1. Component 1: Introduction to Health Care and Public Health in the U.S.
Unit 6: Regulating Health Care
Lecture 2
This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC

2. Objective of This Lecture
Describe the basic concepts of law in the U.S.
Branches of government
Sources of law
Kinds of laws
The court system
Trial process
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

3. The Legal System in the U.S.
Legislative
House of Representatives and the Senate
Executive
The president and numerous departments and agencies
Judicial
Judges and courts
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

4. Health IT Workforce Curriculum Version 2.0/Spring 2011
Balance of Power
Separation of powers
Three branches of government
Designed to prevent any one branch from becoming too powerful
Checks and balances
Legislative branch makes laws
Executive branch enforces laws
Judicial branch interprets laws
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

5. Health IT Workforce Curriculum Version 2.0/Spring 2011
Sources of Law
Legislative branch makes statutory laws
Executive branch makes administrative laws
Laws made by the courts are called common law or case law
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Health IT Workforce Curriculum Version 2.0/Spring 2011

6. The Judicial System: Courts
Trial court
Hears evidence and hands down verdicts
Can be federal, state, or local
Appellate court
Losing party can appeal
Court usually does not hear new evidence
Reviews case to determine if the law was properly applied to the facts as determined by the trial court
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

7. The Judicial System: Jurisdiction
Federal courts
Constitutionality of a federal law
Disputes primarily involving federal law
Disputes between citizens of different states
State courts
Often called courts of common pleas or county courts
City or municipal courts
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

8. Comparing Court Systems: An Example
U.S. Government
State of Ohio
City of Cleveland
Trial courts
U.S. District Court for the Northern District of Ohio
Cuyahoga County Court of Common Pleas
Cleveland Municipal Court
Appellate courts
U.S. Sixth Circuit
Court of Appeals
Ohio Eighth District Court of Appeals
Highest court
U.S. Supreme Court
Ohio Supreme Court
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

9. Classification of Laws
Civil or private law
Relationships between people
Relationships between people and organizations
Relationships between organizations
Includes family, property, inheritance, corporate, contract, and tort law
Public law
Relationships between people and the government
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Health IT Workforce Curriculum Version 2.0/Spring 2011

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Two Kinds of Penalties
Civil law—exchange of money between the private parties to the lawsuit
Public law—can result in fines paid to the government and/or imprisonment
The same action can result in both kinds of penalties
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Health IT Workforce Curriculum Version 2.0/Spring 2011

11. Example: Traffic Accident
Drunk driver crashes car, causing serious injury to the driver of the other car
Criminal (public) penalty
State vs. drunk driver
Civil (private) damages
Injured driver vs. drunk driver
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Health IT Workforce Curriculum Version 2.0/Spring 2011

12. General Classification: Private Law
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Contract Law
Contract elements
Offer
Acceptance
Consideration: something of value given in exchange for a promise
Express contract
Written or oral
Implied contract
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Health IT Workforce Curriculum Version 2.0/Spring 2011

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Tort Law
Intentional torts
Battery
Defamation
Negligence
Does not act with a reasonable amount of care
As a result, someone is injured
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Health IT Workforce Curriculum Version 2.0/Spring 2011

15. General Classification: Public Law
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Health IT Workforce Curriculum Version 2.0/Spring 2011

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Litigation: Parties
Adversary system
Each party presents his or her case
Facts determined by neutral fact-finder
Civil case: plaintiff and defendant
Criminal case: government and defendant
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Health IT Workforce Curriculum Version 2.0/Spring 2011

17. Pre-trial Litigation: Discovery
Purpose is to fully develop the facts
Depositions are one kind of discovery
Sworn testimony recorded by court reporter
Parties
Witnesses
Expert witnesses
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

18. Administrative Hearings
Sometimes an administrative agency has a system of hearings that is outside the normal court system
The agency may or may not have an appellate level
Usually reviewable in a court of law
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011

19. Administrative Hearing Example
Social Security Administration (SSA)
Hearing officers
Social Security Appeals Council
Decisions of the SSA appeals board can be further appealed to the U.S. District Court
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Health IT Workforce Curriculum Version 2.0/Spring 2011

20. Health IT Workforce Curriculum Version 2.0/Spring 2011
Summary
3 branches of government: legislative, executive, judicial (the courts)
Courts are divided into:
Trial courts and appellate courts
Federal, state, city/municipal courts
The courts are neutral arenas where the parties to a dispute face off in an adversarial process
2 main types of law: private and public
Component 1/Unit 6-2
Health IT Workforce Curriculum Version 2.0/Spring 2011