Conflicts of Interest Produce HMO HARDBALL Comments

• Conflicts of Interest destroy the Doctor--Patient Relationship!
  
  
• Conflicts of Interest Destroy Patients' Trust in Health Information Sources.

• Transgressing the Boundaries: Towards a Transformative Hermeneutics of Quantum Gravity
  Alan D. Sokal, Department of Physics, New York University

  This article was published in Social Text #46/47, pp. 217-252 (spring/summer 1996). Dissent 43(4), pp. 93-99 (Fall 1996) and, in slightly different form, in Philosophy and Literature 20(2), pp. 338-346 (October 1996).
  
  HMO HARDBALL Comment: This article is an intentional, completely unadulterated fraud, a fragrant example of junk science that was accepted, promoted and printed by editors, peer reviewers and readers. P.T. Barnum was right, "There's a sucker born every minute." Correction: Although this expression is attributed to P.T., he was not its author. Caveat Emptor.
  

• "When Peer Review Produces Unsound Science."
  Lawrence K. Altman, M.D., The New York Times, June 11, 2002. Page D-6.
  
  Peer review problems include the incomplete review of data upon which findings and conclusions are based, failure to discuss limitations of researchers' findings, steering journalists to exaggerate the perceived importance of findings, and failure to inform reviewers and readers of caveats and conflicts of interest. A copy of this article is available from The New York Times archives (for a small fee).
  
  HMO HARDBALL Comment: Peer Review aids and abets "junk science," among other injurious impacts on patients. "Peer Review" is one of those misleading terms (like quality, evidence based medicine, science, research, academy, independent, non-profit, etc.) used to manipulate patients' minds, engender unearned trust, and eliminate even a glimmer of critical thinking, i.e., the process that leads to patient self-actualization. Language is used to undermine patients' application of the Socratic method, (i.e., question - answer, question - answer, question - answer, and on and on and on) in their quest to achieve the healthcare they need. The Socratic method is the perpetual motion machine of patient investigation that leads patients to answers best suited to their achieving the healthcare they need and avoiding unnecessary disease, disability and death.
  
  
• "A Medical Journal Eases Conflict [of Interest] Rule"
  The New York Times, June 13, 2002. Page A-27. "N.E. Journal of Medicine Eases Conflict Rules" Los Angeles Times, June 13, 2002. Page A-28.
  
  HMO HARDBALL Comment: The NEJM is among the most highly regarded and influential periodicals of its kind in the world. It has "relaxed" its conflict-of-interest rules, because it cannot find enough experts who are independent, i.e., who are not being enriched by drug companies while at the same time projecting their objectivity. Whenever you see a doctor riding two horses with his/her sole behind, you will have witnessed the corrosive, corrupting conflict-of-interest that undermines patient trust and diminishes the stature of doctors as once esteemed role models. As the HMO HARDBALL All Star Team explained in The Patient's Self-Protection Manual (aka, How to play HMO HARDBALL), Rule #1 is that the healthcare system and its practitioners follow business plans, not health plans.
  
  
• "Aetna Upheld in Court Ruling,"
  Two federal courts agree that Aetna can lie to patients without being held accountable: "In fighting the case, [re: Aetna violating racketeering laws in its advertising and membership materials] Aetna admitted that claims in its advertising that it was committed to 'maintaining and improving quality health care' were 'mere puffery' but said that did not amount to fraud. The New York Times, August 12, 2000, p. B14.
  
  HMO HARDBALL Comment: The HMO HARDBALL All Star Team has never seen a corpse that asked how it got so cold. And we have never known a patient (who believed an HMO's "mere puffery" that subsequently led to disease, disability or death) who was not outraged when learning how lawyers, judges and others subvert the English language to harm patients and their loved ones. The difference between your life and death, cannot be rationalized away by using legal smoke and mirrors to convince patients that the language used by used car dealers is applicable when communicating with them as patients. Although that is not Aetna's position, there is difference between "consumers" and "patients."
  
  

• "Firm Tracking consumers on Web for Drug Companies."
  By Robert O'Harrow Jr., Washington Post Staff Writer
  Tuesday, August 15, 2000; Page E01

  "A Boston technology firm is surreptitiously tracking computers users across the Internet on behalf of pharmaceutical companies… By invisibly placing ID codes on computers that visit its clients' WWW sites, Pharmatrak Inc. can record consumers' activity when they alight on thousands of pages maintained by 11 pharmaceutical companies."

  "And the company's Web site also suggests that it has plans to identify people. "In the future, we may develop products and services which collect data that, when used in conjunction with the tracking database, could enable a direct identification of certain individual visitors," it says, adding that they would never take advantage of such information.
  
  Click here to view complete article.
  
  HMO HARDBALL Comment: On HMO HARDBALL's reading list: Brave New World by Aldous Huxley (1894-1963)
  

• “The Rise and Fall of the Killer Drug Rezulin”
  Los Angeles Time, June 4, 2000, p.1A.

  “People were dying as specialists waged war against their FDA superiors.  Patient safety was at stake in the scramble to keep a ‘fast-track’ pill on the U.S. market.”  “It was not until a disparate collection of physicians inside the U.S. Food and Drug Administration waged a remarkable revolt that the agency was forced to reverse course.”  These specialists “combined meticulous research and bluntly worded e-mail messages to upbraid their government superiors for contributing to the needless deaths of patients.”  Research for this article revealed “that senior government officials repeatedly played down the drug’s propensity to cause liver failure and death.” 

  The U.S. Food and Drug Administration (FDA) is an agency in the U.S. Public Health Service which is part of the U.S. Department of Health and Human Services.  The FDA has identified and described itself as “The Nation’s Foremost  Consumer Protection Agency.”  NOTE:  The L.A. Times archives provide an extensive history of the conflicts-of-interests within the FDA that have harmed patients starting with a July 28, 1998 Reuters article “FDA Is Urged to Pull Diabetes Drug [Rezulin] Off Market.”
  

• “Ehealth Stakeholders Release Ethics Code for Health Web Sites” Health Care Policy Report (Bureau of National Affairs) May 29, 2000, p.886.
  
  The Internet Healthcare Coalition released the code comprised of eight principles as a response to questionable business practices of health web sites and to forestall government intervention.  Throughout this article, code drafters were quoted as using the phrases such as “expected behavior,” “would be expected,” “adoption will be voluntary,” “universal framework,” “monumental step” in describing their work: 

  In fact, the action of this coalition is reactive and based on fear, not proactive, because it’s the right thing to do.  As for implementation, later is better than sooner as patients have found with anything doing with identifying and implementing patients’ rights.  Additionally, there are competing organizations vying to be the fountainhead of Internet health ethics.  A second coalition, Hi-Ethics, not to be outdone in the race to win the title of being the most ethical, released 14 ethical principles on May 7, 2000—seven more ethical principles than Ehealth.  In light of the confusion, members of the U.S. Senate plan to introduce legislation to require the Federal Trade Commission, DHHS and the Veterans Administration to review the ethics codes proposed by both groups. 

  HMO HARDBALL Comment: Use the Patient Pressure System created for patients to pressure HMOs, their doctors, and allies to be ethical in the first place, i.e., not to delay or deny necessary healthcare to patients.  The place to look – How to Play HMO HARDBALL, (the book) and the website, www.hmohardball.com.

  In the same issue, the Health Care Policy Report included a story titled “FTC Concludes Self-Regulation Not Enough To Protect Privacy, Recommends Legislation.”  The FTC [Federal Trade Commission] report, Privacy Online: Fair Information Practices in the electronic Marketplace” stated that only 20 percent of web sites surveyed implemented the fair information practice principles of notice, choice, access, and security.  Opponents (Online Privacy Alliance) trashed the FTC’s recommendation as “overbroad, premature, impractical and unnecessary.”  A legislative aide for Rep. Edward J. Markey (D-Mass) told attendees at the May 2000 Charles Schwab Washington Research Group’s healthcare conference that “Ultimately, not much will be done to protect your personal [medical] information in this Congress.”
  
  

• “What [health information] You Get Depends on Who Owns the Web Site”
  Los Angeles Times, May 29, 2000, p.S5.
  
  This article, reprinted from the Washington Post, is a survey article addressing how money, power, and conflicts-of-interest impact health information available to patients.  Catherine Monaghan of Gomez Advisors, a firm that tracks Internet businesses, (and a source turned to by CNBC for information), is quoted as follows:  “Pure play health-content sites are dead.”  HMO HARDBALL’s message to patients… no matter how benign, friendly and helpful a health information site portrays itself to be, BEWARE!  Patient empowerment is not the primary motivation of commercial health information sites that attempt to attract a broad audience..  P.S.  www.hmohardball.com  is an exception to Ms. Monaghan’s observation.  HMO HARDBALL is self-financed and free of conflict-of-interest.
  
  

• “A Wonder Drug That Carried the Seeds of Death”
  Los Angeles Times (Sunday Report) May 21, 2000, p. A1.
  
  Following are excerpts, from this well researched article, that reflect the duplicity, as well as the refusal of the National Institutes of Health (NIH) to accept responsibility for its incompetence and its turning a blind eye to research risks to children it knew it had helped to create.   NIH promotes itself as one of the world' foremost medical research centers. It is the federal govenrment's focal point for medical research in the U.S. The NIH's stated mission is to uncover new knowledge that will lead to better health for everyone.

   Abstracted from the above cited Los Angeles Times Article
  
  In 1958, an American scientist harnessed the human growth hormone.  For the next 22 years, NIH supplied the hormone which was administered to more than 8,000 children.  It worked.   But then, a succession of recipients began to develop symptoms.  Loss of balance, staggering and drooling.  Personality change.  Within months they were in comas, their brains were turning to sponge. They had Creutzfeldt-Jakob disease, or CJD.
  
  “But the NIH has not apologized, or even helped with the care of victims.  The NIH “has insisted for the last 15 years that the deaths were unforeseeable.”  “It was an experimental treatment, and people signed informed consents,” NIH spokeswoman Jan Demouy said.  However, “ British court documents showed that the deaths were not only foreseeable, they were foreseen.  The NIH lab called in to investigate the deaths in 1985 had been warned of the danger of contamination seven years earlier.”  When confronted with the documents, Demouy said “the NIH involvement was limited to funding the program.”
  
  HMO HARDBALL Comment: When the first HMO HARDBALL dirty trick didn’t work (“Lie Your Heart Out”) i.e., “the deaths were unforeseeable,” NIH executives shamefully and shamelessly used another HARDBALL dirty trick, (“Ostrich Impersonators”), i.e., NIH only funded the program.  Quick to lecture patients to take “responsibility,” or else, this investigative report reveals that NIH will not confront, acknowledge and correct its own conflicts-of-interest that harm patients.
  

• “New England Journal Editor Blasts Some Drug Industry/Academic Links” 
  Wall Street Journal, May 18, 2000, p. B18.
  
  “The departing editor of the New England Journal of Medicine criticized “large-scale breaching of the boundaries between academic medicine and for-profit industry.”  “The call by editor Marcia Angell was paired with a new research report in today’s issue of the Journal that found “academic-industry drug trials have been tainted by the profit incentive.”  Harvard Medical School confirmed that the university is pondering a relaxation.  Problems further include the issue of stock ownership, the intertwining of academic medicine with the pharmaceutical and biotechnology industries, problems of policing researchers, drug companies controlling research by delaying or preventing publication of ad adverse results, and the use of ghost writers, hired by drug companies, to write reports to which academic researchers then claim authorship.

• “King/Drew Medical Research Suspended”
  Los Angeles Times, April, 27, 2000, p.1A
  
  The Charles Drew University of Medicine and Science and its affiliated health care center stopped 250  studies involving human subjects after federal officials found numerous violations of regulations and rules protecting patients who take part in clinical research.  The violations related to accountability meant to assure the studies scientific credibility as well as to breaching patient protections such as not fully informing patients of the risks associated with participation in medical research.  Drew’s 600 member faculty conducted the 250 research projects involving human subjects.
  
  

• “Three Health Care Internet Sites Settle FTC Charges of Consumer Fraud,” Bureau of National Affairs, Health Care Policy Report.  April 10, 2000, p. 588.
  
  

• "DrKoop.CON?" TomPaine.com, An Internet Journal of Opinion, 3/29/2000 www.tompaine.com
  
  

• "Do Sponsors Sway Health Web Sites? Corporate Pressure Denied, but U.S. Watches Closely." The Wall Street Journal, 2/8/2000, p.B7.
  
  

• "Sometimes, the Web Site Is Watching You Right Back." Privacy. Co-author of a report calling for greater protections for Internet users says health dot-coms must do more." Los Angeles Times, 2/7/2000, p.S1. Article cites report titled "Privacy: Report on the Privacy Policies and Practices of Health Web Sites" produced by the California HealthCare Foundation.
  
  

• "Changing Their Role. By mixing celebrity and cyberspace, some high-profile doctors are redefining the way medicine is practiced and promoted." Los Angeles Times, 1/24/2000, p.S1.
  
  

• "Move over drkoop.com: AMA Launches For-Profit Web Venture." The Wall Street Journal, 10/28/99, p. B4
  
  

• "Hailed as a Surgeon General, Koop Is Faulted on Web Ethics." The New York Times, 9/5/99, p.1, E-MEDICINE – A special report.
  
  

• "Inside Medical Journals, A Rising Quest for Profits." The New York Times 8/24/99
  
  

• "Editor Forced to Resign in dispute Over Marketing of Medical Journal’s Name." (The New England Journal of Medicine) The New York Times, 7/27/99, p.A12.
  
  

• "CybeRx: Getting Medical Advice and Moral Support on the Web: The Doctors Are In—but Can You Trust Them?" The Wall Street Journal 4/30/98, p.B10.