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Novartis' Latest Ethical Misadventure: Did it Pay to Play ... with the US President?
DiscussionMost corrupt actions require two parties.  While it is understandable that there has been tremendous recent interest in evidence that the Trump regime is corrupt (lookhere), any such corruption had to have been enabled by unethical actions on the parts of others.  Those others likely included large numbers of leaders of large corporations, including health care corporations.  We have shown repeatedly that top leaders of US health care organizations have enjoyedimpunity that has allowed them to foster a host of unethical actions, includingcrimes such asbribery,fraud, andkickbacks, and truehealth car...
Source: Health Care Renewal - May 11, 2018 Category: Health Management Tags: bribery corporate integrity agreement crime Donald Trump fraud legal settlements Novartis Source Type: blogs

More Dander Rising: Ditto to Dr. Poses
Let me second the emotion now recently and repeatedly voiced by Dr. Poses in these pages. It's getting real hard to separate the health policy and malfeasance fecaliths from the general Washington Schei ßsturm raining down on us. We all feel pretty much buffeted non-stop, like(whomp!)badminton shuttlecocks in the corruption game the prevaricator-in-chief seems happily destined to carry on forever. Or at least until some better angels out there in America rise up to put an end to it. Because it's pretty obvious the party hacks clearly aren't going to. They're way too busy (padre you're fired! padre you'...
Source: Health Care Renewal - May 8, 2018 Category: Health Management Source Type: blogs

The Two-Fold Intimidation of Dr Bornstein, as Orchestrated by Donald Trump, Apparently to Conceal Something About Trump's Medical History
DiscussionAs noted above, we have seen many cases in which health care professionals were pressured to violate their core values and ethical norms by outside parties, most often large health care organizations seeking financial gain.Now, in this new case, we see a single health care professional twice pressured to violate core values and ethical norms by a patient, a wealthy billionaire corporate CEO who became President of the United States.  Thus we are now in a situation in which the President of the US, to whom all federal health care regulatory and law enforcement agencies at least nominally report, has shown con...
Source: Health Care Renewal - May 4, 2018 Category: Health Management Tags: core values Donald Trump fraud intimidation medical ethics medical record confidentiality Source Type: blogs

Don't Know Much About Health Care and Public Health, and Don't Care Much About Their Missions - but in Leadership Positions in US Government Health Agencies
Here we go again.  As we  We have frequently discussed how health care leadership is oftenill-informed ( look here).  More and more people leading non-profit, for-profit and government health care organizations have had no training or experience in actually caring for patients, or in biomedical, clinical or public health research.  Obviously health care and health policy decisions made by ill-informed people could have detrimental effects on patients'and the public's health.Through 2016, our examples of ill-informed leadership in health care tended to be executives of hospital systems (e..g.,in 2014,her...
Source: Health Care Renewal - April 27, 2018 Category: Health Management Tags: DHHS disinformation Donald Trump ill-informed management mission-hostile management propaganda Source Type: blogs

Through the Revolving Door, with a Few Stumbles - Health Care Corporate Executives and Consultants Continue to Become Leaders of Trump's Department of Health and Human Services
We continue to see a remarkable stream of people transiting therevolving door from high-level positions in health care corporations to high-level positions in health care policy or regulation for the Trump administration.  Lately, though, these transitions have not been without missteps. The most recent cases we have found, in the order of their public appearance, appear below.John Bardis, Who Went from MedAssets to Assistant Secretary of Health and Human Services for Administration, Resigned Under FireWe first discussed the appointment of Mr Bardis in May, 2017,here.  We noted then that most recently Mr Bar...
Source: Health Care Renewal - April 18, 2018 Category: Health Management Tags: conflicts of interest CVS Donald Trump finance health care corruption Pfizer revolving doors Source Type: blogs

Don't Know Much About Health Care and Public Health... but Appointed to Leadership Positions in US Government Health Care Agencies
Discussion Again, it stands to reason that people entrusted with running US government health care, public health and health policy should have some level of knowledge of biomedical science, health care, public health and/or health policy.  I dimly remember that before the Trump administration, many such leaders did have such background.  Not any more.This is only the latest examples of amazingly ill-informed people taking important responsibilities in government agencies having to do with health care, public health, and/or health policy.  Remember the brew-master with power over major policies in the V...
Source: Health Care Renewal - April 5, 2018 Category: Health Management Tags: DHHS Donald Trump ill-informed management narcotics Source Type: blogs

The Dander Riseth Ever Higher: Shulkin Case Emblematic of Dysfunction
This isnumero sesto if memory serves in a series of what gets one's dander up in this era of dysfunctional health care. Of course today it's all about the focal dysfunction mirroring the much broader problems of a dysfunctional government. I learned just now of the current VA Secretary's ouster while overseas in a country that does things in many ways much more effectively.Today we blog about this one issue only. It seems to perfectly encapsulate the Reality Show-cum-wrestling match that our Republican leadership has morphed into. Oh, wait, maybe it didn't morph. It was always that way, perhaps, and people are just no...
Source: Health Care Renewal - March 29, 2018 Category: Health Management Source Type: blogs

How Do We Counter Health Care Disinformation Under a Disinformer-in-Chief?
DiscussionAn international organization, Cambridge Analytica/ SCL based in the UK, led by Trump confidantes including his last campaign leader and former White House strategic adviser Steve Bannon, and major Republican donors and hedge fund magnates Robert and Rebekah Mercer, worked with the Trump 2016 campaign, particularly coordinating with digital coordinator Brad Parscale.  Cambridge Analytica/ SCL leveraged Facebook private data on millions of people, obtained from most without their specific permission, to create a " psyops " political disinformation campaign featuring emotional appeals to voters'inter...
Source: Health Care Renewal - March 28, 2018 Category: Health Management Tags: crime disinformation Donald Trump extortion propaganda stealth health policy advocacy stealth lobbying stealth marketing Source Type: blogs

And the Dander Keeps On Rising
This isn úmero cinco in our series of attempts to shed some of this dander. But it keeps on rising. Here are two recent reports both relating to the life-on-the-ground of North American rank and file physicians, especially as that life increasingly revolves around data entry and digital madness over and above everything else.Are physicians suffering from acute, maybe by now chronic, PTSD? In the 20 March 2018 number of the important Boston Globe-affiliated newsfeedSTAT, Elizabeth M étraux, a prolific staffer and author at the eminentorganization Primary Care Progress, gives us another quite useful take o...
Source: Health Care Renewal - March 22, 2018 Category: Health Management Tags: burnout core values EHR managerialism physicians Source Type: blogs

Mrs. Smith Goes to Washington
Newly-appointed Minnesota Senator Tina Smith is off to an energetic start, challenging the powers-that-be in Washington, starting with Big Pharma. She recentlywrote to the CEOs of five drug companies, noting thegigantic tax windfalls reaped by their companies after the fall passage of the tax cut bill, andenquiring whether any of that money might enable them to reduce the skyrocketing prices of prescription drugs.I am sure every one of the five CEOs privately gave a big horse laugh at the very thought. Each of them believes that their duty to the shareholders is precisely to exact themaximum possible amount from the p...
Source: Health Care Renewal - March 20, 2018 Category: Health Management Source Type: blogs

In " Trump Town, " the Revolving Door Runneth Over: Yet More Ex-Lobbyists as Political Appointees at the Department of Health and Human Services
DiscussionOn and on it goes.  The revolving door has been a chronic problem for the US federal government, but the level of revolving door activity in the current regime seems way beyond anything we have seen before.  It seems we chronical multiple instances of people going from important health care corporate positions to government positions that regulate or make policy affecting those same corporations for every instance of someone coming from the previous administrations to industry.So, as I have said before, e.g., in August, 2017,The revolving door is a species ofconflict of interest. Worse, some expert...
Source: Health Care Renewal - March 15, 2018 Category: Health Management Tags: DHHS Donald Trump health care corruption regulatory capture revolving doors Source Type: blogs

Quattro! More from the DOG Patch.
Some more offerings in our fourth effort in these pages to get rid of this damned dander. It's still up! Here in the DOG Patch, D is for Dander, and the dander, in spite of smatterings of good new lately, has still got itself up.Vive le Qu ébec!Nodbody's taking sides in Canadian separatism, if it's still brewing north of the border. But a certain sense of fairness surely prevails, and we have to give them a rousing " jolly good " (whoops) among Canadian physicians. At least in the one province.  As reported by theWaPo,a large group of doctors there have produced a petition (interesting to read&nb...
Source: Health Care Renewal - March 11, 2018 Category: Health Management Source Type: blogs

How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine
The ongoing epidemic ofnarcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies'aggressive promotion of these drugs which minimized their substantial risk.A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing.Background: Impunity of Top Leaders of Big Health Care OrganizationsFor years, we have railed against theimpunity of top leaders of health care organizations.  We have noted that despite numerous legal settlement...
Source: Health Care Renewal - March 6, 2018 Category: Health Management Tags: impunity legal settlements narcotics Purdue Pharma responsible corporate officer doctrine tobacco Source Type: blogs

Dander Gathering Again: Terzo
It's hard these days to rid oneself of the rising dander. DanderOmnium GatherumPatch Numero Terzo. To put it more simply, here are more tales from the DOG Patch. And a smattering of actualgood (how's this possible?) news.Double Back on Politics at the VA.There's a guy now installed under Secretary David Shulkin by the name of Darin Selnick. He carries the title of Senior Advisor, and also works (with the same title) in the White House. Selnick was a California consultant when he fell in with the Koch Brothers and their deep pockets. Together they fostered an organization called Concerned Veterans for America. Check ou...
Source: Health Care Renewal - February 27, 2018 Category: Health Management Source Type: blogs

Tales from the DOG Patch: Numero Deux
A tip of the hat to Dr. Roy Poses, who did a nice job summarizing the first blast from the DOG Patch. (For those who missed it, it's a distillate of all the dander we've mustered in recent health policy debates as they veer more and more toward the utterly surreal.) Danderomnium gatherum, hurled willy-nilly at the gentle readers of HCRenewal. Ready or not, another dispatch from the DOG Patch.Dr. Shulkin at the VA.We commented on the recentposting, also from Dr. Poses, dealing with VA Secretary David Shulkin's " apparently scandalous travel " to Europe way back in July. We've known Shulkin for a long time. He care...
Source: Health Care Renewal - February 21, 2018 Category: Health Management Source Type: blogs

The Case of the Brew Master's Plot - Was the Veterans Affairs Secretary's Travel Spending Scandalous, or Was He Framed in a Plot to Oust a Political Moderate?
DiscussionDr David Shulkin, a holdover appointee of President Obama who was nominated to be Secretary of Veterans Affairs by President Trump, was alleged by the VA Inspector General to have committed various ethical violations involving a trip to Europe the Secretary took with his wife.  This appeared to be just the latest in a string of travel-related scandals by top officials of the Trump administration.When this was first reported, I was inclined to see Dr Shulkin as an entitled, and conflicted  former health care executive who ran afoul of the government's strict ethical standards.  (Dr Shulkin'sofficial...
Source: Health Care Renewal - February 19, 2018 Category: Health Management Tags: Donald Trump ill-informed management mission-hostile management political ideology politics Veterans Affairs Source Type: blogs

Welcome to the DOG Patch: first in a series?
Lately my dander is up so often and so copiously, over what's happening in health care and the world at large, I'm exhausted. Covered with nasty dander. Cowering under the sheets. Others seem to share this dysphoria. But I found if not a cure, at least a palliative. There's so much dander I can scrape it off with a great big shovel and toss as much as I can your way. Here's my first DanderOmnium Gatherum, or DOG, from the Cetona DOG Patch. Remember, these stories are all DOGs.Litmus Test for New HHS Secretary. The new sheriff at Health& Human Services, Alex Azar, has barely had a chance to wipe his feet in front o...
Source: Health Care Renewal - February 15, 2018 Category: Health Management Source Type: blogs

New article in J. of General Internal Medicine calls for simplifying EHRs
At my January 31, 2018 Healthcare Renewal blog post "The inevitable downgrading of burdensome, destructive EHRs back to paper& document imaging" athttp://hcrenewal.blogspot.com/2018/01/the-inevitable-downgrading-of.html, I opined that the downgrading of the clinician-facing components of EHRs was essential and inevitable. A new editorial in the Journal of General Internal Medicine makes similar points:​Electronic Health Records: a " Quadruple Win, " a " Quadruple Failure, " or Simply Time for a Reboot?Journal of General Internal MedicineMichael Hochman05 February 2018https://link.sp...
Source: Health Care Renewal - February 7, 2018 Category: Health Management Tags: healthcare IT simplification Journal of General Internal Medicine Michael Hochman Source Type: blogs

Are You With Us, Dr Gu? - Vanderbilt Suspended Surgical Resident Allegedly Due to Patient's Mother's Compaints About His " Taking a Knee " on Social Media
ConclusionsThis case suggested that at least the leadership of one prestigious university medical center is very uncomfortable at best, with its residents publicly expressing certain political opinions, even clearly outside the confines of the hospital.  Whether the leaders felt licensed by the President of the United States, who had banned the person at the center of this case from following him on Twitter, is a reasonable question.It may not be unreasonable to expect physicians and physician-trainees, as medical professionals, to avoid getting into political arguments with patients.  However, it is unreasonable...
Source: Health Care Renewal - February 7, 2018 Category: Health Management Tags: academic freedom anechoic effect free speech post-graduate medical education Vanderbilt University Source Type: blogs

Free Press? Don't Need No Stinkin' Free Press - Center for Medicare and Medicaid Services (CMS) Tries to Intimidate Modern Healthcare Journalist
DiscussionIt appears that  respected reporter for a well-known US health care business publication was barred from participation in CMS conference calls after some rather mild reporting on his part offended CMS leadership.  There seemed to be an attempt to intimidate the reporter by a federal " contractor " paid by CMS, a contractor who was a criminal, that is, who had pleaded guilty to a federal crime of lying to the Conressional Ethics office.  How far have we descended.OnHealth Care Renewal we have been writing aboutattempts to limit free speech or free discussion in the press in the health...
Source: Health Care Renewal - February 5, 2018 Category: Health Management Tags: anechoic effect censorship CMS First Amendment free speech intimidation Source Type: blogs

Fish gotta fly, birds gotta swim: more on the opiate crisis
At so many levels, the current opiate crisis, and the way in which various actors are seeking to cope with it, proves rich in intriguing detail.For starters, it needs to be memorialized that there is a judge in Ohio--like Pennsylvania a fascinating political see-saw state--who's actually trying to do something about this crisis.Daniel Polster, a Clinton appointee and approaching two decades on the bench, hasconvenedall the parties caught up in the current crisis. Metaphorically locking them all in a room and saying " we'll solve this problem and maybe you get outa this room, " he included players not even directl...
Source: Health Care Renewal - February 2, 2018 Category: Health Management Source Type: blogs

Disastrously conceived, managed, and implemented U.S. Coast Guard EHR leaves our Coast Guard heroes safer ... after reversion to paper records
Sometimes, the typical EHR mismanagement debacles that I have been writing about since at least 1999 leave patientssafer.  This is one such example.I note that the contents of this blog, as well as my still-extant Drexel website "Contemporary Issues in Medical Informatics: Good Health IT, Bad Health IT, and Common Examples of Healthcare IT Difficulties" (http://cci.drexel.edu/faculty/ssilverstein/cases/) and many other resources about healthcare IT mismanagement and failure, are available free of cost.  They could have saved the Coast Guard many millions of dollars if their contents had been reviewed an...
Source: Health Care Renewal - February 2, 2018 Category: Health Management Tags: Coast Guard EPIC Fedscoop News health IT failure IHiS Zaid Shorbajee Source Type: blogs

The inevitable downgrading of burdensome, destructive EHRs back to paper & document imaging
In recent days, I've posted about current articles on the destructive nature of today's vastly over-complex, burdensome EHR technology.  These posts included "Physicians Harassed by Overwhelming Levels of Messaging From Electronic Medical Records" athttp://hcrenewal.blogspot.com/2018/01/physicians-harassed-by-onerwhelming.htmland" Medical Economics: Highly experienced physicians lost to medicine over bad health IT " athttp://hcrenewal.blogspot.com/2018/01/medical-economics-highly-experienced.html.There are many other earlier articles of a similar nature discussed on this blog, e.g., the May 2017 po...
Source: Health Care Renewal - January 31, 2018 Category: Health Management Tags: Alexi Wright MD bad health IT burnout Christine A. Sinsky healthcare IT difficulties Healthcare IT failure Ingrid Katz MD NEJM Source Type: blogs

Burnout Returns to Center Stage
A recentMayo Clinic Proceedings guesteditorial, by Yale University physician Kristine Olson, asks the question--to some of us it's far from a rhetorical one--whether burnout among her fellow physicians is in fact " A Leading Indicator of Health System Performance? "Seems to me that her gist is: yes, it surely must be just such an indicator. If she's right, then our system's performance is in a heap of trouble.What is burnout? Our fearless editor, Dr. Poses, has addressed it repeatedly, including a few months agohere in these pages. But burnout is actually hard to delineate and hard to quantify. People quitti...
Source: Health Care Renewal - January 30, 2018 Category: Health Management Source Type: blogs

Physicians Harassed by Overwhelming Levels of Messaging From Electronic Medical Records
In yet another example of the clerical overload caused by bad health IT, physicians find themselves drinking from a fire hose through cybernetics.  This, in the field of dermatology, let alone critical care specialties:Physicians Overwhelmed by Messaging From Electronic Medical RecordsMedicalResearch.com Interview with: Matilda W. Nicholas, MD, PhDDuke DermatologyJanuary 29, 2018https://medicalresearch.com/author-interviews/physicians-overwhelmed-by-messaging-from-electronic-medical-records/39671/MedicalResearch.com: What is the background for this study?Response: I have found many physicians overwhelmed by the e...
Source: Health Care Renewal - January 30, 2018 Category: Health Management Tags: bad health IT burnout healthcare IT dissatisfaction healthcare IT distraction healthcare IT harms medicalresearch.com Source Type: blogs

Medical Economics: Highly experienced physicians lost to medicine over bad health IT
The title of the article is actually "Physicians leaving profession over EHRs" , but that title omits the real impact of the phenomenon: seasoned physicians, along with their medical expertise, judgment and experience, are lost to the pool of people entrusted to provide care thanks to poorly designed and badly implemented IT:http://cci.drexel.edu/faculty/ssilverstein/cases/Bad Health IT is IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes...
Source: Health Care Renewal - January 28, 2018 Category: Health Management Tags: bad health IT data trafficking Ddulite Medical Economics Munzoor Shaikh physicians leaving medicine Ramin Javahery MD Tom Davis MD FAAFP Source Type: blogs

More on the Opiate Abuse Epidemic: Where Again Does the Finger Point?
In arecentblog post we pointed to conservatives'efforts to implicate Medicaid funding as somehow causative of, or at least promoting, the opiate " crisis. " After all, funding for medications means people will use, and sometimes abuse, those medications. Meds they might otherwise ill be able to afford. (Implied solution: cut Medicaid.)We also alluded to some of the logical fallacies in such thinking. Here, though, let's take it to another level: the blame game, where does it lead? Where does the finger point? Those who agree with Ronald Reagan that government is the problem, not the solution, fall into the trap o...
Source: Health Care Renewal - January 23, 2018 Category: Health Management Source Type: blogs

Not just bad health IT, but SPECTACULARLY bad health IT
I define bad healthcare IT as:... IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is lacking in security, lacks evidentiary soundness, compromises patient privacy or otherwise demonstrates suboptimal design and/or implementation. (http://cci.drexel.edu/faculty/ssi...
Source: Health Care Renewal - January 20, 2018 Category: Health Management Tags: bad health IT healthcare IT amateur KevinMD Niran S. Al-Agba Source Type: blogs

Will the New Conscience and Religious Freedom Division of the US Department of Health and Human Services Help Health Care Professionals Challenge Morally Objectionable Acts - Like Bribery, Fraud and Other Criminal or Corrupt Practices?
For a long time we have argued thathealth care corruption is a major cause of health care dysfunction.  We have documented numerous cases in which health care professionals were exposed to or involved in actions, includingfraud,bribery (also known askickbacks), and othercorrupt orcriminalpractices, to which they likely had moral objections.  We have also noted that in such situations, health care professionals often have little recourse, particularly in academic institutions.The New Conscience and Religious Freedom Division of the US Department of Health and Human ServicesSo perhaps a new initiative of the US Dep...
Source: Health Care Renewal - January 18, 2018 Category: Health Management Tags: bribery crime DHHS fraud health care corruption kickbacks revolving doors Source Type: blogs

Big Bang Theory of Health Care: Ever Since 1967
Hold on to your hat: it all comes together now. Looking at events in our nation's capital, in a strange fever dream, The Big Bang Theory just came to me. No, call it the Big Fecal-Bang Theory, as I read about how our national leadership proceeds from one inanity to the next.But when it comes to health care, and wiping out the safety net using false premises, inanity kills. So this is worth writing. But to see how it all ties together, we have to go back over half a century.Where else can you read about the hidden connections between Hollywood, health insurance in the US of A, Really Bad Tax Cuts, Wisconsin cheese-eaters, o...
Source: Health Care Renewal - January 18, 2018 Category: Health Management Tags: logical fallacies Medicaid narcotics propaganda Source Type: blogs

The Big Bang Theory of Health Care Since 1967
Hold on to your hat: it all comes together now. Looking at events in our nation's capital, in a strange fever dream, The Big Bang Theory just came to me. No, call it the Big Fecal-Bang Theory, as I read about how our national leadership proceeds from one inanity to the next.But when it comes to health care, and wiping out the safety net using false premises, inanity kills. So this is worth writing. But to see how it all ties together, we have to go back over half a century.Where else can you read about the hidden connections between Hollywood, health insurance in the US of A, Really Bad Tax Cuts, Wisconsin cheese-eaters, o...
Source: Health Care Renewal - January 18, 2018 Category: Health Management Tags: logical fallacies Medicaid narcotics propaganda Source Type: blogs

" Hot Spot For User Entry Error " : Hawaii missile alert: How one employee ‘pushed the wrong button’ and caused a wave of panic
A short post.I believe this WaPo story vividly demonstrates issues I've seen in what Australian colleague Dr. Jon Patrick& I call " bad health IT. " We came up with the simple-to-comprehend terminology " Good health IT/Bad health IT " in his living room in Sydney after my presentation to the Health Informatics Society of Australia in 2012 on health IT trust (http://hcrenewal.blogspot.com/2012/08/my-presentation-to-health-informatics.html), to replace my earlier terms " health IT done well " vs. " done poorly. "It wasnot just " one employee who pushed the wrong button. &...
Source: Health Care Renewal - January 15, 2018 Category: Health Management Tags: bad health IT core incompetence good IT/bad IT Hawaii missile alert technology risks use error Source Type: blogs

How To Challenge Health Care Corruption Under a Corrupt Regime?
Introduction: the Corruption of Health Care Leadership as a Major Cause of Health Care DysfunctionFor a long time we have argued thathealth care corruption is a major cause of health care dysfunction.  As we wrote in August, 2017, Transparency International (TI) defines corruption asAbuse of entrusted power for private gainIn 2006,TI published a report on health care corruption, which asserted that corruption is widespread throughout the world, serious, and causes severe harm to patients and society.the scale of corruption is vast in both rich and poor countries.Also,Corruption might mean the difference between life a...
Source: Health Care Renewal - January 15, 2018 Category: Health Management Tags: anechoic effect conflicts of interest Donald Trump health care corruption mission-hostile management Source Type: blogs

Ill-Informed, Incompetent* Health Care Leadership: the Case of President Trump's Interview in the New York Times
ConclusionsWe have frequently criticized the leadership of big health care organizations as ill-informed, incompetent, ignorant of or even hostile to the values of health care professionals, deceptive, self-interested, conflicted or even corrupt. The President of the United States is the country's most important health care leader, since all government agencies that deal with health, health care, health care policy, etc report to him.  Unfortunately, we have previously discussed examples of how the president appeared to be an ill-informed or incompetent health care leader, for examplehere. So it would be easy to ...
Source: Health Care Renewal - January 5, 2018 Category: Health Management Tags: Donald Trump ill-informed management Source Type: blogs

A Remedy for Corruption
Do I really have a remedy for corruption? I wish I did. But, I have lately found an effective balm for the sickening discouragement that it is easy to feel when confronted day after day with another instance of the medical industry ’s price-gouging corruption, purposeful distortions, and callous disregard of patient welfare. That remedy is a new podcast from Australia:Ray Moynihan ’sThe Effective Dose. If you don ’t already recognize Moynihan’s name, he’s an author ofSelling Sickness and he ’s had a persistent interest in overdiagnosis and medicalization. He describes the ...
Source: Health Care Renewal - January 1, 2018 Category: Health Management Source Type: blogs

Transparency International US Corruption Barometer: Striking Increases in Public Perceptions of Government Corruption in the US, Especially in the White House
Introduction: Transparency International's 2017 Global Corruption Barometer US ResultsLast month, Transparency International (TI) released the results of its 2017 US Corruption Barometer, a global survey of peoples'perceptions of the degree to which their national institutions are corrupt.  Wediscussed the results from the US, based on data collected in late 2016, which showed thatthe US had results suggesting it has important problems with corruption.  More than one-third of US respondents thought that most executive branch leaders, legislators, and business executives are involved in corruption,  Just less...
Source: Health Care Renewal - December 14, 2017 Category: Health Management Tags: Donald Trump health care corruption Transparency International Source Type: blogs

Heads They Win, Tails We Lose - Non-Profit Hospital Executives Paid Generously After They Were Shown the Door
OnHealth Care Renewal, we have been decrying American health care dysfunction since 2004.  For years, the US consistently has had the most expensive health care system of any developed country.  For that exhorbitant price, it provides at best medicocre access to and quality of care.  Thelatest (2017) international comparison of health systems produced by the Commonwealth Fund shows that the US spends about 16% of its gross domestic product (GDP) on health care, compared to less than 12% spent by 10 other countries.  The US ranked no better than fifth on performance rankings measuring care process, acces...
Source: Health Care Renewal - December 10, 2017 Category: Health Management Tags: Broward Health contracts executive compensation generic managers intimidation managerialism ' coup d etat non-disparagement clause perverse incentives quality University of North Carolina Source Type: blogs

Heads They Win, Tails We Lose - Non-Profit Hospital ExecutivesPaid Generously After They Were Shown the Door
OnHealth Care Renewal, we have been decrying American health care dysfunction since 2004.  For years, the US consistently has had the most expensive health care system of any developed country.  For that exhorbitant price, it provides at best medicocre access to and quality of care.  Thelatest (2017) international comparison of health systems produced by the Commonwealth Fund shows that the US spends about 16% of its gross domestic product (GDP) on health care, compared to less than 12% spent by 10 other countries.  The US ranked no better than fifth on performance rankings measuring care process, acces...
Source: Health Care Renewal - December 10, 2017 Category: Health Management Tags: Broward Health contracts executive compensation generic managers intimidation managerialism ' coup d etat non-disparagement clause perverse incentives quality University of North Carolina Source Type: blogs

One Barely Noticed Settlement by Pfizer Suggests the Futility of Polite Protests about Health Policy
A few days ago we noticed just one more marcher in theparade of legal settlements.  But it was once again a huge health care corporation, and it had aspects that demanded attention.Pfizer Makes $94 Million Settlement of Allegations of Fraud to Delay Generic CompetitionA tinyitem in Becker's Hospital News on November 28, 2017, stated:Pfizer will pay $94 million to resolve allegations that it used fraudulent patents to delay generic competition for its anti-inflammatory drug Celebrex.The lawsuit, brought by 32 direct purchasers of Celebrex in April and certified a class action lawsuit in August, claimed Pfizer attempted...
Source: Health Care Renewal - December 3, 2017 Category: Health Management Tags: adverse effects Celebrex deception impunity legal settlements Pfizer restraint of competition Source Type: blogs

In US, More than One-Third Think Government and Business Leaders are Corrupt, Media Shrug
We have noted  (most recentlyhere),  thathealth care corruption, particularly its global nature and its presence in developed countries like the US, is a taboo topic and thus remainsanechoic.  Yet corruption in general, and health care corruption in particular, are huge global problems.Transparency International just released the full results of the 2017 version of its Global Corruption Barometer.  (The November 14, 2017 news release ishere.  The full report is availablehere.  Details about the methods arehere. Country by country results arehere.)The report summarizes responses from 162,136 pe...
Source: Health Care Renewal - November 21, 2017 Category: Health Management Tags: anechoic effect health care corruption Transparency International Source Type: blogs

Perpetual Revolving Motion: Yet More Transits Through the Health Care Revolving Door
The pace of people spinning through the US federalrevolving door seems unprecedented. Most were people going from the health care corporations to government positions regulating or making policy influencing those same corporations.  Since our last roundup, of 11 days ago, we have found two more significant travelers from industry to government, and one from the previous administration to industry.  In addition, we realized that the case of one of the travelers discussed only last month is more significant than we realized.Nina Devlin from Mylan to Senior Communications Adviser for the US Food and Drug Admini...
Source: Health Care Renewal - November 16, 2017 Category: Health Management Tags: DHHS Donald Trump FDA Mylan Office of the National Coordinator for Health Information Technology OSHA revolving doors Source Type: blogs

Give Us Those Old Time Conflcts of Interest: Stephen Parente, Key Opinion Leader for UnitedHealth and Redeemer of Former CEO William McGuire to Assistant Secretary of HHS
DiscussionSo here is just the latest embellishment in the march of people transiting the revolving door from health care corporations, and related firms, such as lobbying firms, the the executive branch during the Trump administration. Fortunately, good investigative journalists have looked more deeply into this cases, showcasing its more interesting aspects.  First, Mr Parente was not simply a corporate executive moving to the executive branch where he would be able to influence the fortunes of his former corporation.  Mr Parente was apparently a distinguished academic in a business school.  However&nb...
Source: Health Care Renewal - November 5, 2017 Category: Health Management Tags: conflicts of interest Donald Trump impunity key opinion leaders legal settlements revolving doors stealth health policy advocacy UnitedHealth You heard it here first Source Type: blogs

The Ultimate Version of Ill-Informed Health Care Leadership: Dumb, Incoherent, Confused, Perhaps Psychotic Things President Trump Says and Does About Health Care Policy
DiscussionWe have discussed the doctrine ofmanagerialism promoted in business schools that people trained in management should lead every type of human organization and endeavor.  Management by people from the disciplines most relevant to the mission and nature of particular organizations should be eschewed.  So managers, not physicians or other health care professionals, should lead health care organizations.  Following that theme, managers, or those like them, rather than health care professionals and health policy experts should lead health policy. However, managers who run health care organizations,...
Source: Health Care Renewal - October 29, 2017 Category: Health Management Tags: Donald Trump health care reform ill-informed management Obamacare ppaca Source Type: blogs

Worst Health Care Revolving Door Case So Far, Version 2.0? - From President of Lilly USA to US Secretary of Health and Human Services?
DiscussionLast week we noted that Mr Trump famously promised to " drain the swamp " in Washington.  Last week, despite his previous pledges to not appoint lobbyists to powerful positions, he appointed a lobbyist to be acting DHHS Secretary.  This week he is apparently strongly considering Mr Alex Azar, a pharmaceutical executive to be permanent DHHS Secretary, even though the FDA, part of DHHS, has direct regulatory authority over the pharmaceutical industry, and many other DHHS policies strongly affect the pharmaceutical industry.  (By the way, Mr Azar was also in charge of one lobbying effort.)&n...
Source: Health Care Renewal - October 19, 2017 Category: Health Management Tags: crime deception DHHS Donald Trump Eli Lilly legal settlements marketing regulatory capture revolving doors Source Type: blogs

Worst Health Care Revolving Door Case So Far? - From Lobbyist to Acting Secretary of Department of Health and Human Services
Once again, you just cannot make this stuff up.Last week weposted our latestrevolving door roundup, one of many we have done during theTrump administration.  At the time we noted that a lobbyist, Mr Eric D Hargan, at Greenberg Taurig Alston& Bird, had been nominated to be Deputy Secretary of the Department of Health and Human Services (DHHS).Wikepedia provides a little more information about his past lobbying employment.Hargan left the government in 2007 and joined the health law department of law firm McDermott Will& Emery. Hargan joined the health and FDA business development practice of law firm Greenberg T...
Source: Health Care Renewal - October 11, 2017 Category: Health Management Tags: DHHS Donald Trump regulatory capture revolving doors Source Type: blogs

Round and Round It Spins - Our Latest Health Care Revolving Door Roundup
DiscussionThe revolving door has been a chronic problem for the US, but seems to only be getting worse.  We saw plenty of examples of people transiting the door to or from the US executive branch during the George W Bush and Obama administrations.  We are still seeing people transiting the door from the latter administration.  However, the number of people transiting the door into the Trump administration seems unprecedented, although admittedly that impression is based on series of cases, not systematic quantitative studies.So, as I have said before, most recentlyin August, 2017,The revolving door is a spec...
Source: Health Care Renewal - October 8, 2017 Category: Health Management Tags: Donald Trump health care corruption regulatory capture revolving doors Source Type: blogs

Latest Legal Settlements Suggest Hazards of Making Pharmaceutical Regulation More Lenient, as is Apparently Favored by New FDA Leader
DiscussionAll the cases discussed above were of behavior that could have harmed patients.  Many of the companies involved had records of previous ethical misadventures.  While a few cases resulted in corporate guilty pleas (to misdemeanors), none resulted in monetary penalties that would have much impact on the companies'finances, and none resulted in any negative consequences for people who enabled, authorized, directed or implemented the bad behavior.These, just the latest in the march oflegal settlements by large health care organizations, again demonstrate how often and how seriously pharmaceutical companies ...
Source: Health Care Renewal - October 1, 2017 Category: Health Management Tags: adulterated drugs Celgene crime deception FDA impunity legal settlements market fundamentalism Novo Nordisk revolving doors thalidomide Source Type: blogs

More Dumb Things Leaders Say About Health Policy
These days, legislative efforts to change US health care, especially to " reform and replace " the Affordable Care Act [ACA or " Obamacare " ] seem to inspire displays of jaw dropping ignorance by political and sometimes business leaders on behalf of " reforming " health care.  We lastposted examples on July 7, 2017.  Now there is a new game afoot to reform and replace, and it is generating new - not to put too fine a point on it - foolishness.So herein is a roundup of a two more examples from July after our last post, plus two more revently " ripped from the headlines, " a...
Source: Health Care Renewal - September 22, 2017 Category: Health Management Tags: Aetna Donald Trump health care reform ill-informed management managerialism ppaca Source Type: blogs

" The Censorship That It is " - Now Threatens US Government Health Agencies (DHHS, CMS, CDC)
On Health Care Renewal we discus the dark side of health care, particularly of the leadership and governance of health care, that has enabled health care dysfunction.  Our discussions are based on publicly available information, often produced by dogged health care journalism.Uur work has become more difficult as journalism is challenged by economic circumstances.  Yet now there are worse threats.  Despite First Amendment protections offreedom of speech and the press, journalism is now under fire from the highest reaches of US government.Information Blockade at the Department of Health and Human ServicesTwo ...
Source: Health Care Renewal - September 17, 2017 Category: Health Management Tags: anechoic effect CDC censorship CMS DHHS disinformation free speech Source Type: blogs

The Shame of US Health Care Dysfunction: Hookworm Returns to Alabama
ConclusionsAs we have noted endlessly, the US spends more per capita on health care than any other developed country.  US politicians used to make the claim that the country has the best health care system in the world, often to ward off any attempts at true health care reform.  However, US rankings on various measures - some of which may be disputed - of health care processes and outcomes have been decidedly mediocre.  (See for example the latest Commonwealth Fund studyhere.)The new study of hookworm prevalence was not based on a big, systematic, or geographically diverse sample.  However it is strikin...
Source: Health Care Renewal - September 7, 2017 Category: Health Management Tags: government health care foundations public health Source Type: blogs