AN ELECTION VICTORY FOR PATIENTS

BRUCE HILTON, director of the National Center for Bioethics, has been an
ethics consultant to doctors, hospitals and patients since 1972. He can be
reached at Ethctee@aol.com.

- -- So now we've heard about the wrestler who won the match in Minnesota.

What about us other wrestlers? Those of us who wrestle with sickness and
disease, who go to the mat with arthritis or bulimia or addiction or dental
cavities, and end up getting flattened, in the wallet at least? We're
members of the country's biggest special-interest group -- somewhere around
99.9 percent of the population. We start our lives as hospital patients,
and 80 percent of us are back there at the end.

And how did this huge consumer group fare in the great semi-annual jousting
tournament? As patients, are we better off or worse because our alter egos,
the voters, vented their constitutional right -- or left -- on Nov. 3? The
question may be beyond answer; as Newt Gingrich has been demonstrating,
what everybody else thought was an embarrassing disaster was really a
glorious victory of historic proportions.

So let's just look at the list, starting with the referendums and
propositions around the country:

-MEDICAL MARIJUANA: Voters in Nevada, Arizona and Washington state
approved the controlled medical use of marijuana.

The drug is used to ease pain and stimulate appetite in patients with
cancer or AIDS.

The three states may run into the same difficulties posed to California's
law by the energetic opposition of the federal Drug Enforcement Agency --
which included threats to doctors' license to prescribe controlled substances.

California's law -- passed by the voters two years ago -- got a boost when
Attorney General Dan Lungren, who actively opposed it, was defeated in his
race for governor.

-PHYSICIAN-ASSISTED SUICIDE: Michigan voted down a "death with dignity"
measure by 2-1.

Assisted-suicide proponent Dr. Jack Kevorkian was against the measure,
saying it was too rigid. Some opponents, on the other hand, said they
favored assisted suicide, but thought this law was badly written -- a claim
made in every such referendum, including Oregon's successful campaign.

-TOBACCO TAX: This California referendum was the most expensive in
American history. The tobacco industry put at least $50 million against a
50-cent-a-pack increase in cigarette taxes. At this writing, 48 hours after
the polls close, it was still too close to call.

Cigarettes, the main environmental health choice we patients can make, kill
an estimated 400,000 Americans a year.

-ABORTION: Colorado and Washington state voters defeated measures that
would have banned the rare but controversial late-term or "partial birth"
abortion. Abortion opponents lost five abortion opponents from the House of
Representatives -- but still claimed a majority of 218 members in the
435-member House.

The Senate lost one abortion opponent, reducing the abortion opponents to a
one-vote majority of 51. In California, women's vote for pro-choice Sen.
Barbara Boxer was the key to victory.

Congressional strategy has been to tie anti-abortion amendments to major
bills the president finds it hard to veto. An example: law that denies
abortion to military wives in base hospitals, even in the most remote
countries.

-ENVIRONMENTAL: Despite warnings of long-term environmental health
problems, including floods, Oregon voters rejected a ban on clear-cutting
of forests. South Dakota voters approved new restrictions on corporate
farming in a battle against the stink and environmental dangers of
large-scale hog farming. In Montana, a referendum banned the use of deadly
cyanide in new mines.

-Except for germs, POVERTY is the world's No. 1 cause of disease, and
the great majority of the world's poor -- including millions in America --
are women and children. Thus it isn't a reach to include two other
referendums among the health-related measures. Washington state increased
its minimum wage, and tied future increases to inflation. Iowa and Florida
passed initiatives acknowledging women's equality -- the first states to do
so in 22 years.

-OTHER PROPOSITIONS:

President Clinton and the Democrats were seen as stronger after the fray
than before it. What both parties called "people's issues" were clearly
more important to voters across the country than personal attacks.

That's good news to us patients, because the president has fingered health
care as his major post-election issue.

On the Thursday after the election, he met with Vice President Al Gore and
the Democratic leadership of the Senate and House. At the top of the
agenda, he said, should be passing the Patients' Bill of Rights.

This bill is designed to give patients more power in challenging decisions
by managed-care health institutions. The Republicans were riding high just
before the election, and chose to kill the patients' rights bill on Oct.
10. There seems to be agreement that the balance of power has shifted. The
millions the big for-profit HMOs spent lobbying against it might as well
have gone for aspirin.

And it might just turn out that we patients won one of the biggest battles
in the great election surprise of 1998.

Checked-by: Mike Gogulski