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Introduction: Conflicts of Interest and the Trump Administration We have been discussing the pervasiveness of conflicts of interest in health care for years.  Recently,  we have worried how conflicts of interest and corruption in health care could be combated under an administration with such severe conflicts of interest and corruption at the highest levels, most recently here. President Trump

We now see reports of how the US is short of either masks, gowns, doctors, hospital beds, ventilators, community health workers, tests, treatments, or some combination thereof, to manage the new COVID pandemic and the annual influenza season.  We see Congress hustling to adopt a funding package to catch up with the gaps. I just saw, as an attending physician on a busy urban internal medicine

Health Care Renewal presents a guest post from Dr Michael Fine, a writer, community organizer, and family physician. He is the chief health strategist for the City of Central Falls, RI, and Senior Clinical and Population Health Services Officer for Blackstone Valley Community Health Care, Inc., and recipient of the Barbara Starfield Award, the John Cunningham Award, and the Austin T. Levy

Introduction: Health Care Dysfunction We have been talking about health care dysfunction for a very long time, starting with a publication in 2003: Poses RM.   A cautionary tale: the dysfunction of American health care.  Eur J Int Med 2003; 14(2): 123-130. (link here).  In that article, I postulated that US physicians were demoralized because their core values were under threat, and

Introduction: Threats to Core Values In the late 1990s, my colleagues and I started noting a rising tide of what we then called physician dissatisfaction.  One small clue was that physicians I met at meetings seemed to be responding to polite questions about their well-being with less enthusiastic responses.  In the early 2000s, publications begin appearing about health care professionals'

Unfortunately, the rapid progression of coronavirus is providing a demonstration of the dysfunction, and worse, that can be produced by bad leadership in health care and public health. Ill-Informed Leadership During the Trump regime we began to find striking examples of top government officials expressing ill-informed, if not outright ignorant opinions about medical, health care and public

Introduction: Propaganda and Disinformation in Health Care We used to write about propaganda and disinformation used to promote health care goods and services (stealth marketing campaigns), and advocate for policies favorable to private health care organizations (stealth health policy advocacy and stealth lobbying).  Some stealth marketing, lobbying and policy advocacy campaigns encompass not

With constituents pressing for something to remedy unexpected liabilities incurred from “surprise” medical bills, it was expected that surprise medical bill legislation would pass federally in December 2019 as part of an end-of-year legislation package. House and Senate committees had worked for months on consensus legislation that was ready to go, but that fell through at the last moment. What

In  2020, cases of the revolving door accumulated quickly.  The Old School Outgoing Revolving Door Let us begin with cases of the old fashioned outgoing revolving door, that is, of people leaving leadership positions in governmental bodies which regulate health care or make health care policy, then soon obtaining jobs in the health care industry, particularly organizations which they

Considering the devastating and deadly opioid problems in this country, this news release from DOJ describes particularly despicable behavior from an EHR vendor and pharmas. These problems are likely more widespread, but this EHR company got caught. The company admitted that it solicited and received kickbacks from a major opioid company in exchange for utilizing its EHR software to

Transparency International has just released its 2019 version of the Corruption Perceptions Index.  This version emphasized public sector corruption.  Once again, it appears the US has a worsening corruption problem.  Once again, the results are largely anechoic. Summary of the 2019 CPI Methods Per the TI summary The CPI scores 180 countries and territories by their perceived levels of

Mysteries still abound in the not so wonderful world of health care dysfunction, so once again, quick, the game's afoot... The current mysteries involve beneficial ownership.  Beneficial ownership questions are important to anti-corruption campaigners.  Beneficial ownership simply refers to "anyone who enjoys the benefits of ownership of a security or property, without being on the

US and Canadian medical education has a peculiar gray zone.  A substantial proportion of US and at least some Canadian doctors have received their medical degrees from offshore medical schools.  These are medical schools located in other countries, mainly the Caribbean, that exist only to train students for North American practice.  They are often owned by for-profit US or Canadian based

On Health Care Renewal, we have been decrying American health care dysfunction since 2004 (look here).  For years, the US consistently has had the most expensive health care system of any developed country.  For that exhorbitant price, it provides at best medicocre access to and quality of care. We have long contended that a major reason for health care dysfunction is perverse incentives,

Introduction: Conflicts of Interest in Health Care Our first post about conflicts of interest appeared on December 22, 2004, and was about "senior NIH scientists [who] were collecting hundreds of thousands of dollars in consulting fees and stock from industry."  We were not the first to be concerned about the problems resulting from financial relationships among health care professionals,

Today is the fifteenth anniversary of Health Care Renewal. As a reminder of where we began, below is a re-post of our welcome to the blog. Welcome to HCRENEWAL Health care around the world is beset by rising costs, declining access, stagnant quality, and increasingly dissatisfied health care professionals. Discussions with physicians and other professionals revealed pervasive concerns

In last night's debate which included leading candidates from the Democratic Party for its presidential nomination, as reported by Mother Jones, Senator Bernie Sander (D-VT) said (per Mother Jones). the current health care system is not only cruel, it is dysfunctional The video is here. So the concept of health care dysfunction has officially made it to the big time. You Heard It Here

At my Nov. 12, 2019 post "Google’s ‘Project Nightingale’ Secretly Gathers Personal Health Data on Millions of Americans - Time to Refuse Use Of EMR's In Your Healthcare?" (https://hcrenewal.blogspot.com/2019/11/googles-project-nightingale-secretly.html) on a massive clinical data project by Google and Ascension Health, I wrote: ... I believe invasive healthcare data trafficking projects like