Studies

S2012-04

The Shortage of Generic Sterile Injectable Drugs: Diagnosis and Solutions

According to the U.S. Food and Drug Administration, the number of times drugs were in short supply almost tripled from 61 in 2005 to 178 in 2010. The figure reached more than 250 in 2011. This means that manufacturers reported to the FDA that they were unable to meet demand for the drugs. Hospital and health-system pharmacists, as well as oncologists, anesthesiologists and other specialists have also increasingly reported difficulties acquiring drugs.

These are mostly injectable drugs for cancer and other important therapies, and they are frequently produced by generic drugmakers. These drugs are not dispensed by community pharmacies, but rather administered by health professionals in clinical settings.
Currently proposed solutions are unlikely to address the crisis satisfactorily. Congress appears ready to give more power to the FDA, but making FDA regulations more onerous will not alleviate the current shortage of crucial medicines.
A more promising approach is to make it easier for competitors to enter the market in response to forthcoming shortages. In general, this means reducing and ultimately removing the FDA’s monopoly on the approval of drugs for medical use. Shifting these medicines to Medicare Part D insurance may also stabilize supply by helping ensure manufacturers receive adequate compensation for the medicine, even as taxpayers are protected from escalating costs. … more

Stress Claims in Michigan: Worker's Compensation Entitlement for Mental Disability

The worker's compensation system was developed as a way for workers who suffer on-the-job physical injuries to be compensated fairly and quickly for medical expenses and loss of income. In recent years, however, it has expanded into a new area fraught with vagueness: mental stress. Though the focus of this report is on Michigan, which has been in the forefront among states in mental stress claims, its searching analysis of the inherent difficulty in evaluating these claims will be useful for anyone interested in this growing area of workplace abuse. 36 pages. … more

Michigan Education Special Services Association: The MEA's Money Machine

This exhaustive report illuminates the inner workings of the Michigan Education Association's health insurance division, known as MESSA. It documents how tens of millions of the public's education tax dollars are wasted each year on uncompetitive teacher health insurance, and how MESSA is part of a systematic plan to subsidize the MEA's basic operation and political activity. 64 pages. … more

Twenty Myths About National Health Insurance

The allure of national health insurance comes largely because it is perceived as successful in Canada and Britain. This thoroughly documented report shows conclusively that government-run national health insurance has led to serious and inevitable dilemmas that no country should want to emulate. The authors prove that other models have not been more successful than the U.S. in controlling costs or providing superior access to care, and that adoption of a national health system would have negative consequences. Released in cooperation with the Dallas-based National Center for Policy Analysis. 68 pages. … more

Auto Insurance in Michigan: Regulation, No-Fault, and Affordability

Written by one of America's foremost authorities on auto insurance, this study is a thorough review of Michigan's Essential Insurance Act and No-Fault Law. Harrington examines in-depth the structure of rates in the state and explains that they are not the result of price-gouging or insufficient competition. He analyzes the effects of the state's insurance regulations, and makes suggestions that would increase competition, lower costs, and limit the interference of government in a free insurance market. 33 pages. … more

Tort Law and the Products Liability Insurance Crisis

This report examines the theories behind the products liability insurance crisis, including the idea that the crisis is contrived by the insurance industry. Smith argues that the real source of the problem is judicial changes in tort law that undermine the predictability of risk and the independence insurance markets need to adequately measure risk. He recommends steps that governments should take to solve the crisis and bring down consumer and industry costs. 55 pages. … more

The Michigan Accident Fund: A Need for Privatization

Though prevailing legal opinion had concluded that the Accident Fund, a workers' compensation insurer, had been operating as a private insurer, Attorney General Frank Kelley ruled in 1976 that the Fund was in fact a state agency. Smith examines the controversy ignited by Kelley's ruling, culminating in a state takeover of the Fund in 1989. His powerful case for privatization of the Fund is just as relevant today and, in fact, is a major reason why the Engler administration planned to do just that in 1994. 31 pages. … more

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