Thursday, March
22, 2001
by Jacquelyn Horkan, Editor
DOCS AT ODDS WITH AMA
Organized medicine, in the form of the
American Medical Association, is one of the biggest fans of the
trial-lawyer-backed Patients’ Bill of Rights, which would allow lawsuits
by patients whenever their HMOs denied coverage of a particular course of
treatment. Unorganized medicine, in the form of doctors who actually take
care of people, however, seem to prefer an independent appeals process
over lawsuits, according to a new survey.
The survey was conducted by Ayers, McHenry
& Associates at the behest of the American Association of Health
Plans, the nation’s largest HMO industry group. Four hundred physicians
nationwide were asked to pick the option that best served the interests of
patients involved in disputes with health plans: a lawsuit against the
health plan and a possible damage award; or a quick appeals process
involving independent review of complaints. The appeals process was the
choice of 75 percent of physicians, while 17 percent opted for lawsuits
(margin of error of plus/minus 5 percent). An AMA spokesperson interviewed
by Reuters dismissed the survey, calling it "rigged."
A November 2000 survey showed that consumers
also favored the appeals process by a margin of 65 percent to 19 percent.
THAT"S GOTTA HURT
Broward Circuit Court Judge Robert Lance
Andrews called plaintiff lawyers from four South Florida law firms and
another from New York a mean name: greedy. Then he got really vicious.
The five firms had just reached a $2.9 million
settlement in their class-action lawsuit against Renaissance Cruises,
Inc., of Fort Lauderdale, and were waiting patiently for the judge to
rubber stamp their request for $1.4 million in legal fees. Judge Andrews,
however, had a surprise in store.
The lawsuit belonged raft of actions against
cruise lines spurred by Florida Attorney General Bob Butterworth’s
investigation of the industry for padding the government port charges the
cruise lines pass along to customers. Under the Renaissance settlement,
the 80,000 plaintiffs will receive vouchers worth between $10 to $60 that
they can use reduce the charges for future cruises.
According to Judge Andrews, the effort put out
by the plaintiff lawyers did not justify a payoff of $1.4 million, so he
slashed the fee to $294,000. He also ordered that 25 percent of the fee be
paid in the form of the same vouchers the attorneys won for their clients.
The ruling blows a breath of fresh air at the
smelly practice of class-action lawyers who win pennies for their clients
and then take home millions of dollars for themselves.
WAGGING THE DOG
The U.S. Senate is spending two weeks debating
an issue few Americans really care about: campaign-finance reform. In the
past, Republican leaders in Congress kept the bill from reaching the
president’s desk, over the objections of Democrats. Now that the bill
might actually pass, Democrats are waking up to the threat the bill’s
ban on so-called soft money represents to their own election efforts.
Newcomers to the campaign-finance-reform
opposition are welcome guests, no matter their lateness or motives. An
estimated $3 billion, including soft money, was spent in 1999 and 2000 on
all campaigns for all federal, state and local offices, which, as
columnist George Will notes was $2 billion less than Americans spend
annually on Halloween snacks.
Yet, campaign-finance-reform activists claims
that there is too much money in politics and they intend to remove its
pernicious influence once and for all. Rich Lowry, editor of National
Review, explains why, even without the First Amendment, their efforts
will fail: "The logic of this position means that a mere limit on
party soft money … or even a ban … is not enough. Because if money can’t
go to parties, it would just go to other parallel organizations — say,
‘Republicans for the GOP,’ instead of the [Republican National
Committee]. In other words, there would still be ‘too much money’ in
politics, just in a different way. So, outside groups must be regulated as
well. Campaign-finance reform is a dog forever chasing its tail."
THE MORALITY OF PROPERTY RIGHTS
In 1997, the South African government enacted
the Medicines Act, which allows the country to ignore patents held on
drugs, opening the door for domestic production of cheap generics.
Thirty-nine pharmaceutical companies have challenged the act in court.
AIDS activists hope that the law can be used
to give South Africans cheap access to the expensive HIV "drug
cocktail" that helps inhibit the progression of the virus. The
activists accuse the manufacturers of the 30 or so drugs that make up the
cocktail of putting "profits before lives." Would that the
matter were so simple.
The cocktail regime is complicated: some drugs
must be taken with food, others without, each must be taken at the right
time and in the right doses or there is a danger that the virus will
develop resistance to the treatment. In developed countries, the HIV
cocktail costs patients up to $15,000 a year, putting it beyond the reach
of some low-income Americans, not to mention most patients in Third World
countries.
Activists believe that there is something
immoral about the high cost of a life-saving treatment, but the
"filthy lucre" collected by pharmaceutical firms is what
provides most of the financing for the next generation of AIDS treatments,
including a vaccine. Protecting the companies’ property right to their
patents not only provides the means to continue the research, it provides
the incentive. Eliminating that property right eliminates both the means
and the incentive, and thus the best hope for those who now have AIDS and
those who have yet to become infected.
What cannot be lost in the condemnation of the
self-defeating socialistic tendencies of the activists is the very
mendacity of some African leaders. Namibian President Sam Nujoma insists
that Africa’s AIDS scourge is the result of a racist plot. South African
President Thabo Mbeki made the news last year with a government document
parroting a similar conspiracy theory. Mbeki has also declared that AIDS
drugs don’t work and that HIV doesn’t cause AIDS. According to a
recent ACNielson survey, the most support for his views comes from South
Africans in the lowest-income bracket.
This week, the South African government
released its latest statistics on the prevalence of HIV in the country.
Half a million South Africans were infected with the virus last year,
bringing the total to 4.7 million, more than any other nation in the
world, or one in four adults. The country’s health officials partly
blame the continued rise in the infection rate on a failure of programs
designed to discourage risky sexual behavior. No doubt Mbeki’s input
didn’t help the effort.
Mbeki also refuses to declare his country’s
AIDS epidemic a national emergency, which would allow him to take
advantage of a World Trade Organization agreement under which his country
could license the production of generic AIDS drugs without the consent of
the patentholders. If South Africa took advantage of this provision,
however, it would have to provide the patentholders with compensation.
Mbeki says that declaring an emergency would have "complex
consequences for the country which are undesirable." Instead, he
wants to steal the right to produce the drugs, which he claims doesn’t
work.
The cold logic of property-rights protection
may not provide much consolation to the sick, their loved ones, and their
caregivers, but trying to defy it is neither moral, compassionate, nor
sensible. Too bad those who didn’t have access to the drugs from which
the drug companies are now profiting aren’t here to testify to that
fact.
