Sidney Wolfe.

• Author: Spero, Robert
• Position: Health care activist - Interview

|Somebody has to look out for people who are being manipulated by the hospitals, doctors., insurance and drug companies,'

Sid Wolfe had become the great hematology biochemist predicted by his mentor at the National Institutes of Health. But the 1960s activism still present in his blood-the spirit that had once led him to disrupt a convention of the American Medical Association because its president pronounced that "health care is a privilege, not a right" - that spirit was latent.

Then, in 1971, Wolfe got a call in his lab that abruptly changed his life. A physician he knew from his internship in Cleveland was frantic. Contaminated intravenous fluids were causing an outbreak of deaths and life-threatening infections in hospitals, yet hospitals were being told to keep using them. A joint statement by Abbott Laboratories (the drug company that made the fluids), the Centers for Disease Control, and the Food and Drug Administration advised hospitals that the fluids could be used, unless the patient got sick.

"You know Ralph Nader," the colleague said. "Can you do something about this?"

Wolfe read the evidence and decided to try to get the intravenous fluids recalled right away. But Abbott, which made half of all the intravenous fluids in the United States, had persuaded the Government that a recall would leave a deficiency and people would die from that.

Wolfe rounded up other fluid manufacturers to fill the void. With Nader, he wrote a letter to the FDA Commissioner and promptly released it to the press. The letter made the evening news, and the FDA recalled the toxic fluids forty-eight hours later.

Wolfe and Nader began getting letters and phone calls. "If you think that's important," they'd read or hear, "what about this? What about this?"

Wolfe thought: This kind of work has an impact on the health of a larger number of people than what I can do at NIH or in the private practice of internal medicine.

So Public Citizen Health Research Group was born. By now it has issued some 1,200 reports, most combatively critical, on drugs, food, health-care delivery, medical devices and products, and occupational safety. Wolfe's in-your-face tactics have taken red dye number two off the market, forced aspirin makers to put labels on bottles warning about the drug's danger to small children, and raised the public's consciousness - and the health-care industry's ire - about the risk of toxic shock syndrome from super-absorbent tampons and cancer from silicon-gel breast implants.

"Somebody," says this man who describes himself as "controversy personified," "has to look out for people who are being manipulated by the hospitals, doctors, insurance and drug companies."

Q: The Commerce Department says health care will cost the nation $939.9 billion this year - almost a quarter of the national debt. If nothing is done, we will spend over $1 trillion by 1994 and $2 trillion by 1999! Yet thirty-five million Americans are uninsured and, as you've pointed out, sixty million people are underinsured. How did we get into this fix?

Sidney Wolfe: The cost of health care was a fraction of what it is now when I was in medical school in the early 1960s. You didn't have this flow of money into waste - unnecessary services, unnecessary hospital beds, unnecessary angiograms and Caesarean sections, administrative waste - $200 billion of waste. Money that could be spent taking care of patients.

Hospitals spend a quarter of their revenues on administration and billing - hospitals in Canada don't do any billing. Doctors in this country are going crazy with paperwork; with 1,500 different health insurers, you guarantee...