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In this Foreword, we wish to insert a degree of innovation into debates about global law and the supposed demise of state-based public law. We do so by asking how considerations of space, place and density impact the conceptualization and utilization of state power in a world of growing complexity and interdependence. In an array of key policy areas, we examine in considerable detail how state-centered public law defines, and where required redefines, space and territory in order to tame potential threats—local or global, vertical and horizontal—to the state’s territorial sovereignty. Our exploration highlights the tremendous versatility and creativity of states in deploying and stretching, through the classic tools of public law, their spatial and juridical tentacles in a new and complex global environment. Taken in conjunction, these illustrations suggest that the disregard for and dismissal of the state as a potent actor in the public law arena is premature. State sovereignty may be metamorphosing, but it is evidently not vanishing.

Religion and constitutionalism often collide on both substantive values and policy preferences. Moving beyond the familiar angle of divergent value sets, this Essay critically highlights the structural, “clash of orders” features that make religion a credible rival and a serious challenger to modern constitutionalism. We identify three additional dimensions of the potential clash between religion and constitutionalism in a world of resurgent populist nationalism: (1) the structural logic of competing orders; (2) the strategic reliance on religious identity markers to generate unequal civic standings among formally equal citizens; and (3) the transnational nature of religious solidarity and affiliation, which permits escape from, and may destabilize, the project of the territorially bounded constitutional state. Comparative examples reveal how the confluence of these factors has played out in various settings—north and south, national and international—to present a serious threat to the constitutional domain. Taken together, the conjunction of these ideational and structural sources of friction positions religion as one of today’s main challenges to the constitutional order as a whole, but especially to its liberal iterations.

Despite manifestations of constitutional convergence on a global scale, expressions of constitutional resistance or defiance in the form of secessionism and nullification have not subsided, and may in fact be regaining ground worldwide. Whereas at first glance the reemergence of such sentiments appears counterintuitive in an age of apparent globalization, it may actually reflect a predictable reaction to, perhaps even a backlash against, powerful global convergence vectors, the centralization of authority and the decline of the local in an increasingly constitutionally and otherwise universalized reality. When understood against the backdrop of formi- dable centripetal forces of political, cultural, and economic globalization, the rise of a new trans-national constitutional order and judicial class, and the correspond- ing decrease in the autonomy of "Westphalian" constitutionalism, as well as an ever-increasing deficit of democratic legitimacy, counter pressures for preserving a given sub-national unit's, region's, or community's unique constitutional legacy, cultural-linguistic heritage, and political voice seem destined to intensify, not to decline.

Purpose: The Clinical Charge Capture system (C3) was developed at the University of Michigan to increase the efficiency and accuracy with which information about physician activity and billing is tracked in academic medical centers. Description: This Oracle-based, Visual Basic system integrates the operating room scheduling system, transcription database, clinical data repository, referring physician database, and IDX to allow physicians and staff to perform paperless and on-line standard tasks such as preauthorizing procedures; creating a bill which describes the charges for procedures performed along with their supporting diagnoses; identifying inpatient daily care and consult charges; dictating, editing, signing, and providing attestations for procedural and inpatient notes (menu-driven boilerplate notes are used for common procedures); submitting of charges on-line to IDX; and downloading of payment data from IDX. A messaging system between physicians and billing specialists allows questions to be posed regarding coding issues and options. Summary information about charges is presented and the status of the bill as it progresses through the internal review and billing process is demonstrated. Any missing data are flagged such that delivery of a bill is accurate, timely, and complete. Outpatient clinic visit charges are acquired on line using bar code technology with direct download of clinic charges to IDX. Generation of charges and referral letters may be performed immediately following the performance of a procedure or patient encounter or subsequently in the office. Resident activity is also tracked. Finally, search functions are provided which allow the program to serve as a clinical information research database. Results: The time to bill submission for operative procedures in fiscal year 1996 (Pre-C3) when compared to 1999 (Post-C3) decreased in each individual surgical division (See figure)as well as for the overall Department (Total: mean Pre-C3=40 days, mean Post-C3=8 days). The average bill was increased by 9% for each primary charge submitted. Conclusions: We conclude that this system has the potential to enhance the efficiency, accuracy, and organization of routine physician documentation, billing, and data collection activities.