Georgia Law’s Elizabeth Weeks on “Healthism,” her new co-authored book about health-status discrimination

Pleased today to welcome a contribution from Elizabeth Weeks, Associate Dean for Faculty Development and J. Alton Hosch Professor of Law here at the University of Georgia School of Law. Weeks concentrates her teaching and scholarship in fields of law related to health care. In the post below, she introduces her new co-authored book, which will be of great interest to all concerned about the human right to health. It will be the subject on Wednesday, February 27, of a Georgia Law book panel featuring Law Professors Jennifer Bennett Shinall of Vanderbilt, Stacey Tovino of Nevada-Las Vegas, Ani Satz of Emory, and Nicolas P. Terry of Indiana-Indianapolis.

I am delighted to announce the recent publication by Cambridge University Press of my book, Healthism: Health Status Discrimination & the Law, co-authored with Jessica L. Roberts, Alumnae College Professor in Law  and Director of the Health Law & Policy Institute at the University of Houston Law Center.

Healthism proposes a new protected category – the unhealthy – and examines instances of discrimination against the unhealthy in multiple contexts:

Our book considers these and a host of other examples. It concludes that some operate as normatively wrong – or “healthist” – laws, policies, or practices. Others, however, are not only permissible, but also may be desirable, inasmuch as they encourage or support healthier lifestyles.

This book’s most important contributions are:

  • To introduce the concept of healthism into the lexicon; and
  • To invite ongoing dialogue about the merits and demerits of treating individuals differently based on their health status.

The genesis of our healthism project was the Patient Protection and Affordable Care Act of 2010, or ACA, which largely prohibits health status discrimination in health insurance in the United States.  Specifically, the ACA prohibits insurers from denying coverage based on preexisting conditions or charging higher premiums based on individual risk factors.

In 2010, single-payer health system, or a national health system, or even “Medicare for All,” were (and likely remain) political nonstarters in the United States. President Barack Obama’s signature law, the ACA, instead effected a sort of mandatory mutual aid society, a compelled communitarian approach, to health care.  In order to ensure that coverage for the unhealthy remained affordable, the law required most Americans to obtain health insurance – whether through eligibility for a government program or employer-sponsored plan, or by purchasing on the individual and small-group market – with government subsidies for some.

As of January 1, 2019, however, a critical pillar of that legislative design has been removed:

According to the Tax Cuts and Jobs Act, or TCJA, a law enacted in November 2017 under President Donald J.  Trump, the tax penalty associated with the so-called individual mandate no longer applies.  Americans now again are free to “go bare,” without any health insurance, or to purchase short-term, catastrophic-only, or other high-deductible/low-premium, limited coverage.  Many plans on the market still operate with the antidiscrimination provisions and other protections required by the ACA; however, no one any longer is compelled to purchase them.

The effect may well be to make those plans less affordable for the unhealthy – those who most need comprehensive coverage.  TCJA is just one of several U.S. reforms that threaten to erode legal protections for the unhealthy and so to reintroduce legal and social acceptance of healthism.

Our book stops short of proposing a model law or draft constitutional provision to comprehensively address this problem. Instead, it offers readers a workable rubric to navigating the shifting landscape of permissible and impermissible health-status discrimination.

My family history & path to the bench

It is an honor today to publish this post by our distinguished alumna, the Honorable Carla Wong McMillian, Judge on the Georgia Court of Appeals since 2013. Born in Augusta, Georgia, she earned her Georgia Law J.D. degree summa cum laude in 1998. She is the first Asian Pacific American state appellate judge ever to be appointed in the Southeast, and, since 2014,  the first Asian American to be elected to a statewide office in Georgia. Judge McMillian also serves as President-Elect of the Georgia Asian Pacific American Bar Association (GAPABA). Reflecting on these achievements in this essay, which we reprint courtesy of and with thanks to the Georgia Asian American Times, she writes:

Carla McMillianI am proud to be an American. I am equally as proud of my Asian American heritage.

I grew up in Augusta, Georgia, where the Chinese community has had a long history. The Chinese first immigrated to the city in 1872 to help build an extension of the Augusta Canal. These Chinese men — and it was all men in those days – began sending for their wives and children, and word spread that Augusta was a good place to immigrate and to make a new life.

My father’s parents were some of those who heard from others in their villages in southern China about Augusta. They originally immigrated to San Francisco, but moved to Georgia in the 1910’s and opened a small grocery store. In those days, if you were Chinese, you had two options to make a living in the South — open a laundry or a grocery store. My father was the youngest of six children and was born in the back room of that store where the family lived.

I am sure that my grandparents never dreamed that they would have a granddaughter who is a lawyer much less a judge. And although they did not know the language or the culture, they instilled in their children a love of this country and a service mindset. I am proud that my father and uncle are veterans who did their part to protect our freedom and way of life.

That’s my father’s side of the family – the Wongs from Augusta. But I also want to talk about my mother, who emigrated from Hong Kong to marry my dad. As a result, Chinese was my first language – that is what we primarily spoke at home before my siblings and I went to school.

One of my most distinct memories as a child was going into a courtroom and watching my mother be naturalized as an American citizen. I can remember my sister and me in our best dresses, standing with my father and watching my mother take her oath of allegiance to the United States. That was a proud day for my mother and for the rest of my family.

Growing up in an Asian American family in the Deep South, there just were not too many people outside of my family who looked like me, spoke like me, or ate the same kinds of foods at home. It used to be when I was a teenager that I wanted to cover up all of those differences and blend in. But as I have grown older, I have learned to embrace those differences because that is what makes our country so great.

I want to share with you that I never aspired to be a judge. I practiced for many years with a law firm in Atlanta where I expected to be for my entire career. But some judicial positions came open in my local jurisdiction. I almost did not apply. I was comfortable with my law practice and frankly I knew that even if I got the appointment, I would then have to run for election to keep my seat. I was fearful about facing the rigors of campaigning each election cycle. So after about a week of soul-searching, I had all but decided not to apply.

But I changed my mind one night as I was looking at my young children. I thought about what I wanted to tell them twenty years from now, about seizing opportunities and about doing what I could to serve the community where they will be growing up. So I applied for the judgeship and was appointed initially to the trial court and later to the Court of Appeals.

As a judge, I have taken an oath to uphold the Constitution. The Constitution ensures that we are a nation of laws, but it begins with the simple words, “We, the people.” Therefore, we must remember that key to the concept that we are a nation of laws is the notion of equality — the belief that “all men are created equal.” No one is above the law, and no one is so low that they cannot avail themselves of the law’s protection.

We must always remind our children that the rights and privileges guaranteed by the Constitution are there for us all. Without them, I would not be in the position that I am in today. The Constitution gives everyone an opportunity to fulfill their potential, even for someone like me who came from a family of immigrants because by protecting the rights that the Declaration of Independence declares to be God-given, the Constitution provides each of us the freedom and opportunity to pursue our own destiny. I am honored to serve as the first Asian American on our Court of Appeals and as the first Asian American to be elected to statewide office in Georgia.

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Women’s voices cast in leading role at 33d annual Edith House Lecture

evansLeading Georgia Law’s annual celebration of its 1st woman law graduate this year was an extra special, and especially inspiring, alumna.

Delivering the 33d annual Edith House Lecture, Stacey Godfrey Evans (left) treated students, faculty, staff, and others in the law school community to a talk entitled “The Voice of a Woman Lawyer: Why it Matters and How to Use It.”

It’s a subject for which she’s well qualified, as 3L Hannah Byars (below right), leader of the Women Law Students Association, made clear. Byars related that after Evans earned her J.D. in 2003, she practiced as an associate at BigLaw firm, then opened a small firm with a handful of colleagues. Evans established her own firm, S.G. Evans Law LLC, in 2014. And since 2011, she’s represented District 42, in Smyrna, as a Democrat in the Georgia State Assembly.hannah

Evans opened her talk by reciting the still-low percentages of women at high levels of the legal profession and politics, then urged the women in her audience to let their voices be heard.

“When you change who is in the room, you change the conversation,”

Evans said at one point, and added that women should not fear to be controversial when the situation merits. She concluded by encouraging women to run for office.

houseIt was a fitting tribute to the namesake of this lecture series, depicted at left: Edith House (1903-1987), whose portrait hangs in the law school rotunda. She and another student in the Class of 1925 were Georgia Law’s 1st women graduates. House was co-valedictorian, and went on to a distinguished career, including a stint as the 1st woman U.S. Attorney in Florida. Thanks to a Women Law Students Association initiative (see this great online scrapbook at p. 53), lectures have been given each year in her honor since 1983.