Let me start by saying I am fully aware of how this thread evolves. There, I said it.
I have dear friends I love who work in law offices who have followed this thread and are e-mailing me. We are disagreeing on issues, and keeping our friendships and love of each other. This is the way life should work. I don't want to live in a world of clones; I recognize the limitations of my intelligence and personal experience.
This whole issue is about the numbers.
* A
single lawsuit against the gem of the U.S. pharmaceutical industry for a quarter of a BILLION ($250,000,000) dollars of an industry which removed its product after the first decent peer-reviewed study was published. Meanwhile five thousand (5000) lawsuits against that product remain in the queue. Do the math.
* I heard on the news yesterday that 800 drugs similarly have been removed from the market in the last two years alone after approval by the new FDA (government) process. Do the math.
* Part of my job is to build and assess statistical models which predict future resource consumption and outcomes in the healthcare system. State-of-the-art models all have 100 to 200 variables which must SIMULTANEOUSLY be considered to predict a future cost for a patient or the statistical likelihood that a certain event (such as death) to happen. Because these issues are so complex, part of my job is to serve as a resource for my company to explain such issues to physicians and really smart business people trying to use these models. And our legal system asks a lay jury to consider whether or not a single drug caused an outcome in one person that is the most common cause of death? Do the math.
I've spent half a lifetime as a poor person getting to where I am to do medical research. It would be very difficult to accuse me, physicians, and workers for pharmaceutical companies that we are in it for the money.
Once there, I have come to observe many things that concern me.
* MDs who DON'T have "the good life" any more (walk a mile in their shoes...) being accused of selfishness and negligence in a nearly impossible SYSTEM. I've work for healthcare providers, with them, done research with them, provide information for them (on their efficiency and compliance to evidence-based care), designed and evaluated incentive systems for them, worked for companies that limit their pay, and live with one. I feel qualified to say we're lucky we have any good people left that want to go into the profession. Meanwhile, we have an ungrateful society benefiting from the best healthcare that money can buy wanting to lash out at them and the companies who work with them.
You want problems? Let me define a healthcare problem or two.
* In 1993 I was part of a contingent of healthcare experts that visited major cities in the former Soviet Union to work on their re-integration into the rest of the world. In Russia, the average MD (then) earned $35 per month. Most MDs were women because as in most societies, the men are usually responsible for the most stable source of income in a family. In the ICUs of major Moscow hospitals, there was no A/C, so windows were left open. This meant that flies were free to wander on fresh wounds. They could not afford latex gloves, and syringes/needles had to be re-used. The wealthy (usually connected to the Russian mafia) knew to bring in their own (western) medical supplies into a hospital if they were admitted and needed even minimal care.
* Just this year, the Canadian Supreme Court ruled that private insurance may enter that country. Why? Because it determined the government failed to meet the healthcare needs of society.
I could go on and on...
The bottom line is that EVERYONE struggles with this.
* I have issues with medical and healthcare product malpractice and liability.
* I have issues with people who justify unethical behavior in a system by pointing out how such behavior complies with the rules of a system that by its very nature should be labeled part of the problem.
Part of our open democratic process is the right to bring issues up and discuss them. What many don't realize is that when they are emotionally hijacked by those discussions, their expressed views often provide ammunition to those who feel strongly about changing this system. I'm often amazed that such people don't realize this. In any case, such behavior is quite predictable
Part of the idea of a democracy is the ability of a system to adjust to problems with the system. To wit...
In a Shift, Bush Moves to Block Medical Suits
By ROBERT PEAR
Published: July 25, 2004
ASHINGTON, July 24 — The Bush administration has been going to court to block lawsuits by consumers who say they have been injured by prescription drugs and medical devices.
The administration contends that consumers cannot recover damages for such injuries if the products have been approved by the Food and Drug Administration. In court papers, the Justice Department acknowledges that this position reflects a "change in governmental policy," and it has persuaded some judges to accept its arguments, most recently scoring a victory in the federal appeals court in Philadelphia.
Allowing consumers to sue manufacturers would "undermine public health" and interfere with federal regulation of drugs and devices, by encouraging "lay judges and juries to second-guess" experts at the F.D.A., the government said in siding with the maker of a heart pump sued by the widow of a Pennsylvania man. Moreover, it said, if such lawsuits succeed, some good products may be removed from the market, depriving patients of beneficial treatments.
In 2002, at a legal symposium, the Bush administration outlined plans for "F.D.A. involvement in product liability lawsuits," and it has been methodically pursuing that strategy.
The administration's participation in the cases is consistent with President Bush's position on "tort reform."
Mr. Bush often attacks trial lawyers, saying their lawsuits impose a huge burden on the economy and drive up health costs. The Democrats' vice-presidential candidate, Senator John Edwards, a longtime plaintiffs' lawyer, says his proudest accomplishment in Washington was to help win Senate passage of a bill defining patients' rights, including the right to sue. (The bill never became law.)
Jay P. Lefkowitz, former director of Mr. Bush's Domestic Policy Council, said the F.D.A.'s litigation strategy embodied "good health policy and good tort reform."
But Representative Maurice D. Hinchey, Democrat of New York, said the administration had "taken the F.D.A. in a radical new direction, seeking to protect drug companies instead of the public." Mr. Hinchey recently persuaded the House to cut $500,000 from the budget of the agency's chief counsel as a penalty for its aggressive opposition to consumer lawsuits.
In the Pennsylvania ruling, issued Tuesday, the appeals court threw out a lawsuit filed by Barbara E. Horn, who said her husband had died because of defects in the design and manufacture of his heart pump. The Bush administration argued that federal law barred such claims because the device had been produced according to federal specifications. In its briefs, the administration conceded that "the views stated here differ from the views that the government advanced in 1997," in the United States Supreme Court.
At that time, the government said that F.D.A. approval of a medical device set the minimum standard, and that states could provide "additional protection to consumers." Now the Bush administration argues that the agency's approval of a device "sets a ceiling as well as a floor."
The administration said its position, holding that individual consumers have no right to sue, actually benefited consumers.
The threat of lawsuits, it said, "can harm the public health" by encouraging manufacturers to withdraw products from the market or to issue new warnings that overemphasize the risks and lead to "underutilization of beneficial treatments."
Allison M. Zieve, a lawyer at the Public Citizen Litigation Group who represented the plaintiff in the Pennsylvania case, said, "The government has done an about-face on this issue." If courts accept the administration's position, Ms. Zieve said, it would amount to a backdoor type of "tort reform" that would shield manufacturers from damage suits.
In the Pennsylvania case, the federal appeals court quoted extensively from the administration's brief and said the views of the F.D.A. were entitled to great deference because the agency was "uniquely qualified" to determine when federal law should take precedence over state law.
Bush administration officials said their goal was not to shield drug companies, but to vindicate the federal government's authority to regulate drug products.
Patients and their families said they felt betrayed.
So to those who wanted to know what politics had to do with this, well there you go. If you think compliance with a flawed system justifies unethical practices in that system, consider that a preponderance of such unethical practices eventually causes a response. We're lucky we live in a society where such change can happen.
On the subject of this thread getting ugly - and I agree, Mike and Panther, IT IS NOT NECESSARY for it to be so - I leave you with this.
The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants
-
Thomas Jefferson
On the subject of a flawed system, I leave you with this.
Every generation needs a new revolution
-
Thomas Jefferson
And on the subject of punitive solutions to a problem we all can see, I leave you with this.
Imagination is more important than knowledge.
-
Albert Einstein
I remain passionate about my beliefs, while still remaining respectful of all those who care to enter the debate with honor and civility. I bear no malice to anyone here, and it is not my intention for any PERSON to feel maligned.
Keep your passions, all - including and especially all those who disagree with me. But remember we are brothers and sisters.
- Bill
I have some health issues that have been brought on by a number of things, but basically it started with being injured, went down-hill, started back up-hill, and has fluctuated over time. I'm working on my health with the help of my Doctor, a wonderful woman who is caring and honest and helpful. No matter HOW MUCH time I devote to my "layperson" reading on the subject, I am not an MD! Therefore...
I mentioned that I thought it was interesting that you can find lawyers who specialize in MEDICAL malpractice all over the place, but just TRY to find a lawyer that specializes in LEGAL malpractice! Virtually impossible! I was also talking with someone that works at a courthouse who told me that they are getting depressed over their job, which they've had for around 15 years. I asked why and the person said that it was because they see all the backroom, unethical, ex parte, deals between certain attorney's and certain judges day in and day out and that they've come to realize that justice isn't blind... it's who you know, not what the truth is. Poor person was really jaded. Maybe Shakespeare was right... 
