News and Analysis (January/February 1998)

Compiled by Medical Sentinel Editors
Article Type: 
News and Analysis
January/February 1998
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Village Care and KidCare — “A Good Start?”

KidCare, the $24 billion government program for children’s medical care included in the budget deal, was lauded enthusiastically by AMNews in various articles. In a front page article entitled, “Kudos, Concerns for Kids Insurance Law” (AMNews, August 18, 1997), Geri Aston, an AMNews staff writer wrote, “When it comes to the new $24 billion children’s health initiative, states now have the opportunity to put their money where their mouth is.” The writer, although recognizing that the program was “billed as the biggest initiative since the 1965 enactment of Medicare and Medicaid,” was not fazed by the implications of the “initiative.”

In another article, “Uninsured Kids’ Health Coverage — A Good Start” (AMNews, September 22/29, 1997, p.19), AMNews contributor Gary F. Krieger, M.D. commented jubilantly, “In enacting the new budget bill, the Congress and President Clinton have created coverage for million of uninsured children. The significance of this cannot be underestimated.”

Never mind that KidCare was proclaimed by journalist E. J. Dionne of The Washington Post (08/01/97) as the largest expansion of health coverage since the passage of Medicaid and Medicare and Paul Bedard of The Washington Times has accurately reported that “the $23.4 billion ‘KidCare’ health insurance program included in the budget package was to be the ‘precursor’ to universal health care sought by First Lady Hillary Rodham Clinton in a secret White House fall back plan prepared in April 1993...”

Our own AAPS sources, in fact, had previously intimated that this would be the case. Internal administration documents have revealed that Hillary Clinton’s Health Care Task Force, “plotted to push a ‘kid’s first’ insurance program as the start of a universal health care program if Mrs. Clinton’s grander effort failed, as it did.” Moreover, as we at AAPS had previously reported, The Washington Times has also now disclosed that the plan signed into law by President Clinton and pushed by Hillary is a “duplicate of the first of the four-year-old health care task force idea, except that it is paid for by a 15 cent tax on cigarettes.”

Although the AAPS had warned Congressional Republicans that the plan to cover three million uninsured children was an old move by the White House to open the door to universal health care, it was ignored until the recent revelations in The Washington Times.

Never mind all of these revelations, Dr. Krieger, vice chair of the AMA medical staff section and regular contributor to AMNews, after expounding on how this law will add “flexibility” to state programs, crows: “expansion of children’s health insurance will certainly not solve all of the problems facing young people today. But, it is certainly a good beginning.”

In AAPS News (January 1996, “Clinton Care Through the Kitchen Door”), we reported how the state of Minnesota implemented Option 3 of the health care task force documents or “Kid’s First Coverage” plan, in which, incidentally, the Robert Wood Johnson Foundation played a significant role, to implement universal coverage by starting with a specific percentage of children and then gradually increasing children’s coverage as to obtain universal coverage including the adult, well-to-do, middle class: “The Minnesota version derived from a 1987 Children’s Defense Fund program for poor children, costing $1.3 million per year, and expanded into a $1 billion per year mandatory managed care program for all Minnesotans.”



Dissatisfied Physicians Serving Managed Care

 A new study by Karen Scott-Collins, et al, “The Commonwealth Fund Survey of Physicians Experience With Managed Care (March 1997),” found that more and more physicians are allying themselves with managed care organizations in order to keep patients or attract new insured patients. Nevertheless, their survey, which included 1,710 physicians, reveals that doctors are joining HMOs, PPOs, and POSs even when they believed that joining these networks “have a negative impact on their ability to care for patients and their satisfaction with medical practice.” Among the findings of the survey, which was taken in 1995 and only recently made public, include:

• “Nearly two in five physicians (38 percent) report that their ability to make the right decisions for their patients has declined in the past three years.

• “Forty-one percent report a decrease in the amount of time they spent with patients over the previous three years.

• “Almost half of those in plans that pay providers either a discounted price or a fixed annual amount per patient (capitated plans) rate their ability to get necessary treatment for their patients as fair or poor, and almost two-thirds (62 percent) rate their ability to get immediate approval for care as low.

• “Sixty percent report very serious or somewhat serious problems with external review and with limitations on their clinical decisions.”

By contrast, among physicians in traditional fee-for-service plans, nearly two-thirds say they have encountered no serious problems in referring patients to their choice of specialists, and 57 percent have had no serious problems with reviews of clinical decisions prior to a patient’s receiving care.

The study was conducted by the Commonwealth Fund, One E. 75th Street, New York, NY 10021, (212) 535-0400, and was summarized by the National Center for Policy Analysis in their Executive Alert, July/August 1997.



AMA Sunbeam Fiasco

Amidst the furor created over the AMA Sunbeam fiasco, the AMA’s Board of Trustees met September 18, 1997, at exactly the same time the AAPS was meeting in Chicago and conducting a panel on the relevancy of “The Oath of Hippocrates Today.” Donald Palmisano, M.D., a member of the AMA Board of Trustees had to rush from one meeting to the other, while avoiding reporters from the Chicago newspapers.

Be that as it may, as a result of the 7-hour meeting of the Board of Trustees, AMA Executive Vice President, P. John Seward, M.D., was directed by the Board to ask for the resignations of three executives. The AMA Executive Vice President himself “averted resignation because he didn’t know the details of the contract,” Dr. Thomas Reardon, Chairman of the AMA Board of Trustees, stated. Attempting to repair the public relations damage, Dr. Reardon, as reported in AMNews (October 6, 1997), addressed the scandal as: “...We need to talk about major initiatives to maintain our momentum — resetting our AMA’s vision and maintaining our emphasis on our major programs such as AMAP and the Ethics Institute.”

Faced with a public relations nightmare after the deal was reported in the major media, the AMA withdrew from the contract with Sunbeam, triggering a $20 million lawsuit filed two days later on September 8, 1997 in federal court.

Among the conclusions reached by the Board of Trustees were that “there was a systemic breakdown on the AMA’s internal system...and responsible individuals failed to recognize the ethical implications of the Sunbeam transaction....”

As a result of the controversy, at least three resolutions are expected to be brought before the House of Delegates to deal with the internal AMA crisis.



Conservative Consensus Strikes a Blow for the First Amendment

The Conservative Consensus has secured a major free speech victory for computer and fax users. “Responding to complaints by the Pennsylvania Attorney General’s office, the Federal Communications Commission (FCC) had ordered an Alabama man, Mr. Stephen Ames, Jr. of Gadsden, Alabama, to ‘cease the unauthorized transmission of fax messages unless and until you receive permission from the recipients...Further violation will result in immediate punitive action, which may include monetary forfeiture.”

You might now be interested in discerning the reason for the transmission of the aforementioned faxes in the first place. And yes, at this juncture, things take a more Kafkaesque turn, which might make you think that this cannot be taking place in America:

In the court of common pleas of Northumberland County of Pennsylvania, according to the report (“The Watchmen,” Gadsden, Alabama), “two children were taken from their parents because the parents were handing out Constitutions and reading the Bible without training.” According to the report, “Leslie Brydon, an attorney for the government stated in court that the parents believed the constitution was still relevant and that the parents read the Bible to the children and that those kind of things are a danger to children.” The parents, Stephen and Dawn Ames, were seeking justice from Pennsylvania Governor Tom Ridge and Mr. Mike Fisher. Mr. Fisher himself, who happens to be the Attorney General of Pennsylvania, filed the complaint with the FCC.

Conservative Consensus was especially alarmed at the chilling effect this order would have on political speech, particularly if citizens were required to obtain the permission of government officials prior to contacting them via faxes to express their views. In fact, courts have repeatedly ruled that political speech represents the most protected form of free speech under the First Amendment of the U.S. Constitution. Following an internal investigation by Mr. Lawrence R. Clance, Assistant Bureau Chief at the Compliance and Information Bureau, the FCC on September 3, 1997 wrote to Mr. Ames rescinding the July 11 letter. (The Conservative Consensus and the McMillan Letter, P.O. Box 71246, Seattle, WA 98107, E-mail:



A Medical Duty to Die?

A short, insightful article that appeared in the July 7, 1997 issue of The New American brought this timely information to my attention.

In 1993, in his book, Setting Limits, medical ethicist Dr. Daniel Callahan, one of the most prominent advocates of the “limits of lifespan” philosophy wrote, “the place of the elderly in our society is a communal, not only an individual question.” Then, in an op-ed column published in the October 4, 1993 issue of Newsweek, Dr. Callahan wrote, “Any serious health care reform efforts should rethink the efforts of medical progress...It should affect openly the need for rationing, not just as a way of controlling costs, but also as a symbol as a need to curb our insatiable appetite for improved health care and longer lives.”

More recently, in the March/April issue of The Hastings Center Report, a journal covering medical ethics, which incidentally is edited by Dr. Callahan, contains an essay by Dr. John Hardwick of East Tennessee State University entitled, “Is There A Duty to Die?” Dr. Hardwick writes, “Modern medicine and an individualistic culture have seduced many [into believing] that they have a right to health care and a right to live, despite the burdens and costs to our families and society.” The professor believes that we are insufficiently collectivist thus creating a scarcity of allocated resources. In his view, because resources are scarce and finite, we have “a duty to die...a responsibility to end one’s life in the absence of any terminal illness...a duty to die even when one would prefer to live.” This duty, comments The New American, exerts itself on the basis of age alone regardless of health.

Indeed, Professor Hardwick further comments: “a duty to die is more likely when you have already lived a rich and full life. You have already had a full share of the good things life offers...To have reached the age of, say 75 or 80 years without being ready to die, is itself a moral failing, the sign of a life out of touch with life’s basic realities.” (The New American, July 7, 1997, 770 Westhill Blvd., Appleton, WI 54914.)



Guns and Safety

The use of firearms to protect oneself against violent predators has proved to be an effective self-defense measure according to several studies including those described in the monumental book, Point Blank: Guns and Violence in America by Prof. Gary Kleck of Florida State University; Don B. Kates, et. al., in the Tennessee Law Review; David Kopel in at least two books; and Dr. Ed Suter and other members of Doctors for Integrity in Policy Research in various articles in the Journal of the Medical Association of Georgia between 1994-1995.

Now, a 1993 Department of Justice study confirms these researchers studies finding that “67.2 percent of people who had used a weapon to defend themselves against violent crime believed it had helped their situation.” The results of this study are, of course, also in line with the 1996 epochal paper by University of Chicago professor John Lott and researcher David Mustard which found that “allowing people to carry concealed weapons deters violent crime — without any apparent increase in accidental deaths. The University of Chicago study was based on 16 years of studying FBI crime data for all 3,054 U.S. counties. It concluded that if states without right-to-carry laws had adopted them in 1992, about 1,570 murders, 4,177 rapes, and 60,000 aggravated assaults would have been avoided annually.”

In this regard, NRA officials advise that individuals who plan to use firearms for self-defense should be encouraged to “develop personal-safety strategies that consider all available possibilities, including better [door] locks and lighting.”

Reduction in firearm accidents, particularly in children, have been markedly enhanced by the presentation of gun safety strategies both by local police and the NRA’s Eddie Eagle program which has now reached about 9 million youngsters and has been very well received by parents. Indeed, children’s death from firearm accidents have continued to decline, year after year, due to the efforts of the NRA and the Eddie Eagle program in addition to police efforts in local school districts. (Linda Klinger, The Washington TimesNational Weekly Edition, September 7, 1997/Dr. Ed Suter, Journal of the Medical Association of Georgia, March 1994.)



Switzerland Update:

Swiss Do the Right Thing

Paul Harvey News reported on July 23, 1997 that for the first time in history, Swiss banks have published a formerly secret list of World War II depositors in dormant bank accounts, so that Holocaust victim’s can be identified and funds distributed to the proper owners and their families.

Although some American politicians have used the issue to gain political mileage and force Swiss banks to establish funds for general compensation, the Swiss government has pointed out that any political decision would have to be approved by a referendum of Swiss voters.


Is It Goodbye Gold?

 If you want to know about one compelling explanation of what may really be behind the massive and relentless attack on Switzerland and its banking and financial institutions, I strongly recommend the article, “Goodbye Gold — The Insiders Have Targeted the Last Bastion of Real Money,” by Jane H. Ingraham in The New American, October 13, 1997.

Ms. Ingraham writes: “The true heart of the matter can be simply put: It is the gold backing of the Swiss currency. This means that the money or credit in circulation in Switzerland must by law be exchangeable at all times by the issuing bank for the equivalent in gold. It is this guarantee that gives foreign investors such confidence in Swiss banking institutions. It is this that has given independence, wealth, and power to the Swiss financial position, which handles 30 percent of all international investments. And it is this that is obstructing the Insiders’ route to global control of money and credit. It is an astonishing fact that the Swiss franc is the only currency left in the world that is still tied to gold.”

As far as the horrendous accusations of Swiss complicity with the Nazis in World War II in exchange for Nazi loot at the expense of Holocaust victims, she writes, “Ironically, the ‘impenetrability’ for which the banks are now being flayed actually came into being to protect Jews. In 1934 as the Hitler regime began to exert pressures, laws on Swiss banking secrecy were passed primarily to prevent the German government from investigating the foreign accounts of that country’s Jewish citizens. Unlike France, Italy, and other countries, Switzerland protected its Jewish citizens (18,000) from deportation. During the war, Switzerland accepted more Jewish refugees than any other country when measured as a percentage of its population. More than 14, 000 Jews escaped Germany to Switzerland before 1940; the following year Switzerland accepted 6,000 Jews who fled before the blitzkrieg against Belgium and France, as well as 50,000 fleeing French and Polish soldiers. In 1944 Switzerland voted to admit up to 14,000 Jews who were trapped in Hungary and who were charges of the Swedish diplomat Raoul Wallenberg. But Adolph Eichmann allowed only 1,600 to leave for Switzerland; those denied safe passage as ‘Swiss protected persons’ were deported to the gas chambers.”

Embarrassingly for America, because of President Roosevelt’s opposition to accepting Jewish refuges in the U.S., only 21,000 were admitted during the war. Likewise, the British were not friendly to Jewish refuges, holding them in concentration camps on Cypress for Arab oil concessions. Moreover, for unexplained reasons, the Allies failed to bomb the German railroads used to transport Jews to the death camps, yet at the request of Joseph Stalin, they bombed Dresden (crowded with refugees) mercilessly until it was completely destroyed. (The New American, 770 Westhill Blvd., Appleton, WI 54913.)


Originally published in the Medical Sentinel 1998;3(1:5-8. Copyright © 1998 Association of American Physicians and Surgeons (AAPS).






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