News Capsules (May/June 2000)

Clinton and the GOP on the Uninsured

In President Clinton's 2000 State of the Union Address and the Republican response by Senator Bill Frist, M.D. (R-TN), there is evidence there is going to be another compromise in the Patients' Bill of Rights legislation. President Clinton asked Congress to pass a real Patients' Bill of Rights. Sen. Frist agreed although he added, "We see lawsuits as a last resort, not the first."

As far as Medicare solvency, President Clinton stated he wanted to use "nearly $400 billion of our budget surplus to keep Medicare solvent past year 2025." Sen. Frist responded, " To guarantee that seniors can rely on Medicare forever, we will add it to the Social Security lock box, which will lock away the surplus for both Social Security and Medicare."

President Clinton proposed "that we follow Vice President Gore's suggestion to make low-income parents eligible for the insurance that covers their children." To this Dr. Frist responded, "[Clinton's plan] makes government even bigger and more bloated because each new proposal we hear about tonight --- and there were about 11 of them in health care alone --- comes with its own massive bureaucracy."

We agree on this point. The president is again attempting to implement the Health Security Act of 1993 piecemeal, using children to get the proverbial "camel's nose in the tent" followed by extending socialized medicine to their parents and then to everyone else. The ugly body of the camel, hump and all, will follow, if the conservative Republicans are not careful.

On Medicare prescription drugs, the president argued that we should extend to our seniors "this lifeline of affordable prescription drugs." Sen. Frist responded, "The answer is not government-dictated price controls that stop life-saving research, or forcing the 65 percent of seniors who now have drug coverage to pay more or give up what they have."

Congress has prom-ised to pass the Patients' Bill of Rights by this spring. We need to look at this bipartisan effort very closely. Compromise leads to socialism. (AMNews, Feb. 14, 2000.)

Rationing Health Care in Britain

Evidence is accumulating that Britain's National Health Service (NHS) delivers a standard of health care that is among the worst in the developed world. Looking at two main killers, cancer and heart disease, one finds the NHS care is far from comprehensive, not consistently of high quality and, for some cancer patients, not always free at the time of use.

--- A government publication shows that the United Kingdom's death rate from circulatory diseases for persons under age 65 ranks it 13th out of 15 countries studies.

--- Patients often do not receive treatment, or wait a long time for treatment because of a shortage of qualified medical staff, drugs and equipment.

--- The head of the World Health Organi-zation's cancer program has calculated that Britain may suffer as many as 25,000 unnecessary cancer deaths a year because of under provision of care.

--- Twelve percent of specialists surveyed admitted refusing dialysis to patients suffering from kidney failure because of limits on cash.

--- Waiting lists have become so long and have been manipulated by the government so much that published figures are no longer considered reliable, and there is now a "waiting list for the waiting list."

--- In many parts of the country, the anti-cancer drug Taxol has been withheld from women suffering from ovarian cancer for reasons of cost.

Health expenditures for the UK amount to 6.9 percent of gross domestic product. Out of 29 developed countries only six spend less.
(David G. Green and Laura Casper, "Delay, Denial and Dilution: The Impact of NHS Rationing on Heart Disease and Cancer," November 1999, Health and Welfare Unit, Institute of Economic Affairs, 2 Lord North Street, London SW1P 3LB.)

Crime Becoming Less Profitable

Dr. Morgan Reynolds, of the National Center of Policy Analysis (NCPA), has reached the conclusion the nation's crime rate had reached a 25-year low.

The downward trend began in the 1980s with the presidency of Ronald Reagan when the likelihood of going to prison and staying there increased: "Most offenders are not mentally deranged and most crimes are not irrational acts. We have less crime because crime has become more costly to criminals." (NCPA, Jan/Feb 2000.)

Ditto for truth in sentencing, more prisons, and more citizens with concealed carry gun permits as compiled by Prof. John Lott at Yale University, have all been crucial in curtailing crime.

Canadian Health Collapse

Canada's government-run health care system is in crisis: over-burdened, forced to ration care and unable to shake off a straitjacket of centralized, bureaucratic planning.

--- Last January 2, 23 of the 25 hospital emergency rooms in Toronto were closed to all patients, regardless of the severity of their illness.

--- The Canadian Medical Journal reported that in Ontario during one 12-month period, 121 patients were permanently removed from the waiting list for coronary by-pass surgery because they had become so sick they could no longer undergo surgery with a reasonable risk of survival.

--- The Organization for Economic Cooperation and Development (OECD) ranks Canada in the bottom third of its 29 member countries for availability of medical technology such as MRI and CT scanners, yet Canada ranked fifth in national health expenditures in 1997.

Despite the general belief, not everyone is covered under the government-run health care system.

--- Studies show that in 1997-98 about 170,000 people in British Columbia --- 4.2 percent of the population --- were not covered because they had not paid premiums required by the province.

--- Alberta also requires a premium and does not cover individuals who do not pay.

--- At a large teaching hospital in Vancouver, 10 percent of emergency room patients have no coverage.

A nationwide poll in 1999 found that 76 percent of Canadians now believe the health care system is in crisis. Indeed, as estimated 212,990 Canadians were on hospital waiting lists for surgery in 1998 and the wait continues to increase. So when Quebec Premier Robert Bourassa was diagnosed with cancer, he didn't sit down and wait for his free health care in Quebec; he came across the border, like thousand of Canadians who have the means to obtain medical care in U.S. (Cleveland, Ohio).

Source: Bill McArthur and Owen Lippert, "Canadian Health Care - A System in Collapse," Backgrounder, January 2000, Fraser Institute, 4th Floor, 1770 Burrard Street, Vancouver, BC, V6J 3G7, Canada, (604) 688-0221, http://www.fraserinstitute.ca/publications/backgrounders/20000127/.


Anniversary of the Brady Law

"Error, mistakes, and disruptions have marked the first six years of Brady administration," writes Erich Pratt of Gun Owners of America (GOA) in its January 21, 2000 news letter, The Gun Owners.

"The dirty little secret the gun banners hate to talk about is this: The Brady law has resulted in less than ten people being sent to jail." And he is, in fact, correct. The General Accounting Office (GAO) has disclosed that almost 50 percent of gun purchase denials under the Brady Law were erroneous and most were due to administrative snafus or traffic violations or red tape errors such as sending the paperwork to the wrong department. He writes, "The fact is, even the real criminals who are initially denied at a gun store are not arrested --- which means they are still free to get a gun on the streets."

The bare fact is out of 470,000 who were denied a firearm because of the Brady law, less than 10 people had been prosecuted and sent to jail. (Gun Owners of America, 8001 Forbes Place, Suite 102, Springfield, VA 22151, http://www.gunowners.org.)


Myth of the Uninsured

Robert J. Samuelson writes in Newsweek (Nov. 8, 1999) the assertion that health insurance is necessary to get health care is a myth. He found what most physicians already know --- namely, that most of the uninsured pay for it themselves, and many receive free care subsidized by doctors and hospitals. Lack of health insurance does not translate to lack of access, contrary to what we have been led to believe. Government continues to expand in all sectors of medical care. Although the number of people on welfare have dropped 40 percent since 1996, when welfare reform legislation was passed; many low income working women and children remain eligible for Medicaid, and yet they do not sign up. Up to one-third to one-half of the 11 million uninsured children qualified for Medicaid or the new Children's Health Insurance Program (SCHIPS) but parents are not flocking to enroll them.

One reason some Americans don't obtain health insurance is because a large segment of them are young adults and children, groups who are relatively healthy. Again, not having health insurance doesn't necessarily amount to lack of access to medical care. (Robert J. Samuelson, "Myths of the Uninsured," Newsweek, Nov. 8, 1999)

Pentagon to Proceed with Anthrax Vaccination

On Feb. 18, 2000, the Pentagon announced it was "sticking to its plan to inoculate all 2.4 million active duty and reserve troops against anthrax," which the Department of Defense (DOD) believe poses a serious threat to U.S. troops stationed in the Middle East and South Korea. This decision was made despite a House Government Reform National Security Sub-committee report calling for a suspension of the mandatory anthrax vaccination program until an improved vaccine is approved. The Committee report read: "[Although the vaccine does provide a degree of protection] ...just how much protection is acquired, by whom, for how long...are questions the Defense Department answers with an excess of faith but a paucity of science."

Rep. Christopher Shays (R-CT), Chairman of the Subcommittee said, "Plagued by uncertain supplies, uncertain safety and unproven efficacy against the anthrax threat, the mandatory, force-wide immunization program should be suspended until the Department of Defense (DOD) gets approval to use an improved vaccine."

Moreover, the Com-mittee report charged: "Preposterously low adverse report rates generated by DOD point to a program more concerned with public relations than effective force protection or the practice of medicine."

A military spokesman also testified that the vaccine controversy was hurting morale and a growing number of troops were refusing to take the six-shot vaccine regimen.

The AP report (02/18/00) written by military writer Robert Burns also cites the Committee report: "There is little research on the inhalation of anthrax spores by humans, the vaccine should be regarded as an investigational drug, requiring the approval of troops to be administered. The Pentagon counters by saying research on humans is not possible because anthrax is deadly."

Embarrassing MSJAMA Gun Poll

With this introduction MSJAMA (Medical Student Journal of the American Medical Association) opened the following medical student opinion poll:

"In the United States, firearms are used to commit a majority of all homicides, guns in the home increase the risk of homicide almost 3-fold, and the risk of suicide almost 5-fold. Most of the risk is related to handguns. Given these data do you feel that a universal ban on handgun sales and licenses would be an appropriate public health measure?"

The four choices for participants were:

1. All public health statistics aside, the right to bear arms is absolutely protected by the Second Amendment of the United States Constitution.

2. The right to bear arms is supported by Charlton Heston. Anything that is considered good for Charlton Heston must also be good for the public health.

3. These data clearly demonstrate that access to handguns is a significant and preventable cause of homicide and suicide; therefore, public health measures limiting the distribution of handguns are long overdue.

4. Better data on the epidemiology of firearm-related death are required before a universal handgun ban would be justified.

At the end of the polling period (4/7/00), there were 9650 votes recorded; the result: #1. 90 percent (8641 votes); #2. 3 percent (247 votes); #3. 2 percent (229 votes); #4. 6 percent (533 votes; This last choice was, incidentally, MSJAMA editor's choice.

This was definitely a gun poll that backfired --- despite the relentless propaganda for gun control in AMA publications!

Disarming Citizens Increases Gun Violence

Australians are learning the lessons of gun control the hard way. When a madman slaughtered 35 people at a Tasmanian resort in 1996, the government responded by banning most firearms. More than 640,000 guns were seized from law-abiding citizens.

The result was a sharp increase in violent crime. In the two years following the gun ban, armed robberies rose by 73 percent, unarmed robberies by 28 percent, kidnappings by 38 percent, assaults by 17 percent and manslaughter by 29 percent, according to the Australian Bureau of Statistics.

The same thing happened in England. The government cracked down on guns following a 1996 massacre of school children in Dunblane, Scotland. A terrifying crime wave ensued. The U.S. Department of Justice announced, in 1998, that the rate of muggings in England had surpassed that in the U.S. by 40 percent. Assault and burglary rates were found to be almost 100 percent higher in England than in the United States. ("Seven Myths of Gun Control," http://www. RichardPoe.com.)

Books in Brief

Politicized Medicine by the Foundation for Economic Education, Inc., Irvington-on-Hudson, NY, 1993, ISBN: 0-910614-87-3, $14.95, 157 pp., (Softcover), http://www.fee.org.

This collection of essays is introduced by Hans F. Seinholtz, the former president of the Foundation for Economic Education (FEE).
This is an impressive collection of essays exposing the fallacies of nationalized health care. In "The Right to Health," Dr. Szasz quotes Milton Friedman, Capitalism and Freedom, stating that "the justification for enacting special licensure provision especially for regulating medical practice 'is always said to be the necessity of protecting the public interest. However, the pressure on the legislature to license an occupation rarely comes from the members of the public. ...On the contrary, the pressure invariably comes from members of the occupation itself.' " (p.45)

In another essay, Dr. Richard E. Hunt, an anesthesiologist in Santa Rosa, California writes, "The truth is that capitalism is the only system that has ever given every citizen a chance to improve himself and puts a stop to coercive monopolies which tend to fix prices and wages thereby ensuring that those in a lower economic position will never be able to improve their lot. Coercive monopolies, price and wage fixing, and poverty are results only of governmental interference."

The Dangers of Socialized Medicine by Jacob G. Hornberger and Richard M. Ebolon (eds.). The Future of Freedom Foundation, 11350 Random Hills Road, Suite 800, Fairfax, VA, 22030, 1994, ISBN: 0-9640447-0-6, $9.95,87 pp., (Softcover).

This is another excellent collection of 12 essays dealing with health care. In the Preface to this tome, Mr. Hornberger, founder and president of the foundation, states, "The debate over national health care is ultimately a moral one, not a practical one. Should the state have the power to take money from some to give to othersto force a person to live at the expense of someone else?"

These essays succeeds in accomplishing the goal of exposing many of the dangers of socialized medicine. Sheldon L. Richman, editor of Ideas on Liberty, agrees: "Government intervention is always dangerous. But nowhere is it more so than in the health care industry. The sooner we get the government out, the sooner we can breathe easier - and perhaps, even live longer." (p.42)

Empowering Health Care Consumers Through Tax Reform by Grace-Marie Arnett (ed.). Ann Arbor, MI, The University of Michigan Press, 1999, ISBN: 0-47206716-8, $27.95, 263 pp., (Softcover).

This is yet another collection of papers prepared by members of a "Consensus Group" presented at a March 25, 1996 conference entitled, "A Fresh Approach to Health Care Reform." According to the Preface, "This was the first comprehensive conference ever held to explore the impact of tax policy on the health care sector. It provided a forum for experts in the free market health policy community to present their research and perspectives on this issue in-depth." The conference was organized by The Galen Institute and supported by a grant from The Robert Wood Johnson Foundation.

Despite this sponsorship, this Consensus Group included respected health care analysts and health policy makers including Robert E. Moffit, PhD, John S. Hoff, John C. Goodman, PhD, and others.

Lawyers and Lawbreakers --- Unusual Cases of English Justice Since Alfred the Great by Dick Hamilton. New York, NY, Dorset Press, 1991, ISBN: 0-88029-653-4, 297 pp., Index, (Hardcover).

The book recounts English law through eight centuries. "Beginning with King Alfred's hanging of 44 judges, we learn of the rigors of trial by ordeal, of the rights of sanctuary...it is a dramatic history where horror and humor abound, often side by side."

We also want to cite an excellent website to visit and bookmark: http://www.free-market.net in which the Medical Sentinel has joined the free marketplace of ideas as a network sponsor. Set your browser on the site and click on socialized medicine --- after you have read cover to cover this issue of the Medical Sentinel.


This edition of News Capsules was compiled by Miguel A. Faria, Jr., M.D., Editor-in-Chief of the Medical Sentinel of the AAPS. It appeared in the Medical Sentinel 2000;5(3):78-81. Copyright©2000 Association of American Physicians and Surgeons.