So a disgruntled reporter is stirring up trouble by daring to question the way medical advances happen in this great nation. Apparently this Joel Rutchick character is suggesting that when respected surgeon Dr. Isador Lieberman and his organization the Cleveland Clinic began pushing a new type of back surgery, we are supposed to be surprised he didn’t plaster memos about his stock options and holdings in the company that made the device all over the foreheads of his patients.
Lieberman did not tell his patients about his financial conflict of interest unless asked, the Clinic acknowledged. According to Plain Dealer research, he also did not reveal his stock holdings in numerous articles he wrote about kyphoplasty.
Bunkum! Does every computer come with a message that you’re making Bill Gates richer every time you turn it on? Of course not.
And when he (Lieberman) testified to the treatment’s benefits at a government hearing last year, he did not divulge past stock interests in Kyphon Inc. and other device makers – even when explicitly asked to disclose such holdings.
Well he was correct. He had apparently sold the last of his stock a few months before the Congressional hearing. Like any good capitalist Dr Lieberman is onto the next pony. As he told the commie rag The Plain Dealer
"I strive to be transparent in my disclosures and believe that I have disclosed my interests within the guidelines and policies of the Cleveland Clinic," Lieberman said in a written statement. He declined to be interviewed.
Who needs an interview in the face of that transparency!
Didn’t Rutchick know that unlike a bum masquerading as a reporter Dr Lieberman had been to medical school and therefore knew all about ethics? And didn’t Rutchick also know for there to be great inventions like this it’s required that not just the inventor but anyone who uses it gets rich? Otherwise what incentive would physicians have to help patients and save lives! After all who except some communist would disapprove of such a system?
When Kyphon officials took their company public in May
2002, they disclosed in a filing with the Securities and
Exchange Commission that they had offered stock options to
the eight members of their advisory board. All took them
except Dr. Joseph Lane, a New York orthopedic surgeon who
teaches at the medical school affiliated with Cornell
University. "I felt it was very awkward for me to be honest about
these things if I owned stock in the company," Lane
said last week.
Yeah, and we know what color state this Dr. Lane character is from, don’t we?! Enough said on that topic. Honestly, virtually every great medical advance absolutely requires this kind of capitalist incentive for those using them. After all, most other medical advances come about the same way. The important thing is that there’s clear evidence of an improvement.
On the SpineUniverse Web site, Lieberman, Kyphon co-founder
Reiley and three other doctors published a four-paragraph
synopsis of their initial experiences with kyphoplasty
involving 26 patients. "These results support further
use of kyphoplasty," the March 2000 summary concluded.
What possible other evidence than this initial, non-per reviewed disinterested study could be needed? None, of course! The important thing is to get the new procedure into as general use as quickly as possible for the betterment of patient care and to save lives!
Before 2004, there had been only one reported death
associated with kyphoplasty and seven with vertebroplasty.
Since then, the numbers have changed dramatically. From 2004
through September, 16 deaths involving kyphoplasty were
reported to the FDA versus three vertebroplasty-related
fatalities. Experts agree that vertebroplasty is used more
frequently than kyphoplasty, although the gap has closed in
recent years. “These sorts of complications are extremely rare,” said
Julie Tracy, a Kyphon vice president. “These are procedures
that are very safe and do a lot of good for these patients.”
In a study published two years ago, researchers at the Johns
Hopkins Hospital in Baltimore also concluded that
kyphoplasty was more closely associated with serious
complications than vertebroplasty. Lieberman led the rebuttal for kyphoplasty proponents,
challenging the methodology of the study and completeness of
the data. However, those deaths and other complications underscore a
fundamental flaw of kyphoplasty: the risk of subjecting an
elderly patient to trauma and a general anesthetic, said Dr.
Kieran Murphy, one of the authors of the Hopkins study.
Murphy has disclosed that he receives royalties from one of
several manufacturers of the equipment used in
Exactly, it’s clear that the naysayers are paid off by the communists. And at least we know that the insurance industry and the government are getting better value for money from the new procedure.
Murphy and other critics of kyphoplasty say hospitals need
the fees from general anesthesia and admission to recover
the costs of the equipment used in the procedure. That
equipment averages $3,500 to treat a single fracture,
according to Kyphon; vertebroplasty kits generally cost $500
to $600. Costs vary, but all told, vertebroplasty was found
to be $6,000 cheaper for each fracture treated, according to
a research report.
Well obviously those insurers must think it’s a better deal! Who could imagine insurers or Medicare just paying more for a new procedure without careful vetting it. After all they’re the end payer aren’t they? And they’re really strict about containing costs, as anyone paying insurance premiums knows! And if they weren’t so tough on containing costs for consumers and taxpayers, then why would we have a national clinical cost-benefit analysis center researching all these new treatments and being "transparent" about which ones cost what?
Answer me that, you Cleveland commie reporter, eh!
The only slightly disquieting aspect of this whole article is that the procedure concerned was invented in France. I know it’s a free market and all that, next time I hope that a red-blooded American like Dr. Lieberman could have been a little more patriotic. We don’t want those people with nice new backs only able to run backwards, do we?
That stands to reason. Most of the greatest American capitalists are Canadians fleeing the yoke of their homeland’s socialist tyranny!
It turns out the doctor in question – Dr. Lieberman – is from Canada!
I have a simple five-word solution to the vexing problem of health-care cost containment:
“Outsource it all to India”
Health-care holidays and (way) off-site senior centers (day trips to the Taj Mahal,anyone?) will be driven by employers and adventurous senior citizens.
Granted, this doesn’t address the issue of unbiased product analysis, but the web can take of that. (Unbiased peer review is on its last legs anyway, now that just about every scientist and doc is a ‘consultant’ to a biotech or medical device company.)
Reply to Jeff:
I can’t argue with your logic. You could have even gone farther with it. The Republican Congress under the Bush Administration will probably to go down in history as probably the worst we’ve had. But that really wasn’t what my point was about at all. I’m just slightly skeptical that the Democrats will live up to the noble talk. I hope they prove me wrong …
A doctor has a financial incentive to recommend a particular treatment. He recommends that treatment to a patient. In a perfect world the doctor would only think of what is best for the patient.
We do not live in a perfect world.
How can a patient be sure that a doctor is prescribing the best treatment? More information would be helpful. Information regarding alternatives, cost, and information regarding any investment (financial or otherwise) a physician might have in the recommened prescription.
Note to John: it didn’t “two to tango us into our present situation,” it took a Republican White House with an iron-clad, rubber-stamp Republican majority in Congress.
I don’t want to get into a flame war here, but I have to call them as I see them. The Republicans had no interest in sharing power the past six year; *if* they had your comment would be valid.
But then again, *if* they had we most assuredly would not have tangoed into quite a big a mess as we’re in.
Slightly off topic, but I wanted to try out an argument here. Perhaps it’s been made before:
The cost of going to college and the cost of a stay in the hospital have both increased at a far faster rate than inflation over the last 50 years. What few understand is that many of the reasons why costs are out of control in the two cases are the same.
For each of us, there comes a time when we really need to go to one of these institutions or face dire consequences. We are not very flexible on whether we go or when we go; for most, the only choice is where. Given the huge impact these institutions have on our quality of life when we go, we also make every effort to get the best one we can afford (our family can afford). We don’t want to be sticklers for price. And it’s not just that we’re insensitive to prices…we actually want the most expensive place, because we believe that if it’s cheap it probably isn’t good! And unlike a Wal-Mart shovel, we aren’t willing to take a chance that it isn’t good.
Hospitals and colleges, as economic agents, respond in the way you would expect to these conditions: they charge as much as they can get away with…and they can get away with a lot. Healthcare is more regulated than higher education on pricing, so healthcare expenses have actually increased less dramatically than higher education in the last few years, but through many creative ways (replacing low cost treatments with higher cost treatments that are presented as “the latest”) hospital costs still managed to outpace inflation for most of the last few decades.
The New York Times has an excellent article on the phenomenon in higher education. Colleges are raising tuition simply in order to appear higher quality…and it works! Not only do higher prices (when formerly below average) tend to attract more applicants, but the goodies bought with more funds (new multi-million dollar athletic centers and other facilities) do as well.
The parallels with healthcare should be obvious to readers of this blog, though the widespread use of health insurance to pay for healthcare complicates the comparison somewhat. For example, hospitals have extremely high “official” prices on their chargemasters, but almost everyone gets a discount through insurance. Colleges have extremely high “official” tuitions, though a large majority get discounts through merit and need-based financial aid. What great deals we get!
Some further thoughts:
1. The phenomenon we are witnessing with higher education undermines arguments from CDHP advocates that making people pay a higher share of medical expenses will make them smarter consumers and lower the medical cost trend. Look how well that functions in education, where Americans pay a far higher percentage out of pocket.
2. Public, budget-driven provision of higher education and healthcare tends to be far less expensive than that provided by the private sector for equivalent quality.
3. These markets do not have the kinds of structural feedback mechanisms that will maximize value (quality as a function of cost). Since the sectors have shown an unwillingness to make changes themselves, government must shape the institutions and/or incentives to make the markets move towards maximizing value. It isn’t as though either of these sectors are free markets now, so it isn’t as though our choice is whether to have government involved. Rather, the choice is how to make government involvement as smart as possible when it comes to maximizing quality as a function of cost.
A great rant! And we Canadians, struggling under the yoke of socialized medicine, are so grateful that public-spirited organizations like the Cleveland Clinic are setting up shop here, so we can see the benefits of profit-driven health care first-hand!
PS Both of you are off-topic!
I thought my conclusion was that the French were a bunch of cheese eating surrender monkeys!
I think Mr. Orthopod may be right. You know dude, I think you may be in a rude awakening when you see what goes over the next three years. Personally, I’ll take Charles Grassley and John McCain over ninety percent of the Dems. Although I have to admit I’m a Spitzer fan and I think I may grow to like Mr. Webb.
The problem is an institutional and organizational one within the Democratic party. You can rant all you like about Republicans. But it took two to tango us into our present situation.
Your comment about Joe Lane (whom I know) seems to imply that only Democrats have ethics. While it may actually be true, I suspect some of our Red brethren may object to your non-peer-reviewed conclusion….