Mariner W K
Boston University Schools of Medicine and Public Health.
Am J Law Med. 1986;12(3-4):345-80.
Proposals to reduce national expenditures for health care under Medicare and other programs raise questions about the limits on legislative power to distribute health care benefits. The constitutional guarantee of equal protection has been a weak source of protection for the sick, largely because they fail to qualify for special scrutiny under traditional equal protection analysis. Recent decisions of the United States Supreme Court suggest that the Justices seek a newer, more flexible approach to reviewing claims of unequal protection. This Article examines the application of the equal protection guarantee to health-related claims. It argues that traditional equal protection analysis is too rigid and newer rationality review too imprecise to provide just eligibility determinations. The Article concludes that courts should subject claims of unequal protection in the health care context to heightened scrutiny, as health care plays a special role in assuring equality of opportunity.
在医疗保险及其他项目下削减国家医疗保健支出的提议引发了关于立法机构分配医疗保健福利权力限制的问题。平等保护的宪法保障一直以来都是对病人的薄弱保护来源,很大程度上是因为他们在传统的平等保护分析下不符合特殊审查的条件。美国最高法院最近的判决表明,大法官们正在寻求一种更新的、更灵活的方法来审查不平等保护的主张。本文探讨平等保护保障在与健康相关主张中的应用。文章认为,传统的平等保护分析过于僵化,而新的合理性审查又过于不精确,无法做出公正的资格判定。文章得出结论,由于医疗保健在确保机会平等方面发挥着特殊作用,法院应对医疗保健领域的不平等保护主张进行强化审查。