In March 2000, doctors in most of Israel went on strike. Deaths dropped by 20%. Suppose oseltamivir became unavailable during a bad flu season. Would that cause a health catastrophe – or would it look more like an Israeli doctors’ strike?
Thank you for a nice perspective. Truth in many disciplines. Benjamin Franklin is quoted as saying the following, and I see it daily. “There is nothing more fatal to good health than an over care of it.”
Maybe the only way to communicate with the United CMO would be through lawyers, given the intentional misrepresentation. It is a sad situation when the only acknowledgement of guilt is coerced in courtrooms.
You were very generous not naming the United CMO. Wish you had a copy of the letter to attach to your article. The physicians that are willing to sign their names to flawed strategies should be made more visible and accountable to the patients those companies “serve”.
Ha ha ha. I have one of those…Which brings me to the idea that perhaps there should be a public repository for such items?
A National Archive of sorts and fax/email copies to relevant government entities and representatives and oversight agencies. One could tag these items and when we need “facts”: Voila! I wonder how one could do this for a low cost? Is there AI that could do the tagging? Great research project.
If there is a silver lining to the Covid pandemic it is that it has shone a light on the pharma industrial complex and its unholy relation to government, hospital industrial complex, insurance industrial complex and mainstream media. Perhaps something good will come out of it, though I am not holding my breath. There’s too much money involved.
And on your case, United owns Optum Rx--shuffling more money to their other entity that isn’t subject to the medical loss ratio, increasing profits for PHRMA, further contributing to the shortage of the drug when it is appropriate, and charging you a higher premium, as well as removing the clinician from the transaction altogether
Thanks for this morally enlightening tale. UnitedHealth Group has its headquarters here, located on a beautiful campus where the meticulous landscaping resembles that seen around the various homes of the King of England. Many folks here in Minnesota drive by the UnitedHealth campus every day but I would bet that damned few of them spend much time pondering the potent wisdom outlined in your closing paragraph. UnitedHealth is all about making money, and I mean tons of money, and they run a slick operation. P.S. They don't have just one corporate jet, but multiple such "tools" in their fleet. I have seen only one of them up close -- it's the Dassault Falcon 2000EX, registration number N244C, and it's a beauty. I seriously doubt that its interior appointments are drab. I am thinking leather, I am thinking rare woods used for tasteful trim. I think I will vomit now.
Greetings, Doctor, I live in Connecticut. I have master’s degrees in Philosophy and forensic psychology. I’m basically retired but still write. I’d be interested in auditing or sitting in one of your ethics courses if you are still lecturing. Possible, or no? I’m seriously considering going back to school to finish my philosophy degree (I’m ABD-all but dissertation). I was injured in the 9/11 terrorist incident, and I’ve been through the ringer medically, if you will.
I often wonder if the system you describe of doctors prescribing unnecessary medicine is that patients expect their doctors to prescribe something and the doctors feel pressure to meet those expectations.
Additionally, I think American society, at least here in California, thinks there is a pill that will either fix or ameliorate the symptoms of what ails them. For example, my teenage daughter says she is anxious and wants anti-anxiety medication because that is what you do for anxiety. I saw in the paper today that pediatricians want to prescribe medicine for obese kids. Both doctors and patients believe there is a pill for everything and they also seem to believe that there is no need to look at the benefits vs the risks.
There are certainly effective medicines for many things, but not everything. And there are many situations where the benefit-risk calculation is clearly in favor of taking a medicine. Just not always.
BTW, I just realized that I forgot to mention, that I am alive and well because of modern medicine: I have had seven successful surgeries for various ailments, and I have been to the emergency room several times due to mountain bike accidents and I am thankful for all of the competent doctors and nurses and physical therapists who have cared for me over the years.
I agree - we live in a take a pill society, and pharma grooms (oh that word, sorry) young med students to think this way, we and I think New Zealand are the only countries that advertise for pharma, and public ignorance/expectations is relied upon by the marketers.
As a pediatrician who feels the same way about tamiflu as Dr Buchanan, I can attest that you’re spot on.
Let me add that a huge part of medicine today involves online reviews, so if the doctors don’t give the requested medicine, they get a one star review and their business suffers big time. However, even if a doc stands her ground, reviews be damned, the patient will then just go to urgent care and get all the unnecessary meds they want!
What is the data on the flu shots? It is considered de rigeur but has the data been analysed rigorously ?
See https://igorchudov.substack.com/p/cdc-fakes-high-flu-numbers-in-the
Thank you for this information! Very helpful in making an informed decision.
Thank you for a nice perspective. Truth in many disciplines. Benjamin Franklin is quoted as saying the following, and I see it daily. “There is nothing more fatal to good health than an over care of it.”
Marc what are you doing to stop mandates at UCONN? Anything?
Great piece on tamiflu.
Maybe the only way to communicate with the United CMO would be through lawyers, given the intentional misrepresentation. It is a sad situation when the only acknowledgement of guilt is coerced in courtrooms.
You were very generous not naming the United CMO. Wish you had a copy of the letter to attach to your article. The physicians that are willing to sign their names to flawed strategies should be made more visible and accountable to the patients those companies “serve”.
Alas.... that letter was consigned to my personal Memory Hole many months ago.
Ha ha ha. I have one of those…Which brings me to the idea that perhaps there should be a public repository for such items?
A National Archive of sorts and fax/email copies to relevant government entities and representatives and oversight agencies. One could tag these items and when we need “facts”: Voila! I wonder how one could do this for a low cost? Is there AI that could do the tagging? Great research project.
If there is a silver lining to the Covid pandemic it is that it has shone a light on the pharma industrial complex and its unholy relation to government, hospital industrial complex, insurance industrial complex and mainstream media. Perhaps something good will come out of it, though I am not holding my breath. There’s too much money involved.
And on your case, United owns Optum Rx--shuffling more money to their other entity that isn’t subject to the medical loss ratio, increasing profits for PHRMA, further contributing to the shortage of the drug when it is appropriate, and charging you a higher premium, as well as removing the clinician from the transaction altogether
Thanks for this morally enlightening tale. UnitedHealth Group has its headquarters here, located on a beautiful campus where the meticulous landscaping resembles that seen around the various homes of the King of England. Many folks here in Minnesota drive by the UnitedHealth campus every day but I would bet that damned few of them spend much time pondering the potent wisdom outlined in your closing paragraph. UnitedHealth is all about making money, and I mean tons of money, and they run a slick operation. P.S. They don't have just one corporate jet, but multiple such "tools" in their fleet. I have seen only one of them up close -- it's the Dassault Falcon 2000EX, registration number N244C, and it's a beauty. I seriously doubt that its interior appointments are drab. I am thinking leather, I am thinking rare woods used for tasteful trim. I think I will vomit now.
Greetings, Doctor, I live in Connecticut. I have master’s degrees in Philosophy and forensic psychology. I’m basically retired but still write. I’d be interested in auditing or sitting in one of your ethics courses if you are still lecturing. Possible, or no? I’m seriously considering going back to school to finish my philosophy degree (I’m ABD-all but dissertation). I was injured in the 9/11 terrorist incident, and I’ve been through the ringer medically, if you will.
Do it! I sincerely hope you do / I love to see that despite your difficulties that you want to help.
I often wonder if the system you describe of doctors prescribing unnecessary medicine is that patients expect their doctors to prescribe something and the doctors feel pressure to meet those expectations.
Additionally, I think American society, at least here in California, thinks there is a pill that will either fix or ameliorate the symptoms of what ails them. For example, my teenage daughter says she is anxious and wants anti-anxiety medication because that is what you do for anxiety. I saw in the paper today that pediatricians want to prescribe medicine for obese kids. Both doctors and patients believe there is a pill for everything and they also seem to believe that there is no need to look at the benefits vs the risks.
There are certainly effective medicines for many things, but not everything. And there are many situations where the benefit-risk calculation is clearly in favor of taking a medicine. Just not always.
Thanks for your post!
BTW, I just realized that I forgot to mention, that I am alive and well because of modern medicine: I have had seven successful surgeries for various ailments, and I have been to the emergency room several times due to mountain bike accidents and I am thankful for all of the competent doctors and nurses and physical therapists who have cared for me over the years.
I agree - we live in a take a pill society, and pharma grooms (oh that word, sorry) young med students to think this way, we and I think New Zealand are the only countries that advertise for pharma, and public ignorance/expectations is relied upon by the marketers.
As a pediatrician who feels the same way about tamiflu as Dr Buchanan, I can attest that you’re spot on.
Let me add that a huge part of medicine today involves online reviews, so if the doctors don’t give the requested medicine, they get a one star review and their business suffers big time. However, even if a doc stands her ground, reviews be damned, the patient will then just go to urgent care and get all the unnecessary meds they want!
That’s exactly how pain scores fueled the opiate epidemic.
I’ve heard this called vending machine medicine. You put your copay in and you get out the prescription you want.
Spot on!