If anyone was interested in how Obamacare might lead incrementally to the health-care industry’s form of “Liberal Fascism,” look no further than today’s New York Times article on the recently announced disclosure requirements for medical firms (“U.S. to Force Drug Firms to Report Money Paid to Doctors“), The goal, of course, is laudable — make doctors tell their patients if they receive compensation from drug and medical-device makers. After all, doctors respond to incentives like everyone else. But, as they say, the devil is in the details, and it’s the way the transparency effort is being implemented that opens the door to strangling innovation.
Rather than simply require doctors to disclose the information to their patients, Obamacare requires drug companies to provide to the government what payments they make to doctors for research, consulting, travel, and entertainment. This information will then be put on a web site so everyone can access it. And the government will ramp up staff to audit the information for accuracy and, presumably, monitor and enforce compliance. Voila! Instant bureaucracy. One has to wonder where all the “savings” from cheaper (and less effective?) procedures presumably incentivized by this disclosure will go.
But perhaps the most telling part of the NYT reporting on the policy is the complete lack of reference to whether this will improve health outcomes. The Times reports that “researchers” (including its own reporting) have found that doctors that take money from drug companies tend “practice medicine differently” and prescribe more expensive and sometimes riskier medicines. But the real issue is whether there are improved outcomes for the patient, not whether it’s more or less expensive or even more risky. It’s the patient and the doctor that should decide the relative merits of the risk involved with any particular treatment.
Moreover, by opening the door to providing detailed data about individual doctors, and making implicit assumptions about treatment (expensive and risky is presumptively “bad”), the mechanism used for reporting and enforcing transparency is clearly opening up a door to future regulation of doctor-patient relationships.
Notably, the rules apply only to doctors providing Medicaid and Medicare services. It doesn’t take much imagination to see how this will eventually be applied to the entire profession if: 1) the program is deemed successful by politicians (and the nationwide individual mandate under Obamcare is ruled Constitutional), or 2) doctors withdraw from Medicaid and Medicare to avoid disclosure requirements, thereby limiting the services available to seniors and lower income households.”
Outcomes? Obamunism has previously stated its position on outcomes. In the context of tax law, it was very explicit in its willingness to forgo revenue (the purpose of taxes in the first place?) in order to retain the power to micromanage people's earnings through complexity and punishingly high rates.
"Fairness" was the pretext they invoked then, which was about as believable as "bending the cost curve" is in the healthcare context. Pretext to exert power, nothing more.
Reply to this commentLinkReport AbuseAll of these regulations are pretexts to ever expanding government bureaucracies.
As noted, no thought here exists whether such information will improve or protect patients and their medical outcomes. Its "presumed" (naturally) just like its presumed Head Start improves student lives.
The beauty of the state; loving it means never having to prove its expansion improves anything.
Reply to this commentLinkReport AbuseThis post is more than a little wacky.
The first clue was "Liberal Fascism" in quotes. What, are you afraid to straight up just call us liberals fascist Mr. Staley??? Are we only "sort of" fascist? I don't need you to put it in quotes. By all means, say what you really think.
From there, the post gets even worse, if possible. Of course RISK is bad. Do you WANT, everything else being equal, a 5% chance of a irreparable negative health outcome that causes you pain and anguish for the rest of your life? Because I sure don't. And I am pretty darn sure that this is universally true for nearly all human beings with the exception of Mr. Staley who apparently enjoys pain, anguish, and impaired health.
Of course, just because something is risky (has the potential for negative "side effects") doesn't mean that the risks (which are nearly always negative) that a medicine imposes are not worth the benefits. But to pretend like the risks, standing alone, are anything other than BAD for those of us who are actually mere mortals and whose health does not always automatically recover when something BAD happens is just plain ridiculous.
Yes, sometimes the benefits outweigh the costs. That does not mean that the costs are not costs. RISKS, taken alone without the benefits, are BAD.
You know, what is really annoying is that I am pretty sure that Mr. Staley agrees with all of this. But he actually thinks he has come to an insight. As if no one before him ever thought that the risks of a medicine might be worth it. Well let me be clear for Mr. Staley. You have not come to any unique insights. When people say risks are bad, they don't mean they are never worth it. They are saying that it really sucks when those risks actually manifest themselves as reality, and if you could avoid the risk and still get the benefit, you would. Or alternatively, if you take a big risk and there is actually no chance of a benefit, that this is a bad idea.
What else...
Of course it is worth having more transparency in medicine. If the doctor is steering you towards a particular treatment because they have a financial interest in doing so, then any rational patient sure as the heck would want to know about it. That doesn't mean that the medicine suggested is the wrong choice in the final analysis. It does mean that maybe you should consult multiple sources before taking the RISKS that everyone who actually values their health agrees are negative (even if sometimes worth it).
Reply to this commentLinkReport AbuseYou don't know what you are talking about, David, so maybe you should exercise some discretion. Monitoring a physician for eating a sandwich with a drug rep (and your conflation of that with "having a financial interest") is a ludicrous waste of time.
Have a conversation with a drug rep sometime--a good conversation starter is, "Can you recommend a doctor for X..." physicians who don't talk to reps, who never prescribe newer medications, who don't keep up on the literature...tend to be less competent physicians.
I am just waiting for a pharma company to have the gumption to challenge the Feds on first amendment grounds--freedom of (truthful) speech and freedom of association.
And I shouldn't have to point out to you that often, NOT treating has risks. A good physician discusses risks and benefits with his patient--an honest rep provides fair balance to a doctor. Having Nanny Government hovering around these relationships IS fascist and counter-productive.
Reply to this commentLinkReport AbuseIn an ideal world, no one would EVER allow a mere financial interest to cloud their judgment or affect their advice in any way, shape, or form. A salesperson paid on commission would always be just as likely to recommend his competitors product if he thought that happened to be a better fit, or was just as good of a fit, but at a lower price.
We don't live in an ideal world.
Look around.
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Talking of liberal fascism it might be good to compare Andrew "I won't be ignored" Sullivan's Barack Obama campaign brochure in Newsweek to Mark "The Great One" Levin's Ameritopia. Because the latter is a serious book that conservatives should be reading.
Because what drives these fascist ideas is a plea to utopia. If only... Health care reform is just a step along that bath. That is why Democrats really want to push it.
Reply to this commentLinkReport AbuseWhat are the advertising rates in the comments section? I got a load of jams and jellies that are going bad.
Reply to this commentLinkReport AbuseWe need to be laser focused on repealing obamacare. If the Dem's filibuster with 41 senators, or if, God forbid, Obama is re-elected--whatever--the House must refuse to fund this monstrosity. There's not much more important in Washington than this...
Reply to this commentLinkReport AbuseMr. Staley may have something useful to say, but the minute he - or any of his lazy colleagues anywhere on the political spectrum - start with "fascism!" I find it very difficult to give their opinion much of a read.
Certain words - "Nazi", "Fascist", "Communist", "Racist", etc. - ought to be used only in the rarest of circumstances, when they precisely and narrowly describe what's going on. Personally, I'd avoid them altogether: If the best argument you can come up with against an idea is that it's "racist", "fascist", etc. the chances are you haven't bothered to do the work to come up with an intelligent and persuasive counterargument.
If for example someone writes that a diner should not be prohibited by the Government from denying service to persons who are not white (or, to take it a step further, that diners in your city should deny service to persons who are not white), are you really struck utterly dumb if you can't use the word "racist" in your argument? If someone argues that the Federal Government should institute a single-payer health plan for all Americans, are you really going to dissolve into a puddle of tears if you can't use the words "socialist" or "communist" in your response? Is the word "fascist" really required to argue against a proposed law that bars persons from saying mean things about the President or the Congress or that requires everyone to devote 1% of his income to General Motors?
These words are just big mud pies designed to make more of a point than the argument to which they pertain.
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