Citizens’ Council on Health Care
CCHC HEALTH eNEWS
Tuesday, October 23, 2001


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* URGENT ALERT: Anti-terrorism bill threatens personal
medical and financial privacy, and constitutional rights.

* ACTION ALERT: Groups wage war against education bill
amendment that would protect children and parents’ right
of consent

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* EXPANDING GOVERNMENT HEALTH CARE SUBSIDIES DEBATED

* ORACLE’S CEO WRITES: NATIONAL ID CARDS FOR ALL

 NATIONAL PATIENT ID CARD DEFUNDED AGAIN

* MAMMOGRAMS USELESS IN PREVENTING BREAST CANCER DEATHS

* “ENVIRONMENTAL” ILLS - 60 PERCENT PSYCHOSOMATIC

* HOSPITAL WAITING TIMES IN CANADA LONGER

* NO LINK BETWEEN DRUG PRICES AND DRUG ADVERTISEMENTS


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* CCHC Commentary included
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ACTION ALERT: CONSTITUTIONAL LIBERTIES
AT STAKE IN ANTI-TERRORISM BILLS

The USA Act (Uniting and Strengthening America) is being worked
on by a Congressional conference committee of Senators and U.S.
Representatives. It is expected that a final bill will be
presented to the President for his signature on Tuesday (today)
or Wednesday. Grave concerns have been expressed by the hundreds
of organizations that have come together in a coalition called
In Defence of Freedom ( http://www.indefenseoffreedom.org/ )

The “Big Brother state” is about to be enlarged according to
Robert Higgs, a senior fellow at the Independent Institute.
Americans for Tax Reform’s Grover Norquist says the bill is a
”Justice Department wish list of powers.” Columnist and former
Reagan administration official Paul Craig Roberts predicts,
”These powers will rarely be used against terrorists. They’ll
be used against innocent Americans instead.” The bill includes:

* “Sneak and Peak” searches
Section 213 of the bill allows the government to enter homes
and offices while you are away, search through belonging,
take photos, and copy computer files, and not tell you until
later. This is the “Authority for delayed notice of execution
of a warrant” section of the bill. Current law requires a
warrant be shown at the time of the search, and the specific
property to be searched. This would include medical offices.

* A resurrection of the “Know Your Customer” bank spying scheme

Title III of the USA Act would require banks to “conduct enhanced
scrutiny” of customer bank accounts. This provision was attempted
by the FDIC in 1999, but rescinded after more than 275,000 angry
Americans flooded the government with phone calls, email and faxes.
A separate measure to enact it is also in the House bill, H.R.
3004. This is a long-standing attempt to monitor the banking habits
and monetary practices of citizens.

* Email Surveillance

Section 216 allows FBI agents to monitor routing and addressing
information without a search warrant. The FBI, which had to limit
use of the CARNIVORE system after it is discovered by the public,
now wants to use the system to establish unlimited access to email
(which according to testimony also captures the message portion of
email transmissions). Under the Fourth Amendment against unwarranted
”search and seizure” such surveillance without a search warrant is
already expressly forbidden for U.S. mail and phone calls.

WHAT TO DO:

Call your U.S. House representative and your two Senators
immediately at 202-225-3121 or 202-224-3121. THE VOTE COULD BE
TAKEN AS EARLY AS TODAY. Tell them that search warrants are a
critical piece of American freedom and required by the U.S.
Constitution. In addition, banks should not be forced to spy on
their customers. The banking habits of citizens are protected under
the Constitution. All citizens have a Fourth Amendement right to
privacy.

Source: Information taken from: “Anti-terrorism bill contains ‘sneak-and-peak’ searches, Global Know Your Customer and expanded
e-mail monitoring,” email alert, Steve Dasbach, National Director,
Libertarian Party, 10/22/01. CCHC commentary included.

Seventeen organizations have also sent Congress a letter found at: http://www.aclu.org/congress/l101901a.html

-Citizens’ Council on Health Care
-10/23/01


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PARENTS’ RIGHTS THREATENED IN ATTACKS AGAINST AMENDMENT

House Resolution 1854 (HR1854), the Tiahrt Amendment to the ESEA Reauthorization Bill (HR 1)is before Congress. Under its provisions,
no funds may be made available under any program to any educational
agency that denies or prevents parents from reviewing any educational
or testing materials used in the school, or that requires the student
to undergo medical, psychological or psychiatric examination, testing, treatment or immunization (except in a medical emergency), without
prior written parental informed consent.

The American Psychological Association has mightily opposed the
amendment since this summer. Author of Cloning of the American Mind,
educator and co-founder of the National Education Consortium, Beverly
Eakman wrote this rebuttal:

REBUTTAL TO LETTERS OF OPPOSITION TO THE GRAHAM/TIARHT AMENDMENT TO THE ESEA REAUTHORIZATION BILL (HR1):

On June 7, July 18, and July 20, 2001, coalitions spearheaded primarily by the American Psychological Association crafted
letters to Members of Congress opposing the Graham/Tiarht
Amendment, which requires prior written, informed consent from
parents in order for schools to perform psychological,
psychiatric, and medical examinations and tests. The Amendment
also codifies an across-the-board right of parental access to curriculum and curricular materials.

The Graham/Tiahrt Amendment recognizes that lip-service to
”parentalconsent” frequently is given. But without written,
informed consent there exists no incentive to actually provide
it. Any teacher can refer a child to a psychologist, even take
a young girl to an abortion clinic or require genital exams for 11-year-olds, without further ado.

According to Amendment opponents, it is appropriate for teenagers
to be “seeking timely medical advice”, and meeting with a school psychologist is “routine.” But most parents don’t want their
children “identified” as anything - labeled and categorized by
”pupil services personnel” who seem to think every independent
child is a dangerous “loner,” that inattentiveness is a disease,
and that squirming in one’s seat at the age of 7 is tantamount to having a mental disorder.

Most parents would describe as “troubling,” rather than “unique”
any job description that has a teacher identifying normal daily reactions to events as “depression,” “anger,” or “anxiety” - as
though such feelings are somehow abnormal. If Johnny seems to be having trouble seeing the chalkboard or hearing the lesson, then
that observation can be transmitted by the teacher to the parent directly. It is not the job of the school to take upon itself the delivery of socialized medicine.

The Graham/Tiahrt Amendment is good for teachers, because it frees them to actually teach. It’s good for parents because it puts them back in the drivers’ seat. And, most importantly, it’s good for children because it gets schools back to the business of learning, which is the “critical service” an educational institution should
be offering.

A population not permitted to exercise oversight and judgment eventually quits trying to do so; in other words, they abdicate
their responsibilities by default, because the responsibilities
have been usurped. The Graham/Tiarht Amendment repudiates such usurpation by self-appointed “experts” who believe they are more “qualified” to handle the childrearing function than parents.

- B. K. Eakman, Author, Cloning of the American Mind and executive
director, National Education Consortium, October 15, 2001.

WHAT TO DO:

Contact your members of Congress at 202-225-3121 or
202-224-3121. Contact the House Chairman: Rep. John Boehner
202-225-6205 Fax 202-225-0704, john.boehner@mail.house.gov.

Source: Email message from Parents in Action, Contact given: http://www.humanrights@cchr.org, Phone: 800-869-2247.

-Citizens’ Council on Health Care
-10/23/01


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EXPANDING GOVERNMENT HEALTH CARE SUBSIDIES DEBATED

The Boston Globe reports that “health coverage is one of
the first necessities to disappear as the economy sours and
businesses cut costs.”

At issue is the COBRA law that helps workers to keep their
insurance for 18 months after they become unemployed. Congress
has become concerned that the benefit, which allows laid-off
employees to keep their employer-sponsored coverage as long as
the employees pay the full premium plus 2%, is not generous
enough. Because employees have adjusted to the cost of health
insurance subsidized by their employer, the cost of a COBRA
policy is deemed expensive. Only one-fifth of laid-off workers
enroll.

Since the terrorist attack, Congress has considered ways to help
the newly unemployed and uninsured workers impacted by the attack
and the slow down of the economy. According to the Globe:

* President Bush has called for states to use a new $3 billion discretionary fund for paying a portion of the health premiums
of unemployed workers for 10 months.
* The White House has also suggested use of $11 million in
funds set aside for the Children’s Health Insurance Program
* Republicans want workers to have easier access to 401(k)
plans to pay for insurance.
* Democrats want to expand the Medicaid program to workers
* Democrats want to spend billions “to guarantee direct federal subsidies of private insurance premiums for anyone laid off
since July.”

Republicans worry that the direct government subsidies will lead
to an expanded role of federal government in the private health
care decisions. Republicans favor tax credits. The business community
is in the middle. While the National Association of Manufacturers is
leery about government involvement, Kate Sullivan, director of the
U.S. Chamber says, “More and more people who have jobs are not able
to participate in their health pl.ans because of out-of pocket costs...Government subsidies of health coverage, of private health
coverage, we think sets a good precedent.”

Source: “Congress renews focus on health care, Sue Kirchhoff,
Boston Globe, 10/16/01

- Citizens’ Council on Health Care
- October 23, 2001


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ORACLE’S CEO WRITES: NATIONAL ID CARDS FOR ALL

A commentary on National ID Cards was written by database mongrel
Larry Ellison, CEO of Oracle, in the San Jose Mercury News (Oct 8),
and reprinted in the Wall Street Journal (Oct.18).

Ellison says: “Many Americans instinctively fear that a national
ID card would sacrifice basic freedoms and compromise personal
privacy. On the face of it, issuing ID cards does seem a significant
step. Trusting government to maintain a database with our names,
addresses, places of work, amounts and sources of income, assets,
purchases, travel destinations, and more, seems a huge leap of faith.
But we should remember that these databases already exist, and that
we willingly helped in their creation. For years, companies like
American Express and Visa have been issuing cards and building up
information on millions of Americans. The databases they maintain
are searched and sold on a daily basis.

He says that Americans don’t need a national ID card, but that
social security cards should be made “with modern credit card
technology.” And a national database of suspected criminals
should be created. Currently, agencies have separate databases.
He suggests “a national database combined with biometrics, thumb
prints, hand prints, iris scans, or other new technology...Gaining
entry to an airport or other secure location would require people
to present a photo ID, put their thumb on a finger print scanner
and tell the guard their Social Security number” for cross-checking
with the national database.

His idea: phase in digital ID cards to replace existing Social
Security cards and driver’s licenses, but compel no one to comply.

CCHC Commentary: Although private corporations can sell or give
their data to government officials, VISA databases and other private
databases are not government databases. Pure economics, commercial
pressure and the push for standardization would eventually compel
all citizens to comply with a national ID system if implemented.
On October 17, 2001, the San Jose Mercury News reported that
Ellison has met with Attorney General John Ashcroft. It’s time
for everyone to go to the video store and rent a copy of GATTACA,
a somber but illustrative picture of what life is like in the
system being proposed.

Source:”Smart Cards: Digital IDs can help prevent terrorism.”
Larry Ellison, The Wall Street Journal, October 18, 2001. http://opinionjournal.com/extra/?id=95001336
Article on Ashcroft/Ellison meeting:
http://www.siliconvalley.com/docs/hottopics/attack/014110.htm

- Citizens’ Council on Health Care
- October 23, 2001


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NATIONAL PATIENT ID CARD DEFUNDED AGAIN

In the second week of October, according to a press release by
U.S. Rep. Ron Paul, the U.S. House of Representatives voted to
pass his language prohibiting federal funding for the
implementation of the federal medical ID numbers that are
required by law. The 1996 Health Insurance Portability and
Accountability Act requires all patients, providers, hospitals,
employers and health plans to have unique identification numbers.

While regulations implementing numbers for doctors, hospitals,
health care professionals, employers, and health plans have
been written, but are not yet final, the unique patient ID
has been stalled by the public’s resistance to the idea and by
Rep. Ron Paul’s yearly success at forbidding the use of federal
dollars to create the system.

”The federal government has no business tracking your medical
history throughout your life”, Paul stated. “As a physician,
I know that patients will be reluctant to disclose sensitive
problems if they know their medical file will be placed in a
federal database. Medical privacy is absolutely essential to
effective and humane patient care. The federal government needs
to stay out of the business of snooping through private medical
records.”

Source: “Paul’s Medical Privacy and Prescription Drug Measures
Passed by Congress,” press release, Office of Rep. Ron Paul,
October 16, 2001, http://www.house.gov/paul/press/press2001/pr101601.htm

- Citizens’ Council on Health Care
- October 23, 2001


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DANISH STUDY - MAMMOGRAMS USELESS IN PREVENTING BREAST
CANCER DEATHS

Speaking of health care costs, a new report says that there is no
credible evidence that “mammograms reduce the risk of dying of
breast cancer in women of any age,” according to the Washington
Post. The report was authored by the very well-respected Danish
Cochrane Collaboration. They reviewed each of seven large
mammography trials, involving half a million women, and found
that five of them were either of poor quality or so flawed as to
be discounted altogether. The two remaining studies were found to
be “of medium quality” and found no reduction in breast cancer
deaths. The Post article quotes Maryann Napoli of the Center for
medical Consumers in New York, as saying, “mammography causes
more harm than good...we have been sold a bill of goods.” And
that is based solely on the clinical results, without
consideration of costs. If the cost of mammography were added to
the equation, the conclusion would have to be that it is a
gigantic rip-off. And yet, virtually every state has enacted
mandate benefits that require insurance companies to pay for
periodic mammography screening. So someone is making a fortune
off the procedure.

Source: Scandlen’s Health Policy Comments, National Center for
Policy Analysis, 10/22/01 http://www.washingtonpost.com/ac2/wp-dyn/A18705-2001Oct18


________________________________________
”ENVIRONMENTAL” ILLS OFTEN PSYCHOSOMATIC

Most patients with symptoms they attribute to environmental
pollutants actually have psychological problems, according to a
recent German study. Studies in Sweden, the United States and
the United Kingdom have reached the same conclusion.

Illnesses attributed to pollution of air, water or food are
rising in developed countries. Symptoms linked to such causes
often include headaches, sleeplessness, breathing difficulties,
inability to concentrate and skin problems.

o A team of environmental scientists, dermatologists,
allergists and psychiatrists evaluated 50 patients who
reported symptoms they attributed to environmental causes,
such as pollution.

o The researchers found that 60 percent of study
participants who displayed symptoms of such
”environmental” illness had mental disorders.

o In many cases, patients had a fixation on environmental
dangers and spent a large amount of time reading news
stories or watching TV programs on the subject.

According to experts, “environmental” health problems occur
almost exclusively in western industrial nations. Although the
environmental pollution often represents a larger problem in
poorer countries, this does not translate into a high incidence
of “environmental” health problems.

Determining the psychosomatic nature of symptoms can help
physicians prescribe effective treatments, such as relaxation
training and social skills training. For patients with
depression or phobias, medicines such as antidepressants or
antipsychotics were successful in treating the “environmental”
symptoms.

Source: “German Study Shows ‘Environmental’ Ills Often
Psychosomatic,” Reuters Health, October 11, 2001.

For Reuters text
http://www.medscape.com/reuters/prof/2001/10/10.12/20011011clin01
9.html

Source: Taken directly from the Daily Policy Digest, National
Center for Policy Analysis, October 2001.


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HOSPITAL WAITING TIMES IN CANADA LONGER

Despite a massive infusion of federal spending on health care,
waiting lists in Canada have grown significantly. Total waiting
time for patients between referral from a general practitioner
and treatment, averaged across all 12 specialties and 10
provinces surveyed, rose from 13.1 weeks in 1999 to 16.2 weeks in
2000-01 (a 23.7 percent increase), according to a Fraser
Institute study.

Canada-wide, total waiting time increased significantly in 2000-
01 and its level is high, both historically and internationally.
Compared to 1993, waiting time in 2000-01 is 69 percent higher.
Moreover, academic studies of waiting time have found that
Canadians wait longer than Americans and Germans for cardiac
care, although not as long as New Zealanders or the British.

Among the significant findings of the study:

o The rise in waiting time between 1999 and 2000-01 is
principally a result of an increase in the waiting time
between GP referral and specialist consultation --
increasing from 4.9 weeks in 1999 to 7.2 weeks in 2000-01,
an increase of 46.9 percent.

o Waiting time between specialist consultation and treatment
increased for Canada as a whole between 1999 and 2000-01,
rising from 8.2 to 9.0 weeks, an increase of 9.8 percent.

o Throughout Canada, the total number of people estimated to
be waiting for treatment was 878,088 in 2000-01, an
increase of 3 percent between 1999 and 2000-01.

The highest percentage of patients seeking treatment outside of
Canada were those in need of radiation oncology (5.6 percent).
For all specialties, 1.7 percent of patients left the country to
receive treatment.

Source: Michael Walker and Greg Wilson, “Waiting Your Turn:
Hospital Waiting Lists in Canada,” Critical Issues Bulletin,
September 2001, Fraser Institute, 4^th Floor 1770 Burrard Street,
Vancouver, B.C. V6J 3G7, Canada, (604) 688-0221.

For text:
http://www.fraserinstitute.ca/publications/critical_issues/2001/wyt/index.html

Source: Taken directly from Daily Policy Digest, National Center
for Policy Analysis, http://www.ncpa.org, October 1, 2001.


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DIRECT-TO-CONSUMER DRUG ADVERTISING

Pharmaceutical companies spent a lot on prescription drug
marketing -- $13.8 billion in 1999 alone. But most of it is
spent promoting their products to physicians, not advertising to
consumers. However, in less than a decade, direct-to-consumer
(DTC) advertising of prescription drugs increased from $55
million (1991) to $1.8 billion (1999). As a result, patients are
more informed about their medical conditions and the treatment
options available.

Many health policy experts believe DTC advertising drives up drug
prices by increasing consumer demand. However, there is no
discernible link between increased DTC spending and drug prices.
In the case of prescription oral antihistamines, for instance:

o Among the three leading antihistamines, the amount spent
on DTC advertising varies widely, from $42.8 million for
Allegra to $57.1 million for Zyrtec and $137.1 million for
Claritin.

o However, there is not a wide difference in costs between
the drugs—Claritin costs $76.69 a month, compared to
$69.69 a month for Allegra and $60.69 a month for Zyrtec.

o If there were a direct correlation between advertising
expenditures and price, Claritin should be significantly
higher than the other two and Zyrtec to be more expensive
than Allegra. That is not the case.

Advertising actually lowers prices by giving consumers
information about product availability, quality and cost that
allow them to make comparisons. Also, by increasing sales,
advertising allows development costs to be spread over a larger
number of patients, resulting in a lower average price to each.
And the increased demand encourages other manufacturers to enter
the market—where they compete on price and quality. For
example, beginning with the release of the first antidepressant
drug in 1988, all new antidepressants have been launched at a
lower price, indicating an attempt to gain market share.

Source: Merrill Matthews Jr., “Who’s Afraid of Pharmaceutical
Advertising? A Response to a Changing Health Care System,” IPI
Policy Report #155, May 16, 2001, Institute for Policy
Innovation, 250 S. Stemmons Freeway, Suite 215, Lewisville, Texas
75067, (972) 874-5139.

For text
http://www.ipi.org/ipi/IPIPublications.nsf/PublicationLookupFullText/F4F61FB
6BB576D4086256A4F00229C21

Source: Taken directly from the Daily Policy Digest, National
Center for Policy Analysis, May 2001.



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