The war on fraud and its effect on dentistry.

The fraudulent actions of a disreputable few people in the health care industry have caused enormous losses to government and private health care payers. Fraud can take a number of forms, but usually is based on some form of deceit. In response, law enforcement efforts have been aided by a number of recent anti-fraud statutes and significant new resources. The challenge to dentistry is to ensure that legitimate efforts to fight fraud do not unduly burden practitioners, the vast majority of whom are honest.

A HIPAA strategy for dental schools.

Certain health care organizations, including dental schools, should be readying themselves to comply with the numerous requirements described within the administrative simplification section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The intent of administrative simplification is to streamline the management of health care transactions while protecting the privacy of certain written, oral, and electronic patient information. There are no field-tested plans for implementing the law because only recently has the health care industry begun to respond to the multitude of requirements. It is essential that each organization create a customized compliance plan that best fits its structure and needs. The purpose of this paper is to propose a five-stage theoretical strategy that could assist a dental school in achieving HIPAA compliance. The first stage involves the selection of a HIPAA task force. The second stage selects the applicable HIPAA requirements, determines the current states of confidentiality and security, manages the electronic transactions standards, and composes a gap analysis. The third stage examines risk analysis and management. The fourth stage encompasses technical modifications, policies and procedures, legal input, and training. The fifth stage addresses the maintenance of the implementation.

"When pirates feast who pays?" condoms, advertising, and the visibility paradox, 1920s and 1930s.

For most of the 20th century, the condom in the United States was a cheap, useful, but largely unmentionable product. Federal and state statutes prohibited the advertising and open display of condoms, their distribution by mail and across state lines, and their sale for the purpose of birth control; in some states, even owning or using condoms was illegal. By the end of World War I, condoms were increasingly acceptable for the prevention of sexually transmitted disease, but their unique dual function--for disease prevention and contraception--created ongoing ambiguities for sellers, consumers, and distributors as well as for legal, political, health, and moral leaders. Not until the 1970s did condoms emerge from the shadows and join other personal hygiene products on open drugstore and supermarket shelves and in national advertisements. Then came the 1980s and AIDS when, despite the rise of Ronald Reagan, the radical right's demonization of condoms, and the initial reluctance of condom merchants to market to gay constituencies, the HIV/AIDS epidemic slowly but inexorably propelled the condom to the top of the prevention agenda. The condom's journey from lewd device to global superstar was fitful, but colorful. The Comstock Act of 1873, prohibiting birth control information and devices, created a vast underground operation--periodically illuminated, however, by arrests, protests, legal proceedings, and media coverage. This essay chronicles one such moment of illumination: the legal battle in the 1920s and 1930s over the legitimacy and legality of the Trojan Brand condom trademark and the unusual series of advertisements produced by the Youngs Rubber Corporation, makers of Trojans, to dramatize the ethical and economic issues of the trademark battle. Culminating in Youngs Rubber Corporation v. C.I. Lee & Co., Inc. (45 F, U.S. Court of Appeals for the Second Circuit 103 [1930]), this landmark case in trademark law established the right of the Trojan Brand condom, despite its ambiguous dual function, to the protection of a federal trademark. I seek to show how the Youngs antipiracy ad series illuminates the paradox of visibility by illuminating the paradox of any binary division: to establish the one depends inevitably on invoking or making visible--even if to suppress--the other. This essay is a case study in the negotiation of such a dialectic.

Medical tourism: assessing the evidence on treatment abroad.

The review focuses on one growing dimension of health care globalisation - medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The review sought to identify the medical tourist literature for out-of-pocket payments, focusing wherever possible on evidence and experience pertaining to patients in mid-life and beyond. Despite increasing media interest and coverage hard empirical findings pertaining to out-of-pocket medical tourism are rare. Despite a number of countries offering relatively low cost treatments we know very little about many of the numbers and key indicators on medical tourism. The narrative review traverses discussion on medical tourist markets, consumer choice, clinical outcomes, quality and safety, and ethical and legal dimensions. The narrative review draws attention to gaps in research evidence and strengthens the call for more empirical research on the role, process and outcomes of medical tourism. In concluding it makes suggestion for the content of such a strategy.

[The inducement of demand in dental medicine in Belgium]. / Induction de la demande en Médecine dentaire en Belgique.

Many factors are important for the existence of supplier-induced demand (SID). Not just the individual practitioner is responsible; his or her behaviour might be influenced by the specific organisation of the market for health care/dental care. The article investigates the characteristics of the Belgian market for dental care and analyses the way in which they might influence the occurrence of SID and/or overconsumption. Attention goes to the payment system of dentists in Belgium, the health insurance system, dentist density and the regulation of the sector. Also mentioned are the recall system and other (governmental) initiatives that may influence patients' and practitioners' behaviour. Some factors--not yet systematically investigated--may be relevant as well: personal characteristics of the dentist (gender in particular) and the way companies direct practitioners' and patients' behaviour.