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Health Freedom Watch
April 2007

Contents:


Americans’ Top Concerns

Except for Iraq, health care ranks as the top issue of concern for Americans, according to a recent national survey conducted for the Kaiser Family Foundation. Here are some survey questions and responses that might be of interest to Health Freedom Watch readers.

When asked the open-ended (combined) questions: “What do you think is the most important problem for the government to address? Is there another problem you think is almost as important for government to address?” 44 percent of respondents cited Iraq/war in Iraq followed by (percentages will add to more than 100 percent due to multiple responses):

  • health care: 29 percent
  • economic issues: 13 percent
  • immigration/illegal immigration: 9 percent
  • education/schools: 8 percent
  • terrorism/national security: 8 percent
  • frustration with government/corruption: 7 percent
  • budget deficit/national debt: 5 percent
  • gas prices/energy: 4 percent
  • taxes: 4 percent
  • Social Security: 4 percent
  • environmental issues/pollution/global warming: 3 percent
  • crime/violence: 3 percent
  • foreign affairs/not Iraq: 3 percent
  • morality issues: 3 percent
  • seniors/retirement issues (not Medicare): 1 percent
  • other: 6 percent
  • don’t know/refused: 11 percent

The 29 percent citing health care were concerned about the following subset of topics (the percentages add to 30 percent due to rounding):

  • health care in general: 13 percent
  • uninsured/access to health care/universal coverage: 7 percent
  • health-care costs: 5 percent
  • other health-care mentions: 3 percent
  • Medicare: 2 percent

Respondents were also asked:

Which ONE of the following three things would you like to see in a health care reform proposal from a presidential candidate? Would you want your candidate to propose…

A new health plan that would make a major effort to provide health insurance for all or nearly all of the uninsured BUT would involve a substantial increase in spending OR

A new health plan that is more limited and would cover only some groups of the uninsured BUT would involve less new spending OR

Keeping things basically as they are? [Emphasis added]

Fifty-two percent selected the first option, 24 percent the second, 14 percent the third, and 11 percent stated “don’t know/refused.”

It is interesting that slightly more than half chose the option that involved a substantial increase in spending, because when asked what issues respondents worry about, having to pay more for health care or health insurance topped the list. The survey included this question:

“Next, I’m going to read you a list of things that some people worry about and others do not. I’d like you to tell me how worried you are about each of the following things.”
Here’s what worried the respondents:
  • Having to pay more for their health care or health insurance: 74 percent worried (40 very worried; 34 somewhat worried)
  • Income not keeping up with rising prices: 73 percent (42/31)
  • Their health plan being more concerned about saving money for the plan than about what treatment is best for them: 67 percent (30/37)
  • Not being able to afford the health-care services they think they need: 62 percent (35/27)
  • The quality of health-care services they receive getting worse: 61 percent (30/31)
  • Not being able to afford the prescription drugs they need: 59 percent (33/26)
  • Being the victim of a terrorist attack: 51 percent (23/28)
  • Losing their health-insurance coverage: 48 percent (29/19)
  • Being the victim of a violent crime: 47 percent (23/24)
  • Not being able to pay their rent or mortgage: 45 percent (27/18)
  • Losing their savings in the stock market: 36 percent (18/18)
  • Having to stay in their current job instead of taking a new job for fear of losing health benefits: 34 percent (20/14)
  • Losing their job: 33 percent (18/15)

The top three issues that respondents were “not at all worried” about were:

  • Having to stay in their current job instead of taking a new job for fear of losing health benefits: 46 percent
  • Losing their savings in the stock market: 44 percent
  • Losing their job: 44 percent

The survey is a first in a new series the Kaiser Family Foundation plans to conduct. Its website notes that “…Kaiser will track changes in the saliency of health as a political and policy priority, what the public’s priorities are for a health reform plan, and whether any candidates are breaking through with the public with their health reform plans.”

Source: “Kaiser Health Tracking Poll: Election 2008 - March 2007,” Kaiser Family Foundation, March 29, 2007.

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FDA Calls for Public Comments on Its Guidance Document Regarding Complementary and Alternative Medicine Products

Submit Comments by [May 29, 2007]

The following excerpts are from the American Association for Health Freedom and the Health Freedom Foundation (unrelated to the Institute for Health Freedom):

[The] American Association for Health Freedom and the Health Freedom Foundation are very concerned [about the FDA’s draft guidance document titled] “Guidance for Industry on Complementary and Alternative Medicine [CAM] Products and Their Regulation by the Food and Drug Administration” (see FDA Summary: http://www.healthfreedom.net/index.php?option=com_content&task=view&id=215&Itemid=). The full text of the CAM Guidance can be read here: http://www.healthfreedom.net/storage/aahf/documents/cam_guideline.pdf

…While we have several concerns with the CAM Regulation Guidance, the two biggest are broadening the definition of “health claim” and the desire to pre-empt the states in the regulation of [health-care issues].

Example: The document attempts to define how vegetable juice might be defined as a drug, “This means, for example, if a person decides to produce and sell raw vegetable juice for use in juice therapy to promote optimal health, that product is a food subject to the requirements for food in the Act and FDA regulations...If the juice therapy is intended for use as part of a disease treatment regimen instead of for the general wellness, the vegetable juice would be subject to regulation as a drug under the Act.”

The FDA defines a drug as “...(B) articles intended for the use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals; and (C) articles (other than food) intended to affect the structure or any function of the body of man or other animals…”

The draft guidance, when finalized, will represent the agency’s current thinking on the regulation of complementary and alternative medicine products by FDA. Though it does not change the law, it does represent a potential major expansion on how foods, therapies, and products could be regulated [emphasis added]...The language in the document gives us great concern and we cannot allow an agency such as the FDA to finalize the document in its present form….We believe the CAM Regulation Guidance would set the tone of the FDA in regards to functional foods; alternative medicine therapy, devices, and products; as well as dietary supplements and could help set the stage for future legislation that would restrict access....

Submit Comments by May 29, 2007 [NOTE: THE NEW DEADLINE FOR COMMENTS IS MAY 29, 2007; previous deadline was April 30, 2007. During April 2007, the FDA came under tremendous pressure from AAHF [American Association for Health Freedom] supporters and many others to extend the CAM Draft Guidance comment period. On April 25, 2007 the FDA website announced the extension of the closing date for public comment from Monday, April 30 to Tuesday, May 29.]

Mail Comments to: Division of Dockets Management (HFA-305) Food and Drug Administration 5630 Fishers Lane, Room 1061 Rockville, MD 20852

Or Email Comments: Click here or copy & paste this link: (http://www.accessdata.fda.gov/scripts/oc/dockets/comments/).

Note: No matter which method, be sure to refer to Docket No. 2006D-0480.

Source: “FDA CAM Regulation Guidance,” American Association for Health Freedom and the Health Freedom Foundation (excerpts reprinted with permission).

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Should the Veterans Administration Take Over All Health Care?
By Richard E. Ralston

For years the advocates of a total takeover of health care by the government have pointed to the Veterans Administration as the model of efficient and caring health care by our government. It provides an ideal model, they said, for all health care. They must have forgotten to tell us to pay no attention to the leaks, the peeling paint and the rats in the corner while they push to eliminate personal choice for everyone and trap us all in a system with no options and nowhere else to go.

For whom should we expect the government to provide the best health care treatment—and living conditions while that care is delivered—if not for those who have fulfilled their duty to that government: our wounded combat veterans? They expect (and should demand) the best treatment possible. Yet, wounded veterans are constrained to a system with few or no choice of options. What, then, should the rest of us expect from the loving arms and warm embrace of government-managed health care? What would happen if we were all involuntarily absorbed into the bosom of government health care? Would we expect tender and solicitous care—or a distant, insensitive, wasteful and indifferent bureaucracy?

Both the U.S. Army and the Veterans Administration clearly have large numbers of competent medical professionals delivering care. But soldiers in rehabilitation often have to wait a long time, travel a long way or live in terrible conditions to receive care. One of the amazing things about the problems at Walter Reed was that only the government could have developed the idea of a live-in, out-patient clinic.

In the face of this calamity and such inspirations as the tired response of all levels of government to Hurricane Katrina, the tireless advocates of medical socialism will continue to maintain that only the government can care for us adequately.

In the face of New York’s cartel of hospital administrators and health care public employee unions driving the annual cost of New York Medicaid past $47 billion and clamoring for more, the friends of ever-growing government will tell us that they will always manage spending better than private providers.

When we encounter those from this fantasy world of supposedly caring and efficient government, we must always respond with the facts. When someone says that the problem with health care is the cost and only the government can restrain expense, we must always ask them exactly when the government developed an ability to restrain expense. During the forty years of exploding Medicare and Medicaid spending? Or while the gross waste and fraud in New York Medicaid was going into orbit?

When we are told that health care by for-profit companies should be outlawed because such profits increase our health care costs, we must respond that it is the need to make a profit that results in what cost control we have. A government drawing on unlimited taxes and debt cannot control costs or even fraud. And what kind of “profit” will the leaders of public employee unions—and the politicians they fund—gain if they seize a total monopoly over health care and eliminate all of our other options?

When we are told that we would not have to worry about paying for our health care—whatever it costs—because the government will pick up the tab, we need to point out that once everything is “free” it will get really expensive. And we will watch the government decide that it owns what it is paying for—and that it therefore owns our bodies and can instruct us what to do with them.

But it will still be a free country, right?

Before engaging in such debates, we must first tell the government to get health care in order and under control for those who have been wounded in government service. In light of their ongoing failure to get that right, however, we should not tolerate even the request to give government more power.

Richard E. Ralston is executive director of Americans for Free Choice in Medicine (reprinted with permission).

Copyrighted © 2007. This article is copyrighted by Americans for Free Choice in Medicine. All rights reserved.

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Will the Political Obsession with Universal Coverage Lead to Neglect of Needed Reforms?
By Michael D. Tanner and Michael F. Cannon

As they tack left and right state by state, the Democratic presidential contenders can’t agree on much. But one cause they all support—along with Republicans such as former Massachusetts Gov. Mitt Romney and California’s own Gov. Arnold Schwarzenegger—is universal health coverage. And all of them are wrong.

What these politicians and many other Americans fail to understand is that there’s a big difference between universal coverage and actual access to medical care.

Simply saying that people have health insurance is meaningless. Many countries provide universal insurance but deny critical procedures to patients who need them. Britain’s Department of Health reported in 2006 that at any given time, nearly 900,000 Britons are waiting for admission to National Health Service hospitals, and shortages force the cancellation of more than 50,000 operations each year. In Sweden, the wait for heart surgery can be as long as 25 weeks, and the average wait for hip replacement surgery is more than a year. Many of these individuals suffer chronic pain, and judging by the numbers, some will probably die awaiting treatment. In a 2005 ruling of the Canadian Supreme Court, Chief Justice Beverly McLachlin wrote that “access to a waiting list is not access to healthcare.”

Supporters of universal coverage fear that people without health insurance will be denied the healthcare they need. Of course, all Americans already have access to at least emergency care. Hospitals are legally obligated to provide care regardless of ability to pay, and although physicians do not face the same legal requirements, we do not hear of many who are willing to deny treatment because a patient lacks insurance.

You may think it is self-evident that the uninsured may forgo preventive care or receive a lower quality of care. And yet, in reviewing all the academic literature on the subject, Helen Levy (of the University of Michigan’s Economic Research Initiative on the Uninsured) and David Meltzer (of the University of Chicago) were unable to establish a “causal relationship” between health insurance and better health. Believe it or not, there is “no evidence,” Levy and Meltzer wrote, that expanding insurance coverage is a cost-effective way to promote health. Similarly, a study published in the New England Journal of Medicine last year found that, although far too many Americans were not receiving the appropriate standard of care, “health insurance status was largely unrelated to the quality of care.”

Another common concern is that the young and healthy will go without insurance, leaving a risk pool of older and sicker people. This results in higher insurance premiums for those who are insured. But that’s only true if the law forbids insurers from charging their customers according to the cost of covering them. If companies can charge more to cover people who are likely to need more care—smokers, the elderly, etc.—then it won’t make any difference who does or doesn’t buy insurance.

Finally, some suggest that when people without health insurance receive treatment, the cost of their care is passed along to the rest of us. This is undeniably true. Yet, it is a manageable problem. According to Jack Hadley and John Holahan of the left-leaning Urban Institute, uncompensated care for the uninsured amounts to less than 3% of total healthcare spending—a real cost, no doubt, but hardly a crisis.

Everyone agrees that far too many Americans lack health insurance. But covering the uninsured comes about as a byproduct of getting other things right. The real danger is that our national obsession with universal coverage will lead us to neglect reforms—such as enacting a standard health insurance deduction, expanding health savings accounts and deregulating insurance markets—that could truly expand coverage, improve quality and make care more affordable.

As H. L. Mencken said: “For every problem, there is a solution that is simple, elegant, and wrong.” Universal healthcare is a textbook case.

Michael Tanner is director of health and welfare studies at the Cato Institute and Michael F. Cannon is director of health policy studies at the Cato Institute (reprinted with permission).

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2007 Institute for Health Freedom.