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Lou Lasagna and the MIC “Integrated Career Ladder” – More Than Just A “Revolving Door.”

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BY MIKE MAGEE

The New York Times recently shined a light on the FDA’s top science regulator of the tobacco industry, Matt Holman, who announced his retirement after 20 years to join Phillip Morris. As they noted, “To critics, Dr. Holman’s move is a particularly concerning example of the ‘revolving door’ between federal officials and the industries they regulate…”

As a Medical Historian, I’ve never been a fan of the casual “revolving door” metaphor because it doesn’t quite capture the highly structured and deliberate attempts of a variety of academic medical scientists over a number of decades in the 2nd half of the 20th century to establish and reward an “integrated career ladder” that connected academic medicine, industry and the government. 

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At the Core, Tuskegee Has Never Been Resolved

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BY MIKE MAGEE

July 25, 1972 was fifty years ago this week and it is a day that all AP Science journalists know by heart. As Monday’s AP banner headline read: “On July 25, 1972, Jean Heller, a reporter on The Associated Press investigative team, then called the Special Assignment Team, broke news that rocked the nation. Based on documents leaked by Peter Buxtun, a whistleblower at the U.S. Public Health Service, the then 29-year-old journalist and the only woman on the team, reported that the federal government let hundreds of Black men in rural Alabama go untreated for syphilis for 40 years in order to study the impact of the disease on the human body. Most of the men were denied access to penicillin, even when it became widely available as a cure. A public outcry ensued, and nearly four months later, the “Tuskegee Study of Untreated Syphilis in the Negro Male” came to an end.”

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M4A as a Swing Issue

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BY MIKE MAGEE

“There’s common ground there—not the warm belonging of full creedal agreement, perhaps, but a place, even a welcoming place, where we can stand together.”    Ian Marcus Corbin, Research Fellow, Harvard Medical School

Most Americans would love to believe this statement. But political reality intervenes. A March, 2022 Pew Research Center analysis found our two major parties to be “farther apart ideologically today than at any time in the past 50 years.” 

Take, for example, Presidential hopefuls, Florida Gov. Ron DeSantis and Sen. Marco Rubio (R-Fla.). They see political pay dirt on the jagged peaks of America’s culture wars with the governor taking on Disney for defending LGBTQ employees by introducing the his “Stop W.O.K.E. Act“, while Rubio goes one step further with his “No Tax Breaks for Radical Corporate Activism Act”.

In academic circles, you increasingly find references to “what’s the matter with…debates.” The phrase derives from a 2004 book “What’s the Matter with Kansas?”  written by historian Thomas Frank, which spent 18 weeks on the New York Times Bestseller List. 

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THCB Gang Episode 96, Thursday June 16

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Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday June 16 were medical historian Mike Magee (@drmikemagee); patient safety expert and all around wit Michael Millenson (@mlmillenson); Queen of all employer benefits Jennifer Benz (@jenbenz); and Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune), who these days also hosts the Is It Serious podcast. We got into mental health, patient safety, drug advertising and whether the Jan 6 committee will make a difference.

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

THCB Gang Episode 93, Thursday May 26 1pm PT, 4pm ET

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Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday May 26 were medical historian Mike Magee (@drmikemagee); Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune); and fierce patient activist Casey Quinlan (@MightyCasey). Plenty of conversation about guns as a public health crisis, and also much about data use, data reidentification and controversy there.

You can see the video below live (and later archived) & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Defanging HIPAA: How Your De-identified Data Was Re-identified For Profit.

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BY MIKE MAGEE, M.D.

Arthur Sackler continues to demonstrate just how wealthy one can become by advantaging patients and their diseases.

He’s been dead since 1987, but his ghost continues to access your personal health data, pushes medical consumption and over-utilization, and expands profits exponentially for data abusers well beyond his wildest dreams. Back in 1954, he and his friend and secret business partner, Bill Frohlich, were the first to realize that individual health data could be a goldmine. That relationship would still be a secret had it not been exposed in a messy family inheritance feud unleashed by his third wife after Sackler’s death.

That company, IMS Health, was taken public and listed on the NYSE on April 4, 2014, transferring $1.3 billion in stock. I’ll come back to that in a moment. But in the early years, the pair realized that the data they were collecting would multiply in value if it could be correlated with a second data set. That dataset was the AMA’s Physician Masterfile which tracked the identity and location of all physicians in America from the time they entered medical school. 

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How About This Opportunity, Health Tech Investors? Promoting Contraception vs. Banning Abortion

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By MIKE MAGEE

Dr. Linda Rosenstock has an M.D. and M.P.H. from Johns Hopkins, and was a Robert Wood Johnson Clinical Scholar. She is currently Dean Emeritus and Professor of Health Policy and Management at UCLA’s Fielding School of Public Health, but also spent years in government, and was on President Obama’s Advisory Group on Prevention, Health Promotion and Integrative and Public Health.

In the wake of the release of Justice Alito’s memo trashing Roe v. Wade, she was asked to comment about the status of abortion in America. Here is what she said:

“The broader the access to proven family planning methods, the lower the unintended pregnancy rate and the lower the abortion rate. We can’t underestimate the role of educating and empowering women – and men – about these issues.”

These are not simply the opinions or insights of a single health expert. They are backed up by the following facts:

  1. Since 1981, abortion rates in U.S. women, age 15 to 44, have declined by nearly two thirds from 29.3 per 1000 to 11.4 per 1000.

2. Approximately half of all pregnancies in the U.S. are unintended.  Of those unintended, approximately 40% of the women chose to terminate the pregnancy by abortion – either procedural or chemically induced.

3.  The decline in the number of abortions has coincided with increased access to long-acting reversible contraception, including IUD’s and contraceptive implants. These options are now safe, increasingly covered by insurers, and more accessible to at-risk populations.

4. The increasing inclusion of sex education in middle school and high school curricula has been accompanied by a decline in high school sexual activity by 17% between 2009 and 2019.

5. There were 629,898 abortions recorded by the CDC in 2019. For every 1000 live births that year, there were 195 other women who chose to terminate their pregnancies. Almost half of the 1st trimester abortions are now chemically induced through Plan B-type pills.

What is clear from these figures is that knowledge and access to contraception is the best way to decrease the number of abortions in America.

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THCB Gang Episode 89, Thursday April 28, 1pm PT 4pm ET

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Joining Matthew Holt (@boltyboy) on #THCBGang on April 28 for an hour of topical and sometime combative conversation on what’s happening in health care were: THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); medical historian Mike Magee (@drmikemagee); patient safety expert and all around wit Michael Millenson (@mlmillenson) & Principal of Worksite Health Advisors Brian Klepper (@bklepper1). Matthew had COVID so didn’t do much & Kim ran the show. Lots of discussion on telehealth, primary care, private equity and much more…

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Dara’s “Hero Quest”: How About Embracing Universal Health Care in America?

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By MIKE MAGEE

Joseph Campbell, who died in 1987 at the age 83, was a professor of literature and comparative mythology at Sarah Lawrence College. His famous 1949 book, “The Hero With a Thousand Faces” made the case that, despite varying cultures and religions, the hero’s story of departure, initiation, and return, is remarkably consistent and defines “the hero’s quest.” Bottom line: Refusing the call is a bad idea.

George Lucas was a close friend and has said that Star Wars was largely influenced by Campbell’s scholarship. On June 21, 1988, Bill Moyers interviewed Campbell and began with a clip from Star Wars where Darth Vader says to Luke, “Join me, and I will complete your training.” And Luke replies, “I’ll never join you!” Darth Vader then laments, “If you only knew the power of the dark side.”

Asked to comment, Campbell said, “He (Darth Vader) isn’t thinking, or living in terms of humanity, he’s living in terms of a system. And this is the threat to our lives; we all face it, we all operate in our society in relation to a system. Now, is the system going to eat you up and relieve you of your humanity, or are you going to be able to use the system to human purposes.”

Systems gone awry? Think Putinesque Russia, or Psycho-pernicious Trumpism, or Ultra-predatory Capitalism.

Dara Kharowshaki, the CEO at Uber, who took over the company from uber-bro, Travis Kalanick, is a fan of Campbell’s and understands the journey of a hero – departure, initiation, return. Perhaps that is why he defines “movement” as fundamental to life…adding deliberately the qualifier “movement in the right direction.” In an interview in December, 2021, with Brian Nowak, Equity Analyst, U.S. Internet Industry, for Morgan Stanley, he pushed for corporate engagement in a range of issues including “sustainability, safety, equity, and anti-racism – these are all issues that go to the core of who we are, and our identity.”

How did health care escape that list, especially considering the companies investment in “Uber Health” – a health care delivery service promoting speed, care coordination, privacy, and cost-effective and reliable transport to and from care-giving brick and mortar?

It may have something to do with the fact that Uber has fought tooth and nail to avoid providing health care as a benefit to its drivers. In 2020, the company joined Lyft, DoorDash and other gig companies in throwing $205 million into a lobbying effort in California titled “Yes on 22”.

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