Medicine as a Tool of the State — Cuba (September/October 2000)



Author: Virgilio Beato-Núñez, MD, Enrique Cantón, MD, Gladys Cárdenas, DO, José Carro, MD, et al
Article Type: Feature Article
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Introduction Cuba's health services have come under attention recently.(1,2) Since 1963, Fidel Castro has been exporting health care personnel including physicians to countries in Africa, Latin America, and Asia. It is estimated that approximately 5 percent of the Cuban physicians working for Castro's MINSAP (Cuban Public Health Service) are involved in service abroad.(3) The so-called "doctor diplomacy" may have begun in the manner of an assistance program for guerrilla movements, but it soon turned into big business for Havana. In this article, we analyze briefly the current events that led to two physicians serving in Castro's "doctor diplomacy" in Africa to desert in a maneuver that turned dangerous for them and for innocent bystanders.(4) Furthermore, we analyze the recent offer from...




Author: Mark D. Hiatt, MD, MBA
Article Type: Feature Article
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Phileas Fogg had won his wager, and had made his journey around the world in eighty days. To do this he had employed every means of conveyance - steamers, railways, carriages, yachts, trading-vessels, sledges, elephants. The eccentric gentleman had throughout displayed all his marvelous qualities of coolness and exactitude. But what then? What had he really gained by all this trouble? What had he brought back from this long and weary journey? Jules Verne Around the World in 80 Days The Flexner Report(1) is one of the most cited evaluations of medical education in the twentieth century. Published in 1910 by the Carnegie Foundation, the Report arose from research conducted by Abraham Flexner, who claimed to have visited and objectively evaluated 155 graduate and twelve postgraduate medical...




Author: James A. Albright, MD
Article Type: Feature Article
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


The accumulation of all powers, legislative, executive and judiciary,in the same hands whether of one, a few or many, and whether hereditary, self-appointed or elective,may justly be pronounced the very definition of tyranny. James Madison, 1787 Federalist Papers #47   Executive Agencies with the Power of Legislation   Many of the current problems in this country can be traced to the growth of the regulatory agencies, some of which have become independent fiefdoms with legislative as well as executive and judicial powers. This has indirectly led to disaffection of the population, which in general believes that the government no longer represents their interests. It is a justifiable conclusion, because a high percent of our "laws" are now written by the regulatory agencies in the...


FDA


Author: Robert Cihak, MD and Michael A. Glueck, MD
Article Type: Editorial
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


The U.S. government's Medicare program became effective in 1967. It was supposed to help senior citizens get medical care. Although it now costs ten times more than predicted, many feel that it has helped elderly patients significantly. But how much harm does it do? Government and academic researchers back away from even asking such a question. Recent events show how Medicare is destroying trust between patients and doctors in the name of cost cutting, fraud prevention, and other tangential issues. Take cost cutting alone. A year ago, Medicare unilaterally determined that two different blood vessel examinations to evaluate risk for stroke would be "bundled" if the examinations were done on the same day. When the two examinations were done on different days, $32.10 would be allowed. But if...




Author: Kristine M. Severyn, RPh., PhD
Article Type: Editorial
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Who should make decisions about the medical treatment of Ohio's children --- state legislators at the beck and call of pharmaceutical companies, or parents across the state? That's the issue before state lawmakers in Columbus as special interests push for another mandatory vaccine for our schoolchildren, this time for chickenpox (varicella). If the bill passes, chickenpox vaccine, manufactured in human fetal tissue, will be the ninth in the cocktail mix of vaccines required for school attendance. At the urging of vaccine manufacturer, Merck, Senator Bruce Johnson (R-Westerville) introduced Senate Bill 254 which mandates the vaccine for schoolchildren in grades K-12. Ohio marks the latest effort by Merck to require chickenpox vaccine in every state --- a plan which would guarantee Merck...




Author: Lydia M. Usategui, MD
Article Type: Commentary
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


By now, most people are aware of the tragedy involving Elián González, the six-year-old Cuban boy who was found floating in an inner tube off Hollywood, Florida, on Thanksgiving Day, 1999. Elián had left Cuba on November 22 on a small boat in the company of his mother, common-law stepfather, and a group of eleven others in search of freedom. The group encountered mechanical difficulty during the crossing and all but three in the group drowned, including Elián's mother. Elián was taken to a hospital following his rescue. Lázaro González, Elián's great-uncle, went to pick up Elián from the hospital with the explicit consent of Juan Miguel González, Elián's father, who had remained in Cuba. The Miami family, in observance of the expressed wishes of Elián's mother, Elizabet Brotons, requested...




Author: Debra Monde, MD
Article Type: Commentary
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


When a public policy isn't working, we should try something different. Despite thousands of arrests and seizures, America is still not drug free. Despite billions of dollars expended annually, no progress has been made to curb the war on drugs. Despite increasing numbers of prisons, there is still not enough room for all the criminals. The Cato Institute, a nationally recognized Libertarian think tank, points out that the war on drugs is waged without Constitutional authority and, therefore, is inherently illegitimate. A costly failure, the drug war has corrupted law enforcement, distorted foreign policy, destroyed the lives of many, often innocent, people, and interfered with America's Fourth Amendment. Yet, illegal drugs are as easily available today as ever before. Police officers and...




Author: Anthony Ross, MD
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Dr. McCammon, You seem surprised and frustrated (Medical Sentinel 2000;5(3):92-95) that the law does not provide a remedy to physicians and others for legal harassment or malicious prosecution. Let us look at this logically. When action is taken the plaintiff hires an attorney to file suit. The defendant then hires another attorney to protect his or her interests. The case is heard before a judge (another attorney). The laws are made by legislatures that consist primarily of attorneys thus we have full employment for attorneys (they need it --- 80 percent of the world's attorneys live and practice in the United States). The laws are made by, argued for and against, and adjudicated by attorneys. If physicians had such a cozy arrangement it would be called conflict of interest and/or...




Author: Gerald N. Yorioka, MD
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Editor, Regarding "The Cancer Risk of Low Level Radiation" by Prof. Bernard Cohen (Medical Sentinel 2000;5(4):128-131), the phenomenon of hormesis appears to be similar to the "healthy worker effect" that I recall being proposed when the long term health consequences with Hanford Nuclear Works employees showed a lower than expected cancer rate. Part of the explanation was that of selection of more conscientious workers, but the other thought that there could even have been a protective effect from the background radiation.... Gerald N. Yorioka, MD Bothell, WA Correspondence originally published in the Medical Sentinel 2000;5(5);149-151. Copyright©2000 Association of American Physicians and Surgeons (AAPS).  




Author: Jane M. Orient, MD
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Editor, I agree with the concern about anthrax vaccine expressed in the article by Nicolson, Nass, and Nicolson (Medical Sentinel 2000;5(3):97-101). The government seems to be placing all its bets on an inadequate vaccine against only one of many possible threats. There are additional, desperately needed protective measures: better technology to detect an attack; better, more widely distributed laboratories for identifying the organisms; stockpiles of antibiotics; nontoxic decontaminants; and shelter.(1,2) Every Swiss home has an NBC shelter (nuclear, biological, chemical) with blast and radiation protection, HEPA filters, and agents to remove chemicals. Iraqi troops in the Iran-Iraq war had buried shelters with Swiss ventilation systems. Israeli citizens had sealed rooms. American...




Author: Garth L. Nicolson, PhD
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Dr. Faria, I have been contacted by various news agencies [including ABC News after the article on anthrax in the Medical Sentinel], but so far, few have actually run the story...A reporter said that DC insiders had told him that soon the Secretary of Defense will announce that the anthrax vaccine program will be halted. ABC aired this report earlier today [June 30, 2000]. The Army Times is interested, as are some newspapers here in California. There is so much disinformation being put out from the Department of Defense (DOD) that most mainstream news agencies may be hesitant to run the story just yet and are taking a wait and see attitude. I have been asked to do four national radio programs on the topic (three have been done to this date). Dr. Nass has also been a popular guest on...




Author: Kathryn A. Serkes
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Wall Street Journal Editor, Restoring the erosion of the public's confidence in the practice of medicine must be the foremost priority of the new editor of The New England Journal of Medicine in light of questions about the objectivity of recently published articles ("NEJM Appoints Drazen as Editor in Chief," 5/11/00). The Association of American Physicians and Surgeons (AAPS) is both optimistic and skeptical about the recent appointment of Dr. Jeffrey Drazen. As your article states, Dr. Drazen's clinical research credentials are impeccable. But much of Dr. Drazen's work has been funded by pharmaceutical companies with an inherent conflict of interest in the results of that research. Therein lies the basis for our skepticism. While the NEJM has long held a place as one of the most...




Author: Alfred Manrara, Jr. (with Dr. Lydia M. Usategui)
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Editor, ...The steps taken by the AAPS on the Elián González matter are most commendable and we hope that AAPS continues to be one of the loud voices of the medical community to appeal to the conscience of the nation in how this was handled by the Clinton Administration. My name is Alfredo Manrara and my field of work is real estate. My wife is Dr. Lydia Usategui, psychiatrist, who had met the child Elián González and his Miami family --- although she was not Elián's treating physician. On the day of the raid by federal agents, Lydia was at the González home as described in her article in this issue. I was there accompanying her and, within 10 feet of the home's front door, was thrown by the agents against a fence, sprayed with pepper gas, and witnessed the screaming child being...




Author: Enrique Canton, MD
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


Dear Dr. Faria, I did receive the package [of recruitment materials] from AAPS. We'll be at the physician's convention this weekend recruiting. We feel this is an excellent opportunity to let physicians know about the AAPS. My wife and I had plans to go to the Keys for the 4th of July weekend, but when I told her that I had to stay for most of the day on Saturday and will have to come back on Monday, she almost fainted...Thank God I married a woman who supports me 100 percent in the work I do. She really thinks the AAPS is a great patient-physician-advocate organization. She wondered as I did, where were you all these years?... I will keep you posted on the outcome of the convention. Also, depending on how successful we are recruiting, we want to extend our efforts to our Cuban Pediatric...




Author: Compiled by Medical Sentinel Editors
Article Type: Correspondence
Issue: September/October 2000
Volume Number: 5
Issue Number: 5


As we learned from the Clinton administration and much of the media, a machine gun in the hands of a federal agent is now a symbol of benevolence and concern for a child's well-being. James Bovard Author, Lost Rights   Each of us has a natural right --- from God ---to defend his person, his liberty, and his property...the preservation of any one of them is completely dependent upon the preservation of the other two...If every person has the right to defend - even by force --- his person, his liberty, and his property, then it follows that a group of men have the right to organize and support a common force to protect these rights constantly. Thus the principle of collective right --- its reason for existing, its lawfulness --- is based on individual right...Thus, since an individual...



It is now legend the AAPS legally lanced the secret task force and pulled its secrets...into the sunshine. It destoyed the Health Security Act.


The Oath of Hippocrates
and the Transformation of Medical Ethics Through Time


Patients within a managed care system have the illusion there exists a doctor-patient relationship...But in reality, it is the managers who decide how medical care will be given.


Judicial activism...the capricious rule of man rather than the just rule of law.


The largest single problem facing American medicine today is the actions of government...


The lessons of history sagaciously reveal wherever governments have sought to control medical care and medical practice...the results have been as perverse as they have been disastrous.


Children are the centerpiece of the family, the treasure (and renewal) of countless civilizations, but they should not be used flagrantly to advance political agendas...


Prejudice against gun ownership by ordinary citizens is pervasive in the public health community, even when they profess objectivity and integrity in their scientific research.


The infusion of tax free money into the MSA of the working poor give this population tax equity with wealthier persons...


It was when Congress started dabbling in constitutionally forbidden activities that deficit spending produced a national debt!


Does the AMA have a secret pact with HCFA?


The lure of socialism is that it tells the people there is nothing they cannot have and that all social evils will be redressed by the state.


Canada's fatal error — Health Care as a Right!


The Cancer Risk from Low Level Radiation: A Review of Recent Evidence...


...Moreover, the gun control researchers failed to consider and underestimated the protective benefits of firearms.


Vandals at the Gates of Medicine — Have They Been Repulsed or Are They Over the Top?