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Soros and Lewis' measure may well have helped hasten the day recreational marijuana use becomes legal; it's impossible to know for sure.
But it's clear that as a health initiative, Prop. 215 has been a harsh toke.
In place of ordinary health care of the sort that endeavors to identify, and then treat, the ailments of patients, Prop. 215 has created a reefer-blurred medical underground.
Shuffling through this world are the tens of thousands of conniving potheads who know that "medical marijuana" bought with city ID cards can be cheaper, of higher quality, and less likely to result in arrest than street weed. They're the ones lining up at the script-doc clinics, at the medical cannabis clubs, and on "cannabis medicine" Internet bulletin boards.
This world is populated with profiteering drug dealers -- "medical cannabis clubs," in this world's parlance -- who've enjoyed a multimillion-dollar windfall, often tax free. (Many of these groups are organized as nonprofits.)
In place of legitimate medical professionals, Reefer Rx has script-churning M.D.s with Web sites such as potdoc.com or cannabisdoctor.com. Their approach to medicine, which involves writing thousands upon thousands of identical prescriptions for a flat fee of around $250 each, appears to run afoul of ordinary medical ethics.
According to Schulz, just three aggressive script doctors have provided approximately a third of the 7,500 prescriptions San Francisco has used as evidence for issuing medical marijuana ID cards. James Green, owner of the Market Street Club, which seeks to provide marijuana only to legitimate patients, says he believes the San Francisco ID program makes his task more difficult, rather than less. Green demands doctor recommendations of medical marijuana use, regardless of whether patients have city pot-ID cards. He says that he's recorded some 10,000 cases where documents came from doctors he considers illegitimate profiteers.
"I refuse 24 out of the 25 [S.F. pot-ID] cards that are handed to me," Green says. "I've always been kind of surprised the Department of Public Health isn't concerned about this. Why can't I buy a letter of recommendation for Demerol? Why can't I buy a death certificate for somebody I have life insurance on? Why can't I buy a certificate to verify a workman's comp claim? I can't believe these people haven't noticed this."
Bamberger, the city bureaucrat who helps supervise the pot-ID program, defends his department's practices in regard to doctor recommendations.
"Are doctors doing this for the right reason? Or are they just being paid to do it? We don't feel that's something our Health Department or any other department should be involved in," Bamberger says. "The relationship between doctor and patient is a sacrosanct relationship we don't wish to undermine."
There are other reasons why public health officials such as Bamberger might want to distance themselves from the details of medical marijuana. Despite widespread sympathy for the theory that marijuana can have legitimate medical uses, George Bush's Justice Department remains bent on enforcing federal narcotics laws that prohibit pot. Bureaucrats assigned to the implementation of medical marijuana programs look over their shoulders and imagine handcuff-toting federal agents.
"Anything that normally is done with any other DPH program, such as talking to the public, is not done with the medical cannabis program," Schulz says. "It's schizophrenic."
As bureaucrats distance themselves, prescription-mill doctors make fortunes, and perfectly healthy "medical" pot smokers get high as kites, the AIDS patients, leukemia patients, and glaucoma patients whom Prop. 215 was meant to help suffer in Doobieland. They have heard that the THC in marijuana may help alleviate their suffering, but when they look for health care providers who will help educate them about it -- and provide or not provide it, depending on what is the appropriate medical course -- they find themselves in the company of people who seem unconcerned with the spirit of the Hippocratic oath, which precludes prescribing inappropriate drugs.
And then, they have to deal with a city bureaucracy that strews the medical records of AIDS patients willy-nilly on the desks of well-trafficked offices.
When Hank Schulz entered the world of medical marijuana three years ago, he was a true believer in the potential for implementing Prop. 215.
"Marijuana is really a fantastic drug. I have seen it make huge differences in people's lives," he says. "It was really changing people's lives. People couldn't eat. They'd come back and say, 'I've gained 15 pounds.'"
But Schulz says he couldn't get his superiors to focus on creating a quality pot-ID program. The word from those superiors, he says, was, "'Don't talk to me about that -- it's the lowest priority.'"
So Schulz, a former college anthropology instructor who had worked in the DPH's disease control division for the previous five years, says he went about fashioning a program on his own, sans supervision. This task was difficult; the issuance of medical marijuana IDs had been shunted to the department's vital records counter, an area run so inefficiently that employees feared a furious customer might come in and shoot the place up, an area so disorganized it was known in the department as "hell."
Mail requests for birth or death records, for instance, typically took six months.
"They had a person whose job it was to open the mail, take the check off the order, put the order aside, then process the check. The check would come through, or the credit card would come through, and the documents wouldn't come," Schulz recalls. "Talk about making people angry."
Even within the Siberia of vital records, the medical marijuana ID program was given lowest priority, Schulz says. So he and his fellow vital records clerks began dealing with obvious needs. Though plenty of potheads and street people came to the window, some customers were elderly cancer patients, or young people with AIDS. They were squares, straights -- people ignorant and nervous about the possible implications of toking up.
