Americans will cough their way into the 21st century and die by the millions from tobacco-related illnesses, former U.S. Surgeon General C. Everett Koop warned Wednesday. Speaking to the Rotary Club of Birmingham, the pediatric surgeon who led the fight against secondhand smoke during his seven-year tenure as surgeon general in the 1980s called for national "outrage that the Congress still has failed to pass anti-tobacco legislation." "The nation is apparently ready to condemn the president over a blue dress, but ignores the buying and selling of its Congress by tobacco lobbyists. Where is the outrage?" Koop asked. Tobacco leads his list of unresolved health problems that the United States will carry into the 21st century. "By the year 2025, close to 500 million people worldwide who are now living will have died of a tobacco-related disease, a rate of one death every 1.7 seconds," he said. Koop expressed concerns about the use of rapidly expanding knowledge of genetics and managed care:
"What to do about the tremendous number of people who are getting to be as old as I am --- 82?" he said. "How are we going to handle the knowledge that we are accumulating about human genetics?" Researchers in the 1980s began mapping the location of human genes and chromosomes to find causes for inherited illnesses, an ongoing project that raises questions about testing, privacy and selective reproduction. "Managed care, responding to market forces as a way of doing business, has not been able to do what it promised, which was to raise the quality, reduce the cost and improve efficiency of medical care. Something has to be done to manage managed care," he said.
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