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Copyright of Canadian Bar Review is the property of Canadian Bar Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dialogue: Canadian Philosophical Review is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Many philosophers suppose that sometimes we think we are saying or thinking something meaningful when we're not saying or thinking anything at all: we are producing nonsense. But what is nonsense? An account of nonsense must, I argue, meet two constraints. The first constraint requires that nonsense can be rationally engaged with, not just mentioned. In particular, we can reason with nonsense and use it within that-clauses. An account which fails to meet this constraint cannot explain why nonsense appears meaningful. The second constraint requires that nonsense does not express thoughts. An account which fails to meet this constraint undercuts the critical force of the concept of nonsense. I offer an account which meets both constraints. The central idea is that to be under the illusion that some nonsense makes sense is to enter a pretence that the nonsense is meaningful. [ABSTRACT FROM AUTHOR]

When interactions between modern states and their citizens result in harm to individuals, the legal system is called upon to provide redress. Holding public authorities liable in tort is one solution the common law has developed to compensate individuals for harm incurred through state action. This article highlights the role that tort law plays in seeking redress against public authorities, and explores the extent to which tort law has converged with, or diverged from, other avenues of redress. After providing a brief history of tort claims against public authorities, we proceed to compare torts with judicial review, looking to their respective principles of liability, the formal aspects of bringing a claim, the substantive conditions of liability, and remedies. Through this comparison, we hope to elucidate the structure of the existing legal framework governing tort claims against public authorities. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine how health care utilization and spending vary for low-income employees compared with high-income employees enrolled in an employer-sponsored high-deductible health plan (HDHP). STUDY DESIGN: We use commercial medical claims data and administrative human resource data from a large employer between 2014 and 2018. We link the administrative data, which include details on salary and other benefit choices, to each employee in each year with medical claims. Our variables of interest include medical spending and utilization outcomes grouped into different care settings. METHODS: Using multivariate regressions, we estimate the association between salary buckets and health care utilization and spending, controlling for demographic characteristics, comorbidities of employees, human resource health plan benefits, and geography. RESULTS: Employees earning less than $75,000 show lower rates of utilization and spending on preventive measures, such as outpatient visits and prescription drugs, while having higher rates of utilization of preventable and avoidable emergency department visits and inpatient stays, resulting in lower overall health care spending among lower-salary employees. CONCLUSIONS: Low-salary employees enrolled in HDHPs have higher rates of acute care utilization and spending but lower rates of primary care spending compared with highsalary employees. Results suggest that HDHPs discourage routine physician-patient care among low-salary employees. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the impact of value-based insurance design (VBID), which removed patient cost sharing for primary care visits, on healthcare spending in a large, geographically diverse employer., Study Design: Quasi-experimental, difference-in-differences (DID) design, administrative claims-based study., Methods: Healthcare spending during the preintervention period (2008 and 2009) was compared with the postintervention period (2011 through 2014) to measure the impact of removing primary care cost sharing. The study population included Anthem commercially insured enrollees with continuous medical eligibility from 2008 to 2014 who were younger than 65 years. The VBID cohort included health plan enrollees from a national large employer that implemented the benefit change. The comparison cohort included other Anthem enrollees who did not have a similar benefit change and were propensity score-matched to the VBID cohort. Utilization of various types of healthcare services was also examined., Results: The VBID cohort experienced a $12.0 per member per month relative reduction in overall spending compared with the comparison cohort (P = .02). The trend was driven by reductions in expenditures for emergency department (ED) visits ($1.3 relative reduction; DID, -10.0%; P = .03) and other outpatient services ($7.6 relative reduction; DID, -5.8%; P = .02), which aligned with reduced utilization of ED visits (DID, -4.5%; P = .07) and other outpatient services (DID, -4.1%; P = .004). For physician office visits, the VBID cohort did not experience a significant relative increase compared with the comparison cohort (DID, 0.9%; P = .25)., Conclusions: The attempt to increase primary care access by reducing cost sharing did not produce a negative outcome in terms of total spending for healthcare.