- The Washington Times - Friday, March 4, 2005

Debating drug spending

Doug Bandow rightly points out that the price of drugs is not the highest factor in the cost of U.S. health care (“The costs of health care” Op-Ed, Wednesday). Nevertheless, drug companies benefit, at the expense of patients, from the lack of free trade in pharmaceuticals. The ban on drug reimportation helps drug companies enjoy the highest profit margins of any U.S. industry, almost four times the Fortune 500 average. Removing the ban on drug reimportation will cut costs for American consumers without harming research and development.



Globalization Institute


I must issue a word of caution to Doug Bandow as he cites the report from the Office of the Centers for Medicare and Medicaid Services on health care spending.

This report is a treasure trove of information about medical spending in the United States and should be studied carefully by anyone evaluating the nation’s health-care system. The one thing it does not do, however, is distinguish between medically necessary and medically elective spending. This report lumps together spending for childhood immunizations with spending for Botox injections.

One must pose the question: How much of America’s “excess” spending is a result of our prosperity and our choice to use discretionary income for elective health care? In fact, a major flaw in all attempts to address problems with the American health-care system is the failure to accurately define what is medically necessary and what is elective.

The pharmaceutical industry must bear some of the blame for muddying the distinction between necessary and elective medical care. Direct-to-consumer advertising creates an expectation that a condition is supposed to be treated. Erectile dysfunction is a quality-of-life condition. Its therapy is an elective medical option. You would never know that when viewing the myriad commercials advocating its treatment.

Americans spend more on psychiatric drugs for children than they do on either antibiotics or asthma medications. I acknowledge that some children truly suffer from attention deficit hyperactivity disorder (ADHD) and benefit from drug therapy. However, a significant number of the children I have seen in my family medicine practice suffer more from adult discipline disorder than ADHD. Their parents still demand that they receive the medication advertised in the latest issue of their favorite women’s magazine.

The appropriate use of pharmaceuticals can lower overall health-care costs. The key phrase here is “appropriate use.”


Fairfax Station

‘Abstinence is the surest way’

In an article on preventing sexually transmitted diseases, an advocacy group charged that HIV prevention efforts are “increasingly based on scientifically discredited abstinence-only approaches.” (“Gay-rights leader calls to ‘redouble’ efforts against HIV,” Nation, Feb. 24).

Abstinence education is far from being “scientifically discredited.” At least 10 published studies — four in scientific peer-reviewed journals — have shown that such education helps youth delay the onset of sexual activity. That’s important because research shows that the longer someone delays the onset of sexual activity, the fewer lifetime sex partners that person will have. The fewer lifetime sex partners, the less likely one is to become a parent out of wedlock or contract a sexually transmitted disease.

What’s more, abstinence education is what teens want. According to the National Campaign to Prevent Teenage Pregnancy, 93 percent of teens believe they should be given a strong message about abstinence. In fact, a 2002 study by researchers at Mathematica Policy Research found: “Youth tend to respond especially positively to programs when the staff are unambiguously committed to abstinence until marriage and when the program incorporates the broader goal of youth development.”

Abstinence education is pro-youth because it empowers youngsters to see themselves in a positive way and make the healthiest choices in life. Waiting has its benefits. In the words of President Bush, “Abstinence is the surest way, and the only completely effective way, to prevent unwanted pregnancies and sexually transmitted disease.”


Assistant secretary

Administration for Children

and Families

Department of Health and Human Services


Detaining enemy combatants

In his article criticizing the South Carolina District Court’s decision in favor of Jose Padilla (“Padilla, Quirin and Detention,” Op-Ed, yesterday), Michael Billok’s comparison between World War II and the “war on terrorism” is inapt. World War II involved a war against the German state, not against Nazism. Therefore, though one could not predict when World War II would end while it was being fought, everyone knew that the war would end with a definitive event — that is, the surrender of the German regime.

The metaphorical “war on terrorism,” like its counterpart “war on drugs,” has no ending because there is no way to know with any degree of certainty when the last terrorist or drug dealer has been busted, especially given that the ones who are busted are quickly replaced by new ones.



Future of Freedom Foundation


Michael Billok argues that the president has the authority to confine Jose Padilla forever without any court review. Suppose a president had Mr. Billok arrested, labeled an enemy combatant and locked up for three years. Would Mr. Billok be just as enthusiastic in his support of a president’s powers if he were the one locked up?

Mr. Billok labels Padilla a terrorist. How does he know Padilla is a terrorist? Has even a scintilla of evidence been presented in any courtroom that he is, indeed, a terrorist? I suspect that Padilla is, indeed, a terrorist and should be locked up — but only after due process.

If a president has the legal authority to lock up Padilla without any court review, then he has the legal authority to lock up the entire editorial board of The Washington Post without any court review. After all, if the president names them as enemy combatants, that’s what they must be, right?


Grantham, N.H.

An American in Britain

I am a British citizen, and I compliment your paper on a column relating to the European Union’s constitution (“Be wary of the EU constitution” Commentary, Wednesday).

A majority of the British public is also against the proposed constitution and undemocratic procedures being adopted by the European Union. I am sure most people in Britain would choose to be associated with the United States rather than with Europe. Those of us who will be putting all effort into ensuring a “no” vote when Britain has its own referendum welcome any publicity or assistance from the United States to keep Britain independent of Europe.

You will find a lack of democracy when looking into the structure of the European Commission, parliament and presidency. The whole system has all the markings of the old communist Soviet Union.

I admire the American vision to spread democracy to the world. It is therefore important that the American people be aware that the European Union is going in the opposite direction.


Exmouth, England

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