President Obama has proposed covering the costs of his new medical plan with "smarter" medicine, meaning the adoption of procedures that eliminate inefficiencies and stress prevention. At a town hall meeting in New Hampshire on August 11, 2009, he gave the example of a diabetic needing to have a foot amputated, at a cost of $30,000 to $50,000. It would have been smarter to counsel the patient on diet and weight loss and monitor his medications before amputation was required. The insurance company would have saved money and the patient would have saved a foot.
The 2008 Obama/Biden Plan for a Healthy America also stressed preventive approaches to disease, including the reduction of toxins to which the body is exposed; and chief among these toxins was mercury. The Plan stated as a fundamental goal:
"Reduce Risks of Mercury Pollution. More than five million women of childbearing age have high levels of toxic mercury in their blood, and approximately 630,000 newborns are born at risk every year. The EPA estimates that every year, more than one in six children could be at risk for developmental disorders because of mercury exposure in the mother's womb."
As a Senator, Obama was responsible for extensive legislation reducing environmental exposure to mercury, including a ban on the export of elemental mercury, and legislation to phase out the use of mercury in the manufacture of chlorine.
Mercury can get into the blood by various routes, and one that has been lately in the news is the mercury found in the thimerosol in vaccines. Another source that made the news in July is the mercury released from dental fillings by chewing. The World Health Organization has stated that between 3-17 micrograms of mercury are released into the body each day by chewing, compared to only 2-5 micrograms from fish and all other environmental sources combined. In 1990, the New England Journal of Medicine published an editorial calling mercury amalgam fillings "possibly the chief source of exposure [to mercury] of a large segment of the U.S. population".
Surprise FDA Ruling
When mercury amalgam made the news on July 29, 2009, however, it was not to warn of its hazards. Rather, it was to report the FDA's surprise ruling that mercury fillings are safe. The ruling came after years of foot dragging by the FDA and a wave of consumer lawsuits. A growing consumer movement had amassed so much evidence for the dangers posed by mercury dental fillings that when a court finally ordered the FDA to come out with a ruling, the plaintiffs announced, "We won!" But instead of the declaration they expected, the FDA imposed no restrictions on the use of mercury amalgam. Dentists were not even required to inform their patients that "silver" fillings are composed mostly of mercury. The FDA conceded that it did not know if amalgam was harmful to children under six, pregnant women, or nursing mothers, but it took no steps to protect them. It even pulled from its website an existing neurological risk advisory that said, "Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses."
Consumer advocates were stunned, as the FDA had earlier agreed to strengthen its warnings against mercury amalgam fillings. The evidence against mercury amalgam dental fillings was considered so compelling that Sweden, Norway, and other countries had already banned their use entirely. Degussa, Germany's largest producer of amalgam and the world's largest producer of metals for dentistry, completely shut down its amalgam production after a federal court ruled that dentists who used it faced legal liability. The FDA was expected to follow suit.
Why its unexpected about-face? Charles Brown, of the National Counsel for consumers for Dental Choice, suggests it had to do with a change in personnel. In May 2009, Dr. Margaret Hamburg succeeded to the post of FDA Commissioner. The Wall Street Journal noted that for five years before that, she served on the board of Henry Schein Inc., a $4 billion firm that distributes medical and dental supplies, including vaccines. Brown wrote skeptically:
"Washington is famous for the revolving door -- those in the party out of power take highly paid corporate positions, then return to government to bail out their benefactors. The new FDA Commissioner, Margaret Hamburg, worked in the Clinton Administration, then went out and became a director at the dental products colossus Henry Schein, earning a quarter million dollars a year for the handful of hours it takes to be a director. Corporations do this because they know the other party will return to power, at which time the corporations will call in their chits."
Science or Politics? The Liability Question
Beyond that potential conflict of interest, there was likely to have been heavy pressure from the American Dental Association, the professional union of dentists. If mercury amalgam were officially declared to be toxic, an estimated two billion mercury amalgam fillings might have to be replaced at practitioners' or insurers' expense, not to mention the flood of lawsuits for medical injuries that would follow.
Dentists could hardly defend by pleading ignorance of mercury's harmful effects, since its health risks have long been known. Lewis Carroll alluded to the toxic effects of mercury in his nineteenth century character the Mad Hatter. Felt hat workers exposed to mercuric nitrate were observed to exhibit emotional symptoms including sudden anger, depression, loss of memory, timidity, insomnia, irritability, hallucinations, delusions and mania, a condition referred to as "mad hatter syndrome." The manufacturer of the product Dispersalloy, consisting of capsules of metal powder mixed with liquid mercury and placed in the patient's mouth, has a warning on its website stating:
"Inhalation of mercury vapor over a long period may cause mercurialism which is characterized by fine tremors and erethism"""Erethism may be manifested by abnormal shyness, blushing, self-consciousness, depression or despondency, resentment of criticism, irritability or excitability, headache, fatigue and insomnia. In severe cases, hallucinations, loss of memory and mental deterioration may occur."
Among other disturbing studies prompting consumer concerns was one reported in August 1990 by Drs. Lorscheider and Vimy of the University of Calgary in Alberta, in which twelve radioactive mercury amalgam fillings (a typical number for a human adult) were placed in the mouths of sheep. A control group received fillings made of an inert material. Within thirty days, the sheep that got the amalgam had lost half their kidney function. The study showed that mercury in amalgam fillings is not locked in the teeth but spreads through the body to the organs. Similar data have been reported for monkeys. The isotope labeled mercury showed poisoning of the internal organs and the brain of both sheep and monkeys.
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