Volume 50, No. 4 April 1994

Who Sits at the Clintons' Table, and Who Picks Up the Tab?

When AAPS filed a lawsuit against the secret operations of the President's Task Force on Health Care Reform, in February, 1993, the issue appeared to be a small legal point: Was this task force required to jump through the hoops set up by the Federal Advisory Committee Act (FACA)?

There was a resounding lack of interest at the AMA. Despite public complaints about exclusion, the AMA had a seat at the table. AMA representatives (e.g. at a meeting of the ASPRS) spoke about their direct access to Ira Magaziner.

One possible response by the White House would have been simply to comply with the law: publish meeting notices in the Federal Register, make minutes accessible to all willing to surmount the usual bureaucratic hurdles, and wait for public interest to die down.

Instead, Bernard Nussbaum, former chief Counsel to the President, asserted that the law did not apply to the Health Care Task Force and undertook an aggressive defense of the secret war room. (Nussbaum resigned in March, 1994, in the wake of inquiries about the Whitewater affair, including the removal of files from the office of the late Vincent Foster, Deputy Counsel to the President. Foster was found dead at Fort Marcy last July, shortly after the filing of certain briefs concerning the Health Care Task Force.)

The White House has continued to stonewall, despite a sharply worded order from Judge Royce Lamberth (see AAPS News Dec 1993). Four boxes of documents were released, with a request for an extension of time. AAPS objected to the extension, and the judge has not yet ruled on it.

The Task Force was hastily disbanded. Nevertheless, its demise did not prevent an excruciatingly detailed 1,342-page reform proposal from being submitted to Congress, albeit a little behind schedule. And the questions remain: who is behind the health-care reform fever, whether related to the Task Force or not? And what did the Task Force have to hide?

Task Force documents (such as ethics forms, payroll records, and agendas) might or might not be revealing. Some may have disappeared into the reputedly voracious papershredders at the White House or the Rose Law Firm. Some are under a court protective order and for the present equally inaccessible. However, these documents are not really needed to answer the questions. A search of public archives, under the direction of AAPS legal counsel, may suffice.

Some answers suggest themselves simply from a reading of the so-called Health Security Act. In principle and semantics, it strongly resembles proposals put forth in 1938 by Consumers Union and in the 1970s by the Marxist-oriented Institute for Policy Studies, for example, the Community Health Alternative Project drafted in coordination with Rep. Ron Dellums (D-CA) (Human Events 2/25/94). It also strongly resembles programs enacted in the ``laboratories of democracy,'' states including Hawaii, Washington, Minnesota, and Kentucky. All provide a central role for governmental or government-controlled or -favored entities.

Leftist schemes tend to enjoy a presumption of good intentions and ``public interest,'' as opposed to ``special'' (private) interests. But could their proponents possibly be tainted by human motives for self-aggrandizement and profit? And should they be immune from public oversight under the FACA, which was designed to guard against undue influence from special interests?

``Health-care reform'' involves a trillion dollars. It is literally where the money is. Sutton's Law applies.

Billions of dollars have already changed hands. Between January and September, 1993, investors in 23 pharmaceutical stocks lost $62 billion. The gains from short positions are estimated at $250 million. There is a strong correlation between stock prices and White House political rhetoric (Catalyst Institute Research Report, November, 1993).

Others that stand to gain from managing Clinton-style reform are the Big Five commercial insurers (Aetna, Prudential, Cigna, Travelers, Met Life), which actively promote managed competition in lobbying and magazine advertisements (``Betting the Farm on Managed Care,'' NY Times 6/27/93).

Financial power houses not listed on the stock exchange probably play the pivotal role. Philanthropic foundations give away billions of dollars every year, mostly to promote agendas that list sharply leftward (Stanley Rothman, Wall St J, 3/2/94).

AAPS has received calls from numerous sources-including a medical student and a physician's wife-concerning the role of the Robert Wood Johnson Foundation (worth $4 billion) and the Kaiser Family Foundation (not coincidentally related to Kaiser- Permanente, citadel of managed care and one of two controllers of medicine in Hawaii). Research studies that not coincidentally support governmental control and managed care are heavily funded by these foundations; your medical society and medical college may be a beneficiary.

The grants have strings attached. An RWJ grant to the state of Minnesota was contingent upon passage of a Clinton-like Plan (and was cancelled when the governor vetoed the legislation). But the influence of the tax-exempt foundations extends still further. A number of Task Force members, including Congressional staff members, were on the RWJ payroll. If Clinton-style reform passes, RWJ personnel will be positioned to control billions of dollars and the very lives of American citizens. Could foundations be creating a shadow government, immune from public accountability?

AAPS lawyers believe that they have found the answers to many of these questions. They will move in court by the end of March.

Physicians, AAFP Take Opposite Sides on Reform

President Clinton is claiming the support of all 300,000 physicians who belong to organizations that have endorsed his Health Security Act, including the American Academy of Family Physicians (AAFP). Yet 71% of family physicians are opposed to the Plan, while 12% (�3%) favor it and 15% are undecided, according to a recent informal survey by AAPS.

AAPS sent surveys to 5000 randomly selected family physicians nationwide; about 400 responded.

Given a list of adjectives to describe the plan, 9.5% checked ``cost-saving,'' 4.7% ``quality-enhancing,'' 29% ``access-expanding,'' 11% ``generous,'' 82% ``bureaucratic,'' 63% ``socialist,'' 54% ``destructive,'' and 34% ``unconstitutional.'' Fourteen respondents suggested an additional description that was positive or neutral in tone, and sixty contributed a negative description, e.g. ``tyrannical,'' ``deceitful,'' ``unethical,'' and ``self-aggrandizing for bureaucrats.''

In response to the question, ``If the Clinton Plan is enacted, what will you do?'' only 43% checked the answer ``sign up with the Plan, submit to the system, and try to make the best of it.'' Almost as many (38%) said they would ``work to have the Plan repealed,'' and 21% said they would ``retire or change my occupation.'' About 13% said they would ``refuse to participate and attempt to practice privately.'' (More than one response was permitted.)

A large majority of respondents were opposed to specific provisions found in the Clinton Plan and various alternate proposals. An employer mandate is opposed by 65%. About 65% would object to diverting funds from sickness care to school- based clinics and other social projects. More than 75% oppose a lottery for selecting enrollees for oversubscribed plans; 71% oppose requiring electronic data submission for all clinical encounters; and 61% oppose forcing everyone to pay for a standard benefits package.

The majority of respondents (55%) favor Medical Savings Accounts. Only 13% are opposed to this concept; 30% are undecided.

Here is a sampling of open-ended comments:

``I feel betrayed by the AAFP.''

``This issue is politically inspired to eliminate the middle class. If they really wanted to make health care available, all that would be necessary is to allow tax deductions for giving free care to those in need.''

``AAFP never polled its grass-roots members. I am undecided about continuing my membership as a founding member.'' [About 8% said they had been polled by AAFP.]

``This plan would be the end of true democracy.''

Washington State and ``Clinton-Heavy''

Physicians also find themselves at odds with the Washington State Medical Association, which endorsed that state's version of the Clinton model (enacted last year but not yet implemented). Seven members of the state chapter of AAPS sent questionnaires to all physicians in their counties; 1,591 (30%) responded. Neal Shonnard, MD, of Puyallup, and Estelle Yamaki, MD, of Federal Way, presented the findings at the regional meeting of AAPS held in Bellevue on Feb 18.

The poll showed that 62% of physicians do not support the government-controlled, managed-care reforms of the 1993 Health Services Act. The Act will make fee-for-service medicine illegal after July, 1995.

Moreover, 72% believe that these reforms will have a negative effect on the quality of care, including 18% of those who agree with the reform. Also, 59% believe that the new system will not control costs, and 71% believe that it will not permit patients to choose their own physician.

Almost one quarter of respondents are thinking of a career change, early retirement, or moving out of state.

According to Dr. Yamaki, the survey reflects a ``growing sense of frustration and hopelessness....[M]any physicians feel that the future of medicine is out of their control and in the hands of politicians, lawyers, and MBAs.'' She also noted that many physicians will resign from the WSMA.

Physicians are not the only ones who feel excluded from the decision-making. Also speaking at the Bellevue meeting, Rep. Phil Dyer, ranking minority member of the Health Care Committee of the Washington legislature, stated that the Act was not written in the state, but arrived by FAX bearing the telephone number of the Clinton Health Care Task Force.

The employer mandate, Dyer stated, would not lead to universal access, but would lead to de facto discrimination against employees with dependents. The community rating requirement would probably increase premiums by 17 to 25%. It is claimed, based on Hawaii's experience, that small business would not be devastated.

``All we need to do,'' Dyer said, ``is to build a 5,000 mile salt-water moat around the State of Washington.''

Hawaiian Casualties: Medicine and Free Speech

``Fear of retribution is the glue that holds the system together,'' writes a Hawaii physician-anonymously-in the Feb 15 issue of Postgraduate Medicine. Physicians are held hostage by the state's two major payers.

Yes, there are report cards in Hawaii; Blue Cross/Blue Shield controls the data bases and fills out the reports on itself. There are practice guidelines; diabetics may receive insulin when they spill sugar in their urine. And yes, there are monopoly price controls. It is cheaper and faster to fly a patient to San Francisco for an MRI (including airfare and a hotel stay) than to have one done in Honolulu.

AAPS Membership Drive Underway

Before the end of March, every office-based physician in the US should receive at least one application to join AAPS.

The majority of physicians do not know there is a national organization fighting for the preservation of our profession and our freedom. If you receive an extra application form, please ask a colleague to join us.

This campaign is made possible by the generous donations of our members. If we don't write you an individual thank-you letter, it is because we are too busy packing New Member Kits. Please accept our heartfelt appreciation.

AAPS Distributes 50,000 Copies of Patient Power

A second printing of the abridged Patient Power is now underway. It is again thanks to the generosity of our members that we are able to help the Cato Institute capitalize the print run. The ideas of Medical Savings Accounts, sound catastrophic insurance, tax equity, and individual responsibility are finally being widely discussed-because our patients and associates are asking about them.

Medical Spending Reduced 64%; Coverage Better

Without waiting for Congress to pass any legislation, Golden Rule Insurance Company decided to offer its own employees a Medical Savings Account combined with an umbrella insurance policy to pay 100% of normally covered expenses after $2000 for an individual or $3000 for a family.

Employees are told that the money in the MSA is their money. They have many choices. They may take the money with them if they terminate their employment (and use it to cover their COBRA premium if they wish). They may spend it for medical expenses (including dental work and eyeglasses, not covered by insurance). At the end of the year, they may roll over the balance to cover future medical expenses, or they may withdraw it. (Taxes have already been withheld.)

The results: 80% of the employees chose the MSA, which commenced in May, 1993. On December 31, the employees had $468,000 left in the accounts. This is ``found money'' to the employees. Nobody ever got any money back on the group insurance before.

Medical spending by employees was reduced to 36% of the budgeted outlay.

The most positive response was from single mothers. They now take their children to the doctor without worrying about the deductible. Some said they were going to get a mammogram for the first time. They had not done it before because of the deductible.

``There is nothing in the rubric of managed care that gives this kind of result. All we did was turn the self-interest of the employees loose....[t]hey changed the ball game for us all.''

Milton Friedman recently stated that if patients once again had a financial interest in medical decisions, the cost of medical care could be reduced to ``something like the 5% of total consumer spending that it was before the government got into the act.''

``I no longer believe that that is unrealistically optimistic.''

Letter from J. Patrick Rooney to Milton Friedman

Letters to the Editor

Universal Coverage

The view that we must have universal coverage in medical care in a nonsocialist nation is fundamentally a logical fallacy as well as bad government. The fallacy is what lawyers call special pleading or the double standard. Ironically, the President and First Lady are lawyers. Special pleading means that one may not argue, for example, in favor of universal coverage in medicine, while not also arguing for all human activity or needs. To argue only for universal medical coverage and not for socialism is contradictory. To argue for universal food, clothing, shelter, and so forth, is explicit socialism.

Michael M. Kazanjian, MD, Chicago, IL

Medicare Carriers Violate Rules

Excerpted from a letter addressed to Mary Ann Hardy, Executive Correspondent, Upstate Medicare, 7-9 Court St., Binghamton, NY 13901, dated Feb. 28, 1994.

Upstate Medicare has been (since 1991) and is still violating section 7525 of the Medicare manual with impunity. (By the way, I am provider number 51284B, not 51284A as you have stated in your letter. If Medicare was truly a fair program, you should have your paycheck denied for a week or two, until you attached the right provider number to my letter....)

You state that ``upon reviewing the claim, the additional information did not substantiate the need for the service''....Simply put, that is a lie. The claim was submitted electronically via modem, using Upstate Medicare's own software....There was no ``additional information'' submitted with the claim. Your software doesn't permit any additional information to be submitted with claims. The carrier's response to that is ``well, if you had known [you can't know because the screens are secret], you could have submitted the claim on paper with additional information.'' So, on the one hand you do everything possible to ``encourage'' electronic submission of claims, and on the other hand, if we use your software, we are often doomed to failure....

I wrongfully assumed that [anyone]...would be able to figure out that an internist and a neurologist would be supplying different services to a patient with a life-threatening neurological condition who was also on a ventilator. But again, I suspect that not one person actually reviewed the claim before it was automatically denied without first requesting additional information. This by definition violates section 7525 of the Medicare Carrier's manual....

Only a ``bad physician'' would supply ``medically unnecessary services.'' [You gave the patient] this wrongful impression, [and] you have made no attempt to dispel it when you simply send her an EOMB with an adjustment.

Lawrence R. Huntoon, MD, Binghamton, NY

Managed Care Is a Special Interest

From a letter to Adrienne Radzwiller of Arizona's League of Women Voters, concerning the funding source for a forum on health care presented by her organization:

Although the Kaiser Family Foundation may legally be a separate entity from the Kaiser-Permanente HMO network, this is all one and the same ``family,'' with the same financial interests and the same self-interested goals. It is ludicrous to believe Kaiser is not a ``special interest group''-and one of the most moneyed and most powerful. Kaiser (as well as other HMO organizations) stands to gain enormous financial benefits if the Clinton Plan or ``managed competition'' is enacted. If this happens, experts agree that private medicine will die.

You may not realize that merely by picking the questions on which these discussions are focusing (e.g. the uninsured), Kaiser and the Harvard and Johns Hopkins Schools of Public Health are definitely biasing the discussion by putting a ``spin'' on the presentation.

Joseph Scherzer, MD, Scottsdale, AZ

AAPS Calendar

June 18, Board of Directors meeting, Chicago, IL.

Oct. 12-15, 51st annual meeting, Atlanta, GA.

Stage four [the dominance of a few large HMOs, greater than 50% market penetration, and the solidification of provider-payer alliances] ``constitutes the reduction of medicine to a commodity in which groups of patients are bought and sold....This is neither bad nor good, but different,'' stated John Sullivan, MD, President and CEO of The University Physicians, University of Arizona College of Medicine (The Sombrero, March, 1994).

New Members

AAPS welcomes Drs. Garrett D. Alcorn of Burien, WA; F.F. Amanatulla of Reno, NV; John R. Anderson of Denton, TX; Thomas Antalik of Roxboro, NC; John T. Armstrong, Jr. of Napa, CA; Tom Arnold of Houston, TX; Alan H. Arrington of Huntsville, AL; David M. Atwell of Maumee, OH; William Backlund of Redmond, WA; John Peter Badalamenti of Kenosha, WI; Richard Balon of Troy, MI; Walter Barquist of Portsmouth, NH; Barry F. Bates of Powell, OH; Theodore J. Behe of Franklin Park, NJ; Deane S. Berson of Chipita Park, CO; Sharon F. Billon of Arroyo Grande, CA; Alvin I. Bogart of Phoenix, AZ; Arthur S. Booth, Jr. of Atlanta, GA; James C. Boothe of McComb, MS; Stuart Boreen of Bethlehem, PA; Thomas A. Borland of New Iberia, LA; Edwyn L. Boyd of Hoover, AL; David Boyd of Oceanside, CA; Jack L. Brenner of Yorktown Heights, NY; M. Truett Bridges, Jr. of Smyrna, GA; Gerald S. Brodie of Orange, CA; Arthur S. Brown of Camden, NJ; Richard Brown of Tucson, AZ; Anthony Bruzzese of Warwick, RI; Carlos F. Burroso of Atlanta, GA; Alan Burwinkel of Fairfield, OH; David KA. Byrne of Bloomington, IN; William G. Carey of Evansville, IN; P. Michael Carney of Irvine, CA; Herman M. Carrion of Miami, FL; Anthony A. Cassens of La Habra Heights, CA; Tullio Celano of Boise, ID; Joanne M. Chao of San Jose, CA; Jay Chavda of Houston, TX; Vernon D. Clausing of Seattle, WA; Kenneth H. Cohen of Portsmouth, NH; Jesse A. Cole of James Island, SC; Collin E. Cooper of Glendale, CA; Paul W.F. Coughlin of High Point, NC; Arthur J. Davidson of Mequon, WI; James S. Davies of Birmingham, AL; W. G. Davis of Frisco, TX; Ed Davis of Renton, WA; James Demmel of Snohomish, WA; Ward S. DeWitt of Missoula, MT; Gregg Dickerson of Muncie, IN; John I. Dickinson of Rome, GA; Thomas J. Dowling, Jr. of Commach, NY; Ralph H. Duchett of High Point, NC; Dermot J. Durcan of Houston, TX; Ray Dzelzkalns of Milwaukee, WI; Adel S. H. El-Deiry of Peoria, IL; John H. Elinger of St. Petersburg, FL; James A. Engblom of Oak Ridge, TN; John T. English of Lancaster, PA; Robert L. Erdman of Nassawadox, VA; Dennis M. Everton of Mesa, AZ; Kenneth A. Feucht of Puyallup, WA; Harold Fields of Houston, TX; Stacey M. Fink of Lawrenceville, GA; Dan Fitzpatrick of Warren, OH; David R. Fletcher of Philadelphia, PA; James Furstoss of Puyallup, WA; Paul E. Garland of Tallahassee, FL; William B. Garlow of Salina, KS; Helen Gelhuf of St. Louis, MO; Harold R. Goldberg of Spokane, WA; Kristin Graham of Bellevue, WA; Seldon B. Graham,III of Sherman, TX; David Gralnek of Phoenix, AZ; Lee B. Grant of Ft. Collins, CO; Joseph Guarino of Roanoke, VA; Vincent J. Gulfo of Warwick, NY; Peter W. Guresky of Amarillo, TX; Robert W. Haerr of Terre Haute, IN; Glenn G. Hakanson of Sacramento, CA; Cline A. Handy of Oceanside, CA; Charles Hansing of Bellevue, WA; John W. Harlan of Spokane, WA; Dennis Helmuth of Wooster, OH; Michael Henneberry of Spokane, WA; Kathryn Henry of Tucson, AZ; George Morrison Henry of Little Rock, AR; Patrick T. Hergenroeder of Chagrin Falls, OH; Mary Lee Hess of Powell, OH; G. W. Hetherington of Houston, TX; Robert N. Heyburn of Flossmoor, IL; Yvonne Hillier of Corpus Christi, TX; Robert J. Hoehn of Denver, CO; John B. Holds of St. Louis, MO; David E. Hoover of Indianapolis, IN; James R. House III of Jackson, MS; Robert L. Howisey of Seattle, WA; Lawrence R. Huntoon of Jamestown, NY; Bradley A. Jabour of Santa Monica, CA; George Jackson of San Diego, CA; Daryl L. Jacobs of Belleville, IL; Norman J. James of Spokane, WA; Robert H. Jarman of Savannah, GA; William E. Johnson of Mobile, AL; L. M. Johnston of Seattle, WA; Paul A. Jordan of Bossier City, LA; Aurel J. Kajlich of Edmonds, WA; Jack Kartaginer of Clarkston, MI; Alan Kisner of Huntington, NY; Robert Klein of Tempe, AZ; Jeffrey J. Klein of Akron, OH; JoJo Korzep of Ashland, KY; Robin Kroll of Seattle, WA; Ivan W. Kuhl of McAllen, TX; Patty Kulpa of Tacoma, WA; Michael J. Lanoux of Dallas, TX; Jeffrey S. Lauber of Newport Beach, CA; Vivian Lee of Hawthorne, NY; Keith Austin Lepok of Baton Rouge, LA; Arthur F. Leritz of Spokane, WA; Kenneth J. Lippman of Westport, CT; Robert P. Lonergan of Camp Hill, PA; Alfred C. Lotman of Denver, CO; Joseph A. Maggioncalda of Evansville, IN; Eugene A. H. Magnier of Aiea, Hawaii; Devra C. Marcus of Washington, D.C.; R. E. Marks of Seattle, WA; Timothy Marks of Amarillo, TX; Stephen P. Markus of Bellevue, WA; Arlene R. Martone of Fort Morgan, CO; Catherine L. Matchett of Grapevine, TX; Jerry L. Mathis of State College, PA; Leah S. McCormack of Forest Hills, NY; John W. McKinney of St. Louis, MO; Douglas E. McKinney of Bridgeport, WV; Peter J. Meier, Jr. of Peru, IL; Joseph M. Mercola of Schaumburg, IL; John E. Merriman of Tulsa, OK; Joseph Metcalf IV of Oak Ridge, TN; Charlotte Metzler of Bremerton, WA; Steven L. Moore of Augusta, GA; Ronald L. Moy of Los Angeles, CA; Timothy L. Mullins of High Point, NC; Michael Nahrwold of Indianapolis, IN; Roberta Nataloni of Port Jefferson, NY; Terri A. Norden of New York, NY; Mark Norling of Portland, OR; Bruce W. Novark of Bellevue, WA; David Nunley of Chico, CA; W.W. Ohm of Seattle, WA; Lexey Parker of Reno, NV; Robert L. Parkman, Jr. of Magnolia, AR; Elliott O. Partridge of Eldorado, IL; Christopher J Patitsas of Huntingdon, PA; Frederick A. Pereira of Flushing, NY; Eliseo Perez of Ft. Lauderdale, FL; Kenneth B. Peterson of Scottsdale, AZ; Luis Napoleon Pinzon of Tampa, FL; Seymour C. Post of New York, NY; Frederick and David Ray of Houma, LA; Susan L. Reimer of Bremerton, WA; Stephen L Reisman of Nashville, TN; Laura M. Reuter of Indianapolis, IN; Raymond G. Richardson of Riverside, CA; Charles Rimpila of Wisconsin Rapids, WI; Angel M. Rios of El Paso, TX; Winthrop S. Risk of Cedar Rapids, IA; George L. River of Dubuque, IA; Jerome Rochlin of Phoenix, AZ; James N. Romanelli of Huntington, NY; Wesley Root of Merced, CA; Richard L. Roseman of Havertown, PA; Charles E. Rowe of High Point, NC; Jacob D. Rozbruch of New York, NY; Frederick P. Russek, Jr. of Henderson, NV; Jeffrey Sabloff of Washington, D.C.; Joseph A. Sangster of Soldotna, AK; Maria Scouros of Houston, TX; David C. Shauf of Gainesville, TX; William A. Shipley of Peoria, IL; John C. Sinclair of Delta, CO; Peter D. Sliskovich of San Pedro, CA; Natalia G. Smith of Billings, MT; A. James Sniderman of Dayton, OH; Timothy Sprague of Santa Monica, CA; Monroe A. Sprague of Chico, CA; Richard Steele of Carmel, IN; Terry Steinberg of Orange, CA; Randall A. Stenoien of Houston, TX; Marsden Stewart of Gig Harbor, WA; Robert F. Subers of Clovis, CA; Elliott Sumers of Upper Saddle River, NJ; Lourell E. Sutliff of San Angelo, TX; Michael Swistak of Issaquah, WA; Mark D. Tasch of Zionville, IN; Morris L. Tate Jr. of Knoxville, TN; Edward R. Teitez of Ozark, AK; Douglas K. Tennison of Silsbee, TX; Richard Thaller of Houston, TX; Paul B. Thompson of Sequim, WA; Luiz Toledo of Fort Worth, TX; A. Gregory Tuegel of Abilene, TX; Thelma Villoso of Valparaiso, IN; Rolf F. Vrla of Glendale, AZ; Dennis M. Walker of Lake Charles, LA; James Q. Whitaker of Warner Robins, GA; William White III of Louisville, KY; Victor T. Williams of Las Vegas, NV; I. F. Wood, Jr. of Myrtle Beach, SC; Robert C. Wright of Puyallup, WA; George Wyhinny of Park Ridge, IL; Gerald N. Yorioka of Mill Creek, WA; Thomas J. Young of St. Joseph, MO; Howard S. Yudin of Rye Brook, NY; and Stuart Zykorie of Houston, TX.

New student members are: Thomas F. Collier of Miami Beach, FL; Floyd Forbes of Huntington Bay, NY; David Hartsuch of Bloomington, MN; Michael Sher of Valhalla, NY; Jeremy Smith of Chicago, IL; Viola Wiegand of Brooklyn, NY; and Lauren Zoltick of Rockville, MD.

New associate members are: Bill Baker of Washington, D.C.; David A. Dorn of Scottsdale, AZ; Ryan Elliott of Winfield, IL; W. Joseph Gelling of Wausau, WI; Norm Robins of Walnut Creek, CA; Stanford Rosen of Tuscaloosa, AL; Rudolph B. Skogerboe of Grand Forks, MD; and Ralph Teall of Sacramento, CA.