Drawing on both a managerial discipline perspective and an information intermediary perspective, we explore how media coverage of a firm’s controlling shareholder influences firm valuation in corporate China. Using 366 listed family firms in China from 2003 to 2006, we find that firms in which controlling shareholders receive more neutral media reports enjoy higher valuation, whereas negative media reports on controlling shareholders impose adverse effects on firm valuation. Interestingly, favorable media coverage of the controlling shareholders does not enhance (...) firm value. Further analyses reveal that ownership structure and audit quality moderate the relationship between media coverage and firm valuation. Our study complements the emerging literature on the monitoring role of the media on the stock markets. (shrink)

Rumors, for better or worse, are an important element of public discourse. The present paper focuses on rumors as an epistemic phenomenon rather than as a social or political problem. In particular, it investigates the relation between the mode of transmission and the reliability, if any, of rumors as a source of knowledge. It does so by comparing rumor with two forms of epistemic dependence that have recently received attention in the philosophical literature: our dependence on the testimony of others, (...) and our dependence on what has been called the ‘coverage-reliability’ of our social environment (Goldberg 2010). According to the latter, an environment is ‘coverage-reliable’ if, across a wide range of beliefs and given certain conditions, it supports the following conditional: If ~p were true I would have heard about it by now. However, in information-deprived social environments with little coverage-reliability, rumors may transmit information that could not otherwise be had. This suggests that a trade-off exists between levels of trust in the coverage-reliability of official sources and (warranted) trust in rumor as a source of information. (shrink)

Coverage error is an important type of error that occurs in survey studies when there is a mismatch between the target population and the sampling frame from which a sample is drawn. Coverage error...

Sanford Goldberg’s account of epistemic coverage constitutes a special case of Douglas Walton’s view that epistemic closure arises from dialectical argument. Walton’s pragmatic version of epistemic closure depends on dialectical norms for closing an argument, and epistemic coverage operates at the limits of argument closure because it minimizes dialectical exchange. Such closure works together with a shared hypothetical consideration to justify dismissal of surprising claims.

This chapter examines the ethical issues and policy implications of coverage with evidence development (CED). CED is an approach that grants Medicare coverage for a new medical intervention provided that eligible patients participate in research designed to generate further, more robust evidence of safety and net health benefit. However, the CED policy has sparked ethical controversy, with particular concerns voiced that it is coercive and unfairly restricts access to beneficial treatments. This chapter offers a normative analysis of CED (...) and presents a policy justification for this approach to insurance coverage of a new drug or technology. It also considers a range of ethical concerns, such as coercion, the therapeutic misconception, and the right to medical care, and asks whether research participation under CED should be mandatory. Finally, it discusses the distinction between coverage tied to randomized clinical trials and to registries and its implications for research ethics and informed consent. (shrink)

This Viewpoint analyzes policies for covering GLP-1 receptor agonist drugs for obesity treatment across 13 high-income countries. It identifies four key lessons for developing coverage policies: 1) using up-to-date cost-effectiveness analyses that incorporate new evidence of benefits, 2) negotiating lower prices while preserving innovation incentives, 3) prioritizing coverage for specific populations rather than issuing blanket denials, and 4) treating obesity medications similarly to high-cost drugs for other conditions. It argues that blanket coverage denials are unethical and that (...) countries should implement targeted coverage policies that maximize benefits while managing costs. (shrink)

Politics and religion are two concepts that have constantly intertwined throughout history and continue to do so at the start of the third millennium. Previous studies show that religion plays an important part in the political life and the concepts of state and church are connected. Although there are also certain discursive manners in which the Church adapts to political and socio-economical contexts, it is much more often that the connection between the two spheres of communication (political and religious) comes (...) from the part of politicians. The article deals with notions such as pseudo-events, media spectacle, political marketing and using religion as a tool for political positioning. The current research is based on an analytical descriptive method: the media content analysis. The focus of the analysis is on the highest rated daily print media and it covers the period from 2007 to 2010. It checks the prevalence of politicians in the media coverage of religious events on the most important religious holidays of the year: Easter, St Mary and Christmas. The most relevant results of the study show that the intertwining of politics and religion is often negatively reflected by the media. The results are a necessary addition to previous studies (Iancu and Balaban) that had only focused on a quantitative analysis of politicians' media coverage during religious festivities. (shrink)

We study the coverage of European funds by the mass media and the relationship between media sentiment and public sentiment. We analyze 31,570 media articles published across all European Union (EU) countries between January 1, 2020, and December 31, 2023 — a period significantly shaped by the COVID-19 pandemic and major EU funding initiatives —using the BERTopic modeling technique. We find that public discussions related to European funds can be categorized into 11 distinct topics, ranging from project developments in (...) Central and Eastern Europe to employment and economic measures. Our results show that during the period studied, public sentiment towards European funds is generally stable yet negative, with notable fluctuations corresponding to specific events. Significant positive and negative peaks in sentiment are observed during periods associated with successful project implementations or corruption scandals. We also find significant geographical variation in media coverage and sentiment across EU member states. While Greece, Croatia, and Bulgaria exhibit high media coverage and more negative sentiment, Denmark, Ireland, and Portugal display more positive media sentiments. Our results suggest a negative relationship between media sentiment scores and the proportion of negative responses concerning the EU and the European Parliament (i.e., a proxy for Euroscepticism). (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used (...) by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

I modify the standard coverage construction of the reals to obtain the irrationals. However, this causes a jump in ordinal complexity from ω+1 to Ω.

Well-being is an important policy concept including in discussions around the use of artificial intelligence, machine learning and robotics. Disabled people experience challenges in their well-being. Therefore, the aim of our scoping review study of academic abstracts employing Scopus, IEEE Xplore, Compendex and the 70 databases from EBSCO-HOST as sources was to better understand how academic literature focusing on AI/ML/robotics engages with well-being in relation to disabled people. Our objective was to answer the following research question: how and to what (...) extent does the AI/ML/robot literature we covered include well-being in relation to disabled people? We found 2071 academic abstracts covering AI/ML and well-being, and 1055 covering robotics and well-being. Within these abstracts, only 39 covered AI/ML and 48 robotics and well-being in relation to disabled people. The tone of the coverage was techno-positive and techno-optimistic arguing that AI/ML/robotics could improve the well-being of disabled people in general or improve well-being by helping disabled people overcome their ‘disability’ or make tasks easier. No negative effects that AI/ML/robotics could have or has had on the well-being of disabled people were mentioned. Disabled people were portrayed only within patient, client, or user roles but not in their roles as stakeholders in the governance of AI/ML/robotics discussions. This biased and limited coverage of the impact of AI/ML/robotics on the well-being of disabled people disempowers disabled people. (shrink)

Mass media play a significant role in shaping public opinion. News coverage of abortion reflects narratives about reproductive health, ethics, and women, and may potentially reinforce negative soci...

This article analyzes American television and American and British print news coverage of human rights using a combination of manual and machine coding. The data reveal that television and print news cover very few human rights stories, that these stories are mostly international and not domestic, that even when human rights are covered, they are not covered in detail, and that human rights issues are more likely to be covered when they are not framed as human rights. This suggests (...) that human rights is simply not a frame that journalists employ and provides support for government-leading-media theories of newsworthiness. (shrink)

As the media wrestle with ethical and legal problems in coverage of AIDS stories, such as privacy, terminology, and disclosure, a question is raised about the educational role the media will assume in the face of this health threat. Despite health department hopes for candor in dealing with the threat, blunt‐language ads and commercials have been rejected by most New York City media and legislation may restrict the extent to which media deal with the question. Though the media alone (...) cannot bear the burden of AIDS education, they must provide point‐man services. (shrink)

While the impacts of the Affordable Care Act will vary across the states given their different circumstances, Massachusetts’ 2006 reform initiative, the template for national reform, provides a preview of the potential gains in insurance coverage, access to and use of care, and health care affordability for the rest of the nation. Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were (...) widespread, including a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs. (shrink)

Suicide is a major problem in the United States, with the number of suicides annually exceeding the number of homicides by 10,000. Many studies have examined the relationship between media coverage of suicides and the suicide rate. This article reviews literature on imitative suicide and discusses implications of suicide stories on people in crisis. In addition, it explores the options for suicide coverage and gives suggestions for more ethical coverage that could save people's lives, rather than reinforcing (...) suicide as an option. (shrink)

Media coverage of the effects of abortion restrictions on the care of pregnant patients is an important tool in advocacy for legal access to abortion care. Savita Halappanavar is remembered not onl...

Improvements in the health capital of citizens are central to the development of countries. By exploiting steep decreases in antiretroviral drug prices and the subsequent increases in antiretroviral therapy (ART) coverage, we test whether the resulting improvements in the health of the population are associated with the prevalence of entrepreneurial activity and whether entrepreneurial activity strengthens the relationship between ART coverage and a country’s development. Drawing on a sample of 87 low- and middle-income countries (2006–2019), we find that (...) a 1% increase in ART coverage is associated with a 1.5% increase in the number of newly registered limited liability firms; however, there is no significant relationship with (male or female) self-employment. Higher ART coverage is particularly associated with development—as proxied by gross domestic product (GDP) per capita and the Human Development Index—in countries with low levels of new business formation and high proportions of self-employment. (shrink)

As health policy-makers around the world seek to make progress towards universal health coverage they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We argue first that these points of tension stem largely from (...) inadequate interpretations of the aims of priority setting as well as the right to health. We then discuss various ways in which the right to health complements traditional concerns of priority setting and vice versa. Finally, we set out a three-step process by which policy-makers may navigate the ethical and legal considerations at play. (shrink)

The coverage of national tragedies by the news media has come under increasing criticism. Yet, we continue to watch, listen, and read. One approach to resolving this conflict is through an understanding and recognition of the contribution the news media make to public discourse and public grieving.Themes from communication studies, political theory, and contemporary ethics are all employed to develop a new perspective on this type of news coverage. The perspective taken here is based on the ritual view (...) of communication, according to which the purpose of communication is the maintenance of society and the representation of shared beliefs. The argument is made that the news media in these tragic situations have the responsibility of providing needed information, stimulating public discourse, bringing us together as a community of fellow-citizens, and telling stories that engage our emotions and lead us to re-evaluate our own values, attitudes, choices, and actions. Specific examples are provided from the September 11 attacks to demonstrate that in all of these ways the news media make a valuable contribution to public grieving by initiating and supporting the kind of public discourse that can meet human needs in the face of grief and loss. (shrink)

Activists’ investigations of animal cruelty expose the public to suffering that they may otherwise be unaware of, via an increasingly broad-ranging media. This may result in ethical dilemmas and a wide range of emotions and reactions. Our hypothesis was that media broadcasts of cruelty to cattle in Indonesian abattoirs would result in an emotional response by the public that would drive their actions towards live animal export. A survey of the public in Australia was undertaken to investigate their reactions and (...) responses to. The most common immediate reaction was feeling pity for the cattle. Women were more likely than men to feel sad or angry. Most people discussed the media coverage with others afterwards but fewer than 10 % contacted politicians or wrote to newspapers. We conclude that the public were emotionally affected by the media coverage of cruelty to cattle but that this did not translate into significant behavioral change. We recommend that future broadcasts of animal cruelty should advise the public of contact details for counseling and that mental health support contacts, and information should be included on the websites of animal advocacy groups to acknowledge the disturbing effect animal cruelty exposes can have on the public. (shrink)

The middle-market tabloid newspapers in Britain help to shape a perception of teachers and state schools that is mostly negative and derisory. This article provides examples of this bias in newspaper reportage based on a case study of an annual teacher union conference and journalists' different interpretations of events generally.

This article focuses on how leaders of new right-wing populist parties are portrayed in the mass media. More so than their established counterparts, new parties depend on the media for their electoral breakthrough. From a theoretical perspective, we expect prominence, populism, and authoritativeness of the party leaders' media appearance to be essential for their electoral fortunes. We used systematic content analyses of 17 Dutch media outlets during the eight weeks prior to the 2006 national elections (n = 1,001) and compared (...) the appearances of four right-wing populist and seven mainstream party leaders. This article makes two contributions to the existing literature: First, we develop valid and reliable indicators of authoritativeness and populism and apply them to a systematic content analysis. Second, we show that more successful right-wing populist leaders were more prominent during the election campaign and that the most successful right-wing populist leader also appears more authoritative in the news. (shrink)

In recent years, there has been a growing groundswell of support for the idea that universal health coverage should be provided even in the developing world. While I wholeheartedly agree with the eventual goal of attaining universal health coverage globally, and the sooner the better, I have worries as to whether the world's rich countries, or institutions like the World Health Organization, should be pushing the world's poorest countries to take whatever steps are necessary to achieve that goal. (...) My fear is that universal health coverage in the developing world is an intoxicating, but potentially dangerous, idea whose time may not yet have come. This article's aim is not to settle the question of whether the developing world should be urged, or pushed, to adopt policies of universal health coverage. It is merely to explore some worries about the wisdom of such a tack. The article is divided into eight sections. In Section 1, I give a brief introduction. In Section 2, I provide some background for my topic. In Section 3, I discuss the notion of universal health coverage, and what the push for such a goal in the developing world seemingly involves. In Section 4, I raise some general worries I have about the push for universal health coverage in the developing world. In Section 5, I present a wide range of possible justifications for universal health coverage in the developing world. In Section 6, I discuss whether any of the purported justifications of universal health coverage in the developing world actually do so. In Section 7, I consider some comments, objections, and responses. Finally, in Section 8, I offer a brief conclusion. (shrink)

In his “Games and the Art of Agency,” C. Thi Nguyen makes an intriguing and very plausible suggestion: games, or at any rate a great many of them, are artworks whose medium is, roughly, how one goes about doing what one does. In assigning an objective, laying down the constraints under which it has to be achieved, and specifying the terrain on which it will be played out, a game sculpts the decision-making processes of its players, the ways they see (...) their environment and option space, their motivations, and much else. Thus our by now quite extensive repertoire of games constitutes a library of agency. This library allows us to try on different modes of agency before deciding which is best for us—for a given type of occasion, or generally. It can help educate us into unfamiliar forms of agency, by providing the sort of controlled exercises that allow beginners the practice they need, which is to say that games are exercise and preparation for autonomous agency. And it promises to broaden and enrich our philosophical treatments of the topic, in part by serving as a testbed for competing theories of practical rationality; if we want to get a realistic sense of what it would be like to decide what to do, in the way that one or another theory of practical deliberation says, we can experiment with it in an appropriately designed game. (shrink)

Over the past decades, anti-cancer treatments have evolved rapidly from cytotoxic chemotherapies to targeted therapies including oral targeted medications and injectable immunooncology and cell therapies. New anti-cancer medications come to markets at increasingly high prices, and health insurance coverage is crucial for patient access to these therapies. State laws are intended to facilitate insurance coverage of anti-cancer therapies.Using Massachusetts as a case study, we identified five current cancer coverage state laws and interviewed experts on their perceptions of (...) the relevance of the laws and how well they meet the current needs of cancer care given rapid changes in therapies. Interviewees emphasized that cancer therapies, as compared to many other therapeutic areas, are unique because insurance legislation targets their coverage. They identified the oral chemotherapy parity law as contributing to increasing treatment costs in commercial insurance. For commercial insurers, coverage mandates combined with the realities of new cancer medications — including high prices and often limited evidence of efficacy at approval — compound a difficult situation. Respondents recommended policy approaches to address this challenging coverage environment, including the implementation of closed formularies, the use of cost-effectiveness studies to guide coverage decisions, and the application of value-based pricing concepts. Given the evolution of cancer therapeutics, it may be time to evaluate the benefits and challenges of cancer coverage mandates. (shrink)

As pressures increase to contain growing healthcare expenditures, there is currently a prominent rise in the shift of healthcare costs to patients in the form of deductibles, co-pays, and co-insurance. Rising co-payments are part of a larger picture of increasing overall out-of-pocket healthcare expenditures. From 1990 to 2000, per capita out-of-pocket payments for healthcare reached $707 in the United States, and doubled in several European countries with universal health insurance, reaching $396 in Denmark, $290 in Germany, and $466 in Italy (...) in 2000. (shrink)

Objective: To assess the relation between autocratisation—substantial decreases in democratic traits (free and fair elections, freedom of civil and political association, and freedom of expression)—and countries’ population health outcomes and progress toward universal health coverage (UHC). -/- Design: Synthetic control analysis. -/- Setting and country selection: Global sample of countries for all years from 1989 to 2019, split into two categories: 17 treatment countries that started autocratising during 2000 to 2010, and 119 control countries that never autocratised from 1989 (...) to 2019. The treatment countries comprised low and middle income nations and represent all world regions except North America and western Europe. A weighted combination of control countries was used to construct synthetic controls for each treatment country. This statistical method is especially well suited to population level studies when random assignment is infeasible and sufficiently similar comparators are not available. The method was originally developed in economics and political science to assess the impact of policies and events, and it is now increasingly used in epidemiology. -/- Main outcome measures: HIV-free life expectancy at age 5 years, UHC effective coverage index (0-100 point scale), and out-of-pocket spending on health per capita. All outcome variables are for the period 1989 to 2019. -/- Results: Autocratising countries underperformed for all three outcome variables in the 10 years after the onset of autocratisation, despite some improvements in life expectancy, UHC effective coverage index, and out-of-pocket spending on health. On average, HIV-free life expectancy at age 5 years increased by 2.2% (from 64.7 to 66.1 years) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by 3.5% (95% confidence interval 3.3% to 3.6%, P<0.001) (from 64.7 to 66.9 years) in the absence of autocratisation. On average, the UHC effective coverage index increased by 11.9% (from 42.5 to 47.6 points) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by 20.2% (95% confidence interval 19.6% to 21.2%, P<0.001) (from 42.5 to 51.1 points) in the absence of autocratisation. Finally, on average, out-of-pocket spending on health per capita increased by 10.0% (from $4.00 (£3.1; €3.4) to $4.4, log transformed) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by only 4.4% (95% confidence interval 3.9% to 4.6%, P<0.001) (from $4.0 to $4.2, log transformed) in the absence of autocratisation. -/- Conclusions: Autocratising countries had worse than estimated life expectancy, effective health service coverage, and levels of out-of-pocket spending on health. These results suggest that the noticeable increase in the number of countries that are experiencing democratic erosion in recent years is hindering population health gains and progress toward UHC. Global health institutions will need to adjust their policy recommendations and activities to obtain the best possible results in those countries with a diminishing democratic incentive to provide quality healthcare to populations. (shrink)

(2013). Norway's Media Coverage: The Salute of a Man who does not Regret. Journal of Mass Media Ethics: Vol. 28, No. 1, pp. 59-61. doi: 10.1080/08900523.2013.755078.

(2013). Is Ideological Coverage On Cable Television An Ethical Journalistic Practice? An Examination of Duty, Responsibility, and Consequence. Journal of Mass Media Ethics: Vol. 28, No. 1, pp. 1-14. doi: 10.1080/08900523.2012.746533.

As the only nation in the western world without a national health insurance program, the United States faces ongoing issues of access and fairness in health care coverage. The Clinton administration tried and failed to address the problem of universal coverage. Since then we have focused on the narrower, but nonetheless real, issues of fairness and equity in the benefits package provided in insurance plans. The LORAN Commission spent two years trying to devise agreed-upon principles to govern such (...) issues. The lesson learned was the same as that of the Ethics Force study: there was no possibility of getting agreement, let alone consensus, among the participants on how to decide what should be a covered benefit. There were, however, two generally agreed upon principles that emerged regarding health care: “Every individual should be treated alike,” and “When it comes to health, cost cannot be a consideration.” That formula translated into providing everyone with everything. The only certain outcome from such a policy would be fiscal insolvency and ultimately bankruptcy. (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. Contradicting (...) Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)

American health policy today faces dual problems of too little coverage at too high a cost. The mix of private and public financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country’s productive capacity. The U.S. pays well above what other countries pay and what many people, health plans, businesses, and governments want to pay. This “paradox of excess and (...) deprivation” results from the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

From its beginnings in the 1978 Declaration of Alma-Ata, universal health coverage (UHC) has been constantly evolving, notably so within the last ten years. Although the 2015 Sustainable Development Goals, which identify both UHC and social protection among its targets, represent an important juncture in this evolution, several States are unlikely to meet the 2030 target deadline. This article traces the history of UHC and social (health) protection in global health law, focusing on their development over the past ten (...) years. It concludes by reflecting on what the future of UHC and social (health) protection should look like and what is needed to fully realize their potential to achieve equity and to meaningfully contribute to the betterment of people and planet, highlighting human rights, One Health, legal and financial considerations as key for the future. (shrink)

This issue’s “Legal Briefing” column covers the recent decision by the Centers for Medicare and Medicaid Services (CMS) to expand Medicare coverage of advance care planning, beginning 1 January 2016. Since 2009, most “Legal Briefings” in this journal have covered a wide gamut of judicial, legislative, and regulatory developments concerning a particular topic in clinical ethics. In contrast, this “Legal Briefing” is more narrowly focused on one single legal development. This concentration on Medicare coverage of advance care planning (...) seems warranted. Advance care planning is a frequent subject of articles in JCE. After all, it has long been seen as an important, albeit only partial, solution to a significant range of big problems in clinical ethics. These problems range from medical futility disputes to decision making for incapacitated patients who have no available legally authorized surrogate. Consequently, expanded Medicare coverage of advance care planning is a potentially seismic development. It may materially reduce both the frequency and severity of key problems in clinical ethics. Since the sociological, medical, and ethical literature on advance care planning is voluminous, I will not even summarize it here. Instead, I focus on Medicare coverage. I proceed, chronologically, in six stages: 1. Prior Medicare Coverage of Advance Care Planning 2. Proposed Expanded Medicare Coverage in 2015 3. Proposed Expanded Medicare Coverage in 2016 The Final Rule Expanding Medicare Coverage in 2016 4. Remaining Issues for CMS to Address in 2017 5. Pending Federal Legislation. (shrink)

As health policy-makers around the world seek to make progress towards universal health coverage they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We argue first that these points of tension stem largely from (...) inadequate interpretations of the aims of priority setting as well as the right to health. We then discuss various ways in which the right to health complements traditional concerns of priority setting and vice versa. Finally, we set out a three-step process by which policy-makers may navigate the ethical and legal considerations at play. (shrink)

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These (...) case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

© JNCCN-Journal of the National Comprehensive Cancer Network.Background: Next-generation tumor sequencing panels, which include multiple established and novel targets across cancers, are emerging in oncology practice, but lack formal positive coverage by US payers. Lack of coverage may impact access and adoption. This study identified challenges of NGTS coverage by private payers.Methods: We conducted semi-structured interviews with 14 NGTS experts on potential NGTS benefits, and with 10 major payers, representing more than 125,000,000 enrollees, on NGTS coverage (...) considerations. We used the framework approach of qualitative research for study design and thematic analyses and simple frequencies to further describe findings.Results: All interviewed payers see potential NGTS benefits, but all noted challenges to formal coverage: 80% state that inherent features of NGTS do not fit the medical necessity definition required for coverage, 70% view NGTS as a bundle of targets versus comprehensive tumor characterization and may evaluate each target individually, and 70% express skepticism regarding new evidence methods proposed for NGTS. Fifty percent of payers expressed sufficient concerns about NGTS adoption and implementation that will preclude their ability to issue positive coverage policies.Conclusions: Payers perceive that NGTS holds significant promise but, in its current form, poses disruptive challenges to coverage policy frameworks. Proactive multidisciplinary efforts to define the direction for NGTS development, evidence generation, and incorporation into coverage policy are necessary to realize its promise and provide patient access. This study contributes to current literature, as possibly the first study to directly interview US payers on NGTS coverage and reimbursement. (shrink)