Princess Health and Wall Street Journal on "Misleading [Medical] Journal Articles". Princessiccia

Princess Health and Wall Street Journal on "Misleading [Medical] Journal Articles". Princessiccia

Gusty 13:59 Add Comment

Today's Wall Street Journal has a (front page in the print edition) article that nicely summarizes some cases of a "Worrisome Ailment in Medicine: Misleading Journal Articles." It includes such cases as the controlled trial of Celebrex that included only six-month data (when the twelve-month data failed to show a benefit). As Jeffrey Drazen, editor of the New England Journal of Medicine put it, editors have "found themselves playing a game of hide-and-seek," including "experiences where authors tried to pitch it, where they were telling you the good news and not the bad."
(NB: the link above should work without requiring a subscription.)

Princess Health and Wall Street Journal on "Misleading [Medical] Journal Articles".Princessiccia

Princess Health and Wall Street Journal on "Misleading [Medical] Journal Articles".Princessiccia

Gusty 13:59 Add Comment

Today's Wall Street Journal has a (front page in the print edition) article that nicely summarizes some cases of a "Worrisome Ailment in Medicine: Misleading Journal Articles." It includes such cases as the controlled trial of Celebrex that included only six-month data (when the twelve-month data failed to show a benefit). As Jeffrey Drazen, editor of the New England Journal of Medicine put it, editors have "found themselves playing a game of hide-and-seek," including "experiences where authors tried to pitch it, where they were telling you the good news and not the bad."
(NB: the link above should work without requiring a subscription.)

Princess Health and Allegations of Corruption Affecting the South's Largest Hospital. Princessiccia

Princess Health and Allegations of Corruption Affecting the South's Largest Hospital. Princessiccia

Gusty 13:13 Add Comment

I stumbled over this story while searching for something else. It really isn't new, but it is striking, but not very well publicized.

Last year, a Department of Justice press release revealed that former Georgia State Senator Charles W Walker had been indicted on multiple counts. It alleged two "fraudulant schemes" involving health care.

• "The second scheme to defraud involved Grady Memorial Hospital, Georgia�s largest public hospital, located in Atlanta, Georgia. The indictment alleges that Charles W. Walker misused his public office for private gain and, in so doing, deprived the public of its right to his honest services as a state legislator. The indictment charges that Walker stalled the passage of legislation affecting the Grady�s funding until hospital executives agreed to use exclusively personnel from Walker�s temporary employment agency to work at the hospital."
• "In the third fraudulent scheme, the indictment alleges that Charles W. Walker deceived executives at Georgia�s state medical college, the Medical College of Georgia, into using his temporary employment agency for personnel to work at the hospital and into advertising in the Augusta Focus. Walker deceived college officials by misrepresenting that he did not own his two businesses, a move he took in order to circumvent a state conflict of interest law that generally prohibits state public officials from doing business with state entities such as the medical college. According to the indictment, Walker also breached his fiduciary duty to the public by failing to disclose these transactions, on state-mandated
  financial disclosure forms for public officials, until a media inquiry forced him to do so."

Walker's indictment had been briefly reported in the Augusta Chronicle. In addition, a 2001 article in the Atlanta Business Chronicle had noted Grady Memorial Hospital's worsening financial condition, and the charges made then that "wealthy contractors and trial attorneys are being allowed to rip off the hospital," made by a dissident board member. He also asserted "hospital management is adrift and I don't think they have a clue what they are doing." Furthermore, a Lexis-Nexis search revealed that Walker was fined by the state Senate Ethics Commission for failing to disclose his business relationships with both Grady Hospital and the Medical College of Georgia. The Jacksonville based Florida Times-Union has also followed the story. In 2004 it reported that "the FBI has been asked to investigate claims of witness tampering, intimidation, and even possible attempted poisoning of former Grady Hospital employees who blew the whistle on a sweetheart deal ex-Sen. Charles Walker had with the South's largest hospital." It recently reported that Walker and his daughter will go to trial this month.

How I stumbled on this deserves explanation. A UK publication called The New Criminologist, which proclaims itself "the oldest journal for professionals involved in all aspects of criminology," has a special web-based section on "The Grady Coalition," featuring a large number of articles from a group of apparent whistle-blowers aggrieved over the scandal at Grady. I personally know nothing about this group, and can't vouch for the accuracy of their charges, but their work makes for fascinating reading. And there clearly is evidence from the sources listed above to corroborate at least some of what they have been saying.

If nothing else, this demonstrates that there are an unknown number of stories of alleged corruption of health care organizations have been published in the local news media, but in the absence of any systematic effort to find them, the quantity and impact of unethical and corrupt practices in health care also remain unknown.

Princess Health and Allegations of Corruption Affecting the South's Largest Hospital.Princessiccia

Princess Health and Allegations of Corruption Affecting the South's Largest Hospital.Princessiccia

Gusty 13:13 Add Comment

I stumbled over this story while searching for something else. It really isn't new, but it is striking, but not very well publicized.

Last year, a Department of Justice press release revealed that former Georgia State Senator Charles W Walker had been indicted on multiple counts. It alleged two "fraudulant schemes" involving health care.

• "The second scheme to defraud involved Grady Memorial Hospital, Georgia�s largest public hospital, located in Atlanta, Georgia. The indictment alleges that Charles W. Walker misused his public office for private gain and, in so doing, deprived the public of its right to his honest services as a state legislator. The indictment charges that Walker stalled the passage of legislation affecting the Grady�s funding until hospital executives agreed to use exclusively personnel from Walker�s temporary employment agency to work at the hospital."
• "In the third fraudulent scheme, the indictment alleges that Charles W. Walker deceived executives at Georgia�s state medical college, the Medical College of Georgia, into using his temporary employment agency for personnel to work at the hospital and into advertising in the Augusta Focus. Walker deceived college officials by misrepresenting that he did not own his two businesses, a move he took in order to circumvent a state conflict of interest law that generally prohibits state public officials from doing business with state entities such as the medical college. According to the indictment, Walker also breached his fiduciary duty to the public by failing to disclose these transactions, on state-mandated
  financial disclosure forms for public officials, until a media inquiry forced him to do so."

Walker's indictment had been briefly reported in the Augusta Chronicle. In addition, a 2001 article in the Atlanta Business Chronicle had noted Grady Memorial Hospital's worsening financial condition, and the charges made then that "wealthy contractors and trial attorneys are being allowed to rip off the hospital," made by a dissident board member. He also asserted "hospital management is adrift and I don't think they have a clue what they are doing." Furthermore, a Lexis-Nexis search revealed that Walker was fined by the state Senate Ethics Commission for failing to disclose his business relationships with both Grady Hospital and the Medical College of Georgia. The Jacksonville based Florida Times-Union has also followed the story. In 2004 it reported that "the FBI has been asked to investigate claims of witness tampering, intimidation, and even possible attempted poisoning of former Grady Hospital employees who blew the whistle on a sweetheart deal ex-Sen. Charles Walker had with the South's largest hospital." It recently reported that Walker and his daughter will go to trial this month.

How I stumbled on this deserves explanation. A UK publication called The New Criminologist, which proclaims itself "the oldest journal for professionals involved in all aspects of criminology," has a special web-based section on "The Grady Coalition," featuring a large number of articles from a group of apparent whistle-blowers aggrieved over the scandal at Grady. I personally know nothing about this group, and can't vouch for the accuracy of their charges, but their work makes for fascinating reading. And there clearly is evidence from the sources listed above to corroborate at least some of what they have been saying.

If nothing else, this demonstrates that there are an unknown number of stories of alleged corruption of health care organizations have been published in the local news media, but in the absence of any systematic effort to find them, the quantity and impact of unethical and corrupt practices in health care also remain unknown.

Princess Health and How Can a $124.8 Million a Year CEO Make Health Care More Affordable?. Princessiccia

Princess Health and How Can a $124.8 Million a Year CEO Make Health Care More Affordable?. Princessiccia

executive compensation UnitedHealth

Gusty 12:42 Add Comment

An op-ed piece in the Providence Journal about huge pay packages for corporate CEOs mentioned the breath-taking $124.8 million total compensation of United Health Group (parent of United Healthcare) CEO William McGuire. This figure can also be found in the Forbes Special Report on CEO compensation. Here one can find that other managed care CEOs got less fabulous, but still formidable compensation, e.g., Howard Phanstiel, PacifiCare, 3.38 million; Edward Hanway, Cigna, $13.3 million; John Rowe, Aetna, $22.2 million; and Larry Glassrock, Wellpoint, $25.0 million.
McGuire's compensation was so large as to take a measurable part of this large company's net income (5%). Or to look at it from a stock-holder's (and hence, an company owner's) viewpoint, had McGuire, who is an employee, been only paid a cool million, and this money had been distributed as a dividend, it would amount to about a $0.20 per share dividend. (The current dividend is $0.03 per share.) (See company data available from Forbes as well.)
To look at it from a United employee's viewpoint, had McGuire, who is an employee, been only paid a cool million, and this money had been distributed to employees, each of the 40,000 employees could have received a bonus larger than $3000.
To look at it from the viewpoint of the health care system, the $124.8 million total compensation of a single United employee could pay the salaries of 833 general internists at current typical salaries. Or the $124.8 million could run one reasonable size community hospital for a year.
United Health Group's mission statement is "the company directs its resources into designing products, providing services and applying technologies that improve access to health and well-being services; simply the health care experience; promote quality; and make health care more affordable." (See this fact sheet.) Rather, it seems to be directing a good chunk of its resources into salaries of top management employees. How a $124.8 million CEO salary can be reconciled with a mission to "make health care more affordable" is completely beyond me.

Princess Health and How Can a $124.8 Million a Year CEO Make Health Care More Affordable?.Princessiccia

Princess Health and How Can a $124.8 Million a Year CEO Make Health Care More Affordable?.Princessiccia

executive compensation UnitedHealth

Gusty 12:42 Add Comment

An op-ed piece in the Providence Journal about huge pay packages for corporate CEOs mentioned the breath-taking $124.8 million total compensation of United Health Group (parent of United Healthcare) CEO William McGuire. This figure can also be found in the Forbes Special Report on CEO compensation. Here one can find that other managed care CEOs got less fabulous, but still formidable compensation, e.g., Howard Phanstiel, PacifiCare, 3.38 million; Edward Hanway, Cigna, $13.3 million; John Rowe, Aetna, $22.2 million; and Larry Glassrock, Wellpoint, $25.0 million.
McGuire's compensation was so large as to take a measurable part of this large company's net income (5%). Or to look at it from a stock-holder's (and hence, an company owner's) viewpoint, had McGuire, who is an employee, been only paid a cool million, and this money had been distributed as a dividend, it would amount to about a $0.20 per share dividend. (The current dividend is $0.03 per share.) (See company data available from Forbes as well.)
To look at it from a United employee's viewpoint, had McGuire, who is an employee, been only paid a cool million, and this money had been distributed to employees, each of the 40,000 employees could have received a bonus larger than $3000.
To look at it from the viewpoint of the health care system, the $124.8 million total compensation of a single United employee could pay the salaries of 833 general internists at current typical salaries. Or the $124.8 million could run one reasonable size community hospital for a year.
United Health Group's mission statement is "the company directs its resources into designing products, providing services and applying technologies that improve access to health and well-being services; simply the health care experience; promote quality; and make health care more affordable." (See this fact sheet.) Rather, it seems to be directing a good chunk of its resources into salaries of top management employees. How a $124.8 million CEO salary can be reconciled with a mission to "make health care more affordable" is completely beyond me.

Princess Health and Indictments in Alleged Scheme Involving Illinois Health Facilities Planning Board. Princessiccia

Princess Health and Indictments in Alleged Scheme Involving Illinois Health Facilities Planning Board. Princessiccia

Gusty 11:47 Add Comment

The Chicago Sun-Times reports that the former head of the Illinois Health Facilities Planning Board, Stuart Levine, and two local businessmen, P. Nicholas Hurtgen, formerly of Bear Stearns, and construction executive Jacob Kiferbaum, have been indicted for "influence peddling, kickbacks, and other corrupt actions" that affected local health care organizations. In one instance, they are accused of threatening Edward Hospital in Naperville that the Board would not approve its expansion plans unless the hospital were to use their firms to construct and finance the project. The hospital refused, and its application for expansion was rejected. Another alleged scheme involved Chicago Medical School. (An article from the Sun-Times from June 30, 2004, no longer available on the web, stated that Levine and Kiferbaum were on the school's board of trustees, and that Kiferbaum's company had been involved in large school construction projects. )
Setting aside, for the moment, the question of whether these indictments will result in convictions...
We have reported quite a few stories involving alleged or proven corruption of leaders of health care organizations. Since we have no mechanism in place to comprehensively search the news media for such cases, and since many such cases may go unreported, it is likely that all we have posted amounts to the tip of the iceberg.
What little survey data we have also suggest that unethical business practices in health care may be very widespread. For example, as we have previously posted, 53.8% of the respondents to the survey done by the American College of Physician Executives felt that a health care organization in their community was involved in unethical business practices.
It thus seems reasonable to ask how much effect all the episodes of unethical behavior and corruption have had on health care costs, access and quality. But I have yet to see any serious effort made to answer this question. (If someone else has seen one, please let me know.)
It also seems reasonable to ask why there is so little response to these episodes from the medical and health care communities. For example, although the Illinois Health Facilities Planning Board story first surfaced almost a year ago, I have not been able to find any response to it from a medical or health care organization. (If someone else has seen one, again, please let me know.)