This chapter covers managed care organizations (MCOs). The chapter begins by laying out the general game plan of a MCO: reduce ineffective medical spending so that you can offer the same health outcomes at a lower price. Then the broad organizational structure of common MCO types is discussed: HMOs, PPOs and POS type plans. Next, the chapter goes through various tools that MCOs use to try to achieve their goals: denial of payment, prior authorization, behavioral interventions, gatekeeper and second opinion programs, strategic manipulation of cost sharing, provider payment schemes, and choice of who to contract with for services. Finally, the patient tradeoff between cost of coverage and amount of red tape present is explored.

The content of this book is rather controversial. It paints a rather bleak picture, that the current EU legal economic system being developed for the data-driven economy is both outdated and – to some extent – a policy at war with itself. It promotes dominant platforms to detriment of others. Moreover, the fundamentals for creating rules are also missing. A liberal economic system needs to be based on aspects of a rights system, otherwise, we risk losing innovation, the establishment of new markets, and the creation of wealth, while we will see increasing market failures. Without a legal system for rights to data, we will lose out of a just system for the distribution of wealth. Indeed, it is time that the data-driven economy and the internet economy are granted their ‘property’ rights, reflecting the new paradigm of the data-driven industrial revolution. Moreover, such a regime fits well with the European economic constitution now being established.

Generally, it might seem that the problem of a few system leaders hoarding data should be addressed by competition law. Market power and monopolizations generally trigger competition-law remedies. However, as will be discussed below, when it comes to accessing data, and especially when access to data should be granted as a continuing service, competition law is generally the wrong platform to use. Access or forced collaboration is difficult to establish under competition law. The case law of the Court of Justice of the European Union (CJEU) makes it difficult to succeed in arguing that a refusal to grant access to data is an abuse of market dominance under Article 102 TFEU. Proving market dominance in data-related markets is a challenging undertaking and is highly case specific. Similarly, the very stringent requirements defining abuse were developed for different situations and may need to be adapted to circumstances of the data-driven economy. More importantly, only undertakings would be able to rely on a right to access data under Article 102 TFEU, which would generally exclude access claims of consumers. Finally, the enforcement system of competition law does not seem to be sufficiently effective to guarantee competitive markets for the mass phenomenon of data lock-ins caused by connected devices.1

Sector-specific regulations apply in several network industries. The telecom sector and infrastructures such as utilities have been regulated based on the notion that they are natural monopolies and need to be regulated to prevent facilitation of monopolies. However, in the beginning of the internet era, large tech escaped regulation.1

Data is vital to the internet-based economy and will become even more important in the old economy as the Internet of Things (IoT) gains ground. The competitiveness of firms will increasingly depend on timely access to relevant data and the ability to use that data to develop new, innovative applications and products. In consumer-oriented businesses, the relevant data is often personal information; although this data is becoming increasingly collectable, only a few firms have access to larger amounts of it.1

According to liberal democratic theory, a free press is necessary for a well-functioning democracy. In its ‘ideal’ form, the news media play an essential role in informing the public sphere.

This chapter provides an overview of the challenges and opportunities for media institutions and political journalism in the digital age. It provides a better understanding of the Australian media’s contribution to the public sphere and its role to critically inform Australians about politics and policy. We do this, firstly, by examining the media sphere, including its production, content, and audience within various ‘models’ of media. We then look at a range of theories of media that accounts for its affect, use, and reception. We consider whether having fewer media proprietors affects diversity of voices or the quality of journalistic practice. Finally, we turn to the ‘new media’ political landscape by exploring not only how networks and social media platforms have affected the public sphere but also how media technologies have led to increased form of surveillance of the public.

Relying chiefly on the combination of costly, unsystematic, and unreliable FDA monitoring and state negligence actions, the current postapproval system for controlling medical device risks falls far short of assuring optimal levels of safety. The reform proposal we advance comprehensively addresses these law enforcement deficiencies. The contemplated changes are straightforward and simple to implement yet would substantially reduce cost while increasing the effectiveness of both FDA monitoring and civil liability deterrence. Monitoring would be improved by requiring first-party insurers to investigate and report to the FDA the potential existence of a causal connection between the personal injury for which they are funding treatment and the patient’s (insured’s) use of or exposure to a medical device. The FDA would be authorized to enlist DOJ Civil Division enforcement of a federal cause-based strict liability action against the medical device manufacturer. The manufacturer would bear liability in full, with no reduction for risk contributions from the injured patient or other parties and would pay damages in total to the US Government. We explain the regulatory advantages of this new regulatory rule of cause-based strict liability relative to conventional rules of negligence and strict liability.