Interview of me by Neil Shulman MD about my experiences with the pharmaceutical industry. Exclusive footage you won’t see on the mainstream media.

Part 1

Part 2

Part 3

Part 4

Part 5

I justed posted a guest blog on the Dear Thyroid website, which is a advocacy group for patients with thyroid disease here.

A local FOX Atlanta show, you can see me and read about it here.

Reported By: Beth Galvin | Edited By: Leigha Baugham

Nearly 20 percent of American doctors get paid by drug companies to be consultants or speakers, and in some cases, they’re making quite a lot of money. So does that influence the decisions your doctor makes about your care?

Doctors earn money by giving professional talks to their peers about the latest research and the practice is pretty common.

For years it’s been unclear how much money physicians were actually earning for these speeches. Now, three major drug companies are going public revealing who is on their payrolls and how much money they’re making.

On Eli Lilly’s website, the company lists faculty on the drug company’s payrolls, including educators, advisors and contractors.

Nearly 200 Georgia doctors are on the list and they pulled in over $2.2 million dollars last year.

Some of Georgia’s highest paid physicians on the list are Emory urologist Dr. Muta Issa, who earned $ 91,000 from GlaxoSmithKline. Atlanta endocrinologist Dr. David Robertson cashed in over $78,000 from Eli Lilly and Roswell psychiatrist Dr. Michael Banov banked over $68,000 from Eli Lilly.

Some healthcare providers are earning much more by working for several companies at the same time.

“It’s common, that people who are very active, can make several hundred thousand dollars or more,” said Emory psychiatrist, Dr. Doug Bremner.

“We don’t sell medications. We simply educate physicians about data, and they make their own mind up,” said Dr. Banov.

Dr. Banov, a private practice psychiatrist, was paid over $68,000 by Eli Lilly. The Roswell doctor said he gives speeches for about five companies with competing medications.

“I think my patients welcome the fact they have a doctor who is meeting other doctors, actively involved in research, actively communicating with other physicians, someone who’s on top of the game,” Dr. Banov said.

Dr. Banov said the drug company, not him, creates the materials used in his speeches, and he also said there’s a reason for that. “We are only able to present the data. We’re not able to present our personal opinions, our personal preferences, how we use the medication off label, any of that. So we’re held to a very tight standard by the FDA.”

Emory’s Dr. Bremner said he thought paying doctors to speak for drug makers was a bad idea. Bremner said he used to do it, until he got a wakeup call about six years ago.

“I was going out to give a talk and the sales, the marketing guy like, slapped me on the back and said, ‘Go on out there and sell some,’ I’m not going to say the name of the drug. ‘Sell some of that drug,’” said Dr. Bremner.

Dr. Bremner said he worried that even the most independent doctor can get hooked on all that extra cash coming in. “Doctors are human, and once you get into this routine of making outside income, you become dependent on it.”

When asked how receiving money from the drug companies could from influencing how a doctor treats a patient, Dr. Banov said, “When I close that door, and I’m with a patient, my 100 percent interest is in getting that patient better.”

Last fall, Emory University’s School of Medicine banned staffers from making promotional talks for drug companies after congressional investigators accused the school’s chief of psychiatry, Dr. Charles Nemeroff of failing to report to the university over a million dollars he got from pharmaceutical and medical device manufacturers.

Dr. Nemeroff resigned his chairmanship, and has since left the school.

Another Emory staffer, urologist Dr. Issa listed his earnings as $91,000 in the first three months of 2009 from GlaxoSmithKline. Dr. Issa declined to comment on this story. A school spokesperson said Dr. Issa left the speaker’s bureau when Emory changed its policies.

Atlanta diabetes specialist Dr. David Robertson, who earned $78,000 for giving 47 promotional talks for Eli Lilly, said he only speaks about medications he actually prescribes.

“I think a presentation a physician makes should represent their own practice,” said Dr. Robertson. The doctor did admit that some physicians spend too much time promoting too many products. “That’s bad for everyone. That’s bad for the pharmaceutical companies, that’s bad for physicians as a profession and that’s bad probably for physicians as recipients of information because they become mistrustful.”

So are public lists like this a good thing?

Doctors on both sides say yes.

“I think it’s gotten to the point where the public is looking at it for what it is and they’re saying, ‘What’s going on here?’” said Dr. Bremner.

“Why not let the public know? There is nothing to hide. There is no shame. We’re not doing anything illegal,” said Dr. Banov. “I think it’s terrific. [It] should be completely open.”

So far, GlaxoSmithKline, Eli Lilly and Merck have published online lists of who’s on their payroll. Pfizer will be doing the same this spring.

Related Links: statements and public registries for Eli Lilly, Merck (also see here) and

GlaxoSmithKline (also see here).

Complete statement from Emory University School of Medicine regarding its new Conflict of Interest policy.

“In June of 2009, Emory’s School of Medicine adopted a comprehensive new policy governing faculty relationships with industry. The policy meets the recommendations of the Association of American Medical Colleges, the Association of American Universities, and the Institute of Medicine. Professors Issa, Pacifici, and Schulman are respected faculty members who are in compliance with that policy. Dr. Nemeroff resigned his position at Emory in fall of 2009 to become chair of psychiatry at another medical school.”

A furore has erupted following The Scientist magazine’s revelations that Phoni Pharmaceuticals paid an undisclosed sum to scientific vanity publisher Elsleazier to produce several volumes of a publication that had the look of a peer-reviewed medical journal but which contained only reprinted or summarized articles, most of which presented data favourable to Phoni products. The journal appeared to act solely as a marketing tool with no disclosure of company sponsorship.

The Australian Journal of Boneheads and Joint Medicine, which was published by Extracta Moneya, a division of Dutch scientific publishing juggernaut Greed-Elsleazier, also contained little in the way of advertisements apart from ads for Formonimax, a Phoni drug for osteoporosis, and Viletoxx, Phoni’s controversial pain-killer.

In a statement provided last week to The Scientist, an eminent Australian physician and long-time member of the World Association of Medical Editors reviewed four issues of the journal that were published from 2003-2004.

“An average reader, such as a doctor, could easily mistake the publication for a genuine peer reviewed medical journal”, he said. “Only close inspection of the journals, along with knowledge of medical journals and publishing conventions, enabled me to determine that the Journal was not, in fact, a peer reviewed medical journal, but instead a marketing publication for Phoni.”

“They’ve done a heck of good job, and it was only when I noticed that some of the names of the so-called “honorary editorial board” appeared to be made up that I became suspicious,” the reviewer admitted.

“Professor Phil. I. Daftwhoofing appears to be an anagram of “Ripping Off Fools Who Read This,” for example. Similarly, Dr. Leon Theophuleet is an anagram of “Pulled The Other One”. And “Gill Ripcheap” seems to be an anagram of Rich Pillager, who I believe is Phoni’s Head of Global Marketing…”

A spokesperson for Elsleazier, however, told The Scientist, “All of our journals are thoroughly peer-reviewed prior to publication, by our accountants. Our company would never publish a journal unless it was guaranteed to make us lots of money. After all, our publications are well-known for the standards they deliver – standards of living for our publishing executives, that is…”

Disclosure of Phoni’s funding of the journal was not mentioned anywhere in the copies of issues obtained by The Scientist. Elsleazier acknowledged that Phoni had sponsored the publication, but did not disclose the amount the drug company paid.

The spokesperson added that Elsleazier had no plans to look further into the matter. “The high prices of subscriptions to our journals are a guarantee of their quality,” he said. “After all, everyone recognises the quality of Australian scientific publications, in the same way that American diplomacy journals or Nigerian accountancy and banking magazines are regarded…”

One of the genuine members of the Australian Journal of Boneheads and Joint Medicine’s “Honorary Editorial Board,” Dr. Táké Bakhandar, a rheumatologist in Australia, said he was delighted to serve on the board, however. Dr. Bakhandar has been on Phoni’s Asian Pacific and international advisory boards since the mid 1990s, as well as the advisory boards of other pharmaceutical companies, including Pfizer and Amgen.

“You get involved in a whole bunch of things at this level,” he said, adding that he had put his name on “quite a few advertorials” for pharmaceutical companies in the past 10 years. “I’m delighted to be able to promote the life-enhancing products of the pharmaceutical industry,” Dr. Bakhandar said.

His colleague and fellow member of the Australian Journal of Boneheads and Joint Medicine’s Honorary Editorial Board, Dr. Pádme Baksheesh, agreed. “My own observations conclusively show that there is a direct relationship between the number of products I plug for pharmaceutical companies, and the degree to which my life is enhanced,” he said.

Rich Pillager, Head of Global Marketing for Phoni Pharm. Inc. was also unrepentant.

“The Australian Journal of Boneheads and Joint Medicine” is an important tool in Phoni’s CME (Continuing Medical Education) programme,” he said.

“After all, we’ve been putting out advertorials for years. Everyone remembers our series of children’s books that were designed to promote the use of Phoni’s SSRI Saloadatat in children, for example,” Pillager notes, referring to the controversial “Mr. Bipolar” book based on the UK “Mr. Men” franchise.

“Our competitors have been doing exactly the same thing, only we’re aiming our latest fairy tales at the adult market. I can’t see what the problem is,” he frothed rabidly.

[this was a spoof piece but unfortunately the quote
"You get involved in a whole bunch of things at this level,"
was real, and the fake journal was real as well]

For more of Pharma Giles work see his hilarious children’s book ‘The Story of Modern Medicine’.
[via pharmagossip and scientific misconduct blogs. Hat tip to Dan Abshear]

It all started that night in my office. There I was sitting in the dark, leaning back in my chair, my legs propped up on the desk. If there was one thing better than having a phone that never rang, it was having two phones that never rang.

The smoke from the cigarettes was floating around my head and the whiskey was tasting better with each swallow. On the radio Sinatra was crooning “I’ve Got The World On A String.” Yeah!

I hadn’t had a case in weeks and I was seriously thinking about getting a new line of work. Being a pharmaceutical litigation consultant just wasn’t paying the bills.

I like the good things in life. Like liquor, women, reading, chess and working alone. I’m educated enough to speak English if I’m required to. I used to work for the Big P, but was fired for insubordination, thus starting a cliche that still hasn’t run out of steam. But I’m all done with hating them. It’s all washed out of me. I hate pharmaceutical companies hard, but I don’t hate them very long. How many ex-marketing VPs are there out there that have become litigation consultants? Not many.

I needed a drink. I needed a lot of life insurance. I needed a vacation, I needed a home in the country. What I had was a coat, a hat and an overdraft.

So here I am in 2008. I’ve turned fifty and what do I have to show for it? A second floor office (that doubles as my abode since I was booted out of my apartment) above a two-bit saloon in downtown Peapack NJ that serves watered down drinks and has a neon sign that is driving me wacky. A ‘05 Lincoln Continental that I bought with my last pay check pay from the Big P in 2005. A black suit with two pair of pants, and a broken computer from one of the many working overs it’s taken since I became a Hard Boiled Blogger.

Yeah, I’ve got the world on a string all right…

Then came the knock at the door.

I could see through the frosted window on the door into the lighted hallway that it was a dame. And boy, what a dame! The outline of her body looked like an hourglass with a head on it.

“Come in,” I said. As she started into the room I reached for the desk lamp.

“No,” she drawls in a Mae West voice, “I prefer the dark side.”

As she walked closer to me I could see her face, lit by the flashing neon light shining through the window. She had long brown hair that hung to her shoulders. Her green eyes sparkled from the flashing light. Her full lips were covered with ruby red lipstick, smiling a smile that hit me smack in the libido. She must have greased up real good to fit into that dress.

“Are you the one they call, ‘the Doc’?” she purred, interrupting my inventory of her.

“Yeah,” I replied. I felt like that wolf in those Tex Avery cartoons, with my tongue hanging to the floor and my eyes popped out of my head a foot. “Have a seat,” I managed to say.

“No thank you, I prefer to stand. My name is Linda. But you can call me Mrs. Robinson. Tell me Doc, just what do you want most out of life?” she asked.

I was in luck. Philosophy was my long suite. “A thousand a day, plus expenses,” I told her.

Without batting an eye, she reached into her big black purse and pulled out a big wedge of smackers. She then threw it on the desk in front of me. “Ten days, in advance,” she said.

Well, here’s to you, Mrs. Robinson. I just love it when women talk dirty. And this broad spoke my language.

“So, what’s the case?” I asked.

“You are,” she said.

“Case solved,” I replied. “That’ll only cost you five thousand bucks.”

“No,” she said, “you don’t understand. My clients are a little concerned about your Chinese friend. They want you to call her off.”

I only had one Chinese-sounding friend. A little lady called Qui Tam. And I wasn’t about to sell her down the Suwannee, even for the Abe Lincoln picture collection that was lying on my desk right now.

“So just who are your clients?” I asked. I was getting wary of this dame. She was the kind who lied just to keep in practice.

“Is that any of your business?” she replied sweetly, her smile playing a rumba on my nether regions.

”I could make it my business,” I replied.

”I could make your business mine” she countered.

”Oh, you wouldn’t like it,” I told her. “The pay’s too small.”

Sure, the dame was sharp, but not sharp enough to cut the baloney. I knew I could end up making small talk all evening if I wasn’t careful. Talking to her was like trying to open a sardine can after you’d broke off the metal lip.

“So what’s a smart dame like you doing working for a bunch of crooks like the Big P?” I asked, hoping to make some headway.

She smiled. It hit me in the hip pocket. “It’s a long story and it’s not pretty,” she replied.

”I got lots of time and I’m not squeamish,” I shrugged.

Mrs Robinson sighed. My heart played hoopla in my chest. “Why do you bother with Qui Tam?” she pleaded. You know she’s no good for you.” She gestured to the greenbacks on my desk. “Why not take the money and give up on her? Why do you have to go on?”

It was a good question, and one that I’d often asked on those long lonely nights when sleep itself seems like a dream too good to be true.

“Because too many people have told me to stop,” I replied. “Trouble is, I’m a romantic at heart, see? I hear voices crying in the night and I go to see what’s the matter. I know I don’t make a dime that way. There’s no percentage in it at all. But it’s just something I do.”

It was all beginning to make sense, in a screwy sort of a way. I get dragged in and get money shoved at me. I get pushed out and get money shoved at me. Everybody pushes me in, everybody pushes me out. Nobody wants me to DO anything. Okay, put a check in the mail. I cost a lot not to do anything. I get restless. Throw in a trip to Mexico.

“I hadn’t supposed there were enough whistleblowers these days to make litigation consultancy very attractive to a man like you.” she sneered.

”I stir up trouble on the side.”

“You know, I think you’re nuts. You go barging around without a very clear idea of what you’re doing. Everybody bats you down, smacks you over the head, fills you full of stuff and you keep right on hitting between tackle and end. I don’t think you even know which SIDE you’re on.”

”I don’t know which side anybody’s on. I don’t even know who’s playing today. I had more careers than you’ve had lovers, sweetheart, and they’ve gone just the same way. Don’t try and ask me why.”

“I’m afraid I don’t like your manners.”

“Yeah, I’ve had complaints about them, but they keep getting worse. I grieve over them on long winter evenings.”

Mrs. Robinson finally turned off the megawatt smile. My libido breathed easy.

“I think we’re done talking, Doc,” she said. “I’m at the Courtyard Marriot, Basking Ridge, New Jersey, room 108. Let me know if you change your mind.”

She turned and walked out of the office. “I’ll be waiting,” she purred.

I couldn’t keep my eyes off her swaying hips as she walked towards the stairway and disappeared down the steps. The smell of her perfume lingered on after she left. I could hear the radio again now that she was gone, although it was playing the whole time she was here, Eddie Fisher was singing “I’m Walking Behind You,” and in my mind I was walking behind Mrs. Robinson.

I got up and looked out the window just in time to see her getting into a big red Caddy. Holding the door for her was the biggest guy in the world, at least 6′6″ and 400 pounds. As she was getting into the car, she glanced up at me with a look that could melt your heart.

“Tiny” also looked up at me. His stare could have melted iron. As they drove away, I couldn’t get her out of my head.

But I couldn’t give up on Qui Tam. She was all I had lived for these past two years. I had put in too much to get out. It was a matter of pride. But pride doesn’t pay the rent. I walked over to the coach and laid down. I tried to get some shut-eye but all I could do was think of Mrs. Robinson. And her client’s money.

[via Peter Rost MD blog]

Read more Pharma Giles here.

In the news this week is this story about a company called qforma that creates lists of influential doctors that they of course sell to people who want to use the information for, well, whatever. In the online comments response to the story a lot of doctors flipped out and started making comments about how those weren’t the docs that they would recommend, etc. etc. Those docs totally miss the point that drug companies don’t care who the *actual* best docs are, they just want to know who are the docs are that will help them sell their drugs the most. And those are a mixture of researchers, schmoozers, and a combination thereof.

As I have written about before, sociologists know that there is a group of innovators, early adaptors, and then the “herd” that follows along (see “Diffusion of Innovations in Service Organizations” or “Disseminating Innovations in Healthcare“). It is true for farmers in Costa Rica adopting a new type of grain seed, or for psychiatrists prescribing a new brand of antipsychotic.

Although a new and superior kind of seed was introduced in 1925 it took another 10 years for all farmers to adopt it.

Doctors don’t “read” the literature and then go out there and make a decision about what they should do. They look to their “mentors” or the early innovators, in this case their professors from medical school, or their surrogates.

Human behavior dictates that a few early adopters are looked to for guidance by most

Most look to the early adopters defined as ”experts” in the medical field, who are often branded as such at national professional meetings with the support of the pharmaceutical industry, who have coined the term “key opinion leader” or KOL. They, unfortunately, are often heavily subsidized by the pharmaceutical industry.

Qform is a business, and they are not developing a list of KOLs in every city and speciality for their own amusement, or to help people find doctors. They are doing it because they can make money by selling the lists to others who can make money by identifying the KOLs. They are selling influence. To see another particularly egregious example, take a look at the company called kolonline, where they openly boast on the internet about their ability to “manage” your kol for you (their words, not mine). I couldn’t believe it either when I first saw this.

So I guess that would make kolonline... what?

From their website:

As our name implies, we are a company devoted to providing Key Opinion Leader software and Key Opinion Leader Management services for pharmaceutical, biotechnology and device companies. We have invented two (2) world-class proprietary web-based applications for managing and developing relationships with KOLs (some have described them as ‘knowledge management systems’). More importantly, because we have actual real-world experience from working in the Pharma industry we provide unparalleled service and consulting. We have held positions in medical/scientific affairs, medical science liaisons, medical education, drug information, sales training, strategic marketing, product management and field sales.

The principals in KOL, L.L.C. have deep experience in cardiology, anti-infective, pain management, diabetes, gastroenterology, urology, women’s health and central nervous system products. As such, we have developed personal relationships with many KOLs.

We are “The Key to Opinion Leader Development™”.

Sidebar reads:

We have developed a “validation tool” which provides a systematic, unbiased ranking of all the KOLs in OLms or ISCP.

We can manage your key opinion leaders (KOLs) for you

And let’s not forget their handy software, the Opinion Leader Management Service (OLms), a “web-based application with accompanying on-going services designed to help pharmaceutical and biotechnology companies:”

• Manage and develop KOLs
• Demonstrate value to their organization (ROI)
• Showcase MSL activities
• Build and Monitor KOL Development Plans, Goals and Activities

OLms provides:

• Convenient, secure, confidential, web-based access (24/7/365) to information about your KOLs, including their contact information, publications, presentations, trials, society memberships, etc (the KOL ‘Knowledge Capital’) and links their activities to your core scientific concepts
• KOL identification
• KOL validation – provides an unbiased ranking of KOLs based on predetermined criteria to ensure consistency and avoid favoritism
• Effective communication system – users can enter notes and insights
• Thousands of reports – KOL contact info, KOL Development Plan goals and activities, compliance (consulting/confidentiality agreements), MSL monthly reports, etc
• Service – we build the records of each KOL and continually update them
• Cost-effective KOL management – our pricing is reasonable and OLms is designed to demonstrate a return on your investment (ROI)

How about their demo?

As you can appreciate, for confidentiality reasons, we can not take you to any of our client sites; however we do have two (2) demonstration sites with generic, non-confidential information which will provide you an overview of the kind of information and service we provide. Because these demo sites are web-based, you and your colleagues can view from your office while we are in ours. Then, if we appear to be the “right wrench for the job”, we are happy to come to your office for a formal presentation. A demo normally takes about 30 minutes on line.

Do you think this wrench will work?

Leaders of the American Medical Industrial complex wrote a letter to the Obama administration recently promising to bring down the costs of healthcare. You can read about it in this fluff piece in the New York Times where they claim that they will lower costs by 1.5% per year or two trillion dollars over ten years (in a two trillion dollar per year industry) which will offset the cost of implementing universal healthcare insurance, a goal of the Obama administraiton.

I don’t know about you but to me this is like asking a wolf to eat less red meat! Let’s see, who were on the list of worthies? The American Medical Association (AMA), the Pharmaceutical Research and Manufacturing Association (PhaRMA), the Health Insurance Association of American, and the American Hospital Association, my favorite Gang of Four of evil ones that make up the American Medical Industrial complex and that conspire to wring profits from the American public, giving us health care that costs twice as much as any country on the planet, with second to last healthcare outcomes, and 40 million working people without health insurance. Other signers were the Advanced Medical Technology Association and the Service Employees International Union.

Gang of Four of American Medical Industrial Complex: Clockwise from Upper Left: AMA, HIAA, PhRMA, AHA

So I guess this is the latest chapter in the melodrama (or is it TV Western?) of Obama administration reforms broken American healthcare system (see “Obama Healthcare Plans Unlikely to Get Much Traction“).

I guess I have to paste on something one of my e-friends said to the effect of if you can’t defeat someone directly, adopt them and distort their message.

The letter states that healthcare savings will be achieved by efforts to prevent obesity; coordinate care, manage chronic illnesses and curtail unnecessary tests and procedures; by standardizing insurance claim forms; and by increasing the use of information technology, like electronic medical records.

LOL!

Can you say “tell them what they want to hear?”

Obama administration pushes back against bloated American healthcare system.

Well Rick Lippin MD warned us of Sen Max Baucus (D-Montana, remember the guy missing some fingers?) being a Trojan House leader of healthcare reform for the Democrats and now he is letting the Gang of Four in the door, since they are the only ones allowed to the table to discuss healthcare reform. Even though the majority of Americans are in favor of a single party system noone representing this idea is allowed to the table. Well you can show your anger by attending a Single Payer Rally at noon at the US Senate this Wednesday May 13, 2009, Upper Senate Park (Union Metro Station) or if you aren’t an unemployed person in Washington or don’t have your own lear jet and flexible schedule, you can take action here or call/write your congressman and senator.

Hat tip to Mrs. Bremner.

People have told me that I should go on Oprah because of my book about medications. But I am glad I never did (not that I got the offer anyway) after learning about how Dr. Mehmet Oz, described as America’s Doctor, who makes frequent appearances on the Oprah Show and who authored several books in the popular series of You: The Owner’s Manual which he co-authors with Michael Roizen, MD, is a paid consultant for a website called RealAge that asks you a series of questions to find out your biological or “real” age. The web site has registered 27 million people.

I'm not really that old, am I?

Turns out this web site collects demographic information and sells its services to drug companies, who then use it to target specific groups to sell prescription medications to. For instance, if it turned out that you were at risk for pre-hypertension, they would send you emails with “information”, and then when you were “softened up” hit you up with a pitch about how you should take a medication for hypertension. Which all means, of course, that Dr. Oz gets automatic admission to the Drug News and Health Safety Blog team of MD Cheerleaders for Pharma!

Gimme a D! Go Dr. Oz!

I was actually on their radio show right after my book came out, interviewed by Dr. Michael Roizen, but that is as close as I ever got to the bright lights. It is actually kind of weird how much the media shies away from the issue of prescription medication safety, unless they have the feeling that “everyone else is going after the story.”

The newspaper article on the topic quoted a woman who appropriately stated that she didn’t appreciate having her personal information used for drug marketing. But then the article (I guess to have “balance”?) bizarrely quoted a former pharmaceutical saleswoman who stated that it is important to have all the information you can get so you can make informed decisions for yourself.

“Information”? Give me a break. And my comment on Dr. Oz’s behavior is go back and read your Hippocratic Oath, which sez above all do no harm. And sending blanket emails with scary messages to induce people to take prescription medications which could hurt them and that they may not need is a violation of that oath.

Hat tip to therapy patient.

President Barack Obama’s administration is rolling back into universal healthcare land just like Hillary Clinton tried to way back when. We’ll see if he can survive the shark infested waters any better than she did.

Come on in, the water's fine.

In case you are Rip Van Winkle or someone dropped you on your head so you don’t remember, back in 1993 Hillary Clinton got torn to shreds by insurance lobbiests and other special interest groups. Remember the Harry and Louise ads funded by the Health Insurance Association of American (HIAA), where they sit around fretting about how to pay for their mandatory healthcare insurance?

Now the health insurance guys are whining again. They say they don’t want a “Medicare for all” plan cuz it will drive them all out of business. Or if there is an expanded healthcare they don’t want the government to have the chance to negotiate contracts with doctors and hospitals (unlike them). Oh, and if the government can negotiate with doctors and hospitals they will go out of business too. But isn’t that anti-capitalist to be against negotiating prices? What they might as well say is that they are bloated and inefficient and couldn’t compete with any alternative system. I call the organizations that represent hospitals, insurance, doctors and drug companies the evil Gang of Four.

Clockwise from upper left, AMA, HIAA, PhRMA, AHA

Did you know that Ronald Reagan made promotional videos for the American Medical Association (AMA) that they showed to their members way back in the day, about how they should fight against Medicare, because it was socialized medicine? The AMA really has a disgraceful history and I am glad that their flagship journal, JAMA, is running into rocky shores. The insurance guys and their pals the hospital lobby (American Hospital Association, AHA), the AMA, and pharma (Pharmaceutical Research and Manufacturer’s Association (PhRMA) are gonna do what they can to confuse and confound. But in the meantime, they have offered to not charge people more for insurance who have pre-existing medical conditions, if everyone is required to buy insurance. This looks like a crumb they are throwing out to try and avoid any new government insurance program or expansion of Medicare.

Here is a handy little chart comparing the pros and cons produced by the New York Times.

Hmmm, do we want more government control, or less of it? More government control, or less? Hmmm.
Maybe we should set up an office pool to see how long “healthcare reform” lasts this time around.

He always kind of reminded me of a cat, anyway.

But this just in, the always mischievous Senator Charles Grassley (kind of like out lolcats!) has written a letter to President Barack Obama that says:

One thing I’ve asked every president since Ronald Reagan to do is to hold a Rose Garden ceremony honoring whistleblowers. No one has done so yet, but I hope that you will based on your strong statements about accountability in government. I’m writing this letter to urge you to do so.

Can the Lolcats come? If so, we’re in!

WE CUM TO ROZ GARDEN NAIM THE DAE!

It seems that pharma’s friends within the FDA are not quite ready to jump into the rose garden celebration. This recent memo just went around reminding FDAers about “trade secrets”, in other words not spilling the beans on pharma. I’ve heard that one before. It applies to pretty much everyone from wining and dining to gifting payoffs and other unlovlies. In fact in spite of the much vaunted laws requiring disclosure of payments to physicians in Vermont and a few other states, over half of the payments are not disclosed under the guise of “trade secret”, but they are not required to provide any proof of that, in other words it is a bunch of bs.

Hat tip to Nancy Fruge.