Articles Posted in Conflicts of Interest

cashrain-300x225Politicians almost by reflex decry the skyrocketing cost of U.S. health care by blaming much of it on waste, fraud, abuse. They, alas, really may be on to something, newly published research shows.

Health care experts, including a medical leader of health insurer Humana, “combed through 54 studies and reports published since 2012 that estimated the waste or savings from changes in practice and policy,” leading them to some jaw-dropping calculations about how well spent is the $3.5 trillion or so that Americans drop on health care, the New York Times reported.

Answer: Really badly. The researchers, in their published work, estimated that 20%-25% of American health care spending is wasteful. That turns into giant sums, fast, as the newspaper reported, including:

There seems to be a never-ending outbreak of a certain kind of pathology in the United States. Big Pharma has it and spreads it around, a lot. So, too, do public health figures. Let’s call this scourge what it is — unmitigated gall.

The problem with this nasty condition is that it afflicts the rest of us. Just consider how stomach-churning these shenanigans can be:

Penalties for bogus prescribing of ‘little red pills’ on elderly dementia patients

logopurdue-300x169For those who get a rise out of following the plight of plundering plutocrats, forget about pop culture shows like Succession, Dynasty, or Empire. Instead, it may be worth peeking in on the true-life Sackler family saga. It also underscores the truth of this idea: Never get between Big Pharma and a buck.

The Sackler story, turning on the fate of the family’s Purdue pharmaceutical firm and a fortune estimated at $13 billion, has been ripe with recent developments, including a potential settlement of thousands of claims by states, counties, cities, Indian tribes, and others — all claiming billions of dollars in damages due to the maker’s aggressive and less than accurate sales and marketing of its prescription painkiller OxyContin.

With a federal judge in Ohio consolidating and pushing a “global resolution” of a giant number of opioid-related lawsuits, Purdue and the Sacklers announced a tentative settlement of many of the governments-filed claims. Roughly half the plaintiffs were eager to get what money they could — to not only help constituents staggered by damages due to opioids, overdoses, and addictions, but also to refill government coffers depleted by the huge costs of dealing with nightmares caused by the painkillers.

beaumonthospital-300x115When doctors become medical outliers, shouldn’t hospitals, colleagues, insurers, and the rest of us ask how and why an individual practitioner diverges so much from the way others provide care?

Olga Khazan details for the Atlantic magazine the disturbing charges involving Yasser Awaad, a pediatric neurologist at a hospital in Dearborn, Mich. As she describes him, for a decade he racked up hundreds of cases in which he is accused by patients of “intentionally misreading their EEGs and misdiagnosing them with epilepsy in childhood, all to increase his pay.” Khazan says his case “shines a light on the grim world of health-care fraud—specifically, the growing number of doctors who are accused of performing unnecessary procedures, sometimes for their own personal gain.”

In the malpractice cases that are unfolding against him, Awaad’s pay has become a central issue, with evidence showing his hospital contract rewarded him for boosting the number of screenings he ordered and diagnoses he made. Jurors have been told that Awaad, whose salary increased from 1997 to 2007 from $185,000 annually to $300,000, “turned that EEG machine into an ATM.” He earned bonuses exceeding $200,000, if he hit billing targets.

footballrochester-300x200Although commentators and pro football itself have argued that rule changes by the National Football League have notably reduced possible head harms, new evidence from college athletes shows that even knocks that aren’t severe enough to be deemed concussions may injure young brains.

Those findings come from a University of Rochester study based on brain scans and helmet data from members of the school’s Division III football team (shown above), the New York Times reported.

Researchers scanned the athletes’ mid-brain area twice, once before the season kicked off and at its end. They did so because that region would most likely show the effects of impacts, including those that might be tougher to gauge in other areas of the brain. They also compiled data from special equipment on players’ helmets, registering the number and intensity of every impact — not just from player collisions but also when athletes hit the ground.

zolegensma-300x225Big Pharma is testing crucial boundaries in the way that the nation determines the safety and effectiveness of prescription medications. And regulators, for patients’ sake, need to shove back — hard.

The concerning incidents involve “pay to play” clinical trials and “manipulated” data submitted to the federal Food and Drug Administration by maker Novartis as part of the approval process for a gene therapy drug with a sky-high price.

Neither instance, officials insist, had immediate effects in endangering patients. But both show extreme practices and conduct that regulators should slam to a halt.

axiosinsurancecost-300x170With the 2020 presidential campaign obsessing early about health insurance rather than costly health care overall, voters may wish to reframe their thinking about coverage and candidates’ views on making it affordable. Their chief query may need to be this: Just how much of the vig should the bagman take?

That may be a blunt a way to put it, but is the vernacular of the criminal “protection” racket all that out of place here? Michael Hiltzik, a financial columnist for the Los Angeles Times, makes pretty much the same argument, that the bagman’s share ought to be zero.  Why not get rid of health insurers, he asks in a bit of evidence-based hyperbole? He finds the companies don’t fulfill much of a public mission, save, as a former insurance executive describes it, to make themselves money and to persuade all of us that they are essential. Indeed, as Hiltzik sees it, insurers are not just a rip-off but a failure in their own terms:

“Let’s start by examining what the insurers say are their positive contributions to healthcare. They claim to promote ‘consumer choice,’ simplify ‘the health care experience for individuals and families,’ address ‘the burden of chronic disease,’ and harness ‘data and technology to drive quality, efficiency, and consumer satisfaction.’ (These claims all come from the website of the industry’s lobbying organization, America’s Health Insurance Plans (AHIP). They’ve achieved none of these goals. The increasingly prevalent mode of health coverage in the group and individual markets is the narrow network, which shrinks the roster of doctors and hospitals available to enrollees without heavy surcharges. The hoops that customers and providers often must jump through to get claims paid impose costly complexity on the system, not simplicity. Programs to manage chronic diseases remain rare, and the real threat to patients with those conditions was lack of access to insurance (until the Affordable Care Act made such exclusion illegal). Private insurers don’t do nearly as well as Medicare in holding down costs, in part because the more they pay hospitals and doctors, the more they can charge in premiums and the more money flows to their bottom lines. They haven’t shown notable skill in managing chronic diseases or bringing pro-consumer innovations to the table.”

monsees-300x286Juul, the nation’s dominant maker and seller of vaping devices, may want to deny it looks, acts, or models itself after Big Tobacco. A U.S. House subcommittee, however, has caught the San Francisco-based company in one of the prime profit-boosting practices of its health-killing precursor: targeting young users.

Though it insists it neither wants nor has it sought older teens as its customers, Juul spent tens of thousands of dollars and campaigned in recent months with what was purported to be a health education curriculum to reach out to show itself in most favorable fashion to young people in schools, summer camps, and youth programs, House investigators assert.

They told U.S. representatives on the economic and consumer policy subcommittee that they reviewed 55,000 documents to determine that “Juul operated a division that persuaded schools to allow the company to present its programming to students and paid the schools in several instances at least $10,000 to gain access to students during classes, summer school and weekend programs. The effort ended last fall and involved about a half dozen schools and youth program,” the Washington Post reported.

reuterslogo-300x169The blame and shame for the opioid-drug overdose crisis that kills tens of thousands Americans annually has moved to yet another set of individuals and institutions now — judges and courts that handled Big Pharma lawsuits and may have been too quick to seal from the public information that would have warned of painkillers’ addictive and lethal characteristics.

Makers’ false claims about opioids and their problematic practices in promoting, selling, and distributing the drugs were hidden, too, in the “pervasive and deadly secrecy that shrouds product-liability cases in U.S. courts, enabled by judges who routinely allow the makers of those products to keep information pertinent to public health and safety under wraps,” Reuters reported.

The news agency dug deep into the judicial practices, finding:

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