Airbags and Nixon

It is an engrossing exercise to locate changes of stubborn minds in the face of equally stubborn facts. Two events – one recent and one about to unfold – are instructive.

Last month Chrysler chairman, Lee A. Iacocca, was presented with the All-State Safety Leadership Award, which cited the company for installing driver-side air bags in its entire 1990 line of U.S.-built cars. A beaming Iacocca received the award in a ceremony at the National Press Club in Washington. He observed that air bags have “proved reliable, and in some cases have flat out saved people’s lives.”

What a 180 degree change in Maestro Iacocca’s position. At an Oval Office meeting with Richard Nixon in the early seventies, Iacocca persuaded Nixon to detour the then Secretary of Transportation John Volpe’s desire to require air bag-type equipment on automobiles. Under Nixon’s pressure, Volpe substituted the short-lived interlock system for the air bag and precious years and lives were lost.

Later in the eighties, Iacocca devoted two pages in his best-selling autobiography to lambasting air bags to the point of supercilious ridicule. By that time, the engineering experience with air bag reliability in 12,000 mid-seventies cars was overwhelmingly positive.

This experience meant nothing to Ronald Reagan who unlawfully repealed in 1981 a pending safety standard leading to air bag-equipped cars. More Americans died who could have lived on the highway. Two years later the U.S. Supreme Court in a unanimous opinion vacated Reagan’s repeal and accused his government of waging regulatory war on this auto safety standard.

Confronted by decisive evidence of the air bag’s worth and by Ford Motor Company’s re-entry on the side of this safety device, Iacocca placed full page ads in major newspapers during the spring of 1988. “Who says you can’t teach an old dog new tricks?,” was the way the ad’s headline announced Iacocca’s conversion to air bags. Better late than never and much better than the behavior of General Motors Chairman, Roger Smith, who begrudgingly is following way behind.

The second event about to unfold involves physicians and certain insurance companies who have long called the malpractice problem one of unfettered lawyers, judges and juries, instead of just downright medical negligence or incompetence.

Sometime later this month, a $3 million study of New York State hospitals by a Harvard Medical School group will be released by the New York State Department of Health. The report’s conclusions are jolting: an average of nineteen patients a day die in New York hospitals due to medical malpractice. Another twenty three patients a day suffer permanent maiming.

Given the impartial, prestigious source of these estimates and the study’s published methodological rigor, will the medical profession ever be so smug again? For extrapolating these figures nationwide, significantly more people die in hospitals at the hands of physicians and other health assistants than on the highways as passengers and pedestrians.

Will we see physicians come out, like Iacocca, and confess error? Will they “install” stronger mechanisms to discipline or remove the bad doctors from their lot? Or will they try to continue this Medigate coverup of their peers despite the impact of the Harvard thunderbolt?

In recent years, many insurance companies and physicians’ groups have lobbied state legislatures, with some success, to restrict the rights and compensation levels that malpractice victims could use and obtain. Perhaps after the release of the Harvard report, these lobbyists will look inward and begin cleaning up their own operations from which so many preventable deaths and injuries have occurred.

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