JustCare

Tag: Conflicts of interest

  • Is Mehmet Oz fit to run Medicare agency?

    Is Mehmet Oz fit to run Medicare agency?

    Last month, Senator Elizabeth Warren, along with six other Democratic Senators, sent a letter to Dr. Mehmet Oz, whom President-elect Donald Trump has named as Administrator-Designate, Centers for Medicare & Medicaid Services (CMS), regarding Dr. Oz’s call for the elimination of traditional Medicare and his lack of qualifications for the CMS Administrator position. If Dr. Oz becomes head of CMS will we be playing with fire?

    Dr. Oz has substantial investments in corporate health insurance companies. He has said that he wants everyone with Medicare in a Medicare Advantage plan, even though Medicare Advantage does not work for large swaths of the population. (People in rural communities who are in Medicare Advantage plans often must travel tens of miles to receive hospital care because their Medicare Advantage plans won’t pay their local hospitals appropriately. People with cancer in Medicare Advantage plans can’t see physicians at cancers centers of excellence because they are all out of network. People who travel and need care in multiple parts of the US can’t get the in-network coverage they need in Medicare Advantage. Amputees and other people needing rehab services too often can only get that care covered if they are in traditional Medicare.)

    Dr. Oz also either does not appear to appreciate or does not care that traditional Medicare is far more cost effective than Medicare Advantage. He either does not know or does not care that Medicare is overpaying corporate health insurers operating Medicare Advantage plans tens of billions of dollars each year.

    MedPAC projects that these insurers will overcharge CMS $83 billion relative to traditional Medicare in 2024 alone. To maximize profits, private insurers make their MA enrollees appear sicker than they actually are. The HHS Office of the Inspector General finds that insurers engage in constant inappropriate delays and denials of needed care and force physicians and hospitals to jump through hoops to deliver needed care. Dr. Oz does not seem to know about or ignores these abuses.

    Dr. Oz also has a financial conflict of interest. He owns more than $550,000 of stock in UnitedHealth, which is under Justice Department investigation for antitrust abuses. But, his desire to eliminate traditional Medicare would double revenue for UnitedHealth to nearly $300 billion.

    Senators Warren, Wyden, Cardin, Merkley, Durbin and Blumenthal ask Dr. Oz for answers to a series of questions by December 23, 2024:

    1. Does he continue to believe traditional Medicare should be eliminated and, if so, why?
    2. Will he commit to protecting Medicare, not privatizing it or cutting benefits?
    3. Does he understand why Medicare Advantage is highly dysfunctional and, if not, what does he think about the upcoding and widespread delays and denials of needed care?
    4. Will he sell off all investments in health insurance companies in order to ensure he has no financial conflicts of interest if he is confirmed as CMS Administrator?

    Here’s more from Just Care:

  • Can you trust AARP when it comes to choosing a Medicare Advantage plan or health clinic?

    Can you trust AARP when it comes to choosing a Medicare Advantage plan or health clinic?

    Back in the 90’s, when I was launching the Medicare Rights Center, AARP partnered with United Healthcare to offer standardized Medicare supplemental insurance policies for people in traditional Medicare. Since then, AARP has partnered with UnitedHealthcare to support its private Medicare Advantage plans. Now, Fred Shultz reports for Kaiser Health News, that AARP is now partnering with Oak Street Health, which operates health clinics in more than 20 states. Can you trust AARP when it comes to choosing a Medicare Advantage plan or using a health clinic?

    Make no mistake. AARP, a non-profit trade association for older adults, is partnering with health insurers and health clinics in order to generate hundreds of millions of dollars in income. If AARP had meaningful data to assess and choose partners offering high quality products and services, its partnerships could add value for its members. But, no one has that ability because the data is not available.

    AARP’s partnerships with UnitedHealthcare and Oak Street are all about the money, pure and simple. And, therefore you cannot trust the AARP name when it comes to deciding whether you should join a Medicare Advantage plan operated by UnitedHealthcare or visit a health clinic operated by Oak Street. AARP is generating $1 billion a year from these partnerships. Talk about conflicts of interest.

    As it turns out, Oak Street is under investigation by the Justice Department for possible violation of the False Claims Act because of its marketing practices. Naturally, Oak Street denies any wrongdoing, and it claims it offers “value-based care.” I say, “no data, no value.”

    Oak Street is one of the 99 “direct contracting entities” that the Centers for Medicare and Medicaid Services (CMS), the agency that oversees Medicare, has contracted with as part of an experiment intended to reduce Medicare spending and improve quality of care for people in traditional Medicare. But, the experiment injects for-profit middlemen into traditional Medicare that show no evidence of delivering value as I and many others have argued.

    As health economist Marilyn Moon explains, these partnerships put AARP in a compromising position. These partnerships are very different from AARP partnering with a travel company to help its members get travel discounts. The partnerships could keep AARP from advocating to promote the needs of their members.

    For example, because of its partnership with Oak Street,  AARP does not appear to have spoken out against the privatization of traditional Medicare through direct contracting entities, renamed REACH. REACH is a government experiment in which Oak Street and other private equity and insurer entities are paid to “manage” care for people in traditional Medicare.

    AARP claims that its partnerships do not affect its advocacy on behalf of its members. Even if that were true, the appearance of a conflict in and of itself is troubling.

    Here’s more from Just Care:

  • Which medical sources can you trust?

    Which medical sources can you trust?

    A new Pro Publica and New York Times investigative report reveals that many of the country’s leading medical journals are publishing articles by doctors with ties to the health care industry–who may stand to financially benefit from their articles–without disclosing these ties. Because of these potential conflicts of interest, it would be a mistake to trust articles from these medical journals. So, which medical sources can you trust?

    Evidence abounds that individuals and organizations who take money from the health care industry are more likely to speak favorably about the products of the health care companies who fund them than individuals and organizations who are free of these financial ties. Health care corporate money corrupts people, including doctors, in all kinds of insidious ways. But, a large number of doctors take the money and fail to recognize its corrupting influence, let alone to disclose their financial relationships. In the process, they aid corporations in selling more of their products.

    The journals that publish these articles have done a poor job of ensuring appropriate disclosures. Even the highly regarded New England Journal of Medicine has allowed the president-elect of the American Society of Clinical Oncology, Howard A. Burris III, to publish 50 articles without disclosing his industry ties and with a declaration that he had no conflicts of interest. He apparently did not believe that nearly $8 million in pharmaceutical industry research money to his employer, the Sarah Cannon Research Institute, amounted to a conflict.

    Dr. Robert J. Alpern, the dean of the Yale School of Medicine, wrote a positive article in the Clinical Journal of the American Society of Nephrology about an experimental treatment, without disclosing that he was a member of the board of directors of the company that had developed the treatment, that he owned stock in the company, or that the company had paid for the clinical trial.  

    Almost ten years ago the Institute of Medicine recommended ways that health care journals could do a better job of reporting conflicts of interest. But, little has changed at these journals since then. One recent study reported that only 37 percent of articles by the 100 most highly paid doctors by medical device makers reported their conflicts of interest.

    In September, Memorial Sloan Kettering Cancer Center’s chief medical officer, Dr. José Baselga, resigned after an investigative report revealed his undisclosed ties to industry.

    One doctor recently argued in JAMA that researchers who do not disclose their financial ties should face charges of misconduct. Without these disclosures, their research cannot be trusted. They are effectively “falsifying” information. And the International Committee of Medical Journal Editors may decide to recommend that the institutions that hire researchers who do not disclose financial ties look into whether they should be charged with research misconduct.

    For now, you can find trustworthy research on Cochrane, an independent non-profit research institute. You also should seriously question all research that may have been funded with corporate dollars. And, you should beware of medical advice from the mainstream media.

    Here’s more from Just Care:

  • With alcohol, less is generally more

    With alcohol, less is generally more

    It’s hard to know who to believe any more. When it comes to health care research, industry is almost always in the pocket of the researchers. Roni Caryn Rabin reports for the New York Times on an alcohol study that was pulled because the researchers were working with industry and not looking at the health risks.

    Before explaining, if you’re interested in good, seemingly untainted, alcohol research, click here. We write about a study showing that more than five drinks a week can affect longevity.  And, for the record, alcohol is classified as a carcinogen.

    In the study that was pulled because of conflicts of interest, a Harvard scientist, Kenneth J. Mukamal, and his team, some of them working at the National Institute for Alcohol Abuse and Alcoholism, were working closely with executives in the beer and liquor industry to design a trial that would not capture the negative health effects of alcohol consumption. While Mukamal is unapologetic about the tainted nature of his team’s work, the NIH determined that he was meeting the desires of these executives in order to secure nearly $100 million in support for the 10-year trial from them.

    Mukamal’s team was aiming to show the heart benefits of an alcoholic drink a day and not the negative health effects. It was also not collecting data to show the dangers of heart failure or cancer from  moderate drinking.

    Worse still, Mukamal’s team appeared to be hiding from the NIH its collaboration with alcohol industry executives, including the industry’s likely funding of the trial. The team’s primary goal was to collect the industry money and do the trial to show results at odds with a World Health Organization finding that drinking beer and liquor always raises the risk of cancer.

    Industry influence on the design of clinical trials appears all too common. The pharmaceutical industry has a big hand in drug trials, a likely reason that one in three recently FDA-approved drugs have safety risks.

    Here’s more from Just Care:

  • Beware of researchers with conflicts of interest

    Beware of researchers with conflicts of interest

    When reading about health care, it’s sometimes hard to know who’s telling the truth and who’s burying it. That’s why I try to base all JustCare posts on findings from independent researchers, information from consumer organizations and government agencies and other generally trustworthy sources. But, when things get technical, even seasoned reporters at the New York Times fail to beware of researchers with conflicts of interest and bury the lede.

    Josh Freeman writes on Medicine and Social Justice that Denise Grady at the New York Times promotes a Novartis-funded study published in the New England Journal of Medicine on the effect of canakinumab (Ilaris) on heart attack survivors. The findings, he says, and cardiologist Michael Gilson, M.D., agrees, are not surprising and unremarkable–fewer heart attacks and strokes for patients taking the drug. But, overall, the people taking the drug died at the same rate as the people not taking the drug because the drug “decreases the body’s immune response,” leading to sometimes lethal infections.

    Freeman and Gilson’s conclusion: The drug offers no clinical advance. For $200,000 a year–the cost of the drug–fewer people die of heart attack and stroke but, because of the drug’s side effects, they have the same likelihood of dying as people who don’t take the drug. Moreover, an unknown number of people who take the drug do not die from it but suffer significantly from the infections caused by the drug, including tuberculosis, sepsis, pneumonia and cellulitis.

    In short, contrary to the New York Times article, this drug is “no major milestone.” It costs a fortune, does not decrease people’s risk of death, and it increases their risk of serious infections. In the second half of her NYT article, Grady does cover these issues, but the article headline, “Drug Aimed at Inflammation May Lower Risk of Heart Disease and Cancer,” and its opening paragraphs are terribly misleading.

    N.B. Also beware of doctors with conflicts of interest. Stat News recently published a Pharma puff piece by Dr. Robert Yapundich, who, according to Pro Publica, has received $215,000 from Pharma. If Stat was not aware of the Pro Publica database revealing which doctors take money from Pharma, it should be. If it was aware and still thought the piece offered value for its readers–which is hard to understand–it owes its readers a prominent note about the author’s conflict of interest.

    Here’s more from Just Care: