[Dutch parliament legitimizes harmful quackery]. / Tweede Kamer legitimeert schadelijke kwakzalverij.

The Dutch parliament has recently accepted a tax law in which certain groups of alternative therapists can be exempt from VAT. To be eligible for this VAT exemption, the disciplines to which the therapists belong have to meet certain training requirements. In this article it is contended, in agreement with the Royal College of Physicians in the UK, that statutory regulation is inappropriate for disciplines whose therapies are neither of proved benefit nor appropriately tested. It legitimizes harmful therapies. This is illustrated by two serious accidents, previously described in this journal, caused by a chiropractor and a craniosacral therapist.

Is a black market in telemedicine on the horizon?

BACKGROUND: Regulation of a global market by regional licensure systems and trade barriers has significant drawbacks. METHODS: Literature review of telemedicine, law and economics. RESULTS: Today's patients are willing to use out-of-pocket dollars to purchase medical care from: (a) foreign physicians in the medical tourism market; and (b) nurse-practitioners in pharmacy clinics. As telemedicine comes of age, patients are likely to purchase more health care from foreign telemedical 'pharmacy' clinics to avoid the costs, and the hassle, of travel. Many of these foreign medicine providers are likely to be unlicensed. This is problematic because experience with Mydoc.com and Usanetrx.com demonstrates that today's patients are relatively unconcerned with the licensure status of telemedicine providers. Accordingly, the elements of a black market in telemedicine may be on the horizon. Strengthening medical licensure laws is unlikely to keep foreign providers out the US health care market forever. Alternatively, one method to minimize the size of a black market in telemedical services would be to allow the market to regulate itself through the creation of a commodities-type exchange. CONCLUSION: Now is the time to open a global dialogue on how to regulate telemedicine.

[The miraculous growth of "quackery funds"]. / De wonderbaarlijke opkomst van de 'kwakfondsen'.

In 1998 and 1999 three new charity foundations were established in the Netherlands, covering the same areas as the Dutch Heart Foundation, the Netherlands Cancer Foundation and the National Rheuma Foundation respectively. Analysis of the set-up of the three new foundations, of their philosophy, their constitutions and the background of the persons involved shows a remarkably uniform pattern, making it very likely that the set-up of these alternative foundations is a part of the marketing strategy of some Dutch wholesalers in orthomolecular drugs. More legal regulation of charity foundations is seriously needed.