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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

Information technology-naive defense lawyers vs. " strident critic of electronic health records "
A tale from the trenches.In recent years, as a result of the 2010 IT-related injury and 2011 death of my mother, I have engaged myself as an independent EHR forensic expert regarding evidentiary and patient harm issues in medical malpractice litigation. Interestingly and disappointingly, I still often find that hospital attitudes towards health IT safety and information transparency have changed little since 2010 or, for that matter, the 1990s when I did my postdoc in medical informatics.  Hospitals and defense attorneys often (ab)use the lack of technology experience of judges to delay or prevent evidentiary tra...
Source: Health Care Renewal - September 1, 2017 Category: Health Management Tags: bad health IT Heathkit H8 Jay Hancock Kaiser Health News medical malpractice PICIS Pulsecheck Source Type: blogs

Who Guards the Guardians? - From DeVry at a Time of Alleged Fraud to Anti-Fraud Enforcement for the Department of Education
Discussion - In GeneralWe could start a discussion ofconflicts of interest, and even therevolving door, but,...Thus, as anopinion piece in the Atlantic asserted, the appointment of Dr Schmoke " provoked complaints from critics who pointed out that DeVry recently settled several claims brought against it by regulators alleging it had engaged in some of the very abuses the unit is charged with eliminating. "  A writer for Gizmodoput it  more bluntly, the new student protection bureau of the federal government just hired a guy who worked at the same company whose malicious practicesinspired the creation of...
Source: Health Care Renewal - August 31, 2017 Category: Health Management Tags: deception DeVry Inc Donald Trump fraud legal settlements medical schools offshore medical schools Source Type: blogs

A Stealth Marketer Goes Through the Revolving Door to ... the President's Council of Economic Advisors?!
Stealthy, deceptive systematicmarketing,lobbying, andpolicy advocacy campaigns on behalf of big health care organizations, often pharmaceutical, biotechnology and medical device companies, have long been a subject of Health Care Renewal.  A relatively recently revealedexample was the stealth marketing campaign used by GlaxoSmithKline to sell its antidepressant Paxil.  This campaign includedmanipulating andsuppressing clinical research,bribing physicians to prescribe the drug, use ofkey opinion leaders as disguised marketers, and manipulation ofcontinuing medical education.  Other notable examples included Jo...
Source: Health Care Renewal - August 24, 2017 Category: Health Management Tags: conflicts of interest deception Donald Trump revolving doors stealth health policy advocacy stealth lobbying stealth marketing Source Type: blogs

Health Care Non-Profit Organizations Ignored Conflicts of Interest or Potential Corruption Generated by Mar a Lago Fundraisers, But Drew the Line at Supporting Nazi Sympathizers
Leaders of big health care organizations have long made excuses for rampantconflicts of interest in health care.  Usually, their rationales included something about the need to collaborate with industry to spark innovation.  However, some leaders may have been directly benefiting from such conflicts (e.g., academic leaders on the payrolls of drug, device and biotechnology firms, even on the firms 'boards).  Others may not have been, but were making millions in the current system, so why rock the boat?  Meanwhile, the risks these conflicts posed ofhealth care corruption were not a subject of polite conve...
Source: Health Care Renewal - August 20, 2017 Category: Health Management Tags: Cleveland Clinic conflicts of interest Donald Trump health care corruption Source Type: blogs

Can We Challenge Health Care Corruption Under Morally Failed Government Leadership?
Introduction: Health Care CorruptionAn important theme ofHealth Care Renewal has beenhealth care corruption as a cause of health care dysfunction.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 and death for those in need of urgent care. It is invariably the poor in society who are af...
Source: Health Care Renewal - August 13, 2017 Category: Health Management Tags: Donald Trump health care corruption Source Type: blogs

What the US " Health Care Reform " Debate Did Not Address
It looks like the bizarre process in the US Senate ostensibly to " repeal and replace Obamacare " (aka the Affordable Care Act, or ACA)may be ending, at least for now.  I can only hope that further discussion of health care reform will let sanity prevail, and start to address the major issues that have led to the massive dysfunction of US health care, but were not discussed during the latest kerfuffle (and not even discussed much in the real debate that preceded the introduction of the ACA.)OnHealth Care Renewal we have discussed some of the issues that have received much less attention than the Senate proce...
Source: Health Care Renewal - July 31, 2017 Category: Health Management Tags: health care reform Obamacare ppaca Source Type: blogs

The Mysterious Demise of World Health Networks - Fugitive Kazakhs, the Trump Organization, Dodgy Visa Applications, Oh My
DiscussionAs we have previously discussed, based on the doctrines ofneoliberalism ormarket fundamentalism, the US health care system is increasingly dominated by for-profit corporations.  The practice of medicine is increasinglycorporate.  Hospitals and hospital systems are increasingly owned by for-profit corporations.  Health insurance is increasingly provided by for-profit companies.  Drug, device and biotechnology companies have been almost entirely commercial for a long time.  And touted as  sources of innovations, there are entrepreneurial start-ups everywhere offering new products and s...
Source: Health Care Renewal - July 27, 2017 Category: Health Management Tags: crime Donald Trump market fundamentalism marketing neoliberalism public health Steward Health Care Source Type: blogs

Who Benefits from our Current Health Care Dysfunction? - Mallinckrodt's Leadership Maintains Impunity After Well Publicized Opioid Settlement
DiscussionMallinkcrodt made settlements of four legal cases since 2010, involving kickbacks to physicians, various deceptions, and anti-competitive behavior.  The settlements never involved severe enough penalties to the company to really affect its bottom line, never required admission of responsibility, or any accountability by top executives whose huge remuneration were doubtlessly based on the revenues brought in by bad behavior.  Yet US Attorney General continued the Kabuki performance by proclaiming he would " hold them accountable. "  Sessions just slapped the company on the wrist again, wit...
Source: Health Care Renewal - July 20, 2017 Category: Health Management Tags: Acthar antitrust deception executive compensation impunity kickbacks legal settlements Mallinckrodt Questcor restraint of competition Source Type: blogs

Inexact Sciences
Thoughts on the place of science in an era of false convictionSome recent articles, noted by a few of us in journals regularly monitored byHCR bloggers, provide real food for thought in our New World Order of alternate facts, fake news and truthiness.In a recent number of the still intrepidly pay-wall-free Guardian,  development economist John Rapleysummarizeshis new bookTwilight of the Money Gods. This summary is the best we in the colonies can do until this month's UK publication of the full volume makes it to our shores. (Rapley, a true globalist, both an academic and a public intellectual experienced at ...
Source: Health Care Renewal - July 17, 2017 Category: Health Management Source Type: blogs

Gutting the Health Care Corporate Strike Force
DiscussionSo the Trump administration proposes two part time attorneys to drain the health care corporate swamp.  That seems like bailing out the Titanic with teaspoons. But should we expect anything else from an administration that is being increasinglyidentified with corruption and impunity itself?We have frequently discussed outrightcorruption in health care as one of the most important causes of health care dysfunction.  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 widesp...
Source: Health Care Renewal - July 13, 2017 Category: Health Management Tags: deferred prosecution agreement Donald Trump health care corruption impunity legal settlements US Department of Justice Source Type: blogs

More Dumb Things Politicians and Political Appointees Say About Health Policy
As wepreviously discussed, the fierce debate about whether to revise, or " repeal and replace Obamacare " , more formally, the Affordable Care Act, continues in the US.  The legislators in the US House of Representatives, and then the US Senate who have written " repeal and replace " bills have done so without any obvious input from health care professionals, health care policy experts, or patients, much less legislators from the opposition party, and so far have impeded any consideration of these bills by legislative committees.  Nonetheless, many of the politicians involved in the debates, a...
Source: Health Care Renewal - July 7, 2017 Category: Health Management Tags: health care reform ill-informed management logical fallacies Source Type: blogs

A $1.7 Million/ Year CEO of a Safety Net Hospital - Alleged to Have Hired a Dangerous Surgeon, Paid Unethical Bonuses, and Associated with Organized Crime
We have long contended that a major reason for health care dysfunction isperverse incentives, including those that allowtop health care leaders to become rich by putting money ahead of patient care.  We have presented case after case supporting this point,most recently including a collection of generously compensated top executives of non-profit hospital systems whose pay seemed disproportionate to their personal achievement, and unrelated to their hospitals'clinical outcomes or quality of care.Such cases, with their recitations of monetary amounts and repeated public relations talking points, can be rather dry. ...
Source: Health Care Renewal - June 29, 2017 Category: Health Management Tags: crime executive compensation fraud hospital systems hospitals mission-hostile management perverse incentives Source Type: blogs

Follow the Money: Non-Profit Hospital CEOs Quietly Collect Their Millions While US Health Care Reform Battle Rages
ConclusionsThe current inflamed discussion of " Obamacare " and Republican attempts to " repeal and replace " it focuses on the costs of care and how they affect individual patients.  Examples include concerns about health insurance premiums that are or could be unaffordable for the typical person; insurance that fails to cover many costs, and thus may leave patients at risk of bankruptcy due to severe illness; poor people unable to or who might become unable to obtain any insurance, and perhaps any health care.  Yet there is little discussion of what really drives high and ever increasing hea...
Source: Health Care Renewal - June 22, 2017 Category: Health Management Tags: boards of trustees executive compensation health care reform hospital systems hospitals non-profit organizations Source Type: blogs

Health Care Corruption No Longer a Taboo Topic?
We have been going on about the ruinous effects ofhealth care corruption, the role ofimpunity in enabling worsening corruption, our lack of good ways to challenge these problems, and our ongoing inability to even discuss what amounts to taboo topics (which we dubbed the "anechoic effect. " ) But as  corruption, and crime are increasingly linked to the most powerful leaders in the US, it becomes harder to deny that we have a huge problem with corruption in general, and thus maybe it becomes harder to deny we have a huge problem with health care corruption (see also our posts onconflicts of interest,crime, and...
Source: Health Care Renewal - June 14, 2017 Category: Health Management Tags: anechoic effect Donald Trump health care corruption Source Type: blogs