Articles Posted in Ethics

devito-300x169As tens of millions of Americans struggle with workplace medical insurance that provides them with little benefit when they most need it, consumers may wonder just how naïve their employers may be in overlooking industry SPIFFs, SPIVs, and other little-discussed payments that jack up costs and may reduce benefits.

Before any confusion arises, don’t think about health insurance in high-minded terms, and, instead, as just another business transaction — maybe what occurs at the cheesy used car dealership in the neighborhood (ala actor Danny DeVito in “Matilda,” as shown above). There, customers have gotten savvy about bonuses (Sales Promotion Incentive Funds or Sales Promotion Incentives) ladled on salesmen to get them to move vehicles out of showrooms, asap.

Pro Publica, a Pulitzer Prize-winning investigative site, deserves credit for digging in to the medical insurance business to show how similar incentive programs proliferate in brokerages that purportedly help companies of all sizes figure how to cover their employees’ health needs.

fentanylA steady flow of news reports shows how our nation’s opioid crisis can be fairly blamed on just about every actor in the medical field that should have known better: Big Pharma, doctors, hospitals, and regulators. It’s been a toxic mix of incompetence, indifference and out-and-out  deceptive conduct that produced the epidemic that now claims tens of thousands of American lives each year.

Take, for instance, the drug fentanyl, a lab-created painkiller 100 times more powerful than morphine. How did it escape the confines of legitimate prescription pain control to become a killer street drug? The Washington Post reports, based on research from Johns Hopkins experts, on how doctors, hospitals, and the federal Food and Drug Administration bungled a plan to safeguard the administration of this highly potent drug that had obvious abuse potential from the day it came onto the market.

Meantime, two other news organizations — the Pulitzer Prize-winning investigative website Pro Publica and the online health site Stat — have pried loose disturbing, sealed court testimony, showing how a wealthy, philanthropic family approved a lethal deceit about the potency of OxyContin, a billion-dollar opioid pushed relentlessly by Purdue, the Big Pharma firm they owned.

vamps-300x169Funny the mischief that can happen with a little blood and spit. Seemingly unrelated medical stories last week brought home the lesson of the law of unintended consequences. Those consequences abound everywhere, in health care most especially. So with blood, we’re learning about a bizarre new fountain-of-youth treatment, with echoes of vampires, for seniors who ought to know better.   And with spit, we’re learning how seemingly harmless genetic tests can raise from the dead some disturbing revelations about our deceased family members.

Bunk about blood transfusions

The federal Food and Drug Administration has warned older Americans about a new kind of anti-aging bunk flying out of the Silicon Valley: blood transfusions. Companies, dancing on a fine legal line, have hinted that seniors could benefit by getting transfusions of young people’s blood and blood products.

noop-300x158Seniors and their friends and companions should consider reality versus magical thinking about the power of pills. The blunt truth: Over-the-counter dietary supplements can’t cure diseases. Not  Alzheimer’s, not cancer, not diabetes, not any known disease. They don’t extend your lifespan either.

Scott Gottlieb, commissioner of the federal Food and Drug Administration, not only has warned a dozen companies to stop making reckless health claims about supplements, he also told Congress his agency needs greater authority to regulate what the New York Times reported has become a “$40 billion industry, which sells as many as 80,000 kinds of powders and pills with little federal scrutiny. These products range from benign substances like vitamin C or fish oil to more risky mineral, herbal and botanical concoctions that can be fatal.”

Gottlieb told the newspaper that regulators have been reluctant to rein in the wildfire spread of supplements and their wilder claims. But the public health is at such risk now that Congress must step in.

cbpbust-300x200If  anyone around doubts still the threat that the opioid crisis poses to the nation, a drug bust involving a vegetable truck in Arizona should provide powerful persuasion: Federal agents, suspicious about the vehicle’s floor, loosed a drug-sniffing dog, resulting in the seizure of not just 395 pounds of methamphetamines but also 254 pounds of fentanyl.

Fentanyl is a synthetic opioid, a lab-created super drug that experts say is 50 times stronger than heroin and up to 100 times more potent than morphine. It packs a wallop for users in tiny grains or flecks.

The record-setting seizure at the Arizona border stop amounted to 144 or so kilograms of fentanyl, with drug enforcement officials estimating that just 1 kilogram of fentanyl can produce 1 million fatal doses. That means just this one bust had the potential to cause 144 million deaths.

bathrobe-300x188Already-admitted patients shouldn’t be flummoxed if they’re moved into a bigger, quieter, and nicer room. There, a fluffy complimentary robe may await them. They may receive a warm welcome from well-attired executives — those senior enough so their pictures may even hang in pictures on the hall walls. And, yes, make no mistake, their nurses and doctors really will be kind and attentive.

Welcome to high-roller care as it’s delivered now to a select few by staff in at least three score big hospitals and academic medical centers nationwide, including Johns Hopkins and MedStar Health in Columbia, Md.

You won’t necessarily seek out or request this special attention. It turns out that hospitals will know you’re posh enough to merit it because loopholes in privacy laws allow them, using special software, to run regular searches through patient rosters to determine which guests also might be potential and lucrative donors, reported the independent, nonprofit Kaiser Health News service in a story that appeared in the New York Times. You also may allow the pitches because, likely unbeknownst to you, you signed a form giving your permission for it in that mountain of admission paperwork.

mesh-300x134
Tens of thousands of women complain that a surgery to implant mesh to bolster weak abdominal tissue, instead has inflicted on them incontinence, chronic pelvic pain as well as pains in the groin, hip, and leg, and with intercourse. Others say they suffer complications as if they had the immune system attacking disease lupus, leaving them with persistent runny noses, muscle pain, fogginess, and lethargy.

The federal Food and Drug Administration in mid-February will convene its expert panel on women’s reproductive surgeries to see advice on next steps in what has become a legal and medical morass over transvaginal mesh operations.

As many as 4 million women globally have undergone mesh surgeries to treat urinary incontinence and weakening of walls in the abdominal area that causes prolapses, the Washington Post reported, quoting a UCLA reconstructive expert as estimating that 5 percent — or 150,000 to 200,000 — of those patients have experienced complications.

abraarkaranmdWell, just because.

That isn’t a great answer for cranky toddlers with too many questions. It’s also an unacceptable but real reason why too many hospitalized patients get woken up in the middle of the night and subjected 24/7 to expensive, invasive, and often unnecessary tests and procedures.

Abraar Karan (right), an internal medicine resident at the Brigham and Women’s Hospital/ Harvard Medical School, has blogged with welcome candor about doctors’ casual acceptance of medical routines that not only discomfit but also can harm patients. As he wrote online for BMJ (aka the British Medical Journal): “The reality of medicine is that there are many things we as doctors do for absolutely no reason. That is to say, there is no evidence (randomized controlled trial or otherwise) for doing them, other than ‘that’s the way we’ve always done it.’”

diabetesteststrips-300x200Doctors, hospitals, health officials, and disease advocacy groups race to warn about diabetes’ risks, harms, and increasing prevalence. But why, then, doesn’t modern medicine also do much more to help diabetics with the skyrocketing costs of their care, whether with insulin at excessive prices or with  expensive medical aids?

Ted Alcorn of the New York Times drilled down on one slice of diabetes care to capture how medical profiteering distorts what ought to be a more direct, simple, and less pricey treatment for a disease that afflicts as many as 100 million Americans in varying degree.

He reported on the “strange marketplace” for the chemical-imbued plastic strips diabetics use to test their blood sugar, inserting them into specialized meters for glucose readings. Before diabetics adjust their diet or take insulin, they may test themselves with strips and meters as many as 10 times a day. The costs add up. Diabetics can pay thousands of dollars annually to get test strips over the counter.

artsacklerdc-300x129A plutocratic clan that has labored to portray itself as enlightened patrons of the arts, science, and medicine, instead has been depicted in new court documents as drug profiteers, eager to exploit the misery and even deaths of tens of thousands of Americans.

The stories in the New York Times, Wall Street Journal, Washington Post, and at the online medical science news site Stat paint a damning picture of the Sackler family and their avarice with the family-owned Big Pharma firm Purdue. The company made the clan billions of dollars but also has become the focus of news stories, official investigations, and now a barrage of lawsuits, all asserting that Purdue played a crucial role in fomenting the nation’s opioid drug crisis.

The Sacklers had sought to distance themselves from the horrors unleashed by powerful opioid painkillers, including their company’s top-selling drug OxyContin. The opioid crisis last year alone claimed 70,000 lives, and the prescription and illicit painkillers of their ilk have become a leading cause of death for Americans younger than 50. Overdoses now savage white men, especially in ex-urban and rural areas; women 30 and older; blacks in big cities; and even children.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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