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Conventional explanations of the solicitor general's influence on the Supreme Court emphasize his expertise or experience. We articulate and test a more political account based on insights from signaling theory. We argue justices will be more receptive to signals from the solicitor general (S.G.) when either the justice and S.G. are ideologically proximate or the S.G.'s signal is contrary to his ideological predisposition. We test our account over the period from 1953 to 2002 using a newly developed interinstitutional measure of ideology that places executive and judicial actors on the same spatial scale. Our results highlight the political nature of the S.G.'s influence, challenging the received wisdom about the S.G.'s impact on the Supreme Court.

U nder basic principles that guide the American health care system, decisions regarding which particular treatments, or the amount of treatment, are medically necessary are made by medical professionals in light of their patients' condition and desires, and the state of health care knowledge. Despite all the changes that have taken place in the health system over the past generation, medical professionals remain legally and ethically obligated to make treatment recommendations that reflect sound professional judgment and that are appropriate in light of their individual patients' needs.

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This article examines the Emergency Medical Treatment and Labor Act (EMTALA) in a public health emergency context. Congress enacted EMTALA in 1986 to prohibit the practice of “patient clumping,” which involved hospitals’ refusal to undertake emergency screening and stabilization services for individual patients who sought emergency room care, typically because of insurance status, inability to pay, or other grounds unrelated to the patient’s need for the services or the hospital’s ability to provide them. But in fact EMTALA, whose conceptual roots can be found in the Hospital Survey and Construction Act of 1946 (Hill Burton) as well as an evolution in both the common law and state statutes related to hospital licensure, can be viewed as having a far broader purpose than protection of individuals, and indeed, one that is related to the protection of communities and the public health.