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October 20,1999
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National News
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Side air bags may be dangerous Clinton Expands Insurance Programs
President attempts to put children
for children, government says
under federal funded programs
T he A ssociated P ress
A federal safety agency today warned
consumers that side air bags can kill
or seriously injure children too close
to the devices when they inflate.
The stro n g ly w orded consum er
advisory from the National Highway
Traffic Safety Administrationcomes
as an in c re a sin g n u m b e r o f
automakers are installing side air bags
as e ith e r sta n d a rd o r o p tio n a l
equipment to protect passengers in
side-impactcrashes. Each year, there
are some 7,500 deaths from those
crashes.
The safety agency also is asking all
automakers with side air bags in rear
seats to ship the vehicles to dealers
with the bags deactivated. Dealers
can then turn the side air bags on for
consumers who want them after
customers are advised o f the potential
risk to children, according to a letter
being sent to manufacturers by the
agency’s administrator, Dr. Ricardo
Martinez.
There have been no deaths or serious
injuries reported from side air bags,
unlike front airbags, which have been
blamed for at least 145 deaths since
1990 and have caused a public outcry.
The vast majorityofdeaths from front
air bags were to children who were
unrestrained.
The advisory and letter to automakers
puts pressure on manufacturers to
m ake su re th e ir co n su m e rs
understand the risks from side air
bags to children, especially those
who are unrestrained.
Federal regulators say testing done
by the agen cy o r p ro v id ed by
manufacturers shows that side air
bags could deploy with enough power
to seriously harm or kill children
resting near the door or window or
leaning out the window. In all those
tests, the crash dummies representing
children were not wearing seatbelts
or restrained in child seats.
The consumer advisory says that
side air bags can enhance passenger
sa fe ty in sid e -im p a c t crashes.
“However, children who are seated in
close proximity to a side air bag may
be at risk o f serious or fatal injury,
espec ially if the child’s head, neck, or
chest is in close proximity to the air
bag at the time o f deployment.”
The advisory says manufacturers
h av e an o b lig a tio n to n o tify
consumers “whether it is safe” for
children to sit next to their side air
bags.
In the letter to automakers, the agency
especially targeted side air bags in
the rear seats o f cars because for
years federal safety officials have
been telling parents to put children
age 12 or under in the back seats,
away from front passenger air bags
that could kill or injure them.
Mercedes-Benz, BMW, Audi and
Rolls-Royce offer side air bags as
standard equipment in the rear seats
o f some o f their models. They deploy
either from the door or the seat.
Side air bags also are standard or
optional in the front or front and back
seats o f other m odels for those
automakers, along with many other
manufacturers including General
Motors, Ford, Toyota, Honda and
Volkswagen.
Earlier this year, BMW already began
shipping its cars to dealers with the
rear air bags turned off. An Audi
spokesman, Doug Clark, said the
company could not comment on the
agency’s proposal until company
executives had received it.
Both companies have put warnings
about side air bags in owners manuals,
and provided warnings on stickers or
safety cards.
Mercedes is sending a letter to vehicle
owners later this year stressing they
should properly restrain children and
there “is a potential for them to be
injured if they are out o f position or
not w earin g th e ir seat b e lts ,”
sp o k esm an F red H e ile r said
W ednesday.
However, Heiler said Mercedes was
concerned that the warning being
issued by NHTSA w ould scare
parents away from using side air bags
that “provide significant protection
to adults and children.”
Martinez told automakers he expected
them to come up with a voluntary
common approach to testing side air
bags by the end o f the year to make
sure they are safe for children. He
also said the agency would test the
side air bags when children are
properly restrained in child seats or
seat belts because “it is not clear
w h eth er p ro p e rly se a te d and
restrained children incur any benefit”
from them.
Safety officials have said all but one
of the nine side air bags tested in a
joint research program by NHTSA
and Transport Canada could cause
injury to children leaning or kneeling
against a window or turned backward
on a seat. The 1998 General Motors
Pontiac T ransport was the only
vehicle that passed all the tests,
officials said.
T he A ssociated P ress
President Clinton pressed his effort to enroll more
children in governm ent-funded health program s
Tuesday, and rival interest groups announced they
were coming together to look for ways to get coverage
for millions o f uninsured Americans.
Disappointed that a new children's health program has
not reached more children, Clinton directed federal
agencies to look for ways to find these kids in school.
" I f w e’re going to bring more health care to children,
we’re going to have to start where the children are,”
Clinton said in a speech before the American Academy
ofPediatrics.
Meanwhile, only days after the House finished a
contentious debate over giving patients new rights in
dealing with their insurance companies, two o f the
leading interest groups - on opposite sides - announced
a conference in January to address the larger issue o f the
uninsured.
‘ ’It is no longer appropriate for any o f us who care about
the uninsured ... to go our separate w ays,” said Ron
Pollack, president o f Families USA, a liberal consumer
group that campaigned for new patient protections.
He joined Chip Kahn, president o f the Health Insurance
Association o f America, in announcing the conference
in which groups representing hospitals, doctors, nurses,
workers and employers will present their ideas for
addressing the issue o f the uninsured.
Kahn’s group created the television advertisements
featuring Harry and Louise that helped kill Clinton’s plan
to provide universal health insurance, something Families
USA strongly supported.
‘ ’ We hope this will spur politicians, pundits and, above
all, the public,” he said. The timing, at the start o f2000,
is meant to inject the issue into the presidential election,
they said.
Two pollsters - one Democratic, one Republican - were
on hand to present new polling data indicating that
Americans say the issue o f the uninsured is important
and believe it’s getting worse. They actually overestimate
the number o f people without insurance and say they
would be willing to pay more taxes to help them.
The Center for Studying Health System Change released
a study Tuesday that found 20 percent o f uninsured
Americans are offered insurance by an employer but
decline it, mostly because the premiums are too expensive.
Overall, about 14 percent o f people decline employer-
sponsored insurance, with about two-thirds o f them
finding coverage elsewhere. That leaves the rest - about
7 million people - without any insurance.
Nationally, the number ofpeople without health insurance
rose to 44.3 million Americans last year. The number of
children without insurance remained about 11 million,
despite creation o f a $24 billion program to get children
coverage, targeting those whose families earn too much
to qualify for traditional Medicaid.
So far, the Children’s Health Insurance Program has only
signed up about 1 million o f the 11 million uninsured
children, although it has enough money for about 2.5
million. On several occasions, Clinton has urged states
to look harder for these children, and he announced a
renewed push Tuesday.
” It is simply inexcusable that w e’re sitting here, and
have been, with the money for two years to provide
health insurance to 5 million kids and 80 percent o f them
are still uninsured,” Clinton said.
Clinton hopes to help a total o f 5 million uninsured
children by enrolling some 2.5 million through the new
program, plus other children who have always been
eligible for Medicaid but for some reason have not
enrolled.
The president planned to sign an executive order
instructing the secretaries ofhealth and human services,
education and agriculture to report to him in six months
on how to institutionalize the school outreach programs.
And this week, the secretaries o f health and human
services and education will send information to state
agencies explaining how schools and state governments
can use CHIP funds to pay for school outreach programs.
Teen tobacco law
said not enforced
T he A ssociated P ress
The Department ofHealth and Human
Services and many state governments
have failed to enforce a 1992 law
aimed at ending the sale o f cigarettes
and o th e r to b acco p ro d u cts to
minors, an independent analysis of
their performance says.
While all states and U.S. territories
have laws prohibiting the sale o f
to b acco to m in o rs, m ost have
neglected to properly investigate
whether the laws are followed or
prosecute when the laws are broken,
according to the study released today
by the Substance Abuse Policy
Research Program and published in
The A rchives o f P ed iatric and
Adolescent Medicine, a peer-review
journal o f the American Medical
Association.
"Very few states have implemented
effective enforcement programs, and
national surveys confirm that there
has been no measurable reduction in
the availability o f tobacco to youths,”
said the study’s author, Dr. Joseph
DiFranza, a professor o f family and
community medicine at the University
o f Massachusetts Medical School.
With the 1992 Synar Amendment,
named for its sponsor, the late Rep.
M ike Synar, D -O kla., Congress
required states to pass laws banning
tobacco sales to anyone under age 18
w ith a g g re ssiv e e n fo rc e m e n t
measures that may include random,
unannounced insp ectio n s using
decoy buyers at grocery stores and
other retailers.
States must outline how they have
earned out the Synar Amendment in
their annual applications for block
grants from the Substance Abuse
and M en tal H e a lth S e rv ic e s
Administration. And the Department
ofH ealth and Human Services must
in turn withhold some funding from
states who have not complied.
But the study, which examined the
applications filed in 1997, found that
18 states or territories and the District
o f Columbia had failed to meet the
Synar requirements yet were not
punished by the department. They
were: Alaska, Arkansas, Delaware,
the District o f Columbia, Hawaii,
■
Kentucky, Maryland, Mississippi,
M issouri, M ontana, T ennessee,
V irginia, W yom ing, G uam , the
M arsh all Isla n d s, M icro n esia,
Northern Marianas, Palau and Puerto
Rico.
Fifteen states and territories did not
provide evidence that inspections of
cig arette vendors w ere tied to
prosecutions, and 18 states showed
no evidence that merchants had been
successfully prosecuted for selling
tobacco to minors, the study said.
Most o f the 41 states that prosecuted
such cases did not enforce the laws
in a way that "would even remotely
be expected to reduce the availability
o f tobacco to minors,” it said.
The availability o f tobacco to minors
and the underage use o f tobacco is
reduced when the proportion o f
lawbreaking merchants is cut to 10
percent, the study said, but federal
officials are using a threshold o f 20
percent for its judgments.
"It only takes one store to sell to
minors since youths leam quickly
which stores will sell to them ,”
DiFranza said in a statement.
The report also criticized state law
loopholes that make it harder to
prosecute the laws, and said the Synar
A m endm ent its e lf was flaw ed
because it threatens the funding of
mental health agencies, which are not
in charge o f carrying out tobacco
access laws.
This year, the government notified
D elaw are, Iow a, M in nesota,
Missouri, Oregon, Rhode Island,
W yom ing, and the D istrict o f
Columbia that because they haven’t
met the Synar criteria, the lawrequires
40 percent cuts in 1999 block grants
for substance abuse and treatment
programs. Though they may appeal,
the states could lose $37 million in
drug treatment funds.
But the Clinton administration, and
some members of Congress, say these
penalties should be reconsidered.
T he S u b stan ce A buse P olicy
Research Program is supported by
the R o b ert W ood Johnson
Foundation and administered by the
Wake Forest University School of
Medicine.
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