News Capsules (September/October 1999)

Kudos to Dr. Camardese

Dr. Nino Camardese of Norwalk, Ohio was honored to be a guest speaker at the 27th annual national convention of the American Academy of Physician Assistants which took place in Atlanta, Georgia, May 29-June 3, 1999.

Approximately 6,500 attendees registered at the convention. Dr. Camardese lectured about today's state of medicine and protested the violation of many Constitutional safeguards contained not only in the Bill of Rights but also in the Medicare law Sections 1801, 1802, and 1803.

Bravo, Dr. Camardese!

Reform MSAs Now!

A group of 43 Republican Senators recently wrote Majority Leader Trent Lott (R-MS) recommending key corrections in Medical Savings Account legislation. The four-year MSA pilot program is entering its third year with many people who were previously uninsured signing up.

MSAs combine high-deductible private medical insurance to cover costly illnesses with tax-favored savings accounts designed to pay for routine medical bills.

° The Senators want to allow anyone to open an MSA, lower the minimum family deductible to $2,000 from $3,000, and permit both employees and employers - rather than either one or the other as the law now stands - to contribute to the accounts.

° At present, MSAs are only available to the self-employed and employees of firms with 50 or fewer workers.

° Since under current law no new accounts will be allowed after the end of next year, the Senators want to remove that obstacle and make MSAs permanent --- thus encouraging insurers to enter the market.

° Currently singles may only fund 65 percent of the deductible up front and couples 75 percent --- a provision the Senators want to change to allow full funding initially.

The General Accounting Office has estimated that some 37 percent of MSA participants were previously uninsured.

(Source: Albert B. Crenshaw, "GOP Seeks to Expand Medical Savings Plans," Washington Post, May 9, 1999. For more on MSAs http://www.ncpa.org/pi/health/hedex4.html.)

MSA and Health Care Choice Expansion


Writing for the Tulsa (OK) World, Scott Holleran of Americans For Free Choice in Medicine, quotes Sen. Phil Gramm (R-TX) that attempting to regulate HMOs is like rearranging deck chairs on the Titanic. After describing the collectivist origins of managed care and HMOs (which is well known to readers of the Medical Sentinel), Mr. Holleran writes: "The proper solution lies in a simple concept that [Sen. James] Inhofe champions: a plan to offer every patient a choice to purchase health insurance as an individual --- neither through an employer nor through the government --- by legalizing Medical Savings Accounts for all Americans (MSAs are currently restricted to a small group of self-employed, uninsured, small business people and 390,000 Medicare recipients).

"Sen. Inhofe has proposed the Medical Savings Account Expansion Act, which seeks to make every patient eligible for MSAs and lift restrictions. MSA opponents, including Hillary Clinton and Sen. Ted Kennedy, believe MSAs will attract young and healthy patients and, therefore, raise premiums for the remaining population. According to the IRS and private health plans, the opposite is true: Fully one-third of thousands of MSA enrollees were previously lacking any health insurance and the median age for an MSA health insurance policyholder is over 40."

Holleran correctly insists that Congress should abandon attempts to regulate HMOs and instead grant immediate 100 percent tax de-ductibility for health insurance premiums and fully expand MSAs for all Americans.

(Scott Holleran, Americans for Free Choice in Medicine, e-mail: [email protected].)

ASD Meeting

The American Society of Dermatology (ASD) continues to oppose government and HMO inroads into medicine. ASD strives to preserve what remains of the patient-doctor relationship, restore quality medical care, and place the interests of patients ahead of those of managed care. The ASD annual meeting will be held in Newport, R.I., Oct.1-3, 1999. This year's efforts include opposition and reform of RBRVS, CLIA, fraud and abuse prosecution of physicians, E&M guidelines, and proactive initiatives on behalf of physicians and their patients. Check their website at http://www.asd.org or call (309) 676-3522.

Annual DDP Meeting

The 17th Annual Doctors for Disaster Preparedness (DDP) meeting took place June 4-7, 1999 at the Marriott Sea-Tac in Seattle, Washington. The program entitled "Science, Freedom, and Defense on the Threshold of the Millennium," was an astounding success!

Participants learned about the effects of radiation hormesis and the problems with linear no-threshold theories of radiation carcinogenesis; genetic engineering and the effects of government regulation in the effect of scientific research; the problem with new mandatory vaccines; construction of underground shelters; gun control and public health; and other interesting topics.

Order CD-ROMS, audio and video tapes through DDP, 2509 N. Campbell, Box 272, Tucson, AZ 85719, (520) 325-2680.


AAPS Annual Meeting


AAPS is gearing up for its 56th Annual Meeting in the beautiful resort of Coeur D'Alene, Idaho, Oct. 13-16, 1999. A lineup of outstanding speakers has been assembled to provide us with the much needed ammunition to fight corporate socialized medicine and managed care in all its incarnations.

Topics for discussion include: CPT coding, physician-assisted suicide, mandatory vaccination, and ethical peer review, to name a few.

Special attractions include: Boat Cruise with Mark Twain (Stephen Dow, M.D.); "Mock Trial" featuring defendant Lawrence Huntoon, M.D.; and a banquet with popular film critic and commentator Michael Medved!

American Medical Association (AMAP) Lurching in the Wind?


Dr. William Jessee who joined the AMA three years ago to help launch AMAP, is now leaving "amid critical work to get its final phases off the ground and touchy negotiations with a group of disgruntled specialty boards," reported the June 7, 1999 issue of AMNews.

It appears that the "touchy negotiations" were a repudiation of AMAP by specialty boards, who see their own authority being undermined by the AMA. Moreover, in a public relations disaster the AMA rejected applications by many physicians in New Jersey for accreditation. It has been commented that on accreditation the AMA may not only be about 10 years too late in its effort at monopolizing accreditation programs, but has also created a PR nightmare.

U.S. Intelligence Eavesdropping on American Citizens


On May 13, 1999, U.S. Rep. Bob Barr (R-GA) successfully amended the Intelligence Reauthorization Act on the House Floor to require U.S. intelligence agencies to report to Congress on the legal standards justifying surveillance activities directed at American citizens.

As more and more information moves along electronic paths, law-abiding citizens are increasingly exposed to government surveillance in the use of mobile phones, e-mail, facsimiles, and the Internet.

In amending the Act, Rep. Barr stated: "I am extremely concerned there are not sufficient legal mechanisms in place to protect our private information from unauthorized government eavesdropping through such mechanisms as Project ECHELON. This amendment represents a first step toward finding out whether or not sufficient legal safeguards and privacy protection procedures are in place."

Project ECHELON, run by the National Security Agency (NSA) in conjunction with Australia, New Zealand, Canada, and the United Kingdom, intercepts some two million transmissions each hour, with no judicial review or safeguards.

"If this report, which we seek to mandate, reveals that information about American citizens is being collected without their consent or in the absence of legal authorization, the intelligence community will have some serious explaining to do. In that event, Congress should demand new laws that specifically define the legal limits of government surveillance in the information age," Barr concluded, praising Intelligence Committee Chairman Porter Goss (R-FL) for refusing to allow the intelligence agencies to hide behind bogus claims of "attorney-client privilege" and not supply Congress with requested documents.

Rep. Bob Barr is a former U.S. Attorney and CIA analyst, and serves on the House Judiciary, Government Reform, and Banking Committees. Visit his website at http://www.house.gov/barr.

Also our congratulations go to Rep. Bob Barr for winning the top Congressional website (tied with Earl Blumenauer [D-OR] and Brian Bilbray [R-CA])! In the Senate the top websites belonged to Spencer Abraham (R-MI) and Orrin Hatch (R-UT).

"Know Your Customer" Still on the Books


As unbelievable as it may seem, on the eve of Independence Day, 229 members of the U.S. House of Representatives voted against an amendment offered by Reps. Ron Paul (R-TX) and Bob Barr (R-GA) to the Financial Services Modernization Act of 1999 putting an end to "Know Your Customer" banking regulation invading privacy of bank account transactions. (See Medical Sentinel, News Capsules, May/June 1999.)

As things now stand, information gathered by your bank could be turned over to an arm of the FBI for government surveillance. Federal regulators had previously backed off enforcing this outrage because of public outcry; now they have been given the green light by Congress to invade the privacy of the American people. The FBI and other law enforcement officials lobbied Congress heavily to stop the amendment according to the Wired news service. You should find out how your Representative voted, and let him know how you feel about his authoritarian vote and about the freedom-destroying features of this policy. Once again, it seems regardless of who is in the majority in Congress, authoritarian socialism marches on...Is it time for another American revolution?

Guns and Safety --- Trigger Locks

At a Hand Gun Control-sponsored event, HCI's chief attorney attempted to demonstrate the effectiveness of trigger locks. He discovered, much to his chagrin, he was unable to disengage the locks and proceed with his planned demonstration of efficiency and safety. And likewise, when Beretta tested a safety trigger lock (Saf T Lok), it caused 18 of 27 rounds to totally malfunction, reported The Wall Street Journal (4/23/99).

Trigger locks and other safe storage requirements negate a citizen's right to protect himself and his family. Manufacturers of trigger locks for example warn not to use them on loaded guns. A gun can still discharge, even after the trigger lock is placed on the weapon in the most secure position, needlessly increasing the risk of accidental shooting. Likewise placing the ammunition locked in a closet and the gun kept disabled in another place in the house, as advocated by gun prohibitionists, negates the right to self-defense and the protection of one's family from vicious predators. In fact, trigger locks, safe storage, and "smart gun" technology such as loaded-chamber indicators may not only infringe on an individual's right to self-protection but also increase accidental shootings.

As Dr. Timothy Wheeler was quoted in the Medical Sentinel (January/February 1999):

"Firearm instructors drill the lesson home for every novice: always assume a gun is loaded. Always look in the chamber yourself to confirm that it is empty, and therefore incapable of firing. The loaded-chamber indicator is yet another malfunction waiting to happen. Even worse, a shooter who relies on it will eventually skip the basic safety rule of looking directly in the chamber. That's how people learn firsthand the old lament 'I didn't know the gun was loaded.' "

(Timothy Wheeler, M.D., Director, Doctors for Responsible Gun Ownership, The Claremont Institute, P.O. Box 1931, Upland, CA 91785. E-mail: [email protected].)

Colorado Poll Supports Right to Bear Arms


While anti-gun Senators, with full support and guidance from the Clinton-Gore Administration, continue to exploit the tragedy in Littleton, Colorado to further their attacks on the Second Amendment, a not so publicized poll conducted for the Denver Rocky Mountain News showed that Coloradans' opinions on firearms did not change after the incident at Columbine High. Compared to a similar survey that was conducted in February 1999, this poll conducted in late May 1999 indicates the general public understands that legislative proposals that attack law-abiding gun owners and lawful activities are the wrong response to violent crime.

For example, in February, 66 percent of those questioned supported a shall-issue Right To Carry law. After the Columbine shooting, it was still 65 percent supporting such a law. While the original poll showed 70 percent as believing that gun ownership is a "basic right of all Americans," that number increased to 75 percent.

(Denver Rocky Mountain News, May 22, 1999)

Juvenile Delinquency --- Children and Guns

The U.S. Dept. of Justice's Office of Juvenile Justice and Delinquency Prevention study tracked 4,000 juveniles aged 6-15 in Denver, Pittsburgh, and Rochester (NY) from 1993-1995, and contrary to what was expected by conventional wisdom, the investigators reached some startling conclusions:

Children who get firearms from their parents do not commit gun crimes (0 percent), while children who get guns illegally do so at the rate of 21 percent.

The children who get firearms from their parents are less likely to commit acts of violence and street crimes (14 percent) than children who have no guns in their homes (24 percent), whereas children who obtain guns illegally do so at the whopping rate of 74 percent.

The study also found that "boys who own legal firearms have much lower rates of delinquency and drug use (than boys who own illegal guns) and are even slightly less delinquent than non-owners of guns."

This study also provides more evidence that close family units where children learn from their parents can not only be taught to use guns responsibly but also become moral in their attitude, responsible in their conduct, and more civil in their behavior.

CDC and Misdirected Research Funds

First, it was AIDS; then, it was gun (control) research; now, it's Chronic Fatigue Syndrome (CFS). A government audit has found that the CDC redirected funds allocated to CFS research and used these moneys for other "initiatives." A report was in fact issued by the Inspector General's office in response to charges made by William Reeves, M.D., a CDC bureau chief overseeing CFS activities.

"I believe that CDC has intentionally misrepresented moneys allocated to CFS research, and I cannot ethically support this," Dr. Reeves said in a statement filed in June 1998 under the federal whistle-blower protection act.

AMNews (June 7, 1999) quoted Dr. Reeves' allegation that the funding reportedly used for CFS research had actually been diverted and that CDC officials had provided false information about these budget decisions to Congress.

OIG auditors concur with much of his testimony finding some of the moneys were used to encourage the agency "to enhance an adolescent surveillance and outreach project."

As a result of the CDC's misallocation of resources, a spokesman for a CFS association stated that the CDC had harmed their cause and that they are several years behind where CFS research should have been.

For those also interested in how the CDC misused and misdirected funds allocated for gun and violence research in pursuing a gun control agenda, see the Medical Sentinel, Spring and Summer 1997 issues. For the misapplication of the public health model in AIDS and HIV research, see Medical Sentinel, Summer 1997 issue.

Child Abuse Prevention

Writing in the March/April 1999 issue of Intellectual Ammunition of The Heartland Institute, Twila Brase, R.N., P.H.N, reports: "Home visiting programs, the latest child-abuse prevention strategy, sends government-funded visitors into family homes to determine the quality of parenting, the use of health care services, compliance with immunization schedules, and the safety of the home. Rep. Henry Hyde (R-IL) has called these programs 'cradle-to-grave tracking newborns' and 'big brother interventions as we have never seen before.' "

Indeed, the latest strategy of the Healthy Families America (HFA), an initiative developed by the National Committee to Prevent Child Abuse (NCPCA), home visiting, which was initially targeted to "at risk" children and families, is expanding to encompass all families in keeping with its vision that "one day all new parents will receive the education support they need at the time their baby is born and in the months and years thereafter."

Some home visiting, health care personnel may consider, for example, refusal to immunize children with certain vaccines and punishing disobedience, particularly corporal punishment such as mild spanking, as child abuse.

The Pacific Justice Institute, in fact, recently described a devoted home-schooler who received a call from Child Protection Services (CPS) asking for an appointment to visit her and her children at home. Later that week, CPS showed up with two law enforcement officers who wanted to enter the premises and question her three children. The children were taken and the mother wasn't told where they were taken nor when she would see them again!

The Pacific Justice Institute provides recommendations and possible free legal representation. Visit their website at www.pacificjustice.org or write Pacific Justice Institute, P.O. Box 4366, Citrus Heights, California 95611.

New E&M Guidelines Contain Counting Formula

Despite continued opposition by AMA members over the inclusion of a numeric counting formula in the new Medicare E&M Guidelines, the Current Procedure Terminology (CPT) Editorial Panel of the AMA submitted recommendations for revisions to the E&M codes to HCFA on June 2 with the hated counting formula included. Counting, or numerical formulas, are cumbersome checklists in which each element of the physician's service counts for a certain number of points. When a physician reaches a certain point total, he or she may then bill Medicare at a higher rate.

The AMA (superficially) and other physician groups have opposed counting, but HCFA has insisted that some quantification is necessary to assure consistent interpretation of the E&M guidelines by Medicare carriers.

As Andrew L. Schlafly, Esq., general counsel of AAPS, revealed in "AMA's Secret Pact With HCFA" (Medical Sentinel, July/August 1998): "HCFA shall adopt and use [the AMA's] CPT-4 in connection with HCPCS, for the purpose of reporting physicians' services under Medicare and Medicaid. HCFA agrees not to use any other system of procedure nomenclature in HCPCS for reporting physicians' services."

In the AMA's attempt to establish a monopoly over the government-imposed coding standards for physicians, the AMA has repeatedly implied that HCFA was the perpetrator while the AMA painted itself as the supposed defender of physicians against government requirements, particularly HCFA's 1997 revised Documentation Guidelines for Evaluation and Management Services.

The fact is, as Mr. Schlafly points out, "The AMA imposes its onerous coding regulations on physicians in the name of HCFA." After all, the AMA "generates approximately two-thirds of its annual $200 million operating budget from non-dues services." Of that, $133 million in non-dues revenue, the AMA's publication revenue, including sales of those [onerous and] expensive CPT code books, is its most prominent source."

As we wrote in the January/February 1999 issue, "Readers of the Medical Sentinel should not be surprised the AMA and HCFA are proceeding with their plans to implement the hated E&M guidelines. The AMA and HCFA have invested too much time and effort into this project to easily relinquish it."

Perhaps, it's again time for the AMA House of Delegates and physicians everywhere to express our outrage and begin another uproar to get the AMA leader-ship-of-state back on course, away from the shoals of compromise (and lost membership) and instead navigate safely in the direction of freedom in medicine.

Managed Care 101


In an article in Internal Medicine News (May 1, 1999), Dr. Greg Pawlson, senior associate vice president for health affairs at George Washington University, Washington, D.C., states: "We're responding to changing accountabilities [for medical education]. We're asking, even if every HMO went away, how can we teach [residents] to think about care beyond the individual patient?" [Emphasis added.]

Moreover, the Accreditation Council for Graduate Medical Education (ACGME) is setting its sights not only on patient care but also on "practice-based learning and improvement" and "systems-based practice." ACGME holds that "graduating residents must know how to allocate resources, practice cost effectively, work with health care managers, and assimilate 'best practices.' "

A spokesman for the Department of Veteran Affairs in Washington, D.C., claims that the fee-for-service culture of most academic medical centers looms as the biggest obstacle to more managed care training.

At Children's National Medical Center in Washington, D.C., Dr. Bernhard L. Wiedermann, director of the center's pediatric residency training program and chairman of the center's Managed Care Education Task Force, affirms, "It is one thing to give lectures --- that's easy. But we want evidence-based and population-based practice to be part of everyday teaching at the bedside."

In other words, today "leaders" in medical education want to emphasize population-based medicine (leading to collectivist ethics) rather than the individual-based ethics of Hippocrates that have kept medicine independent and have served the profession well for over 25 centuries.

Hepatitis B Vaccine Criticized

Parents of recently innoculated children who have become ill or who have died are opposing the government's plan for universal vaccination with the Hepatitis B vaccine. A growing number of adults who have suffered complications from the vaccine or who have been struck with chronic illnesses believe that the vaccine is unsafe and dangerous.

The FDA and the public health establishment at the CDC and HHS continue to insist the Hepatitis B vaccination program is safe and effective.

John Hanchette of Gannett News Service reported on May 27, 1999:

"The controversy focuses mainly on babies and their fragile immune systems. Eight years ago, the powerful Advisory Committee for Immuniza-tion Practices (ACIP) essentially mandated the hep B shots for immunization of newborns.

"The FDA's reporting system of 'adverse events' --- the government term for reactions, including death --- shows thousands of reactions following the shots, vastly outnumbering hepatitis cases reported in that age group.

"For the last full statistical year, 1996, figures show 1,080 'adverse events' following shots to kids under age 1, including 47 deaths; CDC reported only 54 cases of the disease in that age span in the 3.9 million births that year. Indeed, a CDC official acknowledged at the hearing, only 279 cases of hepatitis B under age 14 were reported that year."

Wall Street statistician Michael Belkin, whose five-week-old daughter Lyla died in September less than 24 hours after receiving a hepatitis B shot, conducted a statistical analysis of the Vaccine Adverse Events Reporting System database for hepatitis B inoculations and found 24,775 reports from July 1990 to Oct. 31, 1998, with 439 deaths and 9,673 serious reactions involving emergency room visits, hospitalization, disablement or death.

Disputing Belkin's findings, Dr. Harold Margolis, chief of the CDC's hepatitis branch, defended the infant vaccination program stating, "For children less than 1 year of age who become infected, 90 percent will remain chronically infected" --- and hepatitis B "often goes undetected for 20 to 40 years until the resulting liver disease makes the person ill."

At a May 19 hearing of the Subcommittee on Criminal Justice, Drug Policy, and Human Resources of the House Government Reform Committee, chaired by Rep. John Mica (R-FL), the National Vaccine Information Center (NVIC) called for funding of independent (non-government, non-industry) research into reports of hepatitis B vaccine associated problems.

At the same meeting, three medical researchers including Bonnie Dunbar, PhD, Professor of Cell Biology at Baylor College of Medicine in Houston, Texas; Burton Waisbren, M.D. a cell biologist and infectious disease specialist in Milwaukee, Wisconsin; and Barthelow Classen, M.D., President of Classen Immunotherapies of Baltimore, Maryland, criticized the scientific studies used to approve the recombinant hepatitis B vaccine and its required universal use in all newborns and children. (Dr. Dunbar is a scheduled speaker at the AAPS annual meeting to be held October 13-16, 1999 in Coeur D'Alene, Idaho.)

(Sources: National Vaccination Center at http://www.909shot.com; Classen Immunotherapies, Inc. at [email protected], http://vaccines.net; and Parents Requesting Open Vaccine Education (PROVE) at [email protected], and http://home.swbell.net/prove.)

Kaiser Abandons "Customers"

On June 18, Kaiser Permanente abruptly walked away from 575,000 Northeast patients ("customers") leaving them to fend for themselves in the "medical marketplace." Corporate socialism is failing even in its "not-for-profit" incarnation. Patients were left out in the cold in Connecticut, Massachusetts, New York, Vermont --- and now North Carolina. Officials in those states concede the news is "unsettling" and publically have stated they are very disappointed with Kaiser Permanente's plans.

In Massachusetts,x the situation is critical because Harvard Pilgrim's has also announced it's ending its Medicare HMO plans. "We're anxiously waiting to find out who will be remaining out there. It might be a little dicier," stated a spokes-man for the Dept. of Insurance. Yet, he urged patients not to panic!

Don't be surprised if the government decides to come in with another initiative to rescue them from the collapsing "free market" in medical care.

Now, you may ask yourself why would the HMOs refer to patients as "customers" in this instance? Because calling them patients could put them in the unethical dilemma of "patient abandonment" and the legal conundrum of "practicing medicine without a license."

Airman Convicted in Anthrax Court-Martial

An airman first class from the 55th Transporta-tion Squadron was convicted in a summary court-martial April 21 for failing to obey an order by refusing to take the anthrax vaccination. The case was the Air Force's first anthrax vaccination refusal to reach court-martial.

Airman 1st Class Colby Bickley, a general purpose vehicle mechanic, was sentenced to seven days confinement, reduction in grade to airman, and restriction to base for 21 days. The judge accepted the guilty plea from Bickley who had a clean record prior to refusing the vaccination. Bickley's defense counsel stressed that Bickley's refusal grew out of information he found on the Internet that the vaccine may have negative long-term health ramifications, and not from a desire to avoid temporary duty in Kuwait, an assignment he had been notified of prior to refusal.

Capt. Jeff Lustick, the prosecuting attorney, stated, "What he did was illegal, and violated the very laws and regulations he swore to his nation to uphold when he took his oath on enlistment."

While the safety or reliability of the anthrax vaccine remains unproven, Lt. Col. (Dr.) Carey Capell, 55th Aerospace Medicine Squadron commander, asserted, "This vaccine has a 30-year track record of safety, and there have been no reported long-term adverse side effects at all. Compared to a lot of other vaccines, the anthrax vaccine has actually proven itself to be more safe than most of the other routine vaccinations out there."

(Since that time, however, the presence of Squalene, a highly toxic adjuvant, has been found in the blood of military personnel who have received the anthrax vaccine, including veterans sick with the so-called Gulf War Syndrome. (www.af.mil/leadstory.html and www.defenselink.mil.)

Physician Unions

On June 29, 1999, the AMA voted to back the formation of a physician national union to give the medical profession "more leverage" in fighting the policies of the managed care industry. While the House of Delegates voted to unionize (but not to strike), the fact remains that non-employee physicians can't form unions and effectively collective bargain to battle managed care. And while house staff and physician residents may be the most interested in forming unions, it is questionable whether they will have any leverage without the ability of threatening to strike.

And even if they could strike (which is probably unethical), who will sympathize with "greedy" striking physicians?

Full-time physicians in HMOs and hospitals and other physician employees are already able to unionize, and while they have been doing this at an increasing rate, less than 50,000 physicians have joined unions. Self-employed physicians are barred by federal law from forming unions and having collective bargaining rights.

Legislation already pending in Congress will give physicians collective bargaining rights and free independent doctors from anti-trust laws which up to now have prevented physicians from forming unions. We remain skeptical.

Moreover, an AP report (06/25/99) quoted Chip Kahn, president of the Health Insurance Association of America, as saying that the AMA decision could increase premiums by up to 11 percent and add at least 2 million Americans to the rolls of the uninsured. Blue Cross/Blue Shield Association agreed with this assessment.

The same report quoted Federal Trade Commission Chairman Robert Pitofsky who told the Judiciary Committee that such exemptions could lead to price-fixing and boycotts by physicians, dentists, and pharmacists.

At the AMA House of Delegates debate, the main point of debate centered on whether physicians will remain professionals or whether they will become a union. It is ironic that the AMA, given this information that the number of uninsured would likely be increased by 2 million (because of physician unionization), at the same time has joined a coalition of physician groups (i.e., ACP and SIM and others) in explicitly calling for universal coverage and implicitly declaring health care as a right (Internal Medicine News, June 15, 1999).

An excellent article by Linda Chavez published in Human Events, July 23, calls attention to the path the NEA took three decades ago when it decided to unionize. Is this where the AMA is headed?

See also: "Physician Unions --- A Piece of My Mind," in the Medical Sentinel, Jan/Feb 1998.

Unionization --- AMA Press Release

On June 23, 1999, Randolph D. Smoak, Jr., Chairman of the AMA Board of Trustees, released the following statement:

"Our AMA is committed to representing physicians in as many ways as possible. An affiliated labor organization not only broadens the range of tools doctors can use, but it strengthens the value of all the other tools we are using.

"Throughout our 152-year history, AMA physicians have been able to make tremendous advancements in medical care and physician practice by joining together. We expect nothing less in this new endeavor. The Board looks forward to creating a labor organization for the profession that addresses the concerns of America's physicians, but more importantly improves the health and well being of America's patients."

What the AMA has done, wittingly or unwittingly, is aligned itself to some of the most radical groups in the American political spectrum. By aligning itself with unions, the AMA will be placing itself on the opposite side of the Republican party and its conservative allies and placing itself squarely on the side of the Democratic party and its liberal coalition of disparate special interest groups. The AMA will likely not only be losing professionalism but also influence in the power politics of Capitol Hill, ironically for the questionable benefits of becoming a trade union, the very thing AMA members feared the most in their deliberations, for the yet-to-be seen unionization power of collective bargaining.

As I wrote in my editorial of January/February 1998, "Once again the AMA ship is leaving port and sailing into unchartered waters...This AMA policy [regarding collective bargaining] like many others before it, is not written in stone and is subject to change --- subject to the winds of the political expediency of the moment...."

What can you really do? Join AAPS! And, if you are already a member make a point to sign up a colleague --- one a month. Your first gift membership is free and each additional gift membership is $50.00. Do it now!

Diarrhea Vaccines Called Off

The rotavirus vaccine against infant diarrhea was formerly recommended by public health "to protect children we need to give the vaccine to everybody" (AP, 12/08/99). The vaccine has been linked to 5 cases of intussusception among 10,054 recipients (observed rate of 3 out of 10,000 rather the 1 out of 100,000 expected). Now the CDC has had to suspend the vaccination program.

Books in Brief

Textbook of Military Medicine. Medical Aspects of Chemical and Biological Warfare. Part I: Warfare, Weaponry, and the Casualty by Frederick R. Sidell, Ernest T. Takafuji, and David R. Franz. The Office of the Surgeon General, United States Army, TMM Publications, Washington, DC, 1997, pp. 721.

This is a mammoth textbook of military medicine. It comprises 35 chapters and an index. Chapters include "Overview: Defense Against the Effects of Chemical and Biological Warfare Agents," "Nerve Agents," "Toxic Inhalation Injury," "Triage of Chemical Casualties," "Decontamination," "Historical Overview of Biological Warfare," etc.

There is also an interesting acknowledgement on the medical aftermath of the Persian Gulf War which reads in part: "The editors of the Textbook of Military Medicine are mindful that some veterans of the Persian Gulf War (1990-1991) face continuing health problems. Although readers might have hoped to find a discussion in this textbook devoted to the illness known as Gulf War syndrome, the medical aftermath of that war is incompletely understood. A formal academic treatment now would not only be premature, it would soon be outdated.

"One fact seems clear at this time (May 1997): the scientific community has not yet reached a consensus on the medical consequences of serving in the Persian Gulf. Most observers agree that some of the 697,000 U.S. soldiers who were deployed there are sick and have wide-ranging symptoms, but the cause, or causes, have not yet been established. Investigations into the etiology and epidemiology of these illnesses have reached inconclusive and contradictory conclusions. Even the popular name of the illness, Gulf War syndrome, is perhaps misleading because the array of signs and symptoms does not fit the usual medical definition of a syndrome..."

This tome should fill the library of all physicians interested in military medicine, particularly those interested in disaster preparedness, civil defense, and those researching any of its disciplines.

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 1999;4(5):157-164. Copyright©1999 Association of American Physicians and Surgeons.