Tobacco Documents Online

F, J, L. BLASINGAME, M.D. / Publisher KEN C1AVit3/Editor fficials at HEW, Dr. Roche said, oven innocent." J. Stanla Pottin er quoted as declaring the premise on which in employment has existed..." HEW's Office of Civi sities to quotas in employment. raise number of blac requirements (thus lowering standards emphasize "black contributi'ons in all was bluntly warned that it could lose with HEW direetive. Federal fundin volve~d'M federal funding And late1 Dr. Roche added leges' tax-exempt status i IF YOU WANT CHILLIN mean & impl ications for medicine Education" by Geor e C. Roche iIi PhD Dr. Roche's report to Ameri_ was.excerpted in Jan. gant use, or abuse, of power cial quotas on the schools & At staka said Dr. Roche, '"i -"i7Am~rica s inst tuti~rns of h iculum & campus policy--in effect, losing contro teaches in the schools & what standards are enforced higher education will no longer exist." The two bi clubs bain used agaPnst colleges & universities by ucation & Welfare are the Civi l Rights Act & hundreds of mi l l ions of subsidi;s. What has developed, Dr. Roche said, are enforcement pi political attempt to mold the hiring p ractices for America's colleges ion, there Volume 5, Number l January 8, 1973 gov't control ovar private U.S. institutions can of report on "Gov't Intervention in Private t of Hillsdale Colle e,, Hillsdale, Mich. s of Independent Co1)e eg s_,& Universiti ing rev culty & student body ra- uality to accommodate enforced quotas. integrity of higher education." of admissions, hiring, attends the schools, who schoo)s--privata, independent pt of Naal th Ed- 1ars of fed "which r univarsitias, Medical News Report is published weekly by Blasingame Associates, Suite 200, 535 North Michigan Avenue, Chicago, i iiinois 60611. (312)-644-3090. $5C1.C)D a year U,S,A. & Canada, elsewhere $65,00, Single copy ffi1.5C/. Additional yearly subscriptions mailed in same envelope $20,00, Content may not be reproduced or photocopied without permission. it clear the schools are "assumed guilty rector of HEW's Office of Civil Ri hts, is acted "is that systematic discrimination warned that "we have a.whala of a lot of i power & we're prepared to use it HEW denies it sets quota paspita this distinction, whicl remains that both quotas & goals dam members of a group rather than as in HEW has demanded "ood fa i thi" c have ound t amselves una le to pin Since schools have bean°hard resse regulations, MW has decreed th~ry find c has also imposed the rule that "neither min to possess higher qualifications than those-of the lowest qual`ified incumbent,"' which addss up to "equality on the lowest level of performance," Dr. Roche said~ s 11111'results-orianted goals & timetables." lus•ivaly. samanttc, Dr. ~Roche said, "the central i~act hat our colleges & universities treat people as i viduals." llance with its rules & ragulatio hat MEW' means by good 1"a i th : 1ml-nd qual ilwiad candidates to comply with M who are '.'quaiifiab1e." The agency ity nor 1"'emaleempl"oyes should be required chool s. t limited its pressures on colleges & un 'ina's' pavidson Col le e, for examplq, was udent body, draft more flexible admission d Dr. Rocha)+ & rest-ructure curriculum to areas of academic instruction." Another college a $2 million federal grant if it did not comply said Dr. Roche. "Those schools most heavily in~ y most exposed to bureaucratic assault." Internal Revenue Service has threatened to remove tudents. 1 W

society officers rk executives in Dr. Roche's report of his extensive study of gov't inter vention in higher educatiran. Message is particularly important for those officers 6 ex- ecutives who bel ieve they can contra.l the substance of regulations to Implement new' Pro- lwessional Standards Review Organization law, or who bel ieve by forming PSROs & ,jumping hip deep into administration of the PSRO program they can thwart bureaucraticdeci'sions inimical to the interest of physicians & patients. ucati & sex. 9 MDs with c icaid patients Protaaon i s health care pra W has already na . When PSRO law racial quotas on inous parallels. HEW officials justify Intervention In higher ed- rven ovide nder amount a f care. vate practice of medicine constantly accuse lly implemented, with empted to Impose char health needs of minorities.& poor. y care Hill Burton hospitals must pro- its contrals & subsidies to medical or- ty quotas on MDs as wel l,as hospi tals & PSRO law is clear that physicians who ,fs~rm PS,R!Ds~ to police hc~spwi;ta~.i.s,~.,,M1~,wiJl be paid agents of gcw t. Wi l 1 they, l ike ccalleges & universities accepting federal money, become vulnerable to bureaucratic assault? ARVARD MECIi CAL SCHOOL HAS ACCEPTED $2.8 m i l l i ran grant for smcrki ng 6 h 8 tobacco companies 6 a tobacco growers' assn. Gar L. Huber MD, an ass search proJeCt's principal investigator, said money wi l l be used to supplement o tensi ve resea rch program concerned w i th effect of envi ronmenta l i nf 1 uences on the l u "Amon variet of other environmental influences to be studied," Dr. Huber said, "at tention wi l l now also be given to any specific effects cigaret smoke may have in develcrp- ment of such pulmonary diseases as emphysema, chronic bronchitis & lung cancer & in devel- opment of heart & vascular diseases." It will seem a bit stran e to members of American Medical Assn there is no sign of vi- olent reaction from liberal newspapers, like NYTimes, St. Louis Past-Di from those paragons of vi rtue, TV network commentators, Cancer 5cacietj. When ~ search grants to qua rss) had grand time para pcarate soul for $10 mi l l ion came mesmerized by outcry 9 ave reported that alm f contraception o in Huma-n Events, is s even more HEW until he gearl a size. Charles Westhof af`Princeton U6 i:rrX.Bumpaass of U of Wisccrnsin f 5 i e o enc.e. collected dat~ In 1970 thru lnterviews with 1,250 Catholic wives p~ting in a nat'1 fertility study. The younger the wife, the use artificial birth control, study found. Researchers said 76%, i ves under 30 admi tted they used cont racepti ve methods wh i c hing. Washin ton Post quoted high Cathol ic official as saying curate but challenging speculation regarding significance to ilty of wholesale discrimination on basis of race 4 law ,justified impositicrn of controls on hospitals lty of providing poor quality care to Medicare 6Med- to set up special cmte al l over worl d, 1 ighteausnsss d tobacco money. aice to the criticism. to funnel tobacco company re- ev~:rywhere (including Cancer Societ be pining to be President.. ,i i ican,, t hp,, f,9 rc yJ)„~consi n l y be1 ieves VP Spiro Ag- lw' corruptings i ts cor- mi tment of Roman i*athcrl ics.

i T I 5 DOUBTFUL THAT MORE THAN smal of provisions of the new PSRO law. M legislation affecting physicians, h by Coss., MNR is receiving inqu law & their impticat.ions for the priv week will attempt to answer questions with specific refere r ever enacted -reach i ng y, MNR each Q: poesn"t the law restrict functions of PSROs to institutional health Doesn't this mean administration of the PSRO law won't interfere with physicians7 A: The second uestion,is the important one 6 the answer is no. In first place, the restriction is not absolute. Sec. 1155 states "the responsibility for re- view of health care services of any Professional Standards Review Organization shall be the review of health care services provided by or in institutians..." There is, however, an important provisa--"uniess such Organization shal i have made a°request to the 5ea"y (of HEW) that it be charged with the duty & function ~~ ,o;i":, re.viewing., other health care servtces & the 5ee"y shat 1 have approved such re- quest. " It should be noted there Is nothing in the law to prevent bureaucratic pressure on PSC0;tca p;rs7ad~'" them to make the request. No one knows for sure, of course,, what kind of regulations wi 1 i be drafted to t there ist sufficient room within the provisions of the tic interference with the way MDs practice In their caf- fices. Noe one can say now, fcar `examp.ie, hcaw Sec. 1160 wi 11 be enforced in regu- _GM ns, but 5ee. 1160 can be interpreted to put crbi igatians on MDs enti re1y apart from the functions oi•" PSROs. Sec. 1160 im y~~s on doctors, hasp.itais & otherr heai th faci l i ties 6 agencies the cabligaion to assure that services ar ttems (drugs, for example) "ordered or provided" to Medicare, Medicaid& catherpatients whose care is paid with federal funds are medically necessary, will meet predetermined standards of quality & will be supported by evidence of necessity & quality. -0- health care wi th a view to assuring (to Ony eQ t%~Cl r-_ praq. t tiVn= r wr.n hCP Vr =rZj , ice toa Medicare or Medicaid patient by a hos- '" 1. 1 1. 1 ' 1" h d ity "to exercise his professional responsibility tient, such person or the provision of his influence or control over such pa- wi 11 be prc~vided ranly when &- to the ~~cten qual ity which meets professicrnal ly recogn Naither = dc,ct~«r ne,r a hAe i nn 0 "wri tmi c . , , disMtion" take any action " hich would a as an inpatient- in or to continue as an inp care facility" unless both determin 1-1y necessary 9 wi-t i be of a X dards of health care." able limits of professional any individuai to be admitted in any hospital or other heaith ient care is medically necessary, con- sistent with recognized standards& can't be provided more economically elsewhere. -0_ And what is the dut of PSROs in such matters? "it sha11 be.' the duty of each PSRO ... to use such authori ty or i nfl uence i t may possess as a profess ional or- ganization, 6 to enl ist the support of any other professional or av't ar aniza- on having influence or authority over health care practitioners 6 any other rson ... prcrviding health care services in the area served by such review rar- in assuring that each' practitioner or provider»..shall cc,m i with i„mpqj~ed on him under kthe) subsection." n advance an rvices) that such services or items viders are fully aware the most important v admission

WASHINGTON RLPaRr. Cm r Charles to s ucceed M one-time executive o been afraid to challenge industry. For that reason ment of his stature within Pre-election recrrts true. Some fle be h tu rn to. Most controversy was aroused by the firing of Robert Q. "Marston MD; as ., Director of t' Nal Institutes of Health. About 1,000 g ston s caust;r & deman ncJ voice in selecti Sur eon Gerw' 1 Jesse L. Steinfeld M Services &.MentaHealth Admi Meanwhile, w ncami c Oppr,rtun i ty has chief of HEW's Social NEWS d 0 reyo;,Kiis a family practi r admission to a hospital ..» or any other health care service "which will consist of extended or costly courses of treatment" are medicai ly necessary & can~"t be provided more econam.ically elsewhere In case haspitatizat.ian. ,There is plent of authnrit In this law for paid agents of gav"t to challenge th~ medtcal decision c"~physcia;ns. Sec. 1152 re u i res PSROs to keep prof i tes of pat i ents & phys ici ans. Thi s sec- tion also authorizes PSRROs to "examine the pertinent records of any practiti _ or provider of health services..." It seems clear that this section empowers p agents of gc"v"t to examine pa,tient records in Mps caffi.ces in the case of Medicare ~ Medicaid patients who are admitted to hospitals or other health care i.nstituticans. aw part r~d I ble cos reimbursa part of incurred cost health services..." What is considered unnecessar will certainly be a bureaucratic determination. iscussions o der the Medtcare law 6, to those actually be unnecessary in t ive the President Nixon executive shuf considerable speculation that he may `t Sec"y for Hea1th». Dr. Edwards tivist FDA chief & has not ssion -&the pharmaceutica1 ntraversial but not, apparently ation. Nixon Intended to clean house in•the executive agencies he top MI)s were fi red & some left because they wanted HEW Commission on Ma] era of in~re;se n malpractice sui of ccammissirrn were not unamimous. quired to establish patient grievance machin gency fees be developed; methods be found to to resolve disputes;..state legislatures alter rules. o : A former member of AMA Board of Trustees ed he is r; tiring #r6m a0ve mediM although he was trained in specialty of James R. Kimm~, MD, Executive Director of Am c~in staff o~"""W""sccansin Gov. Patrick J. 1.uce Wi l l iam BarclaParsons ,~1~; 84, r~~.i red of ys~ i~n~ 9 Sur,~sc~ns. .. Medenca 1 nc. reported mw ai~n Pa`rk axa Hos ital now under construction at uled to open r.n anuary, 1915. . M & Alcon Laboratories Inc amining possibility of divesting itsel 6 f te part cr Law instruments. .» Goldigger is girl who doesn't l owns i t. -6Q3. Another part of that law has large SROs on physici' ans. It applies i th the PSRO program, ""excluding therefrom any i cient de1 ivery 9f ir0409d, scient.tsts wrote Nixc,n• protesting Dr. Mar of his successar» quit & so did 1lernoln_Wi iberatian that chief cause. -seeki ng 1awyers. Ew"i nd i ngs institutions be re- " te rafcontin- arbitrati.on vidence. wn- M. D, Coos N3ay, wn•was in gyneccr•1 ocdy. . . has resicJnedto . . Died: al umiaia U Col lee of act to manage new 5 Hospital t Worth, said It Is ex Co. subsidiary that makes man's company unless he