by Kristen Kovach, WFU JD Candidate ’21
Michael opened his email on a dreary Tuesday morning. Casually scrolling through the spam messages between sips of coffee, his eyes paused on one message sent to him in the early hours of the morning. “I think your brother is dead,” the subject line read.
Michael froze. His heart pounded in his chest. Sweat beaded on his forehead and dampened his palms. His brother, Todd, had been in prison for drug possession since 2018. The brothers had not spoken in a while. But that’s because it’s just hard to get in contact with prisoners, Michael thought. There’s no way he’s dead.
The email came from his brother’s cellmate, Greg, who said that Michael’s brother had been sick for a while. Todd had been coughing terribly, complaining that his chest hurt, and suffering from a bad fever. Todd thought he had COVID. Two weeks ago, the medics came for Todd. Yesterday, the guards came for Todd’s belongings. Todd never came back.
Continue reading “COVID-19 Has Laid Bare Our Inhumane Treatment of Incarcerated People and Their Families”
by James Hughes, WFU JD Candidate ’22
Due to the infectious nature of COVID-19, our health care system has been forced to evolve in order to appropriately serve patients during this deadly pandemic. Before the public health emergency, roughly 13,000 Medicare beneficiaries received fee-for-service telehealth services per week, while almost 1.7 million Medicare beneficiaries utilized telehealth services in the last week of April, according to Centers for Medicare & Medicaid Services (“CMS”) data. Further, telehealth coverage should be a permanent fixture in our health care system, and the federal government should support telehealth coverage beyond the COVID-19 public health emergency.
Before the public health emergency, the U.S. Department of Health and Human Services (“HHS”) did not provide Medicare reimbursements for audio-visual telehealth visits unless the patient lived in a qualified rural area or was within the confines of certain medical facilities. Reimbursement has historically been the primary obstacle to telehealth services. The Telehealth Services During Certain Emergency Periods Act of 2020 allowed for HHS to modify or waive rules for telehealth under Medicare during the public health emergency, and recently, the American Medical Association asked President Trump, HHS, and Congress to extend some of the telehealth policies used during COVID-19 beyond this public health emergency.
Continue reading “Let’s Continue to Reap the Benefits of Telehealth After the COVID-19 Public Health Emergency”
by Remy Servis, WFU JD/MA in Bioethics Candidate ’22
Amidst the 2020 COVID-19 pandemic in the United States, incarcerated people have been one of the most at-risk subgroups, contracting the virus at a rate five times higher than the national average. Due to overcrowded conditions in prisons and jails, this population has limited opportunity to effectively socially distance, and infection rates are exacerbated by squalid conditions, limited testing, and violence within correctional facilities. Incarcerated persons represent a more vulnerable sector of the population, reflecting the disparities in social determinants of health that affect groups more likely to be incarcerated: racial minorities, those with unstable housing, and those with mental illness. In particular, prisoners over the age of fifty-five experience a uniquely threatening sum of risk due to the uncontroverted finding that COVID-19 has been particularly deadly to older adults, with 80% of deaths in US occurring in patients aged sixty-five and older.
Early in the pandemic, advocates across the country began to call for the early release of incarcerated people who pose a low risk to society, including the elderly and nonviolent. Scholars highlighted how this type of release would assist with “flattening the curve” by removing volume from correctional institutions which are “notorious incubators and amplifiers of infectious diseases.” Regarding the provision of early release, North Carolina has two laws on the books: “Medical Release of Inmates”, passed in 2008 and codified at N.C. Gen. Stat. § 15A-1369, and N.C. Gen. Stat. § 148-4, which provides for state discretion in granting “Extended Limits of Confinement” (ELC). Both of these statutory options have their strengths and weaknesses, but the state has chosen to utilize its more amorphous powers under ELC to mitigate the release of select inmates. However, due to disappointingly narrow release criteria, only about 300 inmates (out of 34,000 total in state facilities) have been granted this ELC privilege. Meanwhile, 3,000 inmates, or close to 10% of the prison population, have tested positive. The ELC law, as it is currently formulated, is a lackluster response from the state of North Carolina to the threat of coronavirus in the state prison population. These ELC policies and eligibility criteria should be appropriately modified given the deadly context of this pandemic and any future virulent public health emergencies.
Continue reading “North Carolina’s Extended Limits of Confinement: Woefully Underutilized in the Face of COVID-19”
by Madison Woschkolup, WFU JD Candidate ’21
The impact of the COVID-19 pandemic on the United States is immense, but this impact has been disproportionately felt by Black communities. In thirty-three states and the District of Columbia, Black people comprise a higher proportion of COVID-19 cases relative to the percentage of the state’s population they make up. In Maine, for example, Black people account for 21% of the state’s total COVID cases, even though only 1% of the state’s total population is Black. In comparison, in all fifty states and the District of Columbia, the percentage of each state’s total COVID cases attributable to white people remains well below the relative percentage of white people in the state. This state-by-state trend extends nationally as well. As of June 2020, the Centers for Disease Control and Prevention (CDC) reported that 21.8% of COVID-19 cases in the United States were Black individuals, despite the fact that this group only represents 13% of the total population.
It is widely recognized that health outcomes of communities of color are objectively worse than those of white communities. In addition to experiencing an increased risk of contracting the virus, Black Americans are also experiencing the highest actual COVID-19 mortality rates nationwide, more than double the mortality rate of their white counterparts. As of August, 1 in 1,125 Black Americans has died from COVID-19, or 88.4 deaths per 100,000. For perspective, the mortality rate for white Americans was 40.4 deaths per 100,000. This gap only increases when the data are adjusted for age differences within the race groups.
Continue reading “The Disproportionate Impact of the COVID-19 Pandemic on Black Americans”
By: Connor Christensen
The prices of insulin have risen to unconscionable levels in just a little over two decades. What used to be a relatively minor expense for Americans with diabetes has, for some, become an insurmountable obstacle to living a normal life, or, in some cases living at all. The purpose of this brief commentary is to address just one of the many issues attributed to the stark increase in insulin prices: patent evergreening.
People with Type I and Type II diabetes constantly depend on insulin injections to supplement their insufficient natural production of the blood-sugar regulating hormone in their pancreas. Without this hormone, a diabetic person’s life expectancy is short and riddled with many serious health complications. For many decades insulin was readily accessible and affordable for those who needed it. Recently, however, things have changed.
Continue reading “The Evergreen Forests of Insulin Patents”
What Do You See?
By: Emily Burke, JD ’18, Wake Forest University
The cold surface pricked my fingers as I stretched my palms flat against the motorized table beneath me. The coolness sent a chill up my spine, stretching up from the very tips of my toes. It was when the chill spread a dull numbness in my ears that I realized how naked, how vulnerable, and how exposed I was.
I was wearing a hospital gown, laying inside a tunnel beneath a thin, white bedsheet. Away from his gaze. And yet, just as I felt the narrow x-ray beams dance across the sheet, I felt his eyes on me. As the beams skipped across my skin, my heart began to race. I closed my eyes. My brow furrowed as my fingertips pushed into the table. I was trying to escape the whiteness, the brightness of the tunnel. Just as I lifted my fingers, the blood rushed and pulsed its way back into my fingertips. I swallowed and realized my jaw was clenched. I knew I couldn’t move my hands, or any part of my body, for that matter. I desperately wanted to massage my jaw, my furrowed brow, my pulsing fingers. Instead, all I could do was lay there. Silently.
Continue reading “What Do You See?”
By: Mary Kate Gladstone, JD Candidate at Wake Forest University School of Law
I still remember the very first day I walked through the doors here. It was much like the first time you do anything, really. There were nerves and excitement and the ever-sobering realization that I would never be able to do that very thing for the very first time ever again. The research center was situated on the outskirts of the city, lifted up on a small hill where it bounced the early morning sunbeams off of its metallic surface and into the eyes of passersby like myself. The first day I drove up to the center, I had to throw my hand up to my eyes to protect from the building’s blinding reflection. Continue reading “What Blinds One Might Blind Another”