Facing the powers that be

Lobbyists, entrenched forces in congress and self-interested friends will try to stymie Clinton's efforts. A look at four key arenas of combat.     

Danger: implants

The superheated debate over breast implants awakened a sleeping giant of an issue clouding "medical devices"--the government's clumsy nomenclature for any medical product that is not a drug, from breast implants and artificial hips to X-ray machines and surgical thread. Some 130 categories of high-risk devices are in use with little or no proof of safety, reliability or effectiveness. All appeared before 1976, the year that the Food and Drug Administration got the authority to regulate such products. Under activist chief David Kessler and with added clout from a 1990 law, the FDA plans to scrutinize the entire 130-item list. Five will get special attention starting early next year: saline-filled breast implants, inflatable penile implants, testicular implants, heart-bypass pumps and cranial stimulators. U.S. News has looked at all five devices, using FDA data obtained through the Freedom of Information Act. In-depth computer analysis suggested that penile implants deserve closer examination. Why is clear from the following report.     

Urban growth in India: demographic and sociocultural prospects

The numerical and qualitative aspects of the growth of the Indians urban population are discussed with the benefit of data from the last 4 censuses. Thinkers exemplified by M.K. Gandhi believe that urban growth erodes Indian culture, while opponents argue that India's traditional way of life deserves to be obliterated. The "mechanics" of erosion of Indian culture is discussed under 5 headings: its locus, speed, direction, type of population shifts, and types of cities affected by growth. The village, which is the principal locus of Indian culture, is the locus affected by urbanization. The quantitative estimate of urbanization is extremely rapid: between 1951 and 1988, the urban population grew from 62 to 217 million. In this period rural numbers grew from 295 to 618 million. Because of the hugh natural increase of the rural population, the proportion of the urban population grew only from 17.3% to 23.3%. The direction of change is described as a process or cultural accretion or "interpenetration" rather than replacement of tradition by urban culture. Populations shifts account for a large amount of urban increase, a net rise in urban sector of 15 million/decade. While the 4 largest cities received the most immigrants, growing at 3.16%, the intermediate 6 cities with populations 1 million in 1981 grew even faster, at 3.48%. It is likely that India's population after the 1991 census is complete will be 910 million, with 27% urban.