MR. MCLAUGHLIN: Issue one: Prescription relief.

PRESIDENT GEORGE W. BUSH: (From videotape.) Economic security for America's seniors is threatened by the rising cost of prescription drugs. I'm pleased that both houses of Congress have responded by passing separate bills providing prescription drug coverage under Medicare. It's absolutely essential that the House and the Senate resolve their differences and enact a piece of legislation I can sign.

MR. MCLAUGHLIN: How best to add prescription drugs to Medicare is being sweated out by both chambers of Congress in a conference committee that reconvenes in the fall. It's proving to be a Herculean task on both the level of policy and complexity. This is an overhaul -- the biggest since Medicare's inception 38 years ago -- at a cost of $400 billion dollars over 10 years.

Question: What's the driving force behind this legislation, Pat

MR. BUCHANAN: Two words: senior power. The American people are getting older. They're living much longer. Seniors have money, they're paying more for drugs, they want help, and both political parties are responding.

John, when the president of the United States, a Republican, a
conservative, celebrates the 38th anniversary of Medicare, it means there is no longer a conservative party in Washington, D.C. Prescription drug coverage is coming one day. It is geezer power.

MR. MCLAUGHLIN: What's the percentage of geezers in the United States -- senior power?

MR. BUCHANAN: Oh, I think it must be up about 18 percent now. It's somewhere --

MR. MCLAUGHLIN: Oh, I think it's closer to 25 percent.

MR. LASZEWSKI: Well, we know that 25 percent of the people that are going to vote in the next election will be seniors --


MR. LASZEWSKI: -- and that's the geezer power you're talking about.


MS. DENTZER: And there are 41 million people on Medicare.

MR. MCLAUGHLIN: What's the answer to my question? What's the driving force behind this? The year 2004? The upcoming election? The
recognition on the part of both parties that they have to do this,
particularly the Republicans, as they control the House, the Senate and the White House?

MR. LASZEWSKI: This president promised in the last election that there would be a prescription drug plan. He's got to go back and run for reelection in places like Florida, where the vote was close and there are lots of seniors. And he's going to have to keep that promise.
That's the driving political force.

But I don't think -- even with that driving force, I think it's going to be still very difficult to get a prescription drug plan this year.

MR. MCLAUGHLIN: Why do you say that?

MR. BLANKLEY: Well, look --

MR. LASZEWSKI: Because there are fundamental differences between the Democrats and the Republicans on this issue, differences that will be very difficult to resolve. And it comes down to whether you continue the Medicare entitlement, the Democratic Medicare entitlement that's been around for 38 years, or you fundamentally change how you pay for Medicare. Conservatives are saying, "We do not want to spend another $400 billion on entitlements, especially facing $4(00 billion) or $500 billion deficits, unless we reform Medicare." There's a fundamental difference here.

MR. MCLAUGHLIN: Are we talking between Republicans and Democrats or between the Senate and the House?

MR. LASZEWSKI: You're talking about differences between the Senate and the House, but largely the difference is conservative Republicans versus liberal Democrats. Liberal Democrats have leverage in the Senate, where it takes 60 votes to pass anything. Conservatives have the leverage in the House.

MR. BLANKLEY: Let me --

MR. MCLAUGHLIN: Tony, there isn't much left for you to say on the subject, is there?

MR. BLANKLEY: Yeah. Let me go back to your original question. First of all, between 75 and 80 percent of the public, not just "geezers," are in favor of this. The prescription drugs become a higher percentage of medical costs because prescription drugs deliver so much curative power, more now than they did 30 years ago. So it's a bigger piece of the cost. It's the equivalent, very often, for people of their 30-year mortgage payment. They stop -- they finish paying their mortgage, and they got to pay that much more in prescription drugs.

Not only did Bush promise it during the campaign; the House
Republicans last year passed their version. The Senate Democrats failed to. So this is a big opportunity to fulfill a promise and, I think, to be -- it's a piece of a possible perfect storm for the Republicans. If they can pass this, along with tax cuts, assuming the economy gets back and Iraq doesn't go bad, they have a chance for a very powerful election in 2004.


MS. DENTZER: There was a Medicare drug benefit, John, on the books, passed and repealed 14 years ago. And what we've been through is a 14-year saga to get one back on the books and essentially do what Tony says: integrate drugs into medical care delivery for the Medicare
beneficiaries, as it is for virtually every other American. So it's not a miraculous driving force here. It's just kind of logical.

But I agree with Bob; it doesn't mean that it's going to happen,
because the divisions are so deep.

MR. BUCHANAN: Exactly.

MR. MCLAUGHLIN: Do you see as much of a contest about it happening or not happening, as Bob does? He feels that this is going to be a real Herculean task to get this through.


MR. BLANKLEY: I disagree.

MR. MCLAUGHLIN: Do you feel that way?

MS. DENTZER: It's everything Bob said and more, because in addition to disagreements about the structure of Medicare, there's a great deal of concern about further expansion of an entitlement program in an environment of $400-billion-a-year budget deficits, possibly as far as the eye can see, as --


MS. DENTZER: -- over and against people who feel very strongly that this is part of medical care delivery which we promised to people in 1965.

MR. MCLAUGHLIN: Yeah. I recognize the polarities that exist, that Bob spelled out. But have you not heard, since you cover this for the Wall Street Journal, and you cover --

MS. DENTZER: "NewsHour." Right.

MR. MCLAUGHLIN: "NewsHour." I'm sorry. You cover it for "NewsHour." Have you not heard that the House is now showing some inclination or there has been some expression of willingness to show give on this?

MS. DENTZER: Well, first of all, I subscribe to the old maxim that you should never trust anyone who tells you what Congress is going to do, because that person will lie to you about other things as well. So acknowledging that, there are so many different opinions in the House. There's the people who don't want to expand the benefit, don't want to expand entitlements; people worried about the deficits; people who are insisting on the reinvention of Medicare --

MR. BLANKLEY: Let me --

MS. DENTZER: -- as well as people who just want to get reelected and who go with the flow --

(Cross talk.)

MR. MCLAUGHLIN: I've got a question for you, Pat. What does the president mean when he says, "Give me a bill I can sign"?

MR. BUCHANAN: What the president means -- he'll -- what comes down is what he will sign!

MR. MCLAUGHLIN: "Give me -- I'll sign anything." That's what he means, right?

MR. BUCHANAN: Look, but this is the problem --

MR. BLANKLEY: No, that is not true --

MR. BUCHANAN: Let me talk about this. Bob's right --

MR. MCLAUGHLIN: Wait a minute. Let him finish.

MR. BLANKLEY: But that's not true.

MR. BUCHANAN: Bob is right that there's -- there are Republicans, John, who are too -- will not go along with this in the House unless they can basically have the privatization side of this thing. And if the president can't get them, he's got to cut a deal with the Democrats. He's got to overrun his Republican base. It'll be good for the president politically. He will sign it. But he will antagonize -- deeply antagonize --

MR. MCLAUGHLIN: Let me hear from Tony for one minute.

MR. BLANKLEY: Let me correct the record. There's a widely
misconceived point that Bush will sign anything he can get. He asked for a more market-oriented proposal than the House Republicans did. The House Republican leadership said, "Let us do it. We're going to do what we want to do." And the president has done nothing but ask for more market forces in it. So he's not the slacker on this, from a conservative mark.

But let me make a bigger point, because I think this is going to pass. And the formula is, they're going to pass the prescription drug side with a bit more money than the House wanted to put into it. And they're going to go with the Republican side in the Senate, and they're going to get about 53 votes, two or three Democrats and the rest Republican, and they're going to dare the rest of the Democrats to vote no.

MR. MCLAUGHLIN: Bob, will you settle this?

MR. LASZEWSKI: Well, I think this is the question I've been dying to ask Pat Buchanan for the last month. This looks to me a lot like the Bush I budget issue back in 1990. For George Bush to get a prescription drug plan, he's going to have to do a deal with the Democrats, and he's going to have to leave conservative Republicans behind.

MR. BLANKLEY: You're wrong.

MR. LASZEWSKI: What happens?

MR. BUCHANAN: Well, the Republicans will take it, quite frankly.
Nobody's going to challenge Bush in the Republican Party, on this or
anything else. They like the idea that they're all in power. And when you get right down to it, they'll surrender principle for power.

MR. MCLAUGHLIN: Exit: Time warp forward to November 2004. Will this legislation be dominantly a political plus for Bush and the
Republicans, or dominantly a political plus for Democrats and their nominees, Pat Buchanan?

MR. BUCHANAN: If it goes through, the president gets a plus, but I think it's going to be a plus -- wind up as a plus for the party of government, which is the Kennedy Democratic Party.

MR. MCLAUGHLIN: Really? A major plus for the Democrats?

MR. BUCHANAN: Oh, on the -- I mean, you're expanding government
enormously. I don't think you're going to get the reforms you want if it goes through.

MR. MCLAUGHLIN: What do you think? So who gets the bigger plus?

MR. LASZEWSKI: I think that what's being missed here are the -- is the senior vote. I think that when Congress in August goes back for the recess, goes to the county fair, they're going to hear from seniors
that, believe it or not, they're not happy with this benefit. This is
$400 billion being spent on 1.8 trillion (dollars). Only about 22 percent of drug costs being spent over the next 10 years are going to be covered. Sixty to 70 percent of seniors already have drug plans that are better than this.

I've got a feeling that when members come back, they're going to say, "Wait a minute. I'm going to -- I'm here to compromise my principles" -- conservative or liberal principles -- "on something that seniors are going to be upset about?" I think that this may be a loser overall as seniors read the details.

MR. MCLAUGHLIN: You don't see this passing, then?

MR. LASZEWSKI: I do not see this passing.

MR. MCLAUGHLIN: What the substance of the question is, who -- is it a greater plus for the -- for Bush or for the Democrats?

MR. BLANKLEY: I do think it's going to pass. I do think that the Republicans think -- and I agree with them -- that it's going to be a big political plus. I've heard the argument that astute senior citizens are looking at all the numbers and they're going to rise up in their millions against $400 billion of new benefits. I don't believe it.

MR. MCLAUGHLIN: Will you accept the assumption that it will pass and answer the question, Susan?

MS. DENTZER: I think there's a chance it will pass. I don't think it's the greater probability at this moment. But if it does pass, even passage doesn't mean the argument is over, because, as Bob says, people are going to go back and look at this benefit, say it's potentially not good enough, and pressure will be on to expand it over time. So who, in the end, ends up --

MR. BLANKLEY: The bill doesn't go into effect till 2005, after the election itself.

MR. MCLAUGHLIN: The answer is, Bush will sign anything that's put before him. And the other answer is, it will definitely pass, because neither the Democrats, neither the House nor the Senate, any way you want to break it down, into any polarities, these politicians cannot let this year pass without there being a prescription drug benefit built into Medicare.

But the next question is, are the insurers going to come forward to insure it? Are we ultimately going to be reduced to single payer? You didn't say anything about that.

MR. LASZEWSKI: Well, as you know, I consult with a lot of big
insurance companies, and I'm not finding a lot of enthusiasm for providing these plans, because --

MR. MCLAUGHLIN: And the bill provides that unless two insurers come forward --

MR. LASZEWSKI: The Senate bill has a fallback. And that's one of the big areas of contention. Conservatives are afraid that that may not happen and will back up into a single payer --

MR. MCLAUGHLIN: So if the bill is passed, then we could wind up with single payer?

MR. LASZEWSKI: You could back up into a --

MS. DENTZER: No, it's not a single payer system --

MR. BUCHANAN: That's why I think the party of government is going to win this in the long run.

MR. MCLAUGHLIN: When we come back: Should genetic data, especially predisposition to diseases like lung cancer and heart disease, be made available to insurance companies and employers?


MR. MCLAUGHLIN: Issue two: Cap medical malpractice?

PRESIDENT BUSH: (From videotape.) For the sake of our health care system, we need to cut down on frivolous lawsuits, which increase the cost of medicine. (Applause.)

The medical liability issue is a national problem that requires a national solution.

MR. MCLAUGHLIN: President Bush is blaming "frivolous lawsuits" for high health costs, particularly the skyrocketing cost of medical
malpractice insurance. Two hundred and fifty thousand dollars is the cap Mr. Bush wants to place on non-economic damages -- that's pain and suffering -- awarded to victims of malpractice, no cap on straight economic damage.

Doctors say they are being driven out of business by phenomenally high malpractice insurance rates.

DR. DONALD PALMISANO (president of the American Medical Association): (From videotape.) It's constantly going up. It's doubling in some states, tripling in some states. Obstetricians in South Florida are now paying $210,000 for one-year coverage.

MR. MCLAUGHLIN: Earlier this year, surgeons in West Virginia walked off the job to protest the high cost of insurance. New Jersey doctors did the same. Many physicians are pulling up stakes and moving to states where insurance is more affordable.

Insurers, for their part, say that high jury awards are forcing them to jack up premium rates.

Question: Are the doctors being gouged, Bob Laszewski?

MR. LASZEWSKI: We're all being gouged. The system's being gouged. And it's going to continue until we see a resolution of this. It's going to be very difficult to ever get medical malpractice reform through the United States Senate. And I think where you're going to start seeing improvement is in the states, one state at a time, as each state comes to crisis. My hope for medical malpractice reform is at the state level.

MR. MCLAUGHLIN: What about the cap?

MR. BUCHANAN: Well, look, it's been done -- I mean, the cap is a good idea, but it's been done -- 250,000 (dollars), I believe, in

Look, John, what patients get in malpractice -- they get compensatory damages. You can get punitive damages. Now they want pain and suffering for 250,000 (dollars). That is enough. And frankly, and they also ought to be put a cap on the legal fees, some of which are running 30 to 40 percent of the awards, and all the lawyer goes in and does is talk it over.

MS. DENTZER: But capping damages is a day late and a dollar short as remedies go. There is an awful lot of medical malpractice and negligence and errors in the medical system. The Institute of Medicine said in 1998 that 44,000 to 98,000 people had died the year before in hospitals because of medical mistakes. There's lots and lots of malpractice. And the notion is, how do you best deal with the negligence in the system, get awards speedily to the people who are injured --


MS. DENTZER: -- and essentially not have these claims take five
years, eight years to resolve and be a lottery, where some people win and some people don't?

MR. LASZEWSKI: And that's really the point.

MR. MCLAUGHLIN: There's no cap on straight economic awards. What about the "punis," punitives? How does that differ from pain and

MS. DENTZER: Punitive damages are awarded in cases of gross
negligence. And actually, in medical malpractice, they're a very small factor. It's really the non-economic, pain and suffering damages that are (stiff ?).

MR. BUCHANAN: Well, that suggests --

MR. MCLAUGHLIN: Well, the $250,000 cap --

MR. BUCHANAN: -- that suggests it's a mistake -- honest mistake that is being made. You know, really, the hammering of the doctors -- look, I mean, you've got a lot of people coming in there that are in danger of losing their lives, and all these people are saved, and in some of them, the wrong decision is made. And this is why the very fact that there are so few punitive damages suggests we got the best doctors on Earth.

MR. MCLAUGHLIN: Do you want to get into this?

MR. BLANKLEY: Yeah. Look. I mean, obviously, we want to see a
higher standard of medical practice, but on the other hand, if you're paying the price by driving the doctors out of the business, you're not
accomplishing much. Now, you can raise the standards of universities, you can raise the standards of examinations to get them in, and all the rest, but the fundamental problem at this point -- that's a multi-year,
that's a decades(-long), generation-long process. Right now we have a
crisis in malpractice insurance. And to say that punitive damages are going to wipe out an industry or used as a deterrent to get competence, I think, is irrational.

MR. MCLAUGHLIN: Do you see the doctors as the white hats, the good guys?

MR. BLANKLEY: Yeah, they -- it's a light-gray hat.

MR. MCLAUGHLIN: Do you think that doctors across the United States are demoralized?

MR. BLANKLEY: Yes, I know they are. I talk to plenty of them.

MR. MCLAUGHLIN: They're terribly demoralized.


MR. LASZEWSKI: Well, I think Susan is right, the issue is quality. And when you look at the states with the highest awards, you do not see an improvement in quality. This medical malpractice system is not working in terms of improving quality. Quality is the issue here. When the trial lawyers say this is about quality, they're right in that case. Doctors may not have a black hat here, but doctors have got to go a long way toward accepting responsibility for improving quality. In the state of Massachusetts, for example, a small state, the same report Susan cited says that there were 2-1/2 million errors in filling prescriptions. That same report says --

MR. MCLAUGHLIN: You mean on the pharmacy level?

MR. LASZEWSKI: Yeah. In Massachusetts only, 2-1/2 million errors in filling prescriptions. That same report said 7,000 people die every year because they're given the wrong medications or the wrong --

MR. MCLAUGHLIN: Well, that's not doctors.

MR. LASZEWSKI: If they're writing the prescriptions, it is. The point is that the provider community -- doctors, hospitals, pharmacists -- have really got to step up to the plate here.

MR. MCLAUGHLIN: A quick answer. Quick answer. We've got to get out.

Exit question: Will Congress cap malpractice awards this year? A simple yes or no, Pat. Will they cap malpractice?


MR. LASZEWSKI: When pigs fly.

MR. MCLAUGHLIN: When pigs fly.




MR. MCLAUGHLIN: The answer is no.

Issue three: Don't screen my genes.

Every living being on Earth has a unique genetic code. The structure of that code -- DNA, deoxyribonucleic acid -- was revealed by James Watson and Francis Crick in 1953, 50 years ago. This year, last April --fewer than six months ago -- the Human Genome Project, a consortium of scientists, issued a final map of the sequences of 3 billion chemical base pairs that make up human DNA.

The 30,000 genes in human DNA have been identified, including ones that determine eye color, hair color and hereditary health
characteristics. New gene testing is now done. It allows anyone to find out whether he or she is predisposed to diseases like cancer or cystic fibrosis or MS and to take steps towards its prevention, all of which is to the good.

But how genetic information is used or misused is causing concern. Fears of discrimination by employers or insurance companies privy to genetic test data is spurring legislation to protect that genetic data. Companies might decline to hire based upon genetic predisposition to some sickness. That's what privacy advocates fear. Forty-three states now have genetic nondiscrimination laws of varying kinds.

Question: Insurance companies are allowed to discriminate by
increasing rates for smokers based on evidence that shows predisposition to diseases like lung cancer and heart disease. If it is permissible to discriminate in this fashion based on behavior, why shouldn't insurance companies be allowed to evaluate one's predisposition to disease?

Susan Dentzer?

MS. DENTZER: Because smoking we know causes those diseases. We do not know definitively that genetic conditions always cause disease, with a couple of exceptions. There are diseases, like Huntington's disease, which are very heavily genetically predisposed, but almost all other diseases seem to be a mix of some genetic factors and some environmental factors. So the notion that we can figure out your genetic predisposition to disease and decide immediately that you're going to get sick 20 or 50 or 80 years down the road is just false.

MR. MCLAUGHLIN: Well, look at all the premises you've built in to the presumptive behavior of insurance companies or employers. They know as well as you that it's not a causal relationship. They know it's a predisposition. They know it's really, to some extent, a crap shoot.


MR. MCLAUGHLIN: Likewise with smokers. You say it's a cause of lung cancer. It is a cause in some people, but there are also protective genes that, irrespective of how much you smoke, you'll never get lung cancer.

MS. DENTZER: But the linkage between smoking and those diseases is much tighter than any link we are currently aware of in almost every
other disease category.

MR. MCLAUGHLIN: We're talking about a predisposition. Why can't it be evaluated in the same way with a constructive intent and result?

Do you have any thoughts on this?

MR. LASZEWSKI: Well, I spent 30 years in the insurance industry, and I'll tell you that there's really no interest in the insurance industry in wanting to use genetic information to exclude people, and I don't see that happening on the employer side, either. There are a series of moral questions around genetic screening, and there are a series of questions even about whether people will want to be screened, out of fear for what they'll find out. But Susan is right, it's about
predisposition, it's not about finality. And no one in the industry is willing to cross that line and --

MR. BUCHANAN: John, it's --

MR. MCLAUGHLIN: Wait a minute. I want to ask you a question. Is it assumed that an employer will deny someone being hired because of a genetic predisposition? Do you know of any employer in the United States that hires for life? Do you know of anybody who stays in a job for more than two or three years who's around -- well, a little bit younger than your age level, Pat. Do you know of anybody? There's no such thing as a permanent job in the United States except in the bureaucracy.

MR. BUCHANAN: But look, in some of these areas, look, there's a
correlation between -- if everybody in your father's family died of a heart attack, there's a correlation. It's probable that you're more at risk for a heart attack. And I think people -- employers have a right to knowledge, people have a right not to give it to them, and then employers have a right to say no.

MR. MCLAUGHLIN: What would be better public policy; to be in
possession of that data and to make it available, as we do data now on whether you have habits of parachuting or smoking or drinking?

MR. BUCHANAN: I think employers have a right to ask you these things. And if you say, "Don't tell 'em," they have a right to --

MR. MCLAUGHLIN: All right. Now let's talk about insurance.

MS. DENTZER: All the things --

MR. MCLAUGHLIN: You are violating the law if you withhold from an insurance company when you're seeking a policy -- correct me on this -- data about your medical condition. Now, why not extend that to the
subject at hand? I ask you.

MS. DENTZER: Almost all the other things you talked about were
questions of volition -- wanting to smoke, wanting to drink, et cetera. You don't invent -- you don't have any power over your own genetic
information. You're going to get saddled with that.

MR. BLANKLEY: Let me get a word in.

MS. DENTZER: And furthermore, none of us is going to be immune from such discrimination if it's allowed to happen, because all of us are going to have genetic predispositions to something.

MR. BLANKLEY: Let me --

MR. MCLAUGHLIN: You don't think that if a disposition for inheriting a disease were to be made public and there was an increasing volume of data, the insurance rates would correspondingly be reduced, they'd be calculated more efficiently, and in addition to that, new therapies would be developed for those who have come forward, simply by reason of the focus and the number of people suffering from X, Y or Z?

MS. DENTZER: And if that fairy tale were to come true, it would be marvelous. And if one knew out of this that coverage would be broadened --

MR. MCLAUGHLIN: What's the clear down side?

MS. DENTZER: The clear down side is that people are going to be
shoved off the insurance rolls for conditions that, A, won't necessarily lead to disease, and B, are not --

MR. MCLAUGHLIN: You don't believe that for one minute, do you?

MR. LASZEWSKI: I'm enjoying this discussion. I come from the
insurance insurance industry. And everybody's arguing about whether we want to use the data or not. I don't know of anybody that wants to use the data. The most important public-policy use of this information is,
first of all, it needs to be private between physician and patent, and
secondly, it needs to be used to treat people in advance. If you know
they're prone to something, you're checking them more often, you're putting them through the appropriate tests and procedures to see if their health status is deteriorating and if, in fact, they're getting it.

The most important thing about insurance is insurance is a pool of the sick and the healthy coming together to make the cost of care efficient for everyone. And we can't start pushing people out of the pool just because we think maybe in 20 years they're going to get something.

MR. MCLAUGHLIN: Do you think that would happen?

MR. LASZEWSKI: Absolutely.



MR. MCLAUGHLIN: I'm not so sure of that at all.

MR. LASZEWSKI: (Inaudible.)

MS. DENTZER: And notwithstanding the fact that health insurers say they don't want to do it now, they are still looking at the legislation that would --

MR. BUCHANAN: I think there would be a market that would develop. A market would develop for those folks.

MR. MCLAUGHLIN: Sure it would.

MR. BUCHANAN: It's a free market.

MR. MCLAUGHLIN: Absolutely.

MR. LASZEWSKI: And it would be far more expensive than elsewhere.

MR. BUCHANAN: Well, yeah, but that's -- the risk is greater.

MR. MCLAUGHLIN: Trust the invisible hand, will you, please? We'll be right back with predictions.


MR. MCLAUGHLIN: Will legislation pass that permits reimportation of drugs to the United States? Yes or no?

MR. BUCHANAN: If it does, it won't go into law, because Bush will veto it.

MR. MCLAUGHLIN: Yes or no?


MR. LASZEWSKI: Bush will veto it out of embarrassment to have 87 Republicans vote to use a single-payer system to lower drug costs.

MR. MCLAUGHLIN: Okay. Yes or no?

MS. DENTZER: Importation will not happen because it will be stopped by the secretary of Health and Human Services.

MR. MCLAUGHLIN: The answer is it will not happen.




MR. MCLAUGHLIN: Issue four: Stay healthy or else.

Get this: If you live in Britain and you start putting on a lot of weight or go back to your old smoking habit, you may lose some of your health care. That's if a proposed plan by the Labour Party passes. The plan would force patients to sign a contract with their doctors
promising to give up cigarettes or fatty foods or alcohol in return for the British government's free health care. Doctors, for their part, would agree to provide all necessary treatment, offer last-minute appointments and keep delays to a minimum. If patients break the contract, however, the government wants to be able to refuse those delinquents specific drugs or treatment until they clean up their act.

Some doctors and patients' rights groups fear that the contracts may create a kind of healthcare hierarchy --- the deserving versus the
undeserving. Others say it will lead to discrimination.

"Do you target people who take part in dangerous sports and people who have promiscuous sex? Will you say you can only get treatment for AIDS if you sign some kind of contract? We're seeing a targeting of activities Labour doesn't like." So says Simon Clark, the director of the Right to Enjoy Smoking organization. Why, then, is the Labour Party pushing this dose of tough love? Answer: They think it will help reduce the financial strain on the country's free health-care system.

Question? Is that what the world needs, health police to sanction our misbehavior? I ask you, Tony.

MR. BLANKLEY: No, it's not what the world needs. But as was said in the set-up, this is being driven by the fact that the British can't afford to provide top-level health care. They're not doing it now. They're doing it by delays and optional treatments and the rest. And it's going to get worse and worse. And that's a foretaste of what's going to happen around the rest of the world. So you've got to figure out some ways to discriminate and say, "You get health care treatment and you don't." This is one method. It's an ugly method. But we're going to have to have discrimination because we can't -- the world can't afford to provide world-class health care for everybody.

MR. BUCHANAN: They're discriminating against -- John, they're
discriminating against the vices they don't like, smoking and drinking and overeating and not exercising. But frankly, bachelors don't live as long as married people, and active, promiscuous homosexuals don't. You think they're going to discriminate against them? No.

MR. MCLAUGHLIN: Obesity and tobacco consume what percentage of our national budget?

MS. DENTZER: Well, what we do know is that obesity is increasingly a leading cause of disease and death, and tobacco certainly. Let's --

MR. MCLAUGHLIN: Do you want the answer to my question?

MS. DENTZER; Let's move to the American --

MR. MCLAUGHLIN: The budget -- the health care budget, 9 percent is owing to obesity and tobacco.

MS. DENTZER: Well, depending on who's doing the counting.

MR. MCLAUGHLIN: So maybe they're justified in taking the position they're taking.

Please continue.

MS. DENTZER: Let's move to the United States, where we talk more in terms of individual rights and responsibilities. It's clear that Americans have a greater responsibility to address these needs personally. We don't need health police; we need ourselves to police ourselves. And a case in point: With one-half of adult Americans overweight or obese, the time has come for individuals to start taking control of the situation.

MR. LASZEWSKI: Exactly. What Susan is getting at is what this
underscores. And I don't believe in the fat police or any of that sort of thing. We were in China a few years ago. They were putting mounds and mounds of food on our table. I asked the government guide, "Why are you giving us so much food?" And she said, "Because we're told to give Americans more because you Americans eat so much more than anybody else that comes to visit us." America has an obesity problem. It's leading to an epidemic in diabetes and other diseases. And it's a serious issue.

MR. MCLAUGHLIN: Do you want to control that the way the British are doing it?

MR. LASZEWSKI: No. I don't want the fat police. I don't want the fat police, but we are --