Americans are infatuated with the stock markets, and today’s stock markets are dominated by a small number of large institutions that manage enormous amounts of money. Those two facts are paradoxical given the history of stock markets in the United States. Modern stock markets in the United States are the consequence of federal legislation responding to widespread social and economic harm caused by the stock market crash of 1929. That legislation was designed to avoid the concentration of economic power in a small number of institutions. Despite those historical facts, over the past century, the centrality of the stock markets in the U.S. economy has steadily grown, and a handful of enormous institutions have come to manage an outsized portion of the money in those markets.

This Article explores the historical choices and forces that led us to this point. It describes the cultural and political forces that led U.S. lawmakers to favor market financing, at first reluctantly, but eventually unabashedly. It catalogs federal lawmaking around the securities markets over the near century between 1929 and today. This review of lawmaking uncovers how, over this time, lawmakers’ affinity for markets strengthened as their skepticism of institutions disappeared. It concludes that once policymaking embraced the capital markets, the development of investment intermediaries was
all but inevitable.

Emily Winston *

* Assistant Professor, University of South Carolina School of Law.

With a specific focus on DSH hospitals, this Comment proposes that Congress amend the statutory provisions governing the 340B Program to require covered entities to reinvest 340B funds in improving the quality and accessibility of health care for their low-income and uninsured patient populations. The true potential of the 340B Program to improve the quality of healthcare for low-income and uninsured patients will remain unknown and unharnessed until gaps in the oversight of the 340B Program are closed. Congress must amend the 340B statute to require covered entities to use and account for 340B funds in a way that is consistent with the policy goals of the program. In addition, the program’s current auditing and oversight mechanisms must be adapted to ensure that appropriate recourse may be taken if 340B funds are not properly used.

Caleb C. Briggs *

* J.D., 2024, University of Richmond School of Law; B.A., 2020, University of Virginia.

This Comment examines the history, structure, and unintended consequences of the Bed of Last Resort law by tracking its development and how it currently operates within Virginia’s broader mental health system. This Comment also evaluates the efficacy of the Bed of Last Resort law by comparing it to best practices for treating those experiencing mental health emergencies, focusing specifically on the Crisis Now model for a continuum of crisis care. This Comment concludes with proposals for improving the Bed of Last Resort law without completely overhauling the legislation.

Mary C. Fritz *

* J.D., 2024, University of Richmond School of Law; B.A., 2020, Villanova University.