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• 5K 5rsce/et ,3i Crystai n IYunlth • If the Food & Drug Administration doesn't like a vitamin, should it be allowed to control literature about that vitamin? Book burning By Suzanne Oliver IN THE U.S. you can legally open a health food store and sell capsules of coenzyme Q10, a nutritional supple- ment that supposedly boosts heart performance. You can also open a newsstand to sell magazines with arti- cles touting the supposed medical benefits of coenzyme Q10. But don't try to open the news- stand in vour health food store. If you do, the Food & Drug Administration can confiscate both coenzvmes and magazines and maybe have you thrown in the cooler. In 1989 the FDA told Kenneth Scott, owner of nutritional supple- ment maker Highland Laboratories, in Mount Angel, Ore., he couldn't send out article reprints with his prod- ucts. According to the FDA, a reprint Forbes  June 21, 1993 constitutes a health claim if it's dis- tributed with the product. Make a health claim about a vitamin and it becomes subject to FDA approval. So Scott set up his daughter, Kim, in the business of mailing out reprints. Scott's vitamin customers were sent order forms for article reprints, in- cluding a reprint of an article extolling coenzyme Q10 from the February 1987 issue of Osnni magazine. Scott's daughter mailed the reprints free to customers who requested them. In October 1990 FDA agents and an armed U.S. marshal entered Kim Scott's home and seized the Ornni reprints. Other contraband seized by the G-men included newspaper and journal articles. Under Dr. David Kessler, a Bush = LEFT: Stephen Levine, owner of NutrlCology ' BELOW. Dr. Jonathan Wright at his Tahoma Clinic in Kent, Wash. The FDA doesn't just police their nutritional supplements; it polices their journal reprints. ® Administration appointee retained by President Clinton, the FDAis one very busy beehive. Its 8,500 employees certify food colors, supervise drug manufacturing practices, review pre- scription drugs-the list of duties goes on and on. The FDA's mandate also includes confiscating literature the agency doesn't approve of, if the literature is too closely connected to the sale of food, drugs or devices. The FDA has cut out a lot ofwork for itself. Medical journals are full of stud ies connecting nutrition to disease prevention, the recent discoveries on vitamin E and heart disease being a telling instance. But there is only one health claim about nutritional supple ments the FDA has approved, and that is that extra calcium may help protect the elderly against osteoporosis. What about the well-documente.i fact that folic acid supplements redu:c a woman's chance of giving birth tc, a babv with severe nen,ous svstem dc formities: This one hasn't vet been formally approved by the tortot+r FDA, notwithstanding that a sister government agency, the Centen tor Disease Control & Prevention, has recommended folic acid supplemcnts to voung women in its Alorbsdin~ Tjlortcrlitv Weeklv Report. In theorv, then, if you were to sell folic acid capsules and at the same time hand out copies of the CDC's newsletter, the FDA could seize both the capsules and the newsletter. (The FDA tells us a formal policy is in the works and not to worrv. ) The FDA has burned books before. In the 1950s, for example, psychia- trist Wilhelm Reich sold an "orgone box"-a device made from phwood, fiberglass and steel that supposedly 65

FDA accumulated energy from the atmo- sphere and revitalized a patient. The FDA in 1956 destroyed the boxes and burned Reich's books and papers. Reich died in prison. Three decades later, the FDA is still valiantly fighting quack medicine. On May 6, 1992 FDA agents and ten police officers, one with gun drawn, burst into the Kent, Wash. clinic of Jonathan Wright, a medical doctor specializing in nutritional treatments for illness. During a 14-hour raid the officials seized injectable vitamins, . minerals and glandular extracts, as well as newsletters published by Wright containing articles on presen- ing health through diet. The FDA has also seized newsletters published by the 10,000-member Life Extension Foundation. In 1987 the FDA asked NutriCol- ogy, a San Leandro, Calif. nutritional supplement maker, to stop selling the book Miracle Cure: Organic Germa- nium, bv Kazuhiko Asai. The firm's owner is Stephen Levine, who holds a Ph.D. in molecular genetics from Berkeley. Levine took the book ot}- the market, but he's still trying to sell his germanium, linseed oil, borage seed oil and coenzvme Q 10 (all avail- able at health food stores) to a mail- order clientele of doctors. The FDA is pursuing a case against him. Okav, maybe Levinc's theories are bunk. But maybe they aren't. Do we rcallv want Dr. Kessler dcciding the matter? ~ Wilhelm Reich, orgone energy theorist In 1956 the FDA burned his books. The Clinton Administration wants to reform the health care system by giving Big Brother more power. Two think-tankers-and a leading Republican senator-want to revolutionize the system by giving individuals the ultimate say in how their health care dollars are spent. All power to the patients An interview with John C. Goodman and Merrill Matthews by Janet Novack IkiAGIhE AN OLD MAN dying from in- operable lung cancer. At a cost of $50,000 his doctor can keep him alive for another two months, at best. Eco- nomic and moral question: Who's to say whether prolonging the patient's life is a sensible use of S50,000? One answer to that question is big government. Most proposals to re- form U.S. health care spending as- sume that market forces cannot ratio- nalhy allocate health care dollars; therefore politicians and/or health care bureaucrats have to step in. This is the logic behind so-called managed Competition reform proposals. But there is another answer. John C. Goodman and Merrill Matthews, of the National Center for Policy Analysis, in Dallas, want to give health care decision making power to indi- vidual patients and their tamilies. How? A plan based on their ideas that Senator Phil Gramm (R-Tex.) intends to sponsor is still evolving. As it now stands, it would allow 54,500 a year to be put into a family's medical t2~,-a savings account designed to pay for routine medical expenses like checkups, diagnostic tests and minor surgery. The contribution to the medical itt.a would qualif<, for a tax break, either a deduction or a tixed credit against taxes; the credit might be structured to provide more dollars of tax savings to the lower income. If an employer paid the $4,500, it would be treated as taxable income to the employee, who would then re- ceive a tax break. What about really big medical bills? Part ofthe annual $4,500-$1,000 to 52,000-would be used to buy a catastrophic care insurance policy, to cover expenses arising from, say, a heart attack. The unused money in the account would compound tax free. If the account got large enough, some of the cash could be used for nonmedical expenses such as educa- tion. For people below a certain in- come level, the government would put cash in their medical ims, with the amount depending on their income. Alternativelv, the whole $4,500 could be used to buy an insurance policy with low deductibles. Or to join a group health plan. The essential point: Only if individuals are spend- ing their own money will health care decisions be rationally made and the market given a chance to work. FoitBEs recently spoke to Good- man and Matthews about health care reform and medical tttAs. Goodman: We have far and away the best health care available in the world, and it would be terrible if reform lost that. There's nothing wrong with ~ spending 14% of our national income p on health care if we're getting our ~ money's worth. But we're not. [The C'~ third party payment system encour- ~ ages] both patients and doctors to W waste a lot of money. On average, ~ only 20 cents of each dollar comes ~ directly out of patients' own pockets; N'+ the rest is paid by employers, insur- ~ 66 Forbes  June 21, 1993