Disclosing Drug Payments

The ACA was derided in part because of its length and complexity.  Funny thing is, the more we see of the health care reform the better it looks.  Here is one small measure packed into it that means a lot:  mandatory disclosure of payments to doctors from drug companies regardless of how it is accounted for.  Sales, research, kickbacks, whatever.  All of it will be subject to public review, so you can judge for yourself how closely your doctor's interests coincide with your own (at least when it comes to prescription drugs).  That might not seem like a lot until you realize you can't do that now, efforts of ProPublica not withstanding.

One of many ways the ACA reforms healthcare in America.

Doctors as Angels?

I have a lot of respect for Paul Krugman’s writing, but he’s off in lionizing doctors:

The idea that all this can be reduced to money — that doctors are just people selling services to consumers of health care — is, well, sickening. And the prevalence of this kind of language is a sign that something has gone very wrong not just with this discussion, but with our society’s values.

In reality, doctors are people.  They are subject to the same frailties, vanities, and flaws that every human being suffers from.  And at least some people know this and are using it to their advantage:

Novartis persuaded doctors to promote Trileptal, and five other of its blockbuster drugs, for off-label uses through millions in “kickbacks” disguised as speaker fees at continuing medical education programs. The company implemented an aggressive recruitment effort in order to train up to 4,000 physicians to speak at these events. Furthermore, the speakers were not recruited based on professional credentials but rather targeted those based on prescription-writing volume potential. According to whistleblower Jeremy Garrity, “As long as they had a prescription pad and were willing to prescribe our products, they qualified as Novartis speakers.” Once speakers were accepted on the speaker circuit, minimum prescription levels were required by some Novartis managers. According to Garrity, he was required to tell underperformers that they would be removed unless they raised prescriptions to a certain level. The company conducted return-on-investment analysis of its kickback scheme.

Note that physicians faced no consequences for their participation, only the drug company.  Is there any other profession that can take bribes in return for robbing the public on a massive scale, get caught and unambiguously exposed, and then walk away without any legal liability?  That’s what you get for pretending doctors are angels.

…

On second thought, Wall Street is an obvious example.  I guess doctors can be added to the upper class of Greenwald’s two tiers of justice.