Sunshine

by hilzoy

Here's an interesting catch by Merrill Goozner:

"The House bill would create an internet accessible database that includes all health-related payments to physicians by corporations including gifts, food, or entertainment; travel or trips; honoraria; research funding or grants; education or conference funding; consulting fees; ownership or investment interests; and royalties or license fees. If I'm reading the bill correctly, it says anything over $5 must be reported. (From pg. 635 of the bill.)"

I believe the relevant section of the bill is 1451, and it does seem to say that. This is really good news. There is a lot of money sloshing around in health care. There are advisory boards, speakers' bureaus, conferences conveniently held in beach resorts, educational (and "educational") events, dinners courtesy of drug companies, gifts, etc., etc., etc. And that's not counting things like industry-sponsored research.

A lot of this is just marketing, sometimes disguised and sometimes not. Making it public would have two very good effects. First, and most obviously, it would allow people to discover any conflicts of interest that their doctors might have. Second, it might shame people. If you're an "opinion leader", or in some other way a good catch for a company, it's possible to get very considerable amounts of money from these sorts of things. If it came out that some doctors were getting, say, hundreds of thousands of dollars, not for doing research but for various marketing-esque activities, I suspect that those doctors might become less greedy. 

And that would be a good thing. Most people don't think that they would allow their judgment to be corrupted by something like a fancy dinner with a flattering sales rep, or even an all-expenses paid trip to an industry-sponsored conference at Waikiki. But there's a fair amount of research that shows that accepting a gift from someone does affect your judgment, whether you're aware of it or not. (Why else would pharmaceutical companies give all these gifts?) 

Making these gifts public is an excellent thing. Good for the House committees for writing it into their bill.

Comments

[John Ballard]

Damn. Just, damn.
You're gonna be missed. Big time.
But that's not why I'm here.

The Kaiser Family Foundation provides a ten-page PDF document comparing and summarizing the Senate and House versions of the health care reform proposals.

http://www.kff.org/healthreform/sidebyside.cfm

Do not believe anything you read or hear about this plan until you have done your own homework. The link is at the top of the screen, above the now obsolete plans that also appear below.

(I have not studied these two most recent permutations of the half-dozen or two that were introduced at the start of the session. My printer is not available at the moment, but when I finish leaving this link a few places I will go to the library where I can make myself a copy to study.)

Critics are probably correct that there is nothing being proposed to control costs. There never has been from the 1930's when Blue Cross and Blue Shield became the first group insurance plans in the country. The only way that they were permitted to come into existence was the understanding that there would not be any controls on physician charges. The country was recovering from price controls of the Great Depression and the AMA, which opposed both the Blues, only relented in return for an agreement that there be no caps on charges.

Nothing has changed since then, which is one of the main reasons for the excessive costs of health care today.

Bon voyage. (But I already found your new digs and put it in the aggregator.)

[steve]

What? No more free pens? Darn.

Steve

[The Crafty Trilobite]

Meh. Money finds a way in. Industry reps will ostentatiously announce "I'm off the clock, let's have lunch!" Besides, I think you overestimate the effect of this sort of information.

'Bye, Hilzoy! Have a good trip! See you in the funny pages.

[cosanostradamus]

.
Kinda reminds me of AE Van Vogt's "planting obs" or obligations, which his characters in one story refused to allow anyone to do, rejecting all gifts, favors and compliments as deliberate attempts to make them obligated to the giver, a foul thing to do.

So, I hope you don't live long and prosper, and that Africa sux.

There. We're square.

; )

.

[Gary Farber]

"Kinda reminds me of AE Van Vogt's
'planting obs' or obligations,"

No, no, no! Not A. E. van Vogt at all! Eric Frank Russell!

You can read the whole story here.

Speaking of classic skiffy genre writers with names beginning with "V" though, this Sunday's New York Times Magazine has a wonderful profile of Jack Vance! What a terrific surprise to see him finally receive just a fraction of the recognition due him, and he's actually still alive to hear it read to him.

[Fraud Guy]

And the weird part is, some amount of the free gifts, would that include the "sample" meds? I have had some people I know receive all their meds, which they could not afford, via this route. This would count against the doctor, when that may not be appropriate in this case.

Is is just me, or is the hilzoy farewell tour starting to resemble a Paul Reubens death scene?

[Ceri B.]

Cosanostradamus, that was Eric Frank Russell, in "And There Were None". Fascinating story.

[D'd'd'dave]

Do congressmen and administration people have a website where we are able to see what they receive down to $5 increments? If not, why not? What's good for the goose...

[D'd'd'dave]

I wonder if the added paperwork involved in reporting this stuff at the $5 level was factored in when the Senate named paperwork reduction as one of the areas where they expected to wring savings out of the medical system?

[Gary Farber]

"Do congressmen and administration people have a website where we are able to see what they receive down to $5 increments?"

Why, yes. Yes, we do. Not quite to $5, but close. You really have no idea about this?

[Gary Farber]

These are the current limits on campaign donations. All donations above $200 must be reported by candidates to the FEC. HTH.

Do you need more detail about the limits on what members of Congress can accept outside of campaign contributions, or can you do your own homework for a change?