Citizens’ Council on Health Care
CCHC HEALTH eNEWS
Monday, March 4, 2002


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* TREATMENT GUIDELINES RIFE WITH CONFLICTS OF INTEREST
Guidelines for care may suggest medications made by funding source...

 PUBLIC HEALTH SURVEILLANCE GROWS UNDER BUSH ADMINISTRATION
-Bush proposes $300 million for disease-tracking systems...
-29 states considering police powers through HEALTH POWERS ACT...

 JAIL FOR PARENTS WHO DON’T VACCINATE CHILDREN
D.C. threatening jail time for MMR refusniks...

* VACCINE-FREE FRENCH HEALTHIER THAN ALLIES
U.S. has almost 4 times the rates of post Gulf War illness...

* BIG BROTHER IN THE MEDICINE CABINET
Monitoring devices working to follow medication compliance...

* CHILDREN’S DNA DISTRIBUTED IN SOUTH CAROLINA
Genetics company got blood samples without parent consent...

* PHYSICIAN CARE WITH LESS BUREAUCRACY AND LOWER COST
Simplecare, a simple, hassle-free alternative for patients...

* IMPORTANT MEDICAL PRIVACY CHANGE FROM FDA
Patients using medical devices can refuse tracking...

* “POSTER PATIENT” FOR THE ILLS OF BRITISH HEALTH CARE
One story tells it all...

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* CCHC Commentary included
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TREATMENT GUIDELINES RIFE WITH CONFLICTS OF INTEREST

Nine out of ten (90%) of medical experts who write treatment
guidelines for doctors to follow in the care of their patients
have financial ties to the pharmaceutical industry, according to
a study published by the University of Toronto. Most ties
are not disclosed.

Clinical practice guidelines are voluntary, but, endorsed by medical
societies, often set the standards for medical care. The survey of
100 medical experts out of 192 contacted, found that most experts
received research money, and speaking, travel or consulting fees. Six
out of ten had “financial ties to companies whose drugs were either
considered or recommended in the guidelines they wrote,” according to
the New York Times.

Of the 44 practice guidelines, 11 (25%) were underwritten by the
pharmaceutical companies, and had declarations regarding the funding.
Only one reported a potential conflict of interest.

Some say the conflicts must be eliminated. Others, like Dr. Allan S.
Detsky, an author of the study, say that conflicts should be made
public and the public must be sensitized to this fact of life.

Source: “Study Says Clinical Guides Often Hide Ties of Doctors,
Sheryl Gay Stolberg, New York Times, February 6, 2002,
http://www.nytimes.com/2002/02/06/health/06DRUG.html

CCHC COMMENTARY: Clinical guidelines possess the potential to be
tools for health care rationing. Studies and research are used to
write the guidelines. Which studies are used and what is reported
is up to the writers. HMOs and government agencies can tie the
financial reimbursement to compliance with the guidelines.
Electronic tracking of care makes monitoring of doctor decisions
an easy task.

-Citizens’ Council on Health Care
-March 4, 2002


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PUBLIC HEALTH SURVEILLANCE GROWS UNDER BUSH ADMINISTRATION

Bush, Thompson Promote Bioterrorism Defense Funding Request on
Visit to Pittsburgh

President Bush traveled to Pittsburgh on Feb. 5 to promote his
budget request to increase spending on bioterrorism preparedness
to $5.9 billion, saying the unprecedented funding level would both
protect against future bioterrorist attacks and improve the nation’s
public health system, the Washington Post reports.

Viewing a “state-of-the-art” health surveillance system at the
University of Pittsburgh Medical Center, Bush said, “It’s money that
will enable me to say we’re doing everything we can to protect America”
(Connolly, Washington Post, 2/6). The proposed fiscal year 2003 budget
that the president released on Feb. 4 seeks $37.7 billion for homeland
defense, with $5.9 billion targeted toward improving the nation’s
ability to respond to a bioterrorist attack. That amount, which
would support such programs as hospital modernization, vaccine
development and antibiotic stockpiling, would represent a 319%
increase over bioterrorism funding this fiscal year (Gerstenzang,
Los Angeles Times, 2/6).

About $300 million of the requested funding would be used to promote disease-tracking systems, an example of which UPMC officials
demonstrated to Bush. The Real-Time Outbreak and Disease Surveillance
System, or RODS, is a “pioneering computer-assisted effort” established
in 1999 to “discern patterns in infectious disease by sifting data
from 17 hospitals in Western Pennsylvania” (O’Toole, Pittsburgh Post-
Gazette, 2/6).

Bush called the system a “modern-day DEW line,” referring to the
Distant Early Warning System employed during the Cold War to warn
of a possible Soviet missile attack over the North Pole (Los Angeles
Times, 2/6). A system similar to RODS will be used at the Winter
Olympics to monitor for a possible bioterrorist attack (Hutcheson,
Philadelphia Inquirer, 2/6).

Public Health Benefits?

Joined by HHS Secretary Tommy Thompson and Homeland Security
Director Tom Ridge, Bush said that his budget request would also help
to correct deficiencies in the public health system. “The monies we
spend to protect America today are likely to yield long-term
benefits, are likely to provide some incredible cures to diseases
that many years ago we never thought would be cured” (Washington
Post, 2/6). Research on biological agents, for example, could lead
to treatments for “more common killers” such as malaria, tuberculosis
and the flu (Ross, AP/Nando Times, 2/6).

But the Post reports that even if Congress grants Bush his full
request, it could take “years, if not decades, to reap many of the
benefits.” For instance, Michael Wagner, director of the RODS
laboratory in Pittsburgh, said that even if more localities develop
similar tracking systems, “few local or state health officials have
the technology to receive and analyze the data” (Washington Post, 2/6).
In addition, some medical researchers are concerned that Bush’s
emphasis on bioterrorism protection will crowd out funding for other
research, such as AIDS and diabetes (Philadelphia Inquirer, 2/6).

Source: Taken directly from the Kaiser Daily Health Policy Report,
February 6, 2002.

CCHC COMMENTARY: Congress and the Bush Adminstration have already
provided $1.1 billion to expand the public health infrastructure to
allows for “24/7 flow of critical health information” between
hospitals, state and local health departments and law enforcements.
There are no provisions for search warrants, court orders, or
patient consent.

The MODEL STATE EMERGENCY HEALTH POWERS ACT is the preferred
vehicle for the assumption of health official power over the
citizens of every state during the declaration of a “public
health emergency.” This bill, which has little to do with bioterrorism,
and everything to do with police power, has been proposed in 29
legislatures. Health care rationing, forced vaccinations/treatment,
and widespread surveillance are included in the bills. See
http://alec.org for details on action in separate states.


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JAIL FOR PARENTS WHO DON’T VACCINATE CHILDREN

From the British Broadcasting Company: Washington, D.C. has
introduced a provision to penalize the parents of children
who are not immunized against Measles Mumps and Rubella.
Unimmunized children are suspended from school pending
vaccination, while their parents face a fine or jail term.

This controversial vaccine, which has been linked to an
increase in autism and bowel disorders has caused immunization
to dip sharply in the United Kingdom leading to concerns
about a re-emergence of disease.

Deborah Holmes, head teacher at Jefferson Junior High School
is supportive of the district’s no holds barred policy: “If
it comes down to deciding which is more important the
education or the health, I think it is both, and I think the
system has made that clear.” The Department of Health in D.C.
took the stand to protect the local population, said Dr.
Michael Richardson.

Source: “Jail threat for MMR refusnicks,” BBC NEWS, February 14,
2002. http://news.bbc.co.uk/hi/english/health/newsid_1820000/1820928.stm

-Citizens’ Council on Health Care
-March 4, 2002


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VACCINE-FREE FRENCH HEALTHIER THAN ALLIES

The French forces who served in the Gulf War are free from
the illnesses of the British and American soldiers that
have emerged since the war ended. The French did not receive
the fourteen innoculations given to the British soldiers.
Nor did they receive the first-ever issue of nerve agent
pre-treatment taablets as an antidote against chemical
weapons or the use of pesticides to prevent fly-borne
diseases.

U.S. and British forces were in total exposed to 33 toxins.
The French simply drank bottled water and wore protective suits.

Only 140 of the 25,000 (5.6%) French Gulf veterans have reported
illnesses related to service, compared with more than 5000 of
the 52,000 (9.6%) British troops and 137,862 of the 697,000 U.S.
service personnel (19.7%).

British Subcommittee on national security received evidence
showing that the protective measures likely damaged the health
of the soldiers.

Source: “Vaccine-free French healthier than allies,” (from the
London Guardian) Sydney Morning Herald, taken off the Internet
2/18/02. http://www.smh.com.au/news/0202/13/world/world3.html
(Percents calculated by CCHC)

-Citizens’ Council on Health Care
-March 4, 2002


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BIG BROTHER IN THE MEDICINE CABINET

The Los Angeles Times reports that even with the threat
of death or illness, “many patients ignore doctors’ orders
and take prescribed medications irregularly, if at all.”
Deborah Willhite, who helped the U.S. Postal Service define
their response to the anthrax attacks, stopped taking her
anti-anthrax medication two weeks before the prescription
ended. In New York City, at least 50 percent of those who
got antibiotics to ward off anthrax never took one dose of
it.

Doctors and insurers note that this patient response is
symptomatic across the spectrum of health care. About 50% of
the population do not take their medication for chronic
conditions as prescribed by their doctors. They forget, they
feel fine, they lack insurance or funds, they don’t like the
side effects, or they mess up the time and try to compensate
for skipped doses by taking more.

Patients lie to their doctors about their compliance, according
to studies. Devices are now being made to monitor patient
compliance because studies have found that patient are more
compliant when monitored. Insurance companies are concerned
about the cost of non-compliance. Aetna sends quarterly letters
to 20,000 doctors reminding them about which patients are late
in refilling their prescriptions.

Source: “A Tough Pill to Swallow,” Charles Ornstein, Los Angeles
Times, (in the Chicago Tribune), February 18, 2002.
http://www.chicagotribune.com/news/nationworld/chi-la-021802drugs.story?coll=chi%2Dnews%2Dhed

-Citizens’ Council on Health Care
-March 4, 2002


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CHILDREN’S DNA DISTRIBUTED IN SOUTH CAROLINA

South Carolinans learned mid-February that the State had
created a DNA library on their children. When children are
tested at birth for a roster of genetic diseases they supply
a few drops of blood. Those samples have been kept by the
Department of Health and Environmental Control since 1995.
No parent permission or consent were required.

Now parents have discovered that the State has given DNA
samples to a genetics laboratory and others DNA samples to
the State Law Enforcement Division to help start a DNA
databank there.

Since the discovery, legislative remedies have been discussed,
including destruction of all samples, parental permission to
keep samples, or a new system that parents can direct that
their children’s DNA not be kept.

Source: “State of mistrust,” GoUpstate.com
http://www.goupstate.com/docs/Opinion/Editorials/5878.asp

-Citizens’ Council on Health Care
-March 4, 2002


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PHYSICIAN CARE WITH LESS BUREAUCRACY AND LOWER COST

An estimated 50 million Americans pay cash for physician visits.
Many are uninsured or have health insurance policies with high
deductibles. Largely as a result of excessive administrative
costs associated with processing insurance claims, specialized
medical services have also sprung up to meet the needs of these
patients.

Analysis of a large, high volume, multi-location physicians’
practice highlighted a common problem found in many practices.
Insurance companies’ average reimbursement for an office visit
was just over half of listed prices. Nonetheless, extensive
paperwork was required to process claims from patients’ visit
resulting in enormous over-head expense. As a result, a team of
physicians decided to streamline a bureaucratic, unprofitable
practice to accept reduced cash payments rather than bill a
myriad of insurance companies. The physicians called their
program SimpleCare and the results have been impressive:

o One minute of patient care resulted in seven minutes of
administrative tasks under insurance and managed care
contracts.

o Using simplified cash payments, seven minutes of patient
care require only one minute of paperwork.

o Profit per patient visit rose to $10 -- from a loss of $7
per visit.

Patient billing is much easier, requiring none of the
verification of insurance plan conditions and coding under
managed care. This allowed the practice to reduce the base price
of a physician visit to less than average insurance
reimbursement. Patient visits are as long in duration as needed
and fees are based upon the amount of time spent with the
physician.

Source: Vern S. Cherewatenko, “The SimpleCare Story,” Health Care
News, February 2002, Heartland Institute, 19 South LaSalle No.
903, Chicago, Ill. 60603, (312) 377-4000.

For text: http://www.heartland.org/health/feb02/simple.htm

Source: Taken directly from Daily Policy Digest, National Center
for Policy Analysis, 2/22/02, http://www.ncpa.org


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IMPORTANT PRIVACY CHANGE FROM FDA

The Food and Drug Administration has ruled that patients can
refuse to be tracked when using medical devices and equipment.

On February 8, 2002, the Federal Register reported that the
final rule on “Medical Devices; Device Tracking” includes the
following change:

”FDA is revising the scope of the tracking requirements,
including the appropriate modification of certain definitions and
certain requirements relating to patient confidentiality, to reflect
FDAMA’s changes....”

”Sec. 821.55 Confidentiality.

(a) Any patient receiving a device subject to tracking requirements
under this part may refuse to release, or refuse permission to release,
the patient’s name, address, telephone number, and social security
number, or other identifying information for the purpose of tracking.

-Citizens’ Council on Health Care
-March 4, 2002


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”POSTER PATIENT” FOR THE ILLS OF BRITISH HEALTH CARE

Some British newspapers print no end of horror stories
illustrating the plight of those caught up in that country’s
socialized medical system. But the treatment of one patient in
particular has caught the attention of Fleet Street and the
public.

o She is 94-year-old Rose Addis, whose case reached the
level of Parliamentary debate.

o After falling and sustaining a nasty wound on her
forehead, she was taken to the emergency ward of
Whittington Hospital in north London—with blood
reportedly gushing from her cut.

o Addis’s daughter found her 48 hours later in a chair in
her emergency room cubicle—confused, unwashed and still
wearing the clothes she had arrived in, now caked with
dried blood.

o The daughter was quoted as saying, “If my mother had been
a dog, she would have been treated better.”

Given the uproar the Addis case generated, two other Whittington
patients came forward to relate similar mistreatments. One was a
13-year-old boy whose parents claim he had to wait eight and a
half hours to see an emergency room doctor—even though he had
a raging fever and a rash, possible symptoms of meningitis. The
other case involved an 88-year-old man whose niece said she found
him covered in vomit and excrement after a five-day hospital
stay.

The hospital has tried to defend itself by calling the families’
accounts “fiction.” But those who have been treated by Britain’s
National Health Service profess to be all too well acquainted
with long, doctorless waits in squalid NHS emergency rooms.

Source: Sarah Lyall, “94-Year-Old Becomes Case Study in British
Health Care Woes,” New York Times, January 26, 2002.

For text
http://www.nytimes.com/2002/01/26/international/europe/26BRIT.html

Source: Taken directly from Daily Policy Digest, National Center
for Policy Analysis, February 1, 2002, http://www.ncpa.org



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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
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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.