The ACA shifted U.S. health policy from centering on principles of actuarial fairness toward social solidarity. Yet four legal fixtures of the health care system have prevented the achievement of social solidarity: federalism, fiscal pluralism, privatization, and individualism. Future reforms must confront these fixtures to realize social solidarity in health care, American-style.

This commentary provides a legal analysis of the extent to which changes proposed by scholars to promote care for substance use disorder or other under-treated illnesses through risk adjustment could be implemented administratively, without legislation, in federal risk adjustment systems: Medicare's privatized component, Medicare's pharmaceutical component, and the individual and small group market. As the article explains, federal laws governing risk adjustment provide broad discretion to regulators and can reasonably be interpreted to permit full and final implementation through the administrative (...) process of almost all of the changes that scholars have proposed. (shrink)

This commentary describes limitations of mental health parity requirements in ensuring access to insurance coverage for mental health treatment and surveys regulatory options employed by states in Medicaid managed care programs as supplements to parity that can further reduce the risk of inappropriate denials of coverage.

Unraveling the molecular detail of insulin receptor activation has proved challenging, but a major advance is the recent determination of crystallographic structures of insulin in complex with its primary binding site on the receptor. The current model for insulin receptor activation is that two distinct surfaces of insulin monomer engage sequentially with two distinct binding sites on the extracellular surface of the insulin receptor, which is itself a disulfide‐linked (αβ)2 homodimer. In the process, conformational changes occur both within the hormone (...) and the receptor, the latter resulting in the disruption of the intracellular interactions that hold the kinase domains in their basal state and in the initiation of the phosphorylation events that drive insulin signaling. The purpose of this paper is to summarize the extant structural data relating to hormone binding and how it effects receptor activation, as well as to discuss the issues that remain unresolved. (shrink)

Current models of insulin binding to the insulin receptor (IR) propose (i) that there are two binding sites on the surface of insulin which engage with two binding sites on the receptor and (ii) that ligand binding involves structural changes in both the ligand and the receptor. Many of the features of insulin binding to its receptor, namely B‐chain helix interactions with the leucine‐rich repeat domain and A‐chain residue interactions with peptide loops from another part of the receptor, are also (...) seen in models of relaxin and insulin‐like peptide 3 binding to their receptors. We show that these principles can likely be extended to the group of mimetic peptides described by Schäffer and coworkers, which are reported to have no sequence identity with insulin. This review summarizes our current understanding of ligand‐induced activation of the IR and highlights the key issues that remain to be addressed. (shrink)

Many are calling for transformative food systems changes to promote population and planetary health. Yet there is a lack of research that considers whether current food policy frameworks and regulatory approaches are suited to tackle whole of food systems challenges. One such challenge is responding to the rise of ultra-processed foods (UPF) in human diets, and the related harms to population and planetary health. This paper presents a narrative review and synthesis of academic articles and international reports to critically examine (...) whether current food policy frameworks and regulatory approaches are sufficiently equipped to drive the transformative food systems changes needed to halt the rise of UPFs, reduce consumption and minimise harm. We draw on systems science approaches to conceptualise the UPF problem as an emergent property of complex adaptive food systems shaped by capitalist values and logics. Our findings reveal that current food policy frameworks often adjust or reform isolated aspects of food systems (e.g., prices, labels, food composition), but under-emphasise the deeper paradigms, goals and structures that underlie the rise of UPFs as a systems phenomenon, and its socio-ecological implications. We propose that a ‘leverage points’ framework illuminates where to intervene in food systems to generate multi-level changes, while the theory of ecological regulation highlights how to respond to complex multi-factorial problems, like the rise of UPFs, in diverse ways that respect planetary boundaries. More research is needed to better understand the transformative potential of ecological regulation to advance food systems transformation and attenuate whole of food systems challenges. (shrink)

_Like a Splinter in Your Mind_ leads readers through the myriad of philosophical themes within the Matrix trilogy, helping them to gain a better understanding of the films and of philosophy itself. Offers a way into philosophy through the Matrix films. Covers thirteen of the biggest philosophical questions in thirteen self-sufficient chapters suitable for course use. Demonstrates how each of these questions is illustrated through the events and characters of the films. Considers whether sentient machines are possible, and whether we (...) should expect them to face the same existentialist issues that we do. Familiarises readers with key issues in metaphysics, epistemology, ethics, philosophy of mind, race and gender, existentialism, Taoism and mysticism. Includes a chapter that explains some of the technical elements of the films and confusing aspects of the plot. Also includes a Matrix glossary, and a cast of characters and their related symbolism. (shrink)

_Like a Splinter in Your Mind_ leads readers through the myriad of philosophical themes within the Matrix trilogy, helping them to gain a better understanding of the films and of philosophy itself. Offers a way into philosophy through the Matrix films. Covers thirteen of the biggest philosophical questions in thirteen self-sufficient chapters suitable for course use. Demonstrates how each of these questions is illustrated through the events and characters of the films. Considers whether sentient machines are possible, and whether we (...) should expect them to face the same existentialist issues that we do. Familiarises readers with key issues in metaphysics, epistemology, ethics, philosophy of mind, race and gender, existentialism, Taoism and mysticism. Includes a chapter that explains some of the technical elements of the films and confusing aspects of the plot. Also includes a Matrix glossary, and a cast of characters and their related symbolism. (shrink)

In recent years an increasing number of moral theorists have come to embrace the term "moral pluralism" to describe a particular kind of moral theory. Unfortunately, there has been little consensus regarding what exactly constitutes a pluralistic theory, and what specific commitments such theories involve. My dissertation takes on the task of articulating the underlying schema of pluralist moral theory, and of analyzing the plausibility and implications of pluralism's fundamental commitments. I argue that the most thoroughgoing pluralist theories are shaped (...) by two defining theses; the plurality of the good , and the plurality of the right , and that these are conceptually linked by two additional meta-ethical commitments. My analysis of the plausibility of these commitments is at times friendly to moral pluralism and at times critical of it. For instance, I develop an account of "value incommensurability," an idea upon which pluralism depends, that resists some of more the important attacks within the literature. Yet I also criticize the commitment to the plurality of the right, as held by Susan Wolf and several other pluralists. I argue that this view is less plausible than "limited pluralism"---a view that is pluralistic about the good but monistic about the right. In the final chapter I explore the relationship between moral pluralism and political liberalism, focusing on the role that overriding values play within each type of theory. (shrink)

The authors in this collection engage with ecstatic naturalism in a variety of ways, comparing it to or integrating it with other philosophies and disciplines to express and fully explore the transcendence and immanence of nature.

While it is often thought that pluralism is best accommodated by a liberal state, John Kekes has recently argued that pluralism and liberalism involve inconsistent commitments. He maintains that liberalism is committed to the idea that one or more of the “liberal values” must override all other values, while pluralism is committed to the idea that there are no overriding values whatsoever. In this paper I challenge Kekes' position by arguing that ethical pluralism does not require an absence of overriding (...) values, and that liberalism does not require that one or more of the liberal values must override all others. (shrink)

When beer starts to flow, philosophical discussions naturally follow. _Philosophy on Tap_ takes pub philosophy to the next level, pairing 48 of life's greatest philosophical questions with 48 of the world's best beers. Features a unique presentation of philosophical puzzles, paradoxes, and debates by considering 48 of life's biggest questions in the context of 48 distinctive beers from around the world Provides a highly engaging and sociable approach to the classic philosophical problems as well as a unique look at the (...) conundrums that directly affect the beer drinker Combines a philosopher's insights with thematic humor and trivia to explore issues such as free will, God's existence, the nature of the soul, time travel, the aesthetics of taste, the role of beer in the good life, and the infamous "beer goggles" paradox For beer drinkers who enjoy philosophy, philosophers who enjoy beer, and anyone who has ever pondered the meaning of life over a pint of ale. (shrink)