Florida is at the center of another contentious battle, but this time it is pulp and not chad that is at issue. On April 24, consumer advocates from the Center for Science in the Public Interest, the Center for Florida's Children, the Children's Foundation and Florida's Department of Citrus announced an alliance to battle what they characterize as 'deceptive marketing practices' employed by the advertising agency for Procter & Gamble to promote the Sunny Delight juice drink as a 'real fruit beverage.'
Bob Crawford, executive director of the Department of Citrus, brought his complaints to Washington and demanded Sunny Delight market itself differently or increase its juice content above 5 percent. Otherwise, a complaint or lawsuit would be filed with the Federal Trade Commission.
The fight about faux fruit juice was not the only marketing melee in Washington this spring. With seven months before congressional midterm elections, and complaining about too little media coverage, Democrats convened a press conference to unveil their new agenda, Securing America's Future for all of our Families. With prescription drug costs, protecting Social Security, saving the environment and pension reform atop their list, the message was not exactly new. In fact, neither was the marketing. Republicans giggled as they noted the striking similarity between this Democrat slogan and the one used by the House Republican Conference since 1999 (see news alert!, p. 6).
Meanwhile, with President George W. Bush and Senate Majority Leader Tom Daschle both traveling to the South Dakota senator's home state to help their respective party's Senate candidates and posture about 'benefit' of the farm bill, politicians inside the Washington Beltway began behaving as if they remember this is an election year. Well aware that it is issues and not marketing slogans that deliver votes at the polls, the GOP focused on what was being obstructed by Daschle, while Democrats moaned about what Bush hath wrought.
Yet again, it was back to the politics of health and wealth. As April faded the American Association of Health Plans (AAHP) released a report assembled by PriceWaterhouseCoopers identifying the causes of skyrocketing health-care costs during the last decade. The report paid especially close scrutiny to health-care spending between 2001 and 2002, finding the average increase in insurance premiums to be a bruising 13 percent. Inflation, prescription drugs and amortization of medical advances together accounted for 40 percent of the increase in health-care costs, while litigation (plus risk management), government mandates and waste/fraud were responsible for 27 percent of the increase. The study focused on private insurance plans, excluding Medicare and Medicaid.
'The pendulum has swung too far, and this report provides a road map for where to begin reforming the system,' says Karen Ignani, president of the AAHP. Ignani and Lee Launer of PriceWaterhouseCoopers both acknowledged the complexities of trying accurately to assign a price estimate to health-care costs, but assert the study highlights the 'disconnect' between the findings and what the legislators have been doing. Ignani pointed to the 89 new mandates in the House and Senate prescription-drug bills as increasing the already high level of concern among employers and insurance providers that they will be forced to increase premiums or drop employee coverage.
The fear of employers and employees was reflected by the number of health-related bills being introduced at a rapid pace. As Senate Democrats and liberal Republicans reacted to voter fears by reviving the drug reimportation movement, a new coalition examined the potential cost of cosseting those fears.
Speaking at an American Enterprise Institute conference examining America's system of medical justice, Phillip K. Howard, head of the bipartisan nonprofit policy coalition called Common Good, said the goal of his group is to address how the legal system affects the well-being of ordinary Americans and the decisions they and their physicians make. He said 'the crazy number of lawsuits' are relatively small in the grand scheme of things, but they are a telling tip of a huge iceberg. A big chunk of that iceberg is the fear of litigation. 'For every legal dispute there are probably millions of decisions made or not made because of the anxiety about possible lawsuits,' Howard told the audience.
According to Howard, as much as $50 billion could be saved by eliminating so-called 'defensive medicine'--prescribing unnecessary medicines and making unnecessary referrals out of fear of malpractice lawsuits--enough to pay for 25 million Americans to get health insurance. In making his case, Howard referred to a recent Harris poll of doctors which found the level of physician distrust is epidemic. As many as 96 percent of doctors believe most malpractice claims are not brought because of medical error, and 83 percent said they do not trust the courts to reach a generally reasonable result. In addition, 73 percent of these physicians report seeing colleagues protecting themselves by prescribing drugs not needed; 44 percent admit to doing it themselves.
That doctors would regard malpractice lawsuits as harassment isn't surprising, but a majority of Americans also display skepticism. A new nationwide poll released by the Health Care Liability Alliance and prepared by Wirthlin Worldwide found 78 percent of those polled expressed concern about the impact medical-liability costs have on access to care and 48 percent believe the number of malpractice lawsuits against providers is 'higher than justified,' compared with just 17 percent who felt the number was too low. This poll of 1,006 adults was conducted in April and had a margin of error of 3.1 percentage points.
Of those surveyed, 71 percent agreed that litigation is one of the primary causes of increasing health-care costs and seven of 10 were in favor of legislation to limit pain-and-suffering damage awards while guaranteeing full payment for medical costs and lost wages. More than three-quarters of Americans (76 percent) favor a law limiting the percentage trial lawyers can collect from settlements.
Noting the decision by Philadelphia's Methodist Hospital to stop delivering babies as a result of a doubling of insurance premiums, Reps. Jim Greenwood (R-Pa.) and Chris Cox (R-Calif.) introduced legislation to return some semblance of sanity to the health-care system. Based loosely on MICRA reforms passed in California in 1975, the Health Efficient Accessible, Low-Cost, Timely Health Care Act would cap punitive damages at $250,000 and place a time limit on the number of years an individual has to file a lawsuit. There would be no cap on medical benefits or loss of wages. Even if the bill gains enough support to pass in the House, any movement in the Senate is unlikely given the power of the trial-attorney lobby and the large contributions it makes to the Democratic Party. Most likely to lead opposition to such reform is former trial lawyer and prospective presidential candidate Sen. John Edwards (D-N.C.), whose New American Optimists political action committee received 89 percent of its donations from trial attorneys, according to Roll Call, a Capitol Hill weekly.
Democrats in the House may believe congressional Republicans and the Bush administration are vulnerable on health care and Social Security, but the GOP will be no pushover since it is focused on regaining control of the Senate to break the legislative logjam and free its initiatives and Bush-nominated judges trapped in the gnarled fist of Daschle.
Echoing a Nov. 30 editorial which contended Senate Judiciary Committee Chairman Patrick Leahy (D-Vt.) had 'offered no reasonable justification for stalling on these nominations' even the Washington Post, usually a liberal-friendly forum, again on its editorial page has called for Democratic action on Bush's judicial nominations with the one-year anniversary of several of the nominees looming.
Some action was taken on April 25 when the Senate voted to confirm Percy Anderson and John F. Walter to serve on the U.S. District Court of the Central District of California, but the unanimous votes belied the convoluted road the nominations took. The nominations of Anderson and Walter were the first to come out of a bipartisan state judicial nomination commission established by Sens. Barbara Boxer and Dianne Feinstein, both California Democrats, in cooperation and agreement with the White House. Similar commissions are in place to advance nominees for Wisconsin and Washington state.
The court situation in the Evergreen State is not running smoothly for the nominee for the Western District of Washington. The nomination of Ron Leighton is being held up by Democratic Sens. Maria Cantwell and Patty Murray of Washington for apparently partisan reasons.
'The tradition in Washington state for years and years has been to have a bipartisan commission review nominations. The senator didn't have an opposition to Mr. Leighton's nomination per se' says Matt McCarthy, a spokesman for Cantwell. Matters had been made confusing when Rep. Jennifer Dunn (R-Wash.) forwarded advocacy for Leighton's nomination to Bush, bypassing the commission system. Murray and Cantwell then refused to sign off on their home-state nominee. Recently, an agreement was reached with the administration to move all nominees through the commission. So where does Leighton now stand?
'I don't know the actual manifestation [under which his nomination] is being held, but it is not going to be considered until there is a bipartisan commission [approval]' McCarthy said, adding he 'would think that his credentials at first glance appear good, but it is important that this tradition is respected.'
For now Leighton, a fellow of the American College of Trial Lawyers and named as one of the '10 Best Lawyers in Washington' by Washington Law & Politics, remains stymied by Democratic posturing.
JENNIFER G. HICKEY IS A REPORTER FOR Insight MAGAZINE.
