The FDA may not regulate tobacco products as "drugs" or as "medical devices"

Professor Richard Merrill contends that the Federal Food, Drug, and Cosmetic Act does not grant the FDA regulatory authority over cigarettes and smokeless tobacco products. The fact that Congress did not expressly deny the FDA regulatory authority over tobacco cannot, Professor Merrill argues, be used to infer such authority. This inference is particularly inappropriate in the case of tobacco regulation, he maintains, because there is compelling evidence that Congress had no intention of delegating this authority to the FDA. He is unpersuaded that presidential approval legally sanctions the FDA's claim of authority by granting it a superficial political legitimacy. Finally, he reminds us of the FDA's own repeated denials of jurisdiction over tobacco products, and he recalls the numerous times that Congress passed legislation directed at tobacco without granting the FDA any role in its regulation. Professor Merrill's Essay, like the other pieces in this volume, was written after the United States District Court for the Middle District of North Carolina decided Coyne Beahm v. FDA, but before a three judge panel of the United States Court of Appeals for the Fourth Circuit reversed that decision in Brown & Williamson Tobacco Corp. v. FDA. In Coyne Beahm, the District Court held that the Federal Food, Drug, and Cosmetic Act authorized the FDA to regulate tobacco products, but not tobacco advertising. The Fourth Circuit rejected the District Court's jurisdictional ruling and invalidated the FDA's regulations in their entirety. The Clinton Administration has since requested an en banc rehearing before the Fourth Circuit.     

Ten-Year outcome in adolescent onset anorexia nervosa

The purpose of the present study was to characterize the psychopathology measured ten years posttreatment in 51 women who had an adolescent onset of anorexia nervosa. Outcome status was determined using the modified categories of Ratnasuriya et al.[1991]. Anorexia Nervosa: Outcome and Prognostic Factors After 20 Years, British Journal of Psychiatry, Vol. 158, pp. 495–502). Psychopathology was assessed using a number of self-report questionnaires: Beck Depression Inventory, Hamilton Depression Inventory, Leyton Obsessionality Inventory, Social Adjustment Scale, and Minnesota Multiphasic Personality Inventory. Within this adolescent age of onset sample of anorexia nervosa, age of onset was not, in and of itself, associated with increased psychopathology at follow-up. Rather, severity of eating disorder outcome was associated with general psychopathology, with patients in the poor outcome group displaying elevations on several of the measures of psychopathology.Received Ph.D. in psychology from Rutgers Univesity. Major research interests are in eating behavior and attitudes toward foods in anorexia and bulimia nervosa, preoccupations and rituals associated with eating disorders, and comorbidity and eating disorders.Received M.D. from the University of Medicine and Dentistry in New Jersey. Research interests are in eating disorders.Received M.D. from University of Minnesota Medical School-Minneapolis, MN. Major research interests are anorexia nervosa and other eating disorders.Received M.D. from the University of Iowa—Iowa City. Research interests are in eating disorders.     

Reviews

Roman Szporluk (ed.), National Identity and Ethnicity in Russia and the New States of Eurasia. New York and London: M.E. Sharpe, 1994, xiii + 328 pp., £40.00 h/b, £16.00 p/b.

Paul Kolstoe, Russians in the Former Soviet Republics. London: Hurst, 1995, xii + 340 pp., £35.00.

Ronald Grigor Suny, The Révenge of the Past. Nationalism, Revolution and the Collapse of the Soviet Union. Stanford: Stanford University Press, 1993, xix + 207 pp., £25.00 h/b, £10.95 p/b.

Ian Bremmer & Ray Taras (eds), Nations and Politics in the Soviet Successor States. Cambridge: Cambridge University Press, 1993, xxvii + 557 pp., £55.00 h/b, £17.95 p/b.

Charles A. Kupchan (ed.), Nationalism and Nationalities in the New Europe. Ithaca & London: Cornell University Press, 1995, xi + 224 pp., £31.50 h/b, £11.95 p/b.

Christopher Williams, AIDS in Post‐Communist Russia and its Successor States. Aldershot: Avebury, 1995, xvi + 216 pp., £35.00.

Amin Saikal & William Maley (eds), Russia in Search of its Future. Cambridge: Cambridge University Press, 1995, xii + 239 pp., £30.00 h/b, £10.95 p/b.

Marco de Andreis & Francesco Calogero, The Soviet Nuclear Weapon Legacy. New York: Oxford University Press, 1995, x + 130 pp., £25.00.

Eva Haraszti‐Taylor, The Hungarian Revolution of 1956. A Collection of Documents from the British Foreign Office. London: Astra Press, 1995, xxxii + 404 pp., £5.95.

Julian Cooper, Maureen Perrie & E. A. Rees (eds), Soviet History, 1917–53: Essays in Honour of R. W. Davies. London and Basingstoke: St Martin's Press, 1995, xxviii + 273 pp. £45.00.

Tsentral'nyi gosudarstvennyi arkhiv Sovetskoi Armii. Putevoditel’ v dvukh tomakh. Minneapolis: East View Publications, Vol. 1, v + 421 pp., Vol. 2, vi + 531 pp., 1991, 1993, £59.00.

Vladimir N. Brovkin, Behind the Front Lines of the Civil War: Political Parties and Social Movements in Russia, 1918–1922, Princeton, NJ: Princeton University Press, 1994, xiv + 455 pp.

Semion Lyandres, The Bolsheviks’ ‘German Gold’ Revisited: An Inquiry into the 1917 Accusations. Pittsburgh: Carl Beck Papers No. 1106, Center for Russian and East European Studies, University of Pittsburgh, 1995, 132 pp., no price.

Al Richardson (ed.), In Defence of the Russian Revolution: A Selection of Bolshevik Writings. 1917–1923. London: Porcupine Press, 1995, xvi + 287 pp., £12.99.

Neil Robinson, Ideology and the Collapse of the Soviet System. A Critical History of Soviet Ideological Discourse. Aldershot: Edward Elgar, 1995, x + 227 pp., £45.00.

Alexsandras Shtromas (ed.), The End of “Isms"? Reflections on the Fate of Ideological Politics after Communism's Collapse. Oxford: Blackwell Publishers, 1995, 234 pp., £13.99.

Simon Tormey, Making Sense of Tyranny: Interpretations of Totalitarianism. Manchester: Manchester University Press, 1995, vi + 199 pp., £7.95.

David L. Hoffmann, Peasant Metropolis: Social Identities in Moscow, 1929–1941. Ithaca and London: Cornell University Press, 1994, xv + 282 pp., £26.95.

Heather Hogan, Forging Revolution: Metalworkers, Managers, and the State in St. Petersburg, 1890–1914. Bloomington, IN: Indiana University Press, 1993, xviii + 319 pp., £32.50.

Marjorie Mandelstam Balzer (ed.), Culture Incarnate: Native Anthropology from Russia. Armonk, New York, London: M.E. Sharpe, 1995, xii + 270 pp.

Michael D. Kennedy (ed.), Envisioning Eastern Europe: Postcommunist Cultural Studies. Michigan: University of Michigan Press, 1994, 249 pp., £30.00.

Blanche H. Gelfant, Cross‐Cultural Reckonings: A Triptych of Russian, American, and Canadian Texts. Cambridge: Cambridge University Press, 1995, x + 190 pp., £35.00.     

Setting limits through global budgeting: hospital cost containment in Rhode Island

In 1974, hospitals in Rhode Island have participated in annual negotiations with state officials and representatives from Blue Cross to determine the allowed increase in statewide hospital costs (the "Maxicap") for the next fiscal year, based on projected increases in hospitals' revenues, changes in patient volume and operating expenses. Individual hospital budgets may be above or below the Maxicap as long as the total increase in hospital costs for all hospitals in the state does not exceed the negotiated amount. At a time when regulatory solutions are increasingly under fire, continued support for Rhode Island's approach to hospital cost containment from third party payers, providers and public officials stands in stark contrast to other states where rate setting was either dismantled or discredited as a cost control strategy. A negotiated global cap on hospital expenditures offers an alternative to formula-based state rate-setting methodologies which could be incorporated as part of an all-payer reimbursement methodology or as an incremental step towards more comprehensive reform.