Citizens' Council on Health Care

CCHC HEALTH eNEWS

Tuesday, July 9, 2002

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Providing news and commentary on health care policy,

health insurance issues, and medical confidentiality.

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* ATTEND UPCOMING MN HEARINGS: RATIONING DIRECTIVES and NEW

VACCINATION REQUIREMENTS

- July 18 and July 24. Details below...

* U.S. BODY PARTS USED FOR PROFIT *

- Family members not told...

* BUREAUCRACY IN A BOOK

- HHS needs 70 pages to list regulations expected in 2003...

* CHICKEN POX VACCINE INCREASES RISK FOR SHINGLES

- Eliminates booster effect on adults...

* HACKERS ALTER COMPUTERIZED MEDICAL RECORDS

- Test results changed...

* STUDY FINDS MEDIA COVERS UNWORTHY MEDICAL RESEARCH

- Many studies not found in peer-reviewed journals...

* A REFORM PLAN FOR MEDICAID

- Policy paper suggests patient-friendly alternatives

* DEMANDING THAT OTHER PEOPLE PAY FOR MEDICAL EXPENSES

- The cost of mandated benefits in insurance policies...

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* CCHC Commentary included

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UPCOMING PUBLIC HEARINGS IN MINNESOTA

Health officials in the state of Minnesota will hold TWO critical

public meetings this month (July 2002):

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1) JULY 18: WORKING CONFERENCE ON PUBLIC HEALTH EMERGENCY POWERS

The legislature required the Minnesota Department of Health to

prepare a study of legislative proposals that could further

empower health officials. Unfortunately, the 2002 legislature

gave health officials new power to detain citizens for up to 48

hours without a court order--and without a declared emergency.

The department's study is almost done. Health officials are now

asking for public input at a meeting to discuss the issues. As a

result of CCHC's suggested amendment, those interested in civil

liberties had to be invited. THAT INVITATION HAS NOW BEEN SENT

(See below). The only other opportunity for public comment will be

after the study has been written.

Officials may plan to use the study to justify new law that would allow

them to compel vaccination, ration health care services, take medical

decisions out of the hands of doctors, give immunity to doctors for

following state directives, control the use of antibiotics throughout

the year, and use the police to enforce their directives. These were

discussed and written as part of the original bill.

YOU MUST REGISTER BY MONDAY, JULY 15 to attend. THERE IS NO CHARGE.

To register, call 651-215-5805 or e-mail [email protected].

Include your e-mail address or mailing address in your response to

receive directions and additional information about the meeting.

SPACE IS LIMITED! REAL CITIZEN INPUT IS CRITICAL!

DETAILS:

When: Thursday, July 18, 2002, 8:00 a.m. - 4:30 p.m. (lunch provided)

Where: Earle Brown Continuing Education Center, 1890 Buford Ave., St. Paul

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2) JULY 24: PROPOSED NEW VACCINATION REQUIREMENTS HEARING

Health Department will hold a public hearing on the plan to require

Chickenpox vaccine and Pneumococcus vaccine for all infants entering

day care, and to require Hepatitis B vaccine on entrance to day care

instead of on entrance to Kindergarten.

The 2001 legislature gave the Minnesota Department of Health (MDH) the

authority to change the vaccination requirements through the rule-making

process. In other words, they can propose a change, publish the proposed

rules, take comments from the public, hold a hearing before an

administrative law judge if at least 25 people object in writing, and

proceed from there. If less than 25 people object, they can alter the

proposal using the comments as they see fit, and then the rule in essence

becomes law. Unless the Governor disapproves. New Minnesota law gives the

Governor veto power over the rules.

As requires by statute, the MDH will hold meetings for the public on the

proposed rule. They are called Advisory Committee meetings. The first

meeting is scheduled for July 24, 2002

Date: Wednesday, July 24, 2002

Time: 5:30 P.M. to 8:00 P.M.

Place: Snelling Office Park, 1645 Energy Park Dr., St. Paul, 55108.

Directions: http://www.health.state.mn.us/divs/dpc/adps/immrule.htm

FMI: Contact Patricia Segal Freeman, MN Dept. of Health P.O. Box 9441,

Minneapolis, MN 55440-9441, Phone:(612) 676-5237 Phone: 1-800-657-3970

FAX (612) 676-5689

- Citizens' Council on Health Care

- July 9, 2002

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BODY PARTS USED FOR PROFIT: FAMILY MEMBERS NOT TOLD

The Massachusetts' Medical Examiner's Office was strapped for cash.

In a deal that guarantees them cash, equipment and staff, the ME's

office agreed to give the New England Eye & Tissue Transplant Bank

immediate access to the names of the deceased who were prime candidates

for tissue donations. The tissue bank called the next-of-kin, who were

not necessarily told that the transplants may be for a commercial,

profit-making purpose, such as cosmetic surgery.

Following a 1996 contract between the M.E. and NEETTB, employees from

the tissue bank were stationed at the M.E.'s office, filling out forms

and faxing the information to the tissue bank's Boston headquarters. The

forms include social security numbers, names and intimate details about

the deceased. Phone calls are made to the families requesting donation,

sometimes before the families even knew about the death. NEETTB paid

the M.E. $100,000 per year and $4,000 per month for this access.

The tissue recovery industry has become a billion dollar business. But

tissue bank executives claim that patient consent is a business priority.

Donors should be told that the tissue may be used for non-philanthropic

purposes, they say. And there should not be any quotas on delivery of

donor tissue to the for-profit industries. But minutes from NEETTB said,

"Each Donor will be evaluated on a case-by-case basis with the goal of

sending Collagenesis a minimum of 2 to 3 Donors a week"

Similar arrangements between medical examiner's offices and tissue banks

in other states, notably California, have led to lawsuits. The National

Association of Medical Examiners calls such arrangements a conflict of

interest and the American Association of Tissue Banks, vowed in 2001 that

the for-profit uses of body parts would be made known to their donors

when solicitations were made.

SOURCE: "Med examiner's office has secret body-parts deal," Tom Mashberg,

Boston Herald, May 20, 2002.

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CCHC COMMENTARY: The federal "privacy regulations" specifically allows

disclosure of private health data WITHOUT PATIENT CONSENT for the

activities of medical examiners and organ transplant organizations. When

it goes into effect in April 2003, will the unconsented disclosure of

data be considered perfectly legitimate according to federal regulators?

- Citizens' Council on Health Care

- July 9, 2002

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BUREAUCRACY IN A BOOK

Federal agencies are required to publish an "semi-annual regulatory

agenda" for regulations. The agenda for the U.S. Department of Health

and Human Services (HHS) is 70 pages long. The agenda lists all the rules

(regulations) that will be under development or review during the ensuing

12 months. The rationale for the publication is increased involvement of

the public. Contact information for each regulation is provided so that

members of the public can make comments, and know in advance the plans of

the various departments. The regulatory agenda for each agency was

published in the Federal Register on May 13, 2002.

In HHS, there are 225 regulations classified as long-term actions,

completed action, final rule stage or proposed rule stage (126 are out

of the Centers for Medicare and Medicaid Services). Another 68

are listed as withdrawn, either because they were listed in a previous

agenda, but development has not continued, or because they will not be

ready within the 12 month period. To get a rough idea on the size of the

Department within the federal government, and its bureaucracy, compare

HHS rulemaking (regulation writing) with the NUMBER OF PAGES of the

semi-annual regulatory agendas of some other U.S. Departments:

Internal Revenue Service - 0 pages

Civil Rights Commission - 2

Education Department - 5

Government Ethics Office - 9

Federal Reserve - 15

Federal Trade Commission - 10

Energy Department - 19

Social Security Administration -23

Veterans Administration - 31

Housing and Urban Development - 33

the Defense Department - 48

Labor Department - 49

Health and Human Services - 70

Commerce Department - 72

Interior Department - 77

Justice Department - 85

Agricultural Department - 85

Treasury Department - 110

Environmental Protection Agency - 161

Transportation Department - 195

The pdf version of the HHS semi-annual agenda:

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2002_unified

_agenda_&docid=f:ua020408.pdf

The text version:

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2002_unified

_agenda_&docid=f:ua020408.wais

The Federal Register for May 13, 2002:

http://www.access.gpo.gov/su_docs/fedreg/a020513c.html

- Citizens' Council on Health Care

- July 9, 2002

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ELIMINATING CHICKENPOX CAN DECREASE IMMUNITY TO SHINGLES

The chickenpox vaccination (varicella) could cause future disease

vulnerabilities in adults. Researchers from Britain's Public

Health Laboratory Service called for a re-evaluation of the mass

chickenpox vaccination policy out of concern for the elderly. It

appears that eliminating adult exposure to chickenpox can cause

increased risk of shingles, a painful blistering rash that usually

occurs after age 60 and can cause death from complications.

In 1995 the chickenpox vaccine was approved for U.S. children over

one year of age. It is now required for entrance to school.

The researchers found that adults living with children had more

exposure to chickenpox and higher levels of protection against shingles.

Exposure to the virus acts like a booster, they believe. Vaccinated

children would no longer experience the disease, therefore eliminating

the booster effect. The scientists used a mathematical model to predict

that eliminating chickenpox in the U.S. would prevent 186 million case

of the disease and 5,000 deaths over 50 years. However, they said it

could cause 21 million more cases of shingles and 5,000 deaths.

SOURCE: "Chickenpox Vaccine Increases Risk for Shingles," JAMA May 1,

2002;287(17):2211:

http://www.mercola.com/2002/may/29/chickenpox_vaccine.htm

- Citizens' Council on Health Care

- July 9, 2002

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HACKERS ALTER COMPUTERIZED MEDICAL RECORDS

Computer hackers are heading for medical records. No one has yet

died, according to a computer security expert, but they have left

patients scared. Hackers broke into computer systems belonging to

a clinic in the United Kingdom. They switched the results of their

cancer testing from negative to positive, leaving those patients

thinking they had cancer. "What would have happened if the switch

had been the other way around?" asks Richard Pethia, manager of

the networked Systems Survivability Program at the Software Engineering

Institute (SEI), a response team partially funded by the Defense

Department.

Pethia told attendees of the 16th annual National High Performance

Computing Council conference of another case. The CAT scan images

were completely corrupted the night before a patient was scheduled

to have surgery to remove a brain tumor. The surgery was postponed

until the test was redone.

Attacks to computer systems and the number of reported vulnerabilities

are rising annually. Criminals, not just kids, are involved. In cases

with financial losses, the average loss from hacking has doubled over

the last year to more than $2 million, according to Pethia. He said

that producers of hardware and software have not made security easy.

The emphasis has been on ease-of-use, not on ease-of-secured

administration.

SOURCE: "Computer Security Expert Warns of Troublesome Threat

Trends," Scott Nance, New Technology Week, April 15, 2002.

- Citizens' Council on Health Care

- July 9, 2002

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STUDY FINDS PRESS JUMPS THE GUN WHEN COVERING MEDICAL RESEARCH

Reporters are rushing into print medical stories that don't yet

deserve the public's attention -- and in some cases never will.

That's the conclusion of a study being published this week in the

Journal of the American Medical Association. The authors of the

study characterized the premature coverage as "too much, too

soon."

The authors analyzed newspaper coverage of five major medical

conferences during 1998.

o They found that 252 stories were written in major

newspapers about 147 research abstracts, or statistical

summaries -- and that 25 percent of those studies were

never published in peer-reviewed medical journals, while

another 25 percent were published in what were called

"low-impact" medical journals.

o The authors concluded this amounted to excessive coverage

of research unworthy of being published in major, peer-

reviewed scientific journals.

o The reports appear before the validity of the research has

been established, and many have "weak designs, are small

or are based on animal or laboratory research," the

study's authors warned.

o They added that "results are frequently presented to the

public as scientifically sound evidence rather than as

preliminary findings with still uncertain validity."

Source: Thomas M. Burton, "Study Finds Press Is Premature in

Reporting on Medical Research," Wall Street Journal, June 5,

2002.

For JAMA text http://jama.ama-assn.org/issues/v287n21/rfull/joc11828.html

SOURCE: Taken directly from the Daily Policy Digest, National

Center for Policy Analysis, June 9, 2002. http://www.ncpa.org

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DEMANDING THAT OTHER PEOPLE'S MONEY PAY FOR MEDICAL EXPENSES

Sadly, many Americans believe that other people should be

required to pay their medical bills. That shows up throughout

the politics of health care -- from government mandates for

insurance coverage of a variety of procedures to demands that

Medicare cover prescription drug costs.

Here are some examples and some effects of this health-care

entitlement mentality:

o Some 39 million Americans lack health-care insurance in

large part because mandates have driven up premium costs

beyond their reach, or they know they can get emergency-

room care for free and regular care through Medicaid.

o Even though today's seniors receive $2.50 in benefits for

every dollar they have paid into Medicare, according to a

report in the Economist magazine, many want a drug benefit

added to the program.

o A recent poll of seniors established that 69 percent would

only be willing to contribute $30 a month to a Medicare

drug benefit -- while 30 percent were not willing to spend

a dime.

The same survey found that few adults understand what health

economists have long known -- a large portion of the rise in

health-care costs is the result of people spending more, and

caring little, when health care is paid for using other people's

money.

Source: Devon Herrick (National Center for Policy Analysis),

"Picking Up the Tab and Hiking Costs," Washington Times, July 5,

2002.

For text http://www.washtimes.com/commentary/20020705-22069441.htm

SOURCE: Taken directly from the Daily Policy Digest, National

Center for Policy Analysis, July 9, 2002. http://www.ncpa.org

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MEDICAID REFORM SHOULD PUT PATIENTS FIRST

Medicaid, considered the "sleeper" in the 1965 legislation,

has gone from a $1 billion program in 1967 to an estimated $226

billion budget-buster in 2001, says Richard Teske, the author of

Abolishing the Medicaid Ghetto: Putting 'Patients First,' a white

paper recently published by the American Legislative Exchange Council.

Teske wants to begin a conversation about the reform of Medicaid,

a system that leaves the most vulnerable with second tier care. He

calls it a national disgrace, and recommends a move from a welfare

entitlement defined benefits structure to a market oriented defined

contribution structure.

He notes the problems of outdated reimbursement formula, inefficient

benefits delivery, eligibility gaps, poor continuity of care,

increasing use of emergency rooms, and growth of middle class use of

Medicaid while hiding "assets." He specifically recommends returning

administration to the States, passage of small market insurance reforms

that encourage people to return to the private market, looking at

federal oversight as a "non-issue" considering the poor quality of care

experienced by patients while under oversight, and expanding flexibility

in how the program is structured state by state.

SOURCE: The paper, released in April 2002, may be found on the ALEC

web site (http://www.alec.org) or ordered by calling Jim Frogue at

ALEC at 202-466-3800.

- Citizens' Council on Health Care

- July 9, 2002

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NOTE: These news items have been taken directly

from email received by CCHC or from Internet

newspaper publications. Titles in ALL CAPS are

CCHC creations except for those heading articles

from the National Center for Policy Analysis,

the Health Law Pulse, PrivacySecurityNetwork,

and LIST.HEALTHPLAN. Credit to the sending

organization or news service is listed at the

end of each article.

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CITIZENS' COUNCIL ON HEALTH CARE

1954 UNIVERSITY AVE. W., SUITE 8

ST. PAUL, MN 55104, 651-646-8935

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