On April 26, 1995, the United States Supreme Court limited the reach of the preemption provision of ERISA in New York State Conference of Blue Cross & Blue Shield Plans v. Tavelers Insurance Co. ). In Travelers, the Supreme Court upheld the validity of a New York statute requiring hospitals to collect surcharges from patients covered by commercial insurers and requiring health maintenance organizations to pay a surcharge to the state's general fund that varies depending on the number of Medicaid-eligible (...) HMO members enrolled. Neither patients insured by Blue Cross/Blue Shield plans nor the plans themselves are similarly charged under the statute. Several commercial insurers and HMOs claimed the surcharges should be preempted under ERISA because they are levied on patients whose insurance or HMO membership premiums are purchased by an ERISA plan.The ERISA preemption clause means that federal regulation, or lack thereof, supersedes state regulation that is related to employee pension and benefit plans. This preemption clause prevents states from changing health care and benefit law for a significant portion of state residents. (shrink)

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

This revised version of Price's 1960 Gifford Lectures in two series at Aberdeen University presents an extensive analysis of the concept of belief and related problems. The author begins by exploring different senses of knowledge. He continues to examine some logical peculiarities of expressions about believing and knowing, of relationships between the two types of expressions, and remarks on the performatory aspects of the relevant expressions. Connections between believing, and the bearing on beliefs of perceptual evidence, self-consciousness, memory and testimony (...) are examined. The results of this examination are applied to introduce systematic distinctions and concepts, which are made constitutive of the concept of belief. The notion of degrees of belief is introduced. The problem of degrees of assent is examined in the context of Newman's criticisms of Locke's view. Specific theories of belief are surveyed, beginning with Hume's theory, and two traditional occurrence analyses of belief are touched upon. The first series is concluded with a brief examination of Descartes' and Hume's views on freedom of assent. The second series examines various dispositional analyses of belief; the notions of believing and "acting as if" are compared, and the connection between inference and assent examined. The notion of half-belief is reviewed, along with Newman's distinction between real and notional assent, and James' self-verifying beliefs. The second series concludes with a discussion of moral beliefs and feelings; belief "in" and belief "that" are compared, and the possibility of a rapprochement between religious belief and empiricist philosophy is examined. While the author offers no full-blown theory of belief--and does not purport to do so--he provides a most informative discussion of the matrix of epistemological and psychological problems called belief, offers new criticisms of both older and present-day views on persisting problems for belief-analysis, and refines these views with new distinctions and concepts.--J. R. H. (shrink)

The experience of newborn screening for Krabbe disease in New York State demonstrates the ethical problems that arise when screening programs are expanded in the absence of true understanding of the diseases involved. In its 5 years of testing and millions of dollars in costs, there have been very few benefits, and the testing has uncovered potential cases of late-onset disease that raise difficult ethical questions in their own right. For these reasons, we argue that Krabbe screening should only be (...) continued as a research project that includes the informed consent of parents to the testing. (shrink)

From the 5th edition of Beauchamp and Childress' Principles of Biomedical Ethics, the problem of common morality has been given a more prominent role and emphasis. With the publication of the 6th and latest edition, the authors not only attempt to ground their theory in common morality, but there is also an increased tendency to identify the former with the latter. While this stratagem may give the impression of a more robust, and hence stable, foundation for their theoretical construct, we (...) fear that it comes with a cost, namely the need to keep any theory in medical ethics open to, and thereby aware of, the challenges arising from biomedical research and clinical practice, as well as healthcare systems. By too readily identifying the moral life of common morality with rule-following behaviour, Beauchamp and Childress may even be wrong about the nature of common morality as such, thereby founding their, by now, classic theory on quicksand instead of solid rock. (shrink)

This article presents the Pilgrimage Model as a template for educators wishing to lead students on site-specific studies of engaged learning. During the 2015–2016 academic year, a group of Georgeto...

We report specific heat and μSR measurements on Th and/or B substituted UBe13. The specific heat data show that either Th or B substitution reduces the Kondo temperature TK and increases the entropy at the superconducting transition by almost 20%, indicating an enhanced density of states. However, whereas μSR shows clear evidence for magnetic correlations for Th substitutions, no magnetism is observed for B substitutions. The enhanced specific heat jump in the B-substituted material is associated with a change in the (...) superconducting properties as TK is reduced. (shrink)

[D. H. Mellor] Kant's claim that our knowledge of time is transcendental in his sense, while false of time itself, is true of tenses, i.e. of the locations of events and other temporal entities in McTaggart's A series. This fact can easily, and I think only, be explained by taking time itself to be real but tenseless. /// [J. R. Lucas] Mellor's argument from Kant fails. The difficulties in his first Antinomy are due to topological confusions, not the tensed nature (...) of time. Nor are McTaggart' s difficulties due to the tensed nature of time. The ego-centricity of tensed discourse is an essential feature of communication between selves, each of whom refers himself as 'I', and is required for talking about time as well as experience and agency. Arguments based on the Special Theory are misconceived. Some rest on a confused notion of 'topological simultaneity'. In the General Theory a cosmic time is defined, as also in quantum mechanics, where a natural present is defined by a unique hyperplane of collapse into eigen-ness. (shrink)