Princess Health and "You Smoke? You're Fired". Princessiccia

Princess Health and "You Smoke? You're Fired". Princessiccia

Gusty 09:18 Add Comment

USA Today summarizes how some companies are firing or refusing to hire workers who smoke while away from work. Meanwhile, the San Francisco Chronicle reports on a study that shows that companies who provide health insurance on average pay smokers less than non-smokers, but no such differential is seen at companies that don't provide such insurance.
Obviously, smoking is an unhealthy habit that increases risk of a number of serious disease. As a physician, I am always encouraging patients not to smoke, or to quit cigarettes. But many patients find it very hard to quit, mainly because the nicotine in cigarettes is highly addicted.
Although I continue to urge such patients to quit, and try to find ways to help them do so, I personally don't think that they deserve to be blamed or shamed.
However, the two stories above seem to illustrate, as I've said before, how companies that pay for their employees' health insurance (presumably with money that would otherwise go the employees as salary) seem to see this transfer of funds a license to control their employees' private behavior. This heavy-handed approach seems like more of an abuse of power to me than a valid approach to public health. As a physician, it's hard enough to try to get patients to quit smoking. For such a patient, losing their job because of the habit adds more than insult to injury.

Princess Health and "You Smoke? You're Fired".Princessiccia

Princess Health and "You Smoke? You're Fired".Princessiccia

Gusty 09:18 Add Comment

USA Today summarizes how some companies are firing or refusing to hire workers who smoke while away from work. Meanwhile, the San Francisco Chronicle reports on a study that shows that companies who provide health insurance on average pay smokers less than non-smokers, but no such differential is seen at companies that don't provide such insurance.
Obviously, smoking is an unhealthy habit that increases risk of a number of serious disease. As a physician, I am always encouraging patients not to smoke, or to quit cigarettes. But many patients find it very hard to quit, mainly because the nicotine in cigarettes is highly addicted.
Although I continue to urge such patients to quit, and try to find ways to help them do so, I personally don't think that they deserve to be blamed or shamed.
However, the two stories above seem to illustrate, as I've said before, how companies that pay for their employees' health insurance (presumably with money that would otherwise go the employees as salary) seem to see this transfer of funds a license to control their employees' private behavior. This heavy-handed approach seems like more of an abuse of power to me than a valid approach to public health. As a physician, it's hard enough to try to get patients to quit smoking. For such a patient, losing their job because of the habit adds more than insult to injury.

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.