Albion Monitor

+ Many readers were likely puzzled by the August 24th report that Clinton would begin paying hospitals not to train physicians, claiming there was a glut of doctors in America. According to the widely-reprinted Washington Post story, this will "save money in the long run" because all those doctors are ordering "more medical tests and expensive specialty treatments... physicians find ways to keep themselves employed." The Post also noted that the U.S. has "more doctors per capita than virtually any other country."

This Post article neglected to mention several important facts about the new policy. Part of the "balanced budget" deal struck between Clinton and Congress, it freezes next year's Medicare payments to hospitals and places below-inflation caps on years following. Those government payments came to $85.8 billion in 1997, and have grown about $4 billion each year. The freeze will affect 5,200 acute care hospitals and 3,400 psychiatric, rehabilitation, long-term, cancer, or children's hospitals. The hospitals hardest hit by cutbacks will be those providing medical services to the poor and minorities.

Those Medicare payments increase $4 billion each year because of all those idle doctors are performing unnecessary tests, right? Although there's rampant hospital and nursing home fraud in the Medicare program, a spokesman for the Department of Health and Human Services (HHS) admitted, "That increase came despite limits on payment growth because we have more people in Medicare and sicker patients being admitted to hospitals."

Sadly, that's one of the crises created by "managed care," as described in Harold Stearley's breakthrough 1995 Nursing on the Edge series that appeared in the Monitor. This completes an unsettling picture: HMOs and other corporate health care organizations dump increasing numbers of critically ill patients into emergency rooms and hospital wards, but the feds refuse to pick up growing Medicare costs. Between fewer doctors in training and hospitals with frozen budgets are caught the usual suspects -- the elderly, poor, and minorities. Hey, is this the same Bill Clinton that wanted to reform our medical system four years ago? (September 8, 1997)

+ Although most commentators thought activists Helen Steel and Dave Morris won significant victories in the famous McLibel trial, the pair has filed an appeal to overturn the parts of the verdict ruled against them.

A calendar date for the full Appeal hearing may not happen until 1999, but the two are also planning to raise many of the fundamental issues again by taking the British Government to the European Court of Human Rights.

Among the more intriguing points of their appeal: Like government organizations, multinationals, as public corporations, should have no right to sue for libel, as it is in the overriding public interest that they be subjected to unfettered scrutiny and criticism. Also, they contend that McDonald's effectively consented to the distribution of the London Greenpeace Factsheet by hiring infiltrators to hand out copies. (September 3, 1997)

+ The recall of 25 million pounds of hamburger from Hudson Foods Inc. landed food poisoning in the headlines, but the press failed to ask the obvious follow-up question: Where were the USDA inspectors when all that meat was exposed to contamination? Monitor readers may recall an April commentary on how the USDA fails to protect consumers from the meat industry.

But vegetarians shouldn't smugly assume they're safe. Last spring, some 200 Michigan students and teachers contracted hepatitis A after tainted frozen strawberries from Mexico were used in the federal school lunch program. In May, the United States suspended imports of raspberrries from Guatemala after an outbreak of cyclospora, a tiny parasite that survives even chlorine rinses.

Last year there was a bumper crop of foodborne illnesses in the United States. Salmonella, cyclospora, hepatitis A and other diseases are occurring more frequently as food imports of fruits, vegetables and meats have doubled in the past five years. Yet the number of FDA food inspections have fallen sharply due to budget cuts, and a recent government audit found the USDA was unable to keep up with inspections of fresh produce imported annually from Mexico as a result of the NAFTA trade agreement. (August 25, 1997)

+ Although the mainstream press routinely ignores or downplays news about hazardous working conditions, you'd think at least one national paper would have reported the proposed $1,072,000 fine against the largest midwestern egg farm.

OSHA charged that AgriGeneral Co., LP, of Croton, Ohio, forces its employees to live and work under life-threatening conditions, including air polluted with ammonia and endotoxins, drinking water contaminated by insecticides and manure, and living quarters for temporary migrant workers that had raw sewage in the basement. When OSHA began inspecting the housing, the company moved the employees to a hotel, later returning them to the same buildings without correcting any of the problems.

The Federal inspectors were tipped off by the Ohio Department of Health, which became concerned about those and other conditions at the company, which produces about 4.5 million eggs daily. Doucas "Duke" Goranites, president of the company, formerly was president of DeCoster Egg Farms, which was the subject of another major OSHA enforcement case. (August 18, 1997)

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