Sunday, March 16, 2008

Time To Stop Small-Time Legal Bribery Of Doctors

By Manifesto Joe

For years, it hasn't been such an uncommon sight to keep a doctor appointment in the early afternoon and see leftover pizza, or Chinese takeout, or such, around the joint. Then, a pharmaceutical salesperson emerges from the back, a walking drugstore with a big valise, after making a "sale." This person has apparently treated everybody in the clinic to lunch. (And then, written it off on the taxes as a business expense.) There are free drug samples galore, and lots of Cialis pens and coffee mugs; but it's understood that prescriptions will be written along with distribution of those samples.

I've witnessed this firsthand, and so has my wife. It's under $100 worth of perks, so it's currently accepted practice (pardon my choice of words). Not every doctor accepts these small perks, but they are legal. And, this kind of unethical coziness between the medical profession and drug companies is one facet, among many, of the U.S. health-care debacle.

The Senate has a bill, the Physician Payment Sunshine Act (S. 2029), currently in the Finance Committee. It would, according to The Associated Press: "...create a database disclosing the names and addresses of doctors who receive gifts or payments. It would also include pharmaceutical company names and the value of the gift or payment."

More specific information is on The bill would:

... amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP.

Sadly, this bill has been mired in committee since September, despite support from medical ethics groups. AP reported, tersely: "Drug companies oppose the act."

What are the "pro" arguments? I'll quote more from the AP story, which was not merely about doctors accepting perks. It was about doctors acting as actual shills, giving testimonials to peers for new drugs, under corporate sponsorship for damned good pay:

Pharmaceutical companies argue that doctors are an essential part of educating colleagues as new drugs are developed. ...

To summarize, their argument is: How can doctors know about new medicines, their potential side effects, their proper use, and so forth, unless they hear it from experienced peers? But, to have the symposiums sponsored by the drug companies, who are paying the doctors who are giving testimonials, seems like a pretty big ethical conflict of interest.

More from AP: PhRMA (the drug industry's lobbying arm) adopted voluntary rules in 2002 that limit the value of gifts to $100 or less and says that all forms of free entertainment, including sporting events, are inappropriate.

All very nice, but I'm offended by even seeing these reps feeding my doctor and his staff fully loaded pizza, beef broccoli and moo goo gai pan, and a lot of sales bullshit. The bill that's bogged down in the Senate committee isn't nearly strong enough. This is legal bribery, even if it's on a small scale. And I realize that any action won't have more than a tiny effect on the American health-care morass.

But on principle alone, it should be banned. And, any effect it has might work toward curbing what is clearly the chronic overmedication of the American people.

Manifesto Joe Is An Underground Writer Living In Texas.


Anonymous said...

Good work Joe! Health care reform is indeed much larger than ensuring that all Americans have coverage. And reform is not only needed in Healthcare but virtually every way that we do business. Mortage underwriters are continually given gifts by the investors who buy their loans, Legislators are given gifts by those who write adventagous laws to their cause, and on and on. And you mentioned a huge problem with all of this...Those gifts are written off as business expense which ultimately means that we tax payers are funding these gifts which are often to the detriment of us in the long run.

Marc McDonald said...

If we think the Dems are going to sweep into power and fix the health care mess in 2008, we ought to be careful what we wish for.

(First of all, I don't believe that it's a lock that the Dems will gain power---they're notorious for fumbling the ball in elections).

Second of all, any Dem president who is aiming to bring us universal health care is going to be facing the world's most wealthy, powerful and entrenched lobbying class.

The latter will ferociously resist any change whatsoever that threatens their profits. (These people know how the game works in Washington---and they always get their way, no matter who is in charge).

The Dem president will indeed be going into the lion's den, trying to "negotiate" with the health care lobby.

I fear that what will emerge from all this is something similar to Bush's Medicare prescription benefit: a bizarre plan written by lobbyists that is so complex that no one besides corporate lawyers can figure out how it works.

And buried in the thousands of pages of complex legal jargon, there will be loads of corporate welfare for the health care industry (just as there is with Medicare Part D). Part D, by the way, includes such gifts to the health care lobby as forbidding the federal government from negotiating for lower drug prices. This has created a gigantic windfall for the prescription drug companies.

And you can bet that the health care lobby is already furiously working on how they can lard any forthcoming health care plan with hundreds of billions in dollars in corporate welfare.