Multinational Monitor

SEP 2003
VOL 24 No. 9

FEATURES:

Fishing Off the Deep End - And Back
by Carl Safina

Dead Seas: Nutrient Pollution in Coastal Waters
by Doug Daigle

Coasts at Risk: Coastal Sprawl and the Shore
by David Helvarg

Deep Trouble: Corporate and Military Designs on the Deep Seas
by Deborah Cramer

The Seaweed Rebellion: Marine Grassroots Movements to Protect Coastal and Ocean Ecosystems
by David Helvarg

INTERVIEWS:

Working for a New Ocean Ethos: Ocean Activism on the Shorelines
an interview with Christopher Evans

DEPARTMENTS:

Behind the Lines

Editorial
A Sea Change to Reverse the Oceans Crisis

The Front
Executive Excess

The Lawrence Summers Memorial Award

Names In the News

Resources

Names In the News

Targeting "Killer Karl"

Chanting and holding signs reading "Dying for AIDS drugs? Karl says drop dead" and "Bush's lies kill, generic medicines now!," AIDS activists in July staged a noisy disruption of a Washington appearance by top White House adviser Karl Rove at the National Conference of the College Republican National Committee.

"President Bush is breaking his promise to fully fund a $3 billion global AIDS bill signed into law in June. Bush is breaking his promise that countries can put access to medicines and public health ahead of the patent rights of greedy drug companies. The deadly global AIDS fraud perpetrated by this White House has gone far enough," says Sean Barry, a protester.

"Rove pulls the strings in this administration, and Rove has the blood of people with HIV on his hands."

In July, the House of Representatives opposed efforts to fully fund the bill President Bush signed into law in June that would provide $3 billion in global AIDS funding in 2004, with $1 billion for the nearly bankrupt Global Fund, the only multilateral program spending money on treatment for dying people with AIDS.

The disruption of Rove's speech also came in the lead up to talks at the September World Trade Organization Ministerial in Cancun, Mexico. The United States alone has blocked a deal on access to medicines in poor countries that lack capacity for efficient domestic manufacturing, though activists have been quick to note that the proposed deal is itself deeply flawed. Karl Rove has been linked to negotiations with U.S. drug companies in determining White House policy on the WTO issue.

"The United States promised they would permit countries to put public health before patent rights -- for killer Karl, that's just one more promise to walk away from," says Sasha Post, a protester.

Squandering Healthcare

Bureaucracy in the healthcare system accounts for about a third of total U.S. healthcare spending -- a sum so great that if the United States were to have a national health insurance program, the administrative savings alone would be enough to provide healthcare coverage for all the uninsured in this country, according to a study published in August in the New England Journal of Medicine.

Seeking to answer whether the ascendancy of computerization, managed care and more businesslike approaches to healthcare have decreased administrative costs, the study answers the question with a resounding "no."

"Hundreds of billions are squandered each year on healthcare bureaucracy, more than enough to cover all of the uninsured, pay for full drug coverage for seniors, and upgrade coverage for the tens of millions who are under-insured," says Dr. Steffie Woolhandler, co-founder of Physicians for a National Health Program and lead author of the studies. "Americans spend almost twice as much per capita on healthcare as Canadians, who have universal coverage and live two years longer. The administrative savings of national health insurance make universal coverage affordable."

The study finds that healthcare bureaucracy cost U.S. residents $294.3 billion in 1999. The $1,059 per capita spent on healthcare administration was more than three times the $307 per capita in paperwork costs under Canada's national health insurance system. Cutting U.S. health bureaucracy costs to the Canadian level would have saved $209 billion in 1999, researchers found.

The authors found that bureaucracy accounted for at least 31 percent of total U.S. health spending in 1999 compared to 16.7 percent in Canada. They also found that administration has grown far faster in the United States than in Canada. Between 1969 and 1999, administrative and clerical personnel in the United States grew from 18.2 percent to 27.3 percent of the health work force. In Canada, those personnel grew from 16 percent in 1971 to 19.1 percent in 1996.

MedMal Crisis Disproved

Contrary to insurance industry and physician organization claims of a medical malpractice epidemic, new data shows that medical malpractice filings in the United States have actually dropped over the last decade.

The most recent data released by the National Center for State Courts (NCSC) shows that "the 1992 to 2001 trend in medical malpractice filings per 100,000 population has only fluctuated minimally, with an overall 1 percent decrease in per capita filings."

In its analysis of five years of data for 17 states, NCSC found that seven states experienced more significant filing decreases -- but that only one of the seven has a cap on damages for injured victims, the major legislative change demanded by insurance and doctor groups to deter malpractice filings. The American Medical Association has described five of the seven states with steep decreases in medical malpractice filings as "in full blown crisis."

"One of the most contentious issues in the debate over medical malpractice is whether the system is being overrun with increasing numbers of claims by patients," says Joanne Doroshow, executive director of the New York City-based Center for Justice and Democracy. "Now, the most reputable, independent source of litigation statistics in the country has definitively answered this question, finding that not only are medical malpractice cases not growing, they are decreasing per capita."

"The legal system is working just fine without industry-sponsored laws that make it even more difficult for sick and injured patients to have their day in court," says Doroshow.

 

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