The influence of money has wormed its way into all aspects of the American medical system- research, practice, access, the guidelines and advice patients are given about their health, and even how diagnostic criteria are determined. This money represents the domination of a few pharmaceutical companies that have twisted and tweaked the entire system to serve their profit motive. The effects of what is called regulatory and institutional capture by economists has had a devastating effect on the health of Americans. It has also led to an unprecedented amount of wealth consolidation at record speed.
In Minnesota, the Mayo Clinic Sometimes Called the Shots With Gov. Tim Walz
Tim Walz has a very close relationship with The Mayo Clinic, to the point that he has allowed them to re-write legislation that was passed by the Minnesota legislature. The Mayo Clinic has costs that are 88% higher than average in Minnesota adjusted for medical complexity of patients. Mayo has consistently fought and eliminated efforts to reduce the cost of health care, often emphasizing internal strategies instead such as AI programs to handle staffing. They were instrumental in killing any "public option" or single payer healthcare including regarding the ACA under Obama.
Industry's Influence in Medicine: Duped, Doped and Dying in America
Gwen Olsen, a former pharmaceutical drug rep, tells about her
experiences seeing pharma companies from the inside. She says that the
system is predatory and was intentionally set up to control us by doping
us up and dumbing us down for profit.
It finally happened: Goldman Sachs asks 'Is curing patients a sustainable business model?
Mother’s death sparks concern about hospital investment
Private equity firms have bought hospitals and extract all the wealth they can from them, leaving them unable to properly care for patients, which can be deadly.
The prices hospitals don't want you to see (NYT)
How Profiteering and Corruption Harm Patients
A Place to Die’: For-Profit Health Care Crisis EXPOSED
Latest huge Big Pharma fraud settlement + shocking history of injury and death cover-ups
Drug Shortages Forcing Hard Decisions on Rationing Treatments
"In recent years, shortages of all sorts of drugs — anesthetics,
painkillers,antibiotics, cancer treatments — have become the new normal
in American medicine. The American Society of Health-System Pharmacists
currently lists inadequate supplies of more than 150 drugs and
therapeutics, for reasons ranging from manufacturing problems to federal
safety crackdowns to drug makers abandoning low-profit products. But
while such shortages have periodically drawn attention, the
rationing that results from them has been largely hidden from patients and the public."
Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds
"Illness and medical bills caused half of the 1,458,000 personal
bankruptcies in 2001, according to a study published by the journal
Health Affairs. The study estimates that medical bankruptcies affect
about 2 million Americans annually -- counting debtors and their
dependents, including about 700,000 children. Surprisingly, most of
those bankrupted by illness had health insurance. More than
three-quarters were insured at the start of the bankrupting illness.
However, 38 percent had lost coverage at least temporarily by the time
they filed for bankruptcy."
The High Cost of Drugs and Treatment and Paying Doctors to Prescribe Drugs
Transparency in medicine Dr Wen
Leana Wen: What your doctor won’t disclose
TED
talk by a doctor about issues of trust in the doctor-patient
relationship, doctors resisting transparency about themselves and how
they practice (including disclosing payments and perks from
pharmaceutical companies).
Docs on Pharma Payroll Have Blemished Records, Limited Credentials
"The implications are great for patients, who in the past have been
exposed to such heavily marketed drugs as the painkiller Bextra and the
diabetes drug Avandia — billion-dollar blockbusters until dangerous side
effects emerged."
"A review of physician licensing records in the 15 most-populous states
and three others found sanctions against more than 250 speakers,
including some of the highest paid. Their misconduct included
inappropriately prescribing drugs, providing poor care or having sex
with patients. Some of the doctors had even lost their licenses. More than 40 have received FDA warnings for research misconduct, lost
hospital privileges or been convicted of crimes. And at least 20 more
have had two or more malpractice judgments or settlements. This
accounting is by no means complete; many state regulators don’t post
these actions on their web sites. Forty five who earned in excess of $100,000 did not have board
certification in any specialty, suggesting they had not completed
advanced training and passed a comprehensive exam. Some of those doctors
and others also lacked published research, academic appointments or
leadership roles in professional societies."
Lawsuits Say Pharma Illegally Paid Doctors to Push Their Drugs
"Pharma companies are being accused in lawsuits of paying doctors to push
off-label uses of their drugs or financially rewarding doctors for
prescribing their brand-name medications. In the past three years alone, pharmaceutical companies have anteed up nearly $7 billion for settlements in cases such as one filed by Angela Maher, a former drug sales rep for Ortho-McNeil Pharmaceutical."
Despite improved transparency, conflicts of interest remain issue in medicine
“These conflicts undermine the reliability and credibility of the
guidelines,” Nissen told Cardiology Today. “I don’t think that
disclosure is the antidote here. The antidote is for physicians who are
involved in public policy discussions not to accept money for promoting
drugs.”
60 Minutes Episode Pharma execs used strip clubs, broke FDA laws to boost opioid sales
Forty-three percent of pediatricians receive industry payments "A significant proportion of pediatricians received payments from industry sources, such as pharmaceutical and device manufacturers, with the greatest amount of payments associated with attention-deficit/hyperactivity disorder treatments and vaccines, according to recent research in Pediatrics."
Insulin should be cheap. Here’s why it's not
High Insulin Prices Drive Diabetics to Take Extreme Measures
Diabetics Are Hacking Their Own Insulin Pumps
Lawmakers grill Mylan CEO over EpiPen price hikes
"Jason Chaffetz (R-Utah), chairman of the House Committee on Oversight
and Government Reform, held up an EpiPen to punctuate his point that
epinephrine — “the juice” inside Mylan’s device — costs about $1 a dose.
The list price of a two-pack of the pens is $608, up about 500 percent
in a decade."
"You virtually have a monopoly, and you've used it
to your advantage - but unfortunately, it's at the expense of people
who need it," said Rep. Gerald E. Connolly (D-Va.). "I'm wondering what
your sense of social responsibility is to those people."
FDA approves first generic version of EpiPen
The article discusses how the new generic version will help ease the
chronic shortage of EpiPens that worsens near the end of the summer as
kids need new prescriptions for school and other activities. It also
talks about how Mylan, the brand name version, actively fought the
approval of the new generic
version out of self interest.
Heather Bresch, the CEO of Mylan, testifies in front of congress about price gauging the epi pen
Damning NEW Email Puts Joe Manchin’s Daughter At Center Of EpiPen Price-Fixing Scheme
Drug executives to testify before Congress about their role in U.S. opioid crisis
"Current and former executives with the pharmaceutical distributors that
are accused of flooding communities with powerful prescription
painkillers have been summoned to testify before Congress about their
role in the U.S. opioid epidemic."
"Since 2000, the epidemic has
killed 200,000 people — more than three times the number of U.S.
military deaths in the Vietnam War."
A Giant Pain in the Wallet
How an effort by the FDA to evaluate drugs that have been on the market
since before testing was required has allowed pharmaceutical companies
to price-gauge patients.
Pharmaceutical advertisements in leading medical journals: experts' assessments.
"In the opinion of the reviewers, many advertisements contained
deficiencies in areas in which the FDA has established explicit
standards of quality. New strategies are needed to ensure that
advertisements comply with standards intended to promote proper use of
the products and to protect the consumer."
Accuracy of pharmaceutical advertisements in medical journals.
"Doctors should be cautious in assessment of advertisements that claim a
drug has greater efficacy, safety, or convenience, even though these
claims are accompanied by bibliographical references to
randomized clinical trials published in reputable medical journals and
seem to be evidence-based."
What if all US health care costs were transparent? | Jeanne Pinder
How drug companies make you buy more medicine than you need
This video talks about how pharmaceutical drugs are packaged and sold in
ways that deliberately lead to waste, which creates costs that are then
borne by the consumer. For some drugs such as chemotherapy drugs these
costs can be very high. This issue is not something that the FDA
regulates.
This article by ProPublica goes into more detail about this topic.
Frequency and Magnitude of Co-payments Exceeding Prescription Drug Costs
"A co-payment suggests sharing the total cost between patients and
payers. However, drug co-payments sometimes exceed costs, with the
insurer or pharmacy benefit manager (PBM) keeping the difference.
Furthermore, some pharmacists are contractually prevented from alerting
patients when their co-payment exceeds the drug’s cash price. Although
some have argued that the practice is uncommon, a 2016 survey of
independent pharmacists indicates otherwise."
The case of the $629 Band-Aid — and what it reveals about American health care
We have all experienced the bizarrely high prices charged for many
medical services and devices, and I think we can all relate to the
parent who wrote this article about the absurdity of medical pricing.
Pharma Influence over Practice and Patient Care
Leana Wen: What your doctor won’t disclose
TED
talk by a doctor about issues of trust in the doctor-patient
relationship, doctors resisting transparency about themselves and how
they practice (including disclosing payments and perks from
pharmaceutical companies).
Conflicts of interest pervade US treatment guidelines, reports say
"Financial conflicts of interest are widespread among the authors of US
clinical practice guidelines, according to two research letters and an
editor’s note that were published in JAMA Internal Medicine. Such
conflicts are “an intractable problem in the United States,” write
Robert Steinbrook, editor at large of JAMA Internal Medicine, and
Colette DeJong of the University of San Francisco."
US Physician Societies are completely Corrupted
Dollars for Docs- How Industry Dollars Reached Your Doctors
We Found Over 700 Doctors Who Were Paid More Than a Million Dollars by Drug and Medical Device Companies
"Each year from 2014 to 2018, drug and medical device companies spent
between $2.1 billion and $2.2 billion paying doctors for speaking and
consulting, as well as on meals, travel and gifts for them."
Docs on Pharma Payroll Have Blemished Records, Limited Credentials
Now There’s Proof: Docs Who Get Company Cash Tend to Prescribe More Brand-Name Meds
"A ProPublica analysis has found for the first time that doctors who
receive payments from the medical industry do indeed tend to prescribe
drugs differently than their colleagues who don’t. And the more money
they receive, on average, the more brand-name medications they
prescribe."
"doctors who received industry payments were two to three times as likely
to prescribe brand-name drugs at exceptionally high rates as others in
their specialty."
"nearly nine in 10 cardiologists who wrote at least 1,000 prescriptions
for Medicare patients received payments from a drug or device company in
2014, while seven in 10 internists and family practitioners did."
Matching Industry Payments to Medicare Prescribing Patterns: An Analysis
(this is mentioned in the above article)
Private equity ownership is killing people at nursing homes
"The researchers studied patients who stayed at a skilled
nursing facility after an acute episode at a hospital, looking at deaths
that fell within the 90-day period after they left the nursing home.
They found that going to a private equity-owned nursing home increased
mortality for patients by 10 percent against the overall average. Or to put it another way: “This estimate implies about
20,150 Medicare lives lost due to [private equity] ownership of nursing
homes during our sample period” of 12 years, the authors — Atul Gupta,
Sabrina Howell, Constantine Yannelis, and Abhinav Gupta — wrote. That’s
more than 1,000 deaths every year, on average."
This is the working paper behind this article:
DOES PRIVATE EQUITY INVESTMENT IN HEALTHCARE BENEFIT PATIENTS? EVIDENCE FROM NURSING HOMES
Payments, Conflict of Interest, and Trustworthy Otolaryngology Clinical Practice Guidelines
"Clinical practice guidelines (CPGs) are the cornerstone of the
evidence-based practice of otolaryngology–head and neck surgery. The
American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) CPGs
are widely distributed, as judged by frequency of downloads, webpage
views, and CPG-related sessions at national meetings. Clinical practice
guidelines are developed to reduce variation in care and to improve
quality. They create debate and even controversy, with concerns
expressed about restraints on clinician decision making as well as the
medicolegal implications of recommendations. Clinical practice
guidelines must be trustworthy, and the Institute of Medicine (IOM) and
the Guideline International Network have provided standards for CPGs.1
A major threat to the creation of trustworthy guidelines is conflict of
interest (COI) among the organizations and the committee members who
create CPGs.
Influence Over Regulation and Policy
Why HEALTHCARE works the way it does: Look at these SHOCKING lobbying numbers
Third member of prestigious FDA panel resigns over approval of Biogen’s Alzheimer’s drug
"A third member of a key Food and Drug Administration advisory panel has
resigned over the agency’s controversial decision to approve Biogen’s
new Alzheimer’s drug, Aduhelm, CNBC has learned."
Secret
Clinical Trial Data to Go Public: Drug companies have begun to share
their clinical trial data. The long-overdue shift heralds a new era in
medicine (from Scientific American)
"How well does a prescription drug work? It can be hard for even doctors
to know. Pharmaceutical companies frequently withhold the results of
negative or inconclusive trials. Without a full accounting, a physician
who wants to counsel a patient about whether a drug works better than a
sugar pill is frequently at a loss. Drug companies share only airbrushed
versions of data on safety and usefulness.
As a consequence,
regulators can approve drugs that have hidden health hazards. Clinical
trials of GlaxoSmithKline's diabetes drug Avandia (rosiglitazone) and
Merck's anti-inflammatory Vioxx (rofecoxib) revealed an elevated cardiac
risk from the drugs, but relevant findings were held back from
regulators or never published.* Far more drugs have gone to market with
critical safety data kept secret. These scandals have tarnished the
reputation of the pharmaceutical industry."
Bill Gates Almost Single-Handedly Derailed the Plan That Could Have Led to a 'People's Vaccine'
"But the inspiring plan devised by the scientists—which promised to
create a vaccine essentially belonging to the world's people, not to
corporate shareholders—was crushed fairly decisively when Bill Gates
ventured into the fray."
Money in Medical Research
The Corruption of Evidence Based Medicine — Killing for Profit
"This has huge implications. Evidence based medicine is completely
worthless if the evidence base is false or corrupted. It’s like building
a wooden house knowing the wood is termite infested. What caused this
sorry state of affairs? Well, Dr. Relman another former editor in chief of the NEJM said this in 2002 “The
medical profession is being bought by the pharmaceutical industry, not
only in terms of the practice of medicine, but also in terms of teaching
and research. The academic institutions of this country are allowing
themselves to be the paid agents of the pharmaceutical industry. I think
it’s disgraceful”
The people in charge of the system — the editors of the most important
medical journals in the world, gradually learn over a few decades that
their life’s work is being slowly and steadily corrupted. Physicians and
universities have allowed themselves to be bribed."
"The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it's disgraceful."
Undisclosed payments in research
Oncology trial authors don’t fully disclose financial conflicts of interests, analysis finds "A substantial proportion of US oncologists involved in clinical trials used to gain marketing authorization for cancer drugs do not fully disclose financial conflicts of interest when the trial is published, research in JAMA Oncology shows. The analysis, published as a research letter,1 found that a of third of oncologist authors failed to completely disclose payments from the drug company sponsor of the trial when the trial was published."
Leading US cancer researcher failed to disclose industry ties in dozens of articles
"One of America’s most prominent breast cancer doctors failed to
disclose pharmaceutical industry ties worth millions of dollars in
authoring dozens of articles in major journals, according to a report by
the New York Times and ProPublica. José Baselga, physician-in-chief at
Memorial Sloan Kettering Cancer Center in New York City, neglected to
mention multiple directorships and consultancy fees when completing
conflict of interest disclosure forms for leading publications including
the New England Journal of Medicine and the Lancet, the report
found. Baselga also left out his industry payments when writing for
Cancer Discovery, the journal of the American Association for Cancer
Research (AACR), even though he was the joint editor-in-chief and
president of the association."
Medicare Privatization Scheme Faced Legal Questions About Profiteering
"Diane Archer, founder of Just Care and a health policy expert, described a similar scenario in an email to The Intercept. “The way they make money is by spending as little as possible on patient care, while ensuring as best they can that they have all diagnoses possible for their enrollees in order to maximize government payments. The more diagnoses, the higher the government payments. Government payments are set upfront and unrelated to the cost or number of services people receive.
Extremely well done article about how insurance companies are avoiding coverage of mental health services, despite the ACA's requirement that they cover mental health services the same as they cover physical health services. They create what are called "ghost networks", meaning that they will list providers who they know are deceased, retired, or not in their network in order to give the appearance that they have adequate coverage for services when in fact they don't. They also keep reducing the amount that they reimburse providers, make it harder and harder for providers to get reimbursed, and challenge the legitimacy of provider's qualifications and treatments, all in an attempt to get providers to drop out of their network. When they do drop out, their names are kept in the listings, and the companies find ways to make consumers work hard and take a long time to establish that care isn't available.
Health Insurance Whistleblower: Medicare Advantage Is "Heist" by Private Firms to Defraud the Public
The Reason Health Care Is So Expensive: Insurance Companies
"But the thing that few people talk about, and that no serious policy
proposal attempts to fix—the arrangement that accounts for much of the
difference between health spending in the U.S. and other places—is the
enormous administrative overhead costs that come from lodging
health-care reimbursement in the hands of insurance companies that have
no incentive to perform their role efficiently as payment
intermediaries."
"Because insurers are paid a fixed percentage of
the claims they administer, they have no incentive to hold down costs.
Worse than that, they have no incentives to do their jobs with even a
modicum of competence."
CNN Exclusive: California launches investigation following stunning admission by Aetna medical director
"California's insurance commissioner has launched an investigation into
Aetna after learning a former medical director for the insurer admitted
under oath he never looked at patients' records when deciding whether to
approve or deny care."
Inside America’s ‘GoFundMe’ Health Crisis
Koch-backed study finds ‘Medicare for All’ would save U.S. trillions