practitioners have historically sought fatāwā (sing. fatwā) on matters ranging from the legal to the ethical to the ritual, these juristic opinions allow us to trace not only the concerns of believers in different Muslim societies over time, but also the moral imagination of the jurists as they grappled with those concerns. In this article, I present a close reading of a fatwā by the late modern Moroccan jurist al-Mahdī b. Muḥammad al-Wazzānī (1849–19231) on the moral value of polygamy versus monogamy. I show how his legal opinion can be fruitfully read in the context of larger debates across the Middle East and Muslim societies over marriage law and ethics. I suggest that al-Wazzānī’s fatwā represents a traditionalist reaction to the wave of modernist-feminist religious reform that was sweeping through the region at the turn of and into the twentieth century, and that sought to discredit the traditional Islamic practice of polygamy in favor of monogamy.
The year 2024 marked a turning point for EU delict law, as the EU adopted a new Product Liability Directive to replace its 1985 predecessor. The new Directive, however, does more than modernise product liability law. It also reflects a deeper shift in how the EU uses private law as a tool of governance. While doctrinal commentary has largely treated the Directive as a remedial private-law instrument, this article argues that it also pursues regulatory functions. In that sense, it reflects the increasingly blurring boundary between private and public law, a development already noted in European legal scholarship. This article contributes to that debate in three ways. First, it shows how that regulatory dimension is expressed through the Directive’s objectives, namely the internal market, innovation, the circular economy and private enforcement. Second, it argues that those objectives are not relevant in every dispute, but only where particular provisions giving effect to them are applied. Third, it proposes a three-step test for determining when regulatory objectives are relevant in a given dispute and examines the consequences that follow: where this is so, those provisions should be interpreted differently from classic private-law provisions, through a forward-looking reading that advances those regulatory aims.
This paper examines the relationship between provider market consolidation, setting-of-care (SOC) dynamics, and healthcare costs in the United States. The authors argue that consolidation is not solely a driver of rising unit prices, but also a response to structural pressures, including rising practice costs, stagnant physician reimbursement, and increasing administrative complexity. Drawing on recent empirical analyses, the authors demonstrate that prices vary substantially by SOC, with hospital outpatient departments representing the highest-cost settings. They further show that physician affiliation models are associated with distinct patterns of SOC utilisation. These findings suggest that the relationship between consolidation and cost is not uniform and depends on underlying organisational incentives. The authors contend that current policy discourse around private capital lacks sufficient nuance and risks obscuring more fundamental drivers of cost growth, particularly reimbursement design. They call for a more balanced dialogue and additional research to better understand how consolidation, payment policy, and SOC decision-making interact, concluding that policymakers should prioritise incentives that support clinically appropriate care in lower-cost settings.
Clinicians and consumers have long been interested in using purpose-built chatbots to provide mental health support. Specifically designed therapy chatbots are now available direct-to-consumer, even though researchers have yet to establish their efficacy, safety and viability. However, whatever their clinical merits or limitations, the role for specialised therapy chatbots has been overshadowed by the increasing number of people using AI companions and general-purpose generative AI for mental health support. Reports have implicated these offerings in instances of user self-harm, prompting calls for more robust regulation across the entire field. This Element examines the opportunities, risks and legal landscape of AI for direct-to-consumer mental health support and considers a response of distributed regulatory networks. This approach abandons any pretence of a single body of law providing an effective and palatable response for concerns raised by therapy chatbots and the challenges posed by evolving technologies operating in sensitive domains.
In 2019, the 33rd International Conference of the Red Cross and Red Crescent adopted the landmark Resolution 2 on “Addressing the Mental Health and Psychosocial Needs of People Affected by Armed Conflicts, Natural Disasters and Other Emergencies”. By examining Resolution 2’s origin and the time and context in which it was adopted, and by analyzing its normative influence on subsequent international instruments adopted by States, this article explores how Resolution 2 has contributed to advancing and establishing norms and standards for responding to the mental health and psychosocial needs of people affected by armed conflicts and other emergencies.
This paper introduces the Granular Trade and Production Activities (GRANTPA) database, which covers international trade flows for 3,124 products and 247 countries over the period 1995–2019 as well as domestic trade flows and production data for the same number of products and years for a subset of 35 European economies. The original data sources that we employ are Eurostat’s Comext and Prodcom databases. A gravity application delivers a large set of product-level ‘home bias’ estimates, which cannot be obtained without domestic trade flows. The average estimates on the standard gravity variables in our model (e.g., distance) are comparable to those from the related literature. However, our disaggregated estimates are very heterogeneous across products, thus highlighting the importance of our new database.
Beyond the Metrics examines how fitness technology subtly affects self-image, social anxiety, and mental well-being through wearables, performance monitoring, and digital affirmation. It uniquely combines academic insights with their practical experiences in competitive sports, user experience, and psychosocial research. It critically examines how fitness technology, while intended to be empowering, can paradoxically lead to self-objectification, social comparison, and performance anxiety. The authors explore the mental health effects of focusing on numbers related to the body, including body dysmorphia in bodybuilding and anxiety from online fitness tracking and social media. This timely book uses sports science, psychology, user experience (UX), and gender studies to explore the risks and potential solutions. Perfect for researchers, mental health professionals, athletes, and tech designers.
What is the employment law at international organizations? The answer – international administrative law – implements treaty-based employment at all international organizations, including the United Nations, International Labour Organization and The World Bank. It governs an encounter between the status of the international civil service, administrative authority at international organizations and the jurisprudence of international administrative tribunals. For the first time, the universal legal basis of international administrative law is concisely and clearly introduced, tracking the employee lifecycle, from selection, through remuneration, performance management and integrity, to ending service. Drawing on the judgments of multiple administrative tribunals, a clear and usable interpretative framework of interconnected legal principles and legal duties is established. Intended for all staff at international organizations, Member State representatives, legal practitioners and scholars, this book serves as the basis for a shared understanding of international administrative law, equal to the enormity of the endeavours entrusted to the international civil service.
Australia, and Australians, stood at a crossroads in October 2023. Before them lay a new and more accommodating way to practice democracy, a future in which First Nations people were given a representative voice in political decisions in this country. After months of a referendum campaign, struggling over foundational ideals and questions of national identity, misinformation, disinformation and racism, the proposal was overwhelmingly rejected in every Australian state and nationally. The referendum campaign was Australia’s first since the failed attempt at a republic in 1999. The political and media environment in which the referendum campaign would unfold was fundamentally changed. These changes included the growth of social media, growing distrust of major political parties, and the rise of fake news and populist politics. This book brings together a diverse set of perspectives to explore the many and complex political, social and historical factors that influenced the conduct of the campaign and led to the loss. It includes contributions from lawyers, political scientists, historians, human rights experts, health policy experts, land rights campaigners and Indigenous affairs policy experts. The contributors in this book include First Nations and non-Indigenous authors, often writing collaboratively. The majority of the views offered, based in expertise and experience, are those of First Nations. Their writings place the referendum loss in the context of political failure and attempts at structural reform, and Australia’s terrible record at amending the Constitution through referendums. The book traces the legal and political development of the draft constitutional provision, and the influence of legal risk on the campaign. A major focus of the book is the impact of misinformation and disinformation, which was rife during the campaign, and media reporting of it. The role that civil society and corporate Australia played in the campaign is considered. The Voice campaign will be placed in the context of Aboriginal and Torres Strait Islander politics and previous attempts at representation. The book will also place the call for Voice in the context of its ongoing relevance and imperative in Aboriginal and Torres Strait Islander affairs, explaining the power of representation, the Voice as an expression of sovereignty, and the need for Voice to pursue other structural reforms such as treaty and to realise the promise of land rights. The book concludes by reflecting on the role that history played in the campaign and the implications of the campaign for the practice of Australian history. The book holds lessons for future constitutional change, Indigenous recognition, structural reform and Australia’s democracy. It also looks, with constructive pragmatism, at the future direction of First Nations structural reform in Australia and the practice of democracy.
Revolutionary Cuba does not recognize the liberal rights on which LGBTQ advocates in the United States rely. How then, has legal progress occurred for LGTBQ people in Cuba? This book traces the history of LGBTQ identity and law in Cuba and the US from the turn of the twentieth century through the legalization of same-sex marriage. It investigates material and discursive conditions during and after the Cold War and the under-recognized importance of legal consciousness. Applying comparative legal analysis, genealogy, critical social theories, and interviewing, the book produces an encounter between Cuba and the US that directs attention to the millions of constitutive run-ins that occur daily between the global and the local. Rich and insightful, it reveals how law and identity evolve under imperialism, anxious nationalisms, racial stratification, and economic hardship.
This chapter addresses the treaty-making processes of some important biological diversity-related treaties whose existence can be traced back to the 1972 Stockholm Convention – in particular, treaties relating to access and benefit sharing from genetic materials related to biosafety. The chapter assesses the extent to which, in the negotiating processes relating to those treaties, the aspirations of developing countries have been adequately catered to. In particular, it suggests that, while in many instances the negotiations were commenced on the basis of the aspirations of developing countries, the final products often deferred these demands to future processes.