Appalling Corruption In US Healthcare

#1

There are discussions in other threads about the reasons for why US healthcare is so much more expensive, yet so much less effective.

A very big reason is just an unbelievable amount of corruption, fraud and bribery with companies from biotech ones like Amgen to old traditional ones like J&J consciously killing hundreds of thousands people, and some 500,000 in the US alone with just one cancer drug alone.

Nobody comes out of this looking good, not researchers, not regulators, not executives, not doctors, not administrators.

This is the story of just one drug. Itā€™s the tip of an iceberg.

The Johnson & Johnson cancer drug scandal that encapsulates corruption in health care

ā€œLies, feckless government oversight, and the participation of nearly every oncologist and cancer hospital in the country are all part of this story.ā€

ā€œIn nearly every case, the results had been kept secret, and none of these researchers had been brave enough to blow the whistle.ā€

ā€œAgain and again over the years, cancer doctors have tended to favor drugs that gave them the most money, whether those drugs worked better than other drugs or not.ā€

ā€œMany paĀ­tients pay a portion of those costs out of their own pockets. So, as doctors enrich themselves, some also bankrupt their patients and ā€” because their prescribing decisions are based on profits instead of effectiveness ā€” undermine their patientsā€™ health.ā€

ā€œIt is also the grim reality of cancer care in the United States and is among the chief reasons why Americans who get cancer tend to die earlier and poorer than their European counterparts.ā€

ā€œBut such preĀ­scriptions undermine almost everything oncologists say they stand for, since the drug can actually shorten life, and leave the victimā€™s family impoverished financially as well as emotionally.ā€

7 Likes
#2

Discussions in the US devolve into an unfortunate capitalism vs socialism fight. When a large amount of government funding goes into an industry, that industry can hardly be considered a free market, but when the profit motive is absent, innovation suffers . I am referring to the electric utility industry --not healthcare. Electricity is highly reliable and fairly affordable. Both government and private groups have established strict rules to protect workers and the public. Fwiw, the IEC in Europe seems a bit more innovative than the US combo of NEC, NEMA, IEEE, etc. If we want to reform healthcare, it might be worth looking at the electrical industry.

4 Likes
#3

FWIWā€¦

In 2009, Pfizer paid the largest health care fraud settlement in US history, a total of $2.3 billion, to resolve allegations of illegal promotion of several drugs, including Bextra, Geodon, Zyvox, and Lyrica.

Nothing New, same play book different Companyā€¦that was caught.

And another Company caught link below.

.US settles biggest ever healthcare fraud case - PMC

The real fact is ā€¦

ā€œThe connivance never stops.ā€

4 Likes
#4

I had a business manufacturing a med device in Canada and selling it in the US market for 8 years. Overall I was in that industry for 13 years. I made decent bank doing that, thanks!!

We ran it by the book and never abused the system. But I was quite aware of people who milked the HCPCS codes to find the fast buck and watched people make millions in short spurts until the loop hole of the month got closed.

While one can rightfully point to big pharma related fraud, that is only a drop in the bucket compared to the overall cost of health care in the US.

The US healthcare system is the most expensive globally, with spending exceeding $4 trillion in 2022 and projected to increase to around 20% of GDP by 2031, per capita health spending is significantly higher than in other high-income nations

It is hard to have a good conversation on this topic due to thisā€¦

Discussions in the US devolve into an unfortunate capitalism vs socialism fightā€¦

ā€¦because many confuse universal health care with ā€œsocialismā€. Why does this apply to health care and not to the following?

Certain public services/resources would fall under the tag of ā€œsocialismā€ but most people are programmed by those who make HUGE amounts of money off the US healthcare system, to believe that ā€œcapitalismā€ is the only way to deliver health careā€¦ Just like ā€œtrickle down economicsā€, itā€™s a screen to enrich the rich while the little guy helps protect the ā€œAmerican Dreamā€ with his/her defence of the get rich ā€œdreamā€.

Those wealthy health care corporate types use the lobby system and the ā€œfree enterpriseā€ hook to make it seem like a, for profit health care system is the best way to deliver health care.

Some other public services that are not for profit;

  1. fire services
  2. police services
  3. military services
  4. public schools

Yes companies that sell to and profit off those public services make good money, that is capitalism at work. But the core ā€œbusinessā€ of providing that service is not for profit.

Health care can be that way, the core service as a not for profit, universal service and the companies that provide equipment, software, consumables, drugs, etc make the profit. Just like the 4 examples above.

Some will say ā€œyou get what your pay forā€ but that leads to the question, how much can you afford? if you canā€™t pay the piper, you are left out of the US health care system.

Instead in the US you have massive bureaucracies deciding who gets what and for that ā€œserviceā€ they make billions pushing paper with ZERO benefit to the people who need health care. In this particular case, the insurance companies are parasites feeding off a bloated and slowly dying corpse.

None of this is newā€¦

5 Likes
#5

Well, when I lived in Buffalo NY we were flooded with Canadians seeking healthcare. Wonder why?

7 Likes
#6

Yesā€¦ in Germany my healthcare friends stateā€¦ the government determines first if you can have treatments or surgeryā€¦ and thenā€¦ it is when? 2 years or 3 years out is not uncommon.

If you want it nowā€¦ you pay privately out of your pocket.

5 Likes
#7

So, the best of both worlds?:rofl:

But more seriously, from what I gather, the system in France works better than Germany, you have a mix of private and public and no excessively long waiting lines. Meanwhile you wonā€™t have long waiting lines for care in the US, youā€™ll just get denied by insurance, at which point, just as in Germany, you can pay out of pocket, except ten times more, or be lucky and get covered partially by insurance and still go medically bankruptā€¦ how often does medical bankruptcy happen in Germanyā€¦ like never? Meanwhile medical bankruptcy in the US is up there with most common.

But forget anecdotes. What counts are outcomes. Which population has better health outcomes, and for way less money, and ultimately letā€™s ask the consumers - which population is more satisfied with their healthcare systemā€¦ it ainā€™t Americansā€¦ how Americans feel about their healthcare system can be seen in the concerning amount of support for Luigi, is how they feelā€¦ 'nuff said.

4 Likes
#8

On the subject of electricityā€¦

Enron.

We could have governance by an accountable hierarchy, but a lot of reform is needed, and continuous effort is required to keep the grifters under control.

2 Likes
#9

It seems like if a study is not reproducible then there should be some penalty, otherwise over time the system will fail. The people paying the bills should care about the system theyā€™re supporting. I have no inside knowlege, and am not rubbing my hands with glee, but this is what happens when they tell obvious lies.

2 Likes
#10

This is tricky, but I agree in principle.

In reality, things fail to be reproducible for many reasons, and most of them are not due to cheating, fraud etc. Even in my own lab, we could have a student leave and another student takes over the work and they donā€™t get the same results - different hands, different animals, different cells etc. The key is that whenever you publish work, you do so truthfully, describing what you did and what results you found.

I do agree though that science should generally try to serve the public good, and should strive to use taxpayer money efficiently. I would also support industry-supported academic research.

The real problem, IMO, is the publication model. There is no reward for doing a really good job of investigating something and failing to find something. As a result, only ā€œpositiveā€ data gets published, and the incentives to find or create positive data grow - especially when your promotion, salary, continue employment, future grants etc rely on it.

2 Likes
#11

I lived in Germany for ~7 years working for a private company.
German healthcare, which I had to pay for myself, was significantly more affordable than U.S. healthcare. I have no idea if this is still the case.
Dental work was also much more affordable.

5 Likes
#12

If youā€™re interested in healthcare and scientific study corruption, listen/read the stuff from Dr Vinay Prasad. Although he may piss off some of you.

2 Likes
#13

Here in Hong Kong, I just went to the hospital today and had a CT brain scan (I hit my head when I passed out due to syncope) and was admitted overnight in a 3 bed ward for observation. I didnā€™t have to wait long at all for the scan even though the technician had already gone home for the night. They called him back in, did the scan within the hour and the results came back that there was no hemorrhaging, fractures or brain tumors. Service was excellent and the cost was about $1100 USD. Insurance will probably pay for most of it. I also got a nice DVD and detailed report about my brain which is something Iā€™ve always wanted.

If I didnā€™t have insurance, I could have gone through the public system which would have required a 5 hour wait in A&E, but there wouldnā€™t be any costs and the results would be the same. Maybe the staff would be a little less amiable.

Good free healthcare for everyone is available in the world. Hong Kong shows that it exists. Itā€™s probably why we have the longest lifespans.

8 Likes
#14

Well Iā€™m glad youā€™re OK. Still would be nice to know what caused this, BP meds - especially if you want to bump your telmi from 40mg to 80mg this summer as you planned - or hypoglycemia which is concerning as empi is not supposed to cause low BG. You should get to the bottom of this.

Also you might have an unfair advantage in lower BP not having to deal with this in the context of the US high cost + insurance hasslešŸ˜‚

4 Likes
#15

The doctor and I now believe it was low blood pressure. Iā€™m cutting my Telmisartan down to 20 mg daily. Maybe Iā€™ll drop it entirely.

2 Likes
#16

Wow. Shocking. Dropping telmisartan entirely. Are you going to make an announcement on the board if you do so? How are you going to control your BP now??

#17

My BP is all over the place. Itā€™s at a high of 145 and a low of 96. However these readings are on different machines and Iā€™m not sure which to trust. I think Iā€™ll need to measure my BP in the middle of the night when my BP is lowest for a conclusive answer. Based on the hospital machines,y BP is between 115 and 125 which isnā€™t too bad. However there was still some Telmisartan in my system. Iā€™m just making my best guess at the moment.

#18

Can you get ambulatory BP 24 hour device? I know itā€™s a hassle, but may be instructive. Perhaps your doc has input on this. Sometimes if youā€™re dehydrated you can get low BP, I know you take empa, so hopefully you drink enough to account for it.

2 Likes
#19

That could be another cause. I definitely didnā€™t drink enough liquids on Friday. Weekdays I usually drink a lot at work, but this Friday was a public holiday and I chilled at home. I didnā€™t drink enough.

I am not sure where I can get an ambulatory BP monitor. Is there a commercial product I can purchase?

#20

Iā€™ve only seen this, but know nothing about how good it is:

1 Like