Senior fellow at the Manhattan Institute David Gratzer MD asks: 

In Canada, private-sector health care is growing. Dr. Day estimates that 50,000 people are seen at private clinics every year in British Columbia. According to the New York Times, a private clinic opens at a rate of about one a week across the country. Public-private partnerships, once a taboo topic, are embraced by provincial governments.

In the United Kingdom, where socialized medicine was established after World War II through the National Health Service, the present Labour government has introduced a choice in surgeries by allowing patients to choose among facilities, often including private ones. Even in Sweden, the government has turned over services to the private sector.

Americans need to ask a basic question: Why are they rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?  http://forums.wsj.com/viewtopic.php?t=6173

SACRAMENTO 7 April: After hearing testimony from medical experts last month, members of a California Senate panel are now seeking more information on medical peer review.

The witnesses, including SSI member and AFPS founder Gil Mileikowsky MD, testified before a California Senate Hearing that asked, “Is the Physician Peer Review a Broken System?”

To clarify conflicts between the published analysis by Lumetra and the California Medical Board, the committee heard testimony from Dr. Mileikowsky (HTML, PDF, Video, Appendix), Los Angeles attorney Paul Hittelman (PDF), Gerald Rogan, MD, and Ian Grady, MD.

After additional testimony from Dr. Mileikowsky and the other witnesses, the committee requested further information and concluded: “If it is determined that the system is beyond repair then there may be a need to examine and consider new methods of ensuring patient safety.”

Whistleblowers often pay a high price for exposing flaws in the healthcare system. Like a lot of physicians who have been in his situation, Gil Mileikowsky, MD, essentially lost his livelihood. It started in 2000 when he was approached by a lawyer representing a patient whose Fallopian tubes were removed without consent. He hadn’t heard of the case, even though it happened in his own department, and he began to suspect that other patient safety incidents weren’t being reviewed through the proper channels. He agreed to serve as an expert witness against Tarzana Regional Medical Center, a joint venture of HCA and Tenet HealthSystem, and four days later the hospital CEO informed him that he would be escorted by security while on hospital grounds. A few months later he was suspended.

That was just the beginning of a long legal battle that is still ongoing. The American Medical Association, the California Medical Association, and other physician and consumer organizations—including a partnership between doctors and trial lawyers spearheaded by attorney Alan Dershowitz—filed amicus briefs on Mileikowsky’s behalf. For many of his supporters, the central issue is peer review and whether hospitals should have authority to remove a physician without due process. His case recently led to a new California law that extends whistleblower protection to all physicians, and he has campaigned for similar protections on the federal level.

But in Mileikowsky’s eyes, he is locked in a much grander struggle to improve the quality of the healthcare system. He founded the Alliance for Patient Safety to document his case and push for safety reforms, and he has developed what he believes is a solution to poor quality control—a “black box” for physicians. Hospital errors should be reviewed in double-blind studies by randomly selected specialists to remove bias or potential conflict of interest, he argues. Although he never intended to become a whistleblower, he says his goal is now to expose flaws in the entire system, not just one hospital.

Whistleblowers like Mileikowsky play an important role in an industry that is often unsuccessful at policing itself; they now initiate nine out of 10 fraud cases for the Department of Justice. Although in some situations they stand to receive up to 25% of any amount recovered, that wasn’t the case for Mileikowsky. “I didn’t wake up one day and say, ‘I want to become a whistleblower,’” he says. “A whistleblower is just someone who tries to sound the alarm about a wrong situation.

(more here)

Dr. Kate Scannell compares disgraced financier Bernie Madoff to pharmaceutical shill, Scott S. Reuben, MD: 

In an analogous manner, the story of Dr. Scott S. Reuben tells the tale of one man who, in pursuit of personal gain, harmed huge segments of our nation’s health care system. That he could get away with falsifying pharmaceutical research and medical publications on such a massive scale over many years also tells a larger story about our nation’s medical research industrial complex. 

That complex — the enormous, poorly regulated, financially incestuous and opaque system that generates and disseminates the medical information we use to determine health care for patients — is similarly structured to allow individuals and privileged industries to profit through backroom deals. 

A few days ago, it was widely reported that Reuben, an anesthesiologist in Massachusetts and a faculty member of Tufts’ medical school, had falsified at least 21 of his 72 published research studies. He simply made them up. 

Many of those fictional studies promoted the use of painkillers — like Pfizer’s Celebrex or Merck’s Vioxx — during orthopedic surgeries, highlighting yet another layer of his disgrace. Those drugs, known collectively as “COX-2″ drugs, have been suspected of causing severe side effects like heart attacks and strokes, and Vioxx was finally withdrawn from the market in 2004. 

As was reported in Scientific American, Reuben’s work tried to encourage surgeons to abandon use of older and less expensive anti-inflammatory painkillers in favor of newer and more expensive ones called “COX-2″ drugs. 

In addition to faking research, downplaying COX-2 side effects, and jacking up the cost of medical care, Reuben also profited from financial arrangements with Merck and Pfizer. Those relationships are hard to confirm in his publications, but you find evidence of them in odd places. For example, in a conference brochure (Reuben lectured widely to disseminate his “research”) you discover that he not only received “grants” from Merck and Pfizer, but that he was also on their for-hire speaker’s bureau.  

The rest of Dr. Scannell’s commentary is found at Inside Bay Area.

In his blog from March 5th, Attorney Dave C. Jones writes about Dr. John Muney’s innovative method of treating those who cannot afford health insurance. In a nutshell, he charges his patients $79 per month plus $10 per visit. In other words, for about $1,000 per year, his patients do not have to worry about routine illnesses or anything else that can be taken care of in Dr. Muney’s New York offices.

Dr. Muney’s practice does not sound much differnt from that of Marcy Zwelling-Amott MD (video). 

Attorney Jones asks:

Who could possibly have a problem with that plan? Apparently, the New York state insurance regulators do. The state told Dr. Muney that his plan is an insurance policy and he has to be licensed to sell insurance.

Give me a break. The government cries out of one side of its mouth that society has an obligation to ensure that every person has access to health care; then, out of the other side, it berates doctors who do something to make that goal a reality. What the government really wants is complete control of everything. If the government really cared about the people, New York state would have no problem with what Dr. Muney is doing. In fact, the state should be recommending that idea to doctors all over the state.

It’s not clear how raising his visit fee to $33 will secure compliance but you can read more on this story at State of (In)dependence, New York Post, News Day, and Crain’s.