At this moment, whose notion of equality is to prevail? Is it the university’s, taking the form of a blanket nondiscrimination policy? Or is it the student group’s, taking the form of the desire to maintain both associational freedom and campus citizenship?

Current First Amendment doctrine is ill-equipped to resolve the tension between these competing values, or “ends.” It is ill-equipped because any traditional First Amendment test is written to consider only one “end” — the end of the regulator. This was true prior to the Supreme Court’s June 2010 decision in Christian Legal Society v. Martinez. However, the Court’s opinion in CLS made the situation worse by applying the simplistic and unhelpful “limited public forum” test. The limited public forum test may have been the least common denominator between competing doctrines, but choosing it was a mistake.

This Article takes on several tasks. It explains the notion of campus citizenship, showing how the goal of equality on campus actually has two aspects to it — the equality of the students potentially excluded from a group, and also the equality of the group that is excluded from the campus. It shows how and why current doctrine, but especially the limited public forum doctrine, are not up to the task of resolving the inherent conflict in this dual conception of equality. Finally, it offers a new (and neo-Aristotelian) means-ends analysis courts should use in this context in order to account for the dual ends of these cases: nondiscrimination and expressive association.

Having explored the practice of constitutional interpretation, it concludes that the Supreme Court can claim expertise with respect to determining constitutional meaning, but that its expertise has limits. The Article proceeds to explore whether and how this insight might be translated into limits to judicial supremacy. Toward that end, it develops a framework for assessing when the work of constitutional interpretation should be shared between the Supreme Court, the other branches of government, and the public itself. Finally, it uses the Court’s doctrine with respect to race-conscious legislative districting to illustrate how the proposed framework might work.

Even the harshest critics of legal education agree that clinical programs in law schools succeed; however, the idea of expanding such programs presents challenges. Others worry that law schools will be tempted to do clinics “on the cheap.” Nevertheless, if we truly are concerned about the quality of legal education, we should focus instead on understanding what exactly students learn through clinics that contribute to their development of professionalism, and, further, whether other academic experiences, such as externships or simulations, can contribute to these same goals.

The article sets out a conceptual model for exploring this professional identity challenge. The first part is called the “Experiential Learning Helix,” a developmental approach that identifies three different roles all law students should experience toward becoming a professional: (1) simulated practice; (2) the “mentee” role, and the “first-chair” role. The second part of this model is “Relationship-Centered Lawyering,” a normative framework focusing on three areas of competency every effective lawyer needs: (a) understanding theory about the person-in-context, (b) promoting procedural justice, and (c) appreciating interpersonal, cultural, and emotional issues. When grounded in this relational framework, the Helix holds promise for legal education’s sustainability into the future.

This article examples the range of patient safety efforts undertaken in the U.S. over the past fifteen years, with particular emphasis on the patient safety initiatives in the Patient Protection and Affordable Care Act. Six broad strategies are examined, including 1) Standardizing Good Medical Practices; 2) Tracking Adverse Events in Hospitals; (3) Disclosing Provider Performance; (4) Reforming Payment Systems; (5) Coordinating and Integrating Care; and (6) Expanding Provider Responsibility.

The PPACA is a major attempt to improve access to health care by expanding coverage through Medicaid and by reforming the private insurance market. Quality is also an important focus of PPACA - it promotes disease management, care coordination, new payment models, value-based purchasing initiatives, and the use of comparative effectiveness research. PPACA offers a strong regulatory push toward the goal of “flawless execution,” the health care equivalent of zero defects in industrial production.

In no industry is this interplay more important than in health care. A series of government programs, most initiated during the latter half of the twentieth century, literally created the health care system as it exists in the United States today. Hospitals grew to their present size and technological complexity because of funding provided by the Hill-Burton Act and Medicare. Medicare also funds physician training, as well as reimbursement for many physician-provided services. Pharmaceutical manufacturers rely on the National Institutes of Health to support basic biomedical research that leads to the development of new drugs. A huge tax subsidy for employer-sponsored coverage finances, in large part, the health insurance industry. Without these programs, none of these health care industry segments could have approached its present size or vitality. To ignore this dynamic is to ignore the true nature of American health care and to fundamentally misunderstand the opportunities for reform.

The Patient Protection and Affordable Care Act (PPACA) continues and extends this paradigm. It will expand coverage in large part by facilitating broader demand for individual policies, which will revitalize private insurance markets. It will also extend Medicaid, a program that in most states is administered by private managed care plans, to millions more beneficiaries. Far from representing a government takeover or novel incursion into the health care system, PPACA extends the underlying arrangement that has built and sustains the structure of American health care as it exists today. In the American health care system, private innovation and government intervention represent not opposing forces, but rather partners in a common enterprise.