MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'accountability'. Sat, 03 Sep 2011 02:01:48 +0100 http://www.medworm.com/index.php?rid=5181703&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fjama-article-begs-key-questions-about.html There was a recent reminder of the case of the tainted heparin, which begged more questions than it answered.  (A case summary is appended to the end of this post, and nearly all our posts are here.)  The case is of fundamental importance because it involves the failure of pharmaceutical companies to fulfill their core mission, to supply pure, unadulterated drugs.   Three years later, how the heparin was adulterated, and who was responsible are still unknown. JAMA just published a major news article (Kuehn BM. As production goes global, drug supply faces greater risks to safety, quality.  JAMA 2011; 306: 811-813.  Link here.) This, in turn, was based on a five page case study of the heparin incident in a report by the Pew Health G... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5181703 Tue, 30 Aug 2011 19:53:00 +0100 5181703 http://www.medworm.com/index.php?rid=5158874&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fwhat-goes-up-non-profit-hospital-ceo.html We have frequently discussed the disconnect between incentives, particularly total compensation, given to the leaders of health care organizations and their roles, or lack thereof, in improving the health care of their patients or the public. One measure of that disconnect is how leaders' pay continues to defy gravity while the economy continues to suffer, and health care dysfunction continues to fester.In particular, total compensation given to CEOs of ostensibly not-for-profit hospitals and hospital systems is increasingly passing the magic $1 million mark. A round up including two recent articles and others from the last four months that we have not discussed before revealed more "million dollar babies" amongst the ranks of these leaders.  (Note that most of the data... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5158874 Fri, 19 Aug 2011 18:37:00 +0100 5158874 http://www.medworm.com/index.php?rid=5097081&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F6qpt6RDLE8I%2F Hired someone new and exciting? Promoted a rising star? Finally solved that hard-to-fill spot? Share the news with us and we’ll share with it others. That’s right. Send us your announcements and we’ll find a home for them. Don’t be shy. Everyone wants to know who is coming and going, especially with all the layoffs. Despite the downsizing, there is movement. Here are some of the latest changes. Recognize anyone? And here is our regular feature. Send us a photo and we will spotlight a different person each week. This time around, we note that Avalere Health hired Leigh Ann Bruhn as a director. Previously, she was a director of managed care marketing at Abbott Laboratories, where she led both managed care and brand marketing teams. Prior to Abbott, she held various marketing and fina... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=5097081 Fri, 05 Aug 2011 12:34:12 +0100 5097081 http://www.medworm.com/index.php?rid=5062241&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthrombolytics-to-give-or-not-to-give%2F2011.07.25 For years now, we’ve all heard the drum-beat.  Bill-boards in cities have proclaimed it.  Various medical associations have touted it’s importance.  Stroke symptoms have to be treated immediately!  Give clot-busting drugs, also known as ‘thrombolytics!’ Until, of course, those in favor of giving the drugs (namely neurologists)  realized that a)  Not everyone with a stroke, aka ‘brain attack’ has insurance and b) people have a very inconsiderate habit of having said strokes at the most inconvenient of hours.  For instance, after 5PM, on the weekend, on holidays.  The nerve! So across the country, physicians in emergency departments like mine are finding themselves expected by the court of public opinion to give a potentially dangerous drug (albeit a sometimes useful drug... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062241 Mon, 25 Jul 2011 16:00:57 +0100 5062241 http://www.medworm.com/index.php?rid=5028069&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F07%2Fcase-of-bleeding-heart-prosecutors-how.html ConclusionsThis seems to be the most recently documented example of important but overlooked, or concealed changes in government policies that have enabled the health care system to become more unethical, dishonest and corrupt, and hence more dysfunctional.Here we discussed a Supreme Court decision interpreting US anti-trust law that has been used to prevent medical societies from enforcing ethical rules, and hence helped medicine to become increasingly commercialized, and to increasingly put money ahead of patient care.Here we discussed little discussed legislation from 1945 that allowed US insurance companies/ managed care organizations to avoid federal anti-trust investigation and enforcement, and hence to increased market power.Here we discussed failure of the executive branch, an... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5028069 Mon, 11 Jul 2011 20:09:00 +0100 5028069 http://www.medworm.com/index.php?rid=4997526&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-psychiatrists-hesitant-to-say-bad-things-about-their-peers%2F2011.07.03 When Jesse read our Shrink Rap book, he said we were too nice to psychiatrists in it– that we didn’t mention that there are some really bad psychiatrists out there and he thinks part of the venom towards psychiatry comes from the whole rushed 15 minute med-check culture. I thought about this and I thought, really?  We have a whole chapter called When Things Go Wrong and we discuss a psychiatrist who is not sensitive enough to a patient (though, granted, the patient is overly demanding and overly sensitive–so I guess not the best portrayal of insensitivity by a shrink), one who is rigid in her formulation to the point of almost destroying a family, one who prescribes medication that makes a patient fat and diabetic, and finally, a psychiatrist who is outright unethical an... Better Health blogs http://www.medworm.com/rss/comments.php?id=4997526 Sun, 03 Jul 2011 14:00:00 +0100 4997526 http://www.medworm.com/index.php?rid=4992665&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FtFB6CH_fkyo%2F By Tad DeHavenAlmost 600 pages into the 2010 Dodd-Frank Wall Street Reform and Consumer Protection Act is a provision directing the Government Accountability Office to assess the feasibility of the federal government certifying organizations that provide financial literacy. The GAO released its report this week and concluded that “While a federal process for certifying financial literacy providers appears to be feasible, doing so would pose challenges.” The challenges cited by the GAO are generally of the bureaucratic variety: What agency or agencies would be in charge? What criteria would be used? How would oversight be conducted? And most importantly, how much would it cost [taxpayers] to implement and operate a federal process for certifying financial literacy providers? Fortunately... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4992665 Thu, 30 Jun 2011 19:17:43 +0100 4992665 http://www.medworm.com/index.php?rid=4902485&cid=t_113006_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F06%2F05%2Fhow-is-your-happiness-challenge-going%2F Unbelievable as this is, the year 2011 is half over. If you’ve joined the 2011 Happiness Challenge, how are you doing? If you’ve managed successfully to keep even one resolution, give yourself a big gold star. It’s hard to make change; it takes mindfulness, self-knowledge, and self-mastery. I’m often surprised by how hard it is to make even a change that’s pleasant, like my resolutions to Read more or to Jump. Why is it so hard to push myself to do something that I like doing? And yet it is. Have you followed any resolutions that have made a particular difference to your happiness? I’m always so curious to hear what people have tried, and what has worked. For instance, to my surprise, one of the resolutions I most often hear mentioned is… Make your be... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4902485 Sun, 05 Jun 2011 15:58:19 +0100 4902485 http://www.medworm.com/index.php?rid=4893342&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F06%2Fshould-phenomenal-1-million-ceo-be.html A recent story with some local color once again illustrates the cognitive dissonance evoked by current patterns of compensation of health care leaders.Let me start chronologically. The Stratospheric Compensation of the CEO, and Its JustificationIn 2009, the compensation given to the CEO of the Palomar Pomerado Health, a public health system in the vicinity of San Diego, California, provided some headlines. As reported then by the San Diego Times-Union,Palomar Pomerado Health CEO Michael Covert has received a 26 percent — or $154,000 — pay raise.The increase, approved by the hospital district’s board of directors last month, is retroactive to July 1, the beginning of the fiscal year, board Chairman Bruce Krider said.The increase brought Covert’s pay from $582,000 a year to $736,000 ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4893342 Fri, 03 Jun 2011 21:40:00 +0100 4893342 http://www.medworm.com/index.php?rid=4862467&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Fmillion-dollar-plus-hospital-ceo.html Health care leaders' compensation has again been in the news. Below are highlights from stories about four medical centers, emphasizing the magnitude of executive compensation, how it is related, or not to hospital and executive performance, and whether and how the organizations' boards chose to justify it. The medical centers are in alphabetical order. University of Pittsburgh Medical CenterCompensationAccording to the Pittsburgh Post-Gazette:In tax documents released Friday, Jeffrey Romoff, president and CEO of the University of Pittsburgh Medical Center, received $4.01 million in salary, bonuses and benefits that year.Also,Other top earners at UPMC include neurosurgeons Ghassan Bejjani, $2.37 million in salary and benefits, and Richard Spiro, $2.23 million; cardiothoracic surgeon James ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4862467 Wed, 25 May 2011 18:31:00 +0100 4862467 http://www.medworm.com/index.php?rid=4789208&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FWBu8A6aiGns%2F By Justin LoganAP Photo/David Guttenfelder There are not going to be many better opportunities to change course in Afghanistan than the one presented by the killing of Osama bin Laden in Abbottabad. It may be worth highlighting how ripe an opportunity this is: The politics on the Hill are changing. It probably comes as no surprise that Reps. Walter Jones (R-NC) and Jim McGovern (D-MA) would like to end the Afghanistan war, but their “Afghanistan Exit and Accountability Act” has brought on co-sponsors like Tea Party stalwarts Reps. Jason Chaffetz (R-UT) and Justin Amash (R-MI). This means that in the days and weeks to come, there will be Republicans on television and radio making the case for withdrawal. That could have a profound effect on where the debate goes from here. On t... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4789208 Thu, 05 May 2011 18:12:45 +0100 4789208 http://www.medworm.com/index.php?rid=4758732&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FEJd6AXyKP1Y%2F By John SamplesIn an earlier post, I wrote about the problems with the Obama administration’s executive order to force government contractors to reveal their political activity. The administration defends the mandate by arguing “taxpayers deserve to know how contractors are spending money they’ve earned from the government.” For the first (and perhaps last) time, I rise to the defense of government contractors. The President apparently believes that anyone who sells a good or service to the government must account for the uses of the money received in the transaction in perpetuity? Obama’s press secretary said the President’s “goal is transparency and accountability. That’s the responsible thing to do when you’re handling taxpayer dollars.” I do ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4758732 Thu, 28 Apr 2011 00:28:56 +0100 4758732 http://www.medworm.com/index.php?rid=4753630&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fwill-pharmaceutical-ceo-finally-be-held.html It appears there may be a move afoot to have the leader of a large health organization suffer some negative consequences for the misbehavior of his organization.  As reported by the St Louis Post-Dispatch,For the past 34 years, Howard Solomon has presided over Forest Laboratories Inc., a midsize pharmaceutical company that runs its national sales operations from Earth City.Solomon, 83, took home $8.3 million last year as the company's chairman, president and chief executive officer. But his company's marketing arm also fell into trouble, pleading guilty to federal charges that its sales force illegally marketed the antidepressants Celexa and Lexapro to children and adolescents, even though these drugs had not been approved for minors.Now, the federal Department of Health and Huma... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4753630 Mon, 25 Apr 2011 19:25:00 +0100 4753630 http://www.medworm.com/index.php?rid=4709423&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F-1ZYMxX-gyQ%2F Is the FDA failing to properly oversee medical devices? That’s the take-away message from a new report by the US Government Accountability Office, which says the FDA failed to strengthen its approval and recall procedures, despite a 2009 GAO recommendation that “expeditious steps” should be taken to issue regulations for high-risk devices are approved under the 510K process. This is used to determine if a device is substantially equivalent to another marketed device. Since the last GAO report (read here), the FDA has issued a final rule, but for only one type of device. As of April 1, in fact, agency action on the remaining 26 types of devices is incomplete, according to the GAO. As a result, such devices - including automated external defibrillators and implantable hip d... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4709423 Wed, 13 Apr 2011 13:17:39 +0100 4709423 http://www.medworm.com/index.php?rid=4664147&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FvIdkR6So0ek%2F By Neal McCluskeyOver the last few days Jay Greene, the Fordham Institute's Kathleen Porter-Magee, and several other edu-thinkers have been arguing about whether national curriculum standards would destroy a competitive market in education, and a market that already provides the uniform standards Fordham wants Washington to impose. But let's be very clear: We haven't had a real market -- a free market -- in education for a long time. Sadly, I'm afraid Jay started this whole mess, though he certainly knows what a free market in education would look like and I don't think he intended to confuse the issue.  Indeed, he doesn't use the term "free market," but mainly writes about the "competitive market between communities." His argument is that Americans over time picked standardize... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4664147 Thu, 31 Mar 2011 19:04:41 +0100 4664147 http://www.medworm.com/index.php?rid=4653605&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Figh8X5xxjNM%2F A provision of the False Claims Act that prevents whistleblower lawsuits from being unsealed does not violate the First Amendment and, therefore, the public’s right to access the documents, a federal appeals court has ruled. In a 2-to-1 vote, the US Court of Appeals for the 4th Circuit upheld an earlier decision that shot down the argument whistleblower lawsuits should be unsealed after a 60-day period because this would allow the public to learn as soon as possible about corporate wrongdoing. The rationale for requiring these lawsuits to remain sealed for at least 60 days is to allow the feds, who are permitted to seek extensions beyond that initial period, to investigate the allegations. During the seal period, the whistleblower is not supposed to discuss the suit or its contents. ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4653605 Tue, 29 Mar 2011 11:55:34 +0100 4653605 http://www.medworm.com/index.php?rid=4552057&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffirst-monetary-hipaa-fine-issued%2F2011.03.05 Via the Threatpost article “HIPAA Bares Its Teeth: $4.3m Fine For Privacy Violation“: The health care industry’s toothless tiger finally bared its teeth, as the U.S. Department of Health and Human Services (HHS) issued a $4.3 m fine to a Maryland health care provider for violations of the HIPAA Privacy Rule. The action is the first monetary fine issued since the Act was passed in 1996. … A copy of a penalty notice against Cignet depicts a two-year effort in which HHS struggled with what appears to be a dysfunctional Maryland provider unaware of the potential impact of HIPAA non-compliance, and unwilling or unable to cooperate with HHS in any way. When first reading the title I was willing to rail against HIPAA, as I’m tired of it. Then I read the post. Wow. It’s like ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4552057 Sat, 05 Mar 2011 18:00:37 +0100 4552057 http://www.medworm.com/index.php?rid=4540553&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FNuK80nyPIyY%2F By John SamplesJust over a week ago, Politico ran a story noting that Justin Amash, a newly-elected House member from Michigan, had already voted "present" more often than his predecessor had in eight years. The story suggested that Amash was trying to avoid electoral responsibility for tough votes by voting present. In general, the story suggested that his "present" votes were a failure in some way to meet his responsibilities as a representative. You can read Amash's take on all this at his Facebook page. Although I have never met Amash, I have followed his political career over the past year or so. In Michigan, he emphasized  transparency and accountability. He reported and explained his votes on his Facebook page. He is continuing to do that here in Washington. Does that sound like a... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4540553 Wed, 02 Mar 2011 19:01:45 +0100 4540553 http://www.medworm.com/index.php?rid=4455248&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FKPwpojpQFvo%2F By Tad DeHavenA report from the Government Accountability Office finds that the federal government administers 47 different employment and job training programs at a cost to taxpayers of about $18 billion. The GAO excluded another 51 programs that could be considered as providing job training assistance, such as student loan subsidies. The takeaway from the report is that there is a lot of duplication, and thus excess bureaucracy and inefficiencies. Moreover, the GAO says that “little is known about the effectiveness of most programs.” Nonetheless, Congress unflinchingly funds these programs even though the GAO has been issuing reports with similar findings since the 1990s. Coinciding with the GAO report, Sen. Tom Coburn (R-OK) released a paper that singles out 25 particularly egregiou... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4455248 Wed, 09 Feb 2011 22:27:12 +0100 4455248 http://www.medworm.com/index.php?rid=4450273&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FgYWKaOKx5CY%2F By Neal McCluskeyToday, the Government Accountability Office (GAO) confirmed what we already knew it would confirm: According to it's own investigation, errors were made in producing a report highly damaging to for-profit colleges, but no one had any bad intentions and the report still stands. Well, the significantly revised report -- the one much more favorable to for-profits schools that got almost no attention because GAO sneaked it out -- still stands. And please, don't try to hold the GAO accountable yourself: The GAO's press release states that the report on its internal investigation will not be publicly released. Now, it's quite possible that the GAO investigation on for-profit colleges really was on the up-and-up and there truly isn't anything to see here. But giv... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4450273 Tue, 08 Feb 2011 21:10:02 +0100 4450273 http://www.medworm.com/index.php?rid=4445774&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FaqZBKSW6SzA%2F By Tad DeHavenA new report from the Government Accountability Office finds that the National Archives and Records Administration’s Electronic Records Archive project is headed for major cost overruns. Initiated in 2001, the project was originally projected to cost $745 million but could end up costing $1.4 billion. The project’s development phase was supposed to be completed by September, but the GAO estimates that it won’t be completed until 2017. The purpose of the Electronic Records Archive project is to create a digital system for gathering and storing government records that would be accessible to the public. In 2005, the National Archives selected Lockheed Martin to develop the system. Unfortunately, the GAO report makes it clear that the National Archives hasn’t been up to t... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4445774 Mon, 07 Feb 2011 21:37:24 +0100 4445774 http://www.medworm.com/index.php?rid=4428999&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FGWpaeNPTmQI%2F By Neal McCluskeyLast week, Sen. Tom Harkin (D-Iowa), chairman of the Senate Health, Education, Labor, and Pensions Comittee, announced that on February 17 he will continue his obssessive attack on for-profit colleges, holding yet another hearing to determine just how evil profit-seekers are.  At least, that is what will presumably be discussed — the specific subject of the hearing is yet to be identified. But the committee actually tackling, say, rampant waste throughout higher education driven by federal student aid, or just giving for-profit schools an even-handed treatment, would be too huge a turnaround to contemplate. Despite there being no end in sight to Harkin’s seige, for-profit institutions aren’t just rolling over, and today they launched their latest ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4428999 Wed, 02 Feb 2011 20:06:56 +0100 4428999 http://www.medworm.com/index.php?rid=4258808&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F12%2Fhealth-professionals-for-new-century.html A major article just published in the Lancet urged global reform of health care education  [Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world.  Lancet 2010; 376: 1923-1958.  Link here.]The problems it recognized included"Pitifully modest" spending for health professional education, compared to overall health spendingHealth care systems that are "dysfunctional and inequitable," due in part to "commercialism in the professions," leading to "breakdown ... especially noteworthy within primary care, in both poor and rich countries."For profit medical education leading to "a so-called de-Flexnerisation process ... in which low-quality professional ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4258808 Mon, 13 Dec 2010 21:19:00 +0100 4258808 http://www.medworm.com/index.php?rid=4241709&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FOS54FWTFrxY%2F By Ilya ShapiroThe first item on this election campaign’s Contract with America was that, if elected (as they have been), the House Republicans would require that all laws that apply to the rest of the country also apply to Congress.  We’ll see if that and the other promised reforms materialize, but it does raise yet another issue in the context of Obamacare. As my colleague Michael Cannon pointed out to me, the new health care law kicks congressmen out of the Federal Employees Health Benefits Program.  (The current FEHB is no different from the health coverage provided by any private employer -– federal employees choose from a series of private plan options (none of which is run by the government), and receive a subsidy from the federal government acting in its role... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4241709 Wed, 08 Dec 2010 13:32:39 +0100 4241709 http://www.medworm.com/index.php?rid=4237872&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FTDEixKJjXYI%2F By Andrew J. CoulsonSo there I was, checking e-mail this morning on my JooJoo when I came across this editorial about how the private sector lacks accountability unless the government provides it through regulation! This naturally caused me to expectorate New Coke all over over myself and my Apple III, forcing me to toss my Levi’s Type 1 jeans in the wash and hop back in the shower. (You know, that Touch of Yogurt shampoo by Clairol is really… uh… something). Twenty minutes later I was still so preoccupied about responding to the editorial that I backed over my neighbor’s Segway as I pulled the Edsel out of the garage. Oops. Sorry Dean. Anyway, once I got into the office I popped a couple of Ben Gay Aspirin to ease my now ferocious headache, but realized as I did so... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4237872 Tue, 07 Dec 2010 19:54:06 +0100 4237872 http://www.medworm.com/index.php?rid=4233418&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fvx8qf4-K0xE%2F The US Government Accountability Office has denied any failures in its January 2010 report about the FDA’s Office of Criminal Investigation. The finding was made in response to a demand by Senator Chuck Grassley that the GAO conduct an internal probe after being told by a whistleblower the GAO report was compromised by a mole who tipped off OCI officials and the GAO failed to detect allegedly disturbing activities by the outgoing OCI director, Terry Vermillion, who is now about to retire (back story). Grassley was told Vermillion allegedly: relocated his domicile to Hampton, Va., and directed OCI work mostly over the phone; used OCI tech support and IT staff to do personal work for him; authorized payment for government contracting training at George Washington University for a fello... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4233418 Mon, 06 Dec 2010 19:14:30 +0100 4233418 http://www.medworm.com/index.php?rid=4230214&cid=t_113006_118_f&fid=34702&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmspblog%2F%7E3%2FH4pPWaLZaZk%2F A scan of recent tweets by various healthcare writers led to a couple of thought-provoking articles regarding the pitfalls of social media, one was via  Kevin Pho, the other Ves Dimov.  #1 - Human Resources and Medical Staff Credentialers Beware: The applicant looks promising, you think he/she may be a good fit for the organization.  Whether you’re seeking to hire a new employee or gather data on an applicant for medical staff membership and privileges, your next step may be to dig a little into the individual’s online life.  After all, if it’s on the Web it’s fair game, right?  So you’re off for a little browsing in Facebook, Twitter, Linkedin, etc. Due dilligence?  Perhaps, but as with many aspects of hiring and/or credentialing, there are some ... MSSPNexus Blog blogs http://www.medworm.com/rss/comments.php?id=4230214 Sun, 05 Dec 2010 13:08:00 +0100 4230214 http://www.medworm.com/index.php?rid=4214482&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Faox1fgZ5g7o%2F Stung by revelations that a mole may have compromised a report issued earlier this year about the FDA’s Office of Criminal Investigation, the US Government Accountability Office is now conducting an internal probe into the leaks, which recently prompted US Senator Chuck Grassley to chastise the agency and demand an investigation. The move, according to a congressional source familiar with the situation, comes just one week after Terry Vermillion announced he would retire next month as head of the FDA’s OCI (look here). The GAO report (look here) found the FDA’s OCI suffers from lax oversight, despite increased in funding and staffing over the past decade, although several of the complaints were leveled specifically at Vermillion, who is a retired Secret Service agent. We awai... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4214482 Tue, 30 Nov 2010 15:27:36 +0100 4214482 http://www.medworm.com/index.php?rid=4151700&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F11%2Fthis-is-really-going-to-set-peoples.html We have been posting nearly every week about the parade of legal settlements, sometimes including guilty pleas to criminal charges, made by health care organizations.  The settlements have involved charges of kickbacks, fraud, conspiracy, and other colorful offenses. Most of these settlements entailed fines or other payments by the organizations that may seem huge, but were fractions of the amounts made by the practices that lead to the charges that were settled.  Almost never have the cases involved penalties for any individuals who authorized, directed, or implemented the misbehavior.  We have also been saying (seemingly endlessly, but most recently here) that such settlements may be viewed by organizations as merely the costs of doing busines... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4151700 Wed, 10 Nov 2010 16:52:00 +0100 4151700 http://www.medworm.com/index.php?rid=4124961&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F11%2Fblogscan-florida-doctors-endorse-ex.html Rick Scott was the CEO of for-profit hospital chain Columbia/ HCA.  The company ended up settling civil and criminal charges for $1.7 billion.  Like many other examples in the march of legal settlements about which we have often posted, no individual who authorized, directed, or implemented the relevant bad behavior suffered any sort of negative consequence or paid any penalty.  Rick Scott left the company, but with a golden parachute.  Now he his running for Governor of Florida, using a substantial amount of his own money (but money that probably mostly came from Columbia / HCA). (See post here.)  He may be in the lead.  And the Florida Medical Association has just endorsed him.  In the Health Beat blog, Maggie Mahar is all over this story.  Read it... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4124961 Mon, 01 Nov 2010 19:35:00 +0100 4124961 http://www.medworm.com/index.php?rid=4125280&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FfB8CHD15wQY%2F In a scathing report, the US General Accountability Office has determined that the FDA failed to implement earlier recommendations that would close the gap between the agency’s approach to inspecting domestic and foreign drug manufacturing facilities. Consequently, the GAO writes that it is unclear if steps being taken by FDA “will prove successful” and there is an “urgent need” to better protect public health by putting GAO suggestions into practice. Here are some key findings: The FDA boosted its budget for foreign inspections to $41 million in fiscal 2009 compared with $12 million in fiscal 2008 and $10 million in fiscal 2007, and increased the number of foreign inspections. In fiscal year 2009, for instance, the FDA conducted 424 foreign inspections, compa... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4125280 Mon, 01 Nov 2010 15:29:16 +0100 4125280 http://www.medworm.com/index.php?rid=4097941&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcares-facebook%2F2010.10.22 [Recently] the Wall Street Journal‘s front page story exposed a significant privacy breech of online personal information via the world’s most popular social networking site, Facebook: Many of the most popular applications, or “apps,” on the social-networking site Facebook Inc. have been transmitting identifying information—in effect, providing access to people’s names and, in some cases, their friends’ names—to dozens of advertising and Internet tracking companies, a Wall Street Journal investigation has found. The issue affects tens of millions of Facebook app users, including people who set their profiles to Facebook’s strictest privacy settings. The practice breaks Facebook’s rules, and renews questions about its ability to keep ident... Better Health blogs http://www.medworm.com/rss/comments.php?id=4097941 Fri, 22 Oct 2010 16:00:00 +0100 4097941 http://www.medworm.com/index.php?rid=4074447&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FZIxbuK-7Dec%2F Last March, the US General Accountability Office issued a report that found the FDA’s Office of Criminal Investigation suffers from lax oversight, despite increased in funding and staffing over the past decade. And the GAO also concluded the FDA “has relied largely on the OCI director to determine which aspects of OCI’s operations and investigations are made known to FDA’s top management.” The effort was undertaken in response to a request by US Senator Chuck Grassley, who has now written a follow-up Sept. 16 letter to Gene Dodaro, the GAO’s acting comptroller general, over concerns that the findings in the GAO report “were less than stellar” after hearing from an unnamed whistleblower who charged the agency report was compromised by a mole. “I am not... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4074447 Thu, 14 Oct 2010 15:27:28 +0100 4074447 http://www.medworm.com/index.php?rid=4013136&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FlvM01BF-uZ4%2F By Tad DeHavenIt’s been a tough week for the Department of Health and Human Services. As I discussed earlier, the Government Accountability Office reported on fraud problems with the Child Care and Development Fund program. Another new report from the GAO finds fraud problems with HHS’s Head Start program. GAO investigators attempted to register children from fictitious families in Head Start programs in six states and the District of Columbia. The GAO created 13 fictitious families that earned too much income or possessed other characteristics that would disqualify the children from participating in Head Start. The result is embarrassing: In 8 out of 13 eligibility tests, our families were told they were eligible for the program and instructed to attend class. In all 8 of these cases,... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4013136 Wed, 29 Sep 2010 21:42:26 +0100 4013136 http://www.medworm.com/index.php?rid=4013140&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FD_iXW1F-MVM%2F By Tad DeHavenThe Department of Health and Human Services’ Child Care and Development Fund is a state aid program that subsidizes child care expenses for low-income working families with children. The federal government largely leaves it to the states to provide oversight for the CCDF program, which HHS estimates loses more than 10 percent of its funding in improper payments. A new report from the Government Accountability Office shows widespread fraud by CCDF recipients in the sampling of states that it investigated: Our proactive testing revealed that CCDF programs in the 5 states we tested were vulnerable to fraud because states did not adequately verify the information of children, parents, and providers and lacked adequate controls to prevent fraudulent billing. In 7 of 10 cases in ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4013140 Wed, 29 Sep 2010 18:49:13 +0100 4013140 http://www.medworm.com/index.php?rid=3915286&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FP96r1KXl_cQ%2F Just how useful are non-inferiority trials? For the uninitiated, such trials compare a drug being developed with one that is already approved by the FDA. Drugmakers, of course, pursue such studies so they can show their new med is no worse than another, and may even show some benefits. But this approach has generated criticism - why approve a new drug when an existing med does the job? There is also concern about ‘biocreep.’ This refers to concerns that successive generations of drugs that are approved based on non-inferiority trials can lead to less effective drugs over time, including those that are, ultimately, no more effective than a placebo. And so after a request from several members of Congress, the General Accountability Office has issued a new report that indicates th... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3915286 Mon, 30 Aug 2010 13:28:47 +0100 3915286 http://www.medworm.com/index.php?rid=3915001&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-twitter-diet%2F2010.08.29 Here is a recent piece in the New York Times by reporter Brian Stelter who decided to lose weight by 1) getting support from fellow Twitterers, and 2) by tweeting everything he eats throughout the day. An excerpt: I knew that I could not diet alone; I needed the help of a cheering section. But rather than write a blog, keep a diary or join Weight Watchers, I decided to use Twitter. I thought it would make me more accountable, because I could record everything I ate instantly. And because Twitter posts are automatically pushed to each person who subscribes to them, an audience — of friends or strangers — can follow along. What’s surprising is that he didn’t start using some kind of data-collecting application. (more…) *This blog post was originally published at ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3915001 Mon, 30 Aug 2010 00:00:55 +0100 3915001 http://www.medworm.com/index.php?rid=3876652&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-advice-for-college-bound-kids%2F2010.08.17 Sending a child off to college? Call your lawyer first. From the Weekend Wall Street Journal: After a few clients ran into difficulty getting information about adult children who were ill, Sheila Benninger, an attorney in Chapel Hill, N.C., began recommending that clients’ children designate a health-care power of attorney after they turn 18 to identify who can speak for them if they can’t. She also includes a Health Insurance Portability and Accountability Act, or HIPAA, release form that allows patients to determine who can receive information about their medical care and whether information about treatment for substance abuse, mental health or sexually transmitted diseases can be disclosed. You don’t have to use a lawyer. Generic health-care power-of-attorney forms ca... Better Health blogs http://www.medworm.com/rss/comments.php?id=3876652 Tue, 17 Aug 2010 18:00:00 +0100 3876652 http://www.medworm.com/index.php?rid=3827055&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FIjWWuoMICgE%2F By Tad DeHavenAs the fall elections approach, two factions within the congressional GOP have emerged. The first faction, which generally controls the Republican leadership, is short-term oriented and just wants to return the GOP to power in Congress. Riding the wave of voter discontent over the government’s finances is a means to an end — the end being power. The second, and considerably smaller faction, is more ideas driven and views the upcoming election as an opportunity to push for substantive governmental reforms. Whereas the “power first faction” offers platitudes about smaller government, the “ideas first faction” isn’t afraid to offer relatively bold suggestions for confronting the federal government’s unsustainable spending. The ideas first faction is willing t... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3827055 Thu, 05 Aug 2010 12:42:06 +0100 3827055 http://www.medworm.com/index.php?rid=3816382&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FKNQ-elAQyxQ%2F By Tad DeHavenAmtrak has announced that it will spend $300 million on 130 new rail cars, including sleeper and dining cars, for its long-distance trains. The government company’s announcement came with the obligatory statement that the purchase will create 575 jobs. That’s more than $500,000 per job. As a Cato essay on Amtrak discusses, all of Amtrak’s long-distance routes are money-losers. For example, the Sunset Limited, which runs from New Orleans to Los Angeles, lost $462 per passenger in 2008. According to the Government Accountability Office, long-distance routes account for 15 percent of riders but 80 percent of financial losses. Amenities like sleeping and dining services contribute to the red ink: The demographic being served by these long-term routes does not demonstrate a ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3816382 Tue, 03 Aug 2010 21:28:08 +0100 3816382 http://www.medworm.com/index.php?rid=3790949&cid=t_113006_180_f&fid=38607&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fsuccessbeginstoday%2FBHWQ%2F%7E3%2F2ci_JkFSL0k%2F I just finished up a powerful and insightful personal development book, entitled The Way We Are Working…Isn’t Working, by Tony Schwartz. Michael Hyatt had recommended the book, and I found it to be chock full of great ideas to improve your life. The thing that sets Tony’s book apart from so many others is the real world statistics that Tony includes, from his company’s work with hundreds of organizations around the world. Tony’s company is called The Energy Project and his work is focused on improving workplace and personal life performance. I found this book ties in with many of the things I’ve blogged about here at Success Begins Today. From diet and exercise, to time management, and goal setting, this little book has some practical and workable solutions to many of the ... Success Begins Today blogs http://www.medworm.com/rss/comments.php?id=3790949 Fri, 23 Jul 2010 14:08:54 +0100 3790949 http://www.medworm.com/index.php?rid=3706674&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhoop-de-do-to-the-medicare-physician-pay-cut-problem%2F2010.06.28 After months of dithering, delaying, denying, and defaulting on a decision, Congress ended up…doing as little as possible to address the Medicare physician pay cut problem. Thursday night the House of Representatives acceded to the Senate’s bill to provide physicians with a 2.2 percent update retroactive to June 1. This respite, though, lasts only through the end of November, when physicians and patients will again face another double-digit cut. And if the past is prologue, a lame-duck Congress then will wait until the very last minute to enact another short-term patch, or worse yet, allow the cut to go into effect on December 1 and then pass some kind of retroactive adjustment. You know that the situation has gotten ridiculously bad when the President says this about the bill he ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3706674 Mon, 28 Jun 2010 18:00:00 +0100 3706674 http://www.medworm.com/index.php?rid=3683620&cid=t_113006_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-doctor-facebook-friends-could-be-a-hipaa-violation%2F2010.06.21 Should you friend your doctor on Facebook? It’s a question that’s gaining increasing relevance as Facebook increases its social networking dominance. I’ve touched upon the issue in the past. So has the New England Journal of Medicine. Washington, DC, physician Katherine Chretian gives her take on the issue in a recent USA Today op-ed. She is an expert of the Facebook-medicine intersection, having authored a JAMA study on the issue. She says, no, doctors should not be friending their patients: Having a so-called dual relationship with a patient — that is, a financial, social or professional relationship in addition to the therapeutic relationship — can lead to serious ethical issues and potentially impair professional judgment. We need professional boundaries to do our job well. F... Better Health blogs http://www.medworm.com/rss/comments.php?id=3683620 Mon, 21 Jun 2010 16:00:12 +0100 3683620 http://www.medworm.com/index.php?rid=3679914&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FMXgDoWb_u_s%2F A sunny day here on the Pharmalot corporate campus, where we are using some spare moments to catch up on our reading. And of course, we are leisurely quaffing a few cups of stimulation. Later, we plan to grab a bite with Mrs. Pharmalot and The Pharmalittles in honor of you-know-what day. Whatever your plans, we hope the day is enjoyable. Meanwhile, here are a few stray items to keep you fresh. And remember to say hi to your dad. Have a great time… Patents on blockbusters are expiring. The human genome is not delivering. And the low-hanging fruit was long ago picked from the orchard of obvious follow-ups. Adrian Ivinson, director of Harvard’s NeuroDiscovery Center, is reminded of the shifts underway in the industry every time he looks out of his Cambridge, Ma., window at the “... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3679914 Sun, 20 Jun 2010 14:13:01 +0100 3679914 http://www.medworm.com/index.php?rid=3644711&cid=t_113006_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F09%2Fa-high-performing-nhs-a-review-of-progress-1997-2010%2F Title: A high-performing NHS?: A review of progress 1997-2010 The Skinny: King’s Fund report assesses how much progress the NHS has made in the following eight areas: access safety health promotion and management of long-term conditions clinical effectiveness patient experience equity efficiency accountability. It identifies important achievements, including major reductions in waiting times and rates of health care associated infections and progress in reducing smoking rates. There has been a concerted effort to implement national standards of care for major diseases across the NHS which has contributed to the continued falls in deaths from cancer and cardiovascular disease. There are less obvious changes too, including improvements in data collection and reporting, at a national and ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3644711 Wed, 09 Jun 2010 06:56:24 +0100 3644711 http://www.medworm.com/index.php?rid=3635705&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F06%2Fattempt-to-hold-health-care-leaders.html We have frequently noted how health care organizations accused of kickbacks, fraud, and other unethical and sometimes illegal behavior involving how they produce or market health care products or services often are allowed to settle the charges only with a fines to the companies, and sometimes with corporate integrity agreements.  Almost never are the people who authorized, directed, or implemented the unethical behavior required to pay any sort of penalty.  We recently commented on a case in which an executive of a medical device company accused of exaggerating the performance of a diagnostic test in development was charged, not with misleading doctors or patients by the US Food and Drug Administration (FDA), but with misleading investors by the US Securities... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3635705 Mon, 07 Jun 2010 14:30:00 +0100 3635705 http://www.medworm.com/index.php?rid=3603572&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FrQ1yipk2OY4%2F By Jim HarperVia the Identity Project’s “Papers, Please” web site, and despite my colleague David Rittgers’ excellent post from yesterday, I note last week’s utterly damning Government Accountability Office report on the SPOT program. “SPOT” stands for “Screening Passengers by Observation Techniques.” In the program “BDO’s,” or “Behavior Detection Officers,” observe travelers in airports, pulling them out of line if a secret list of behaviors signal that they’re a likely threat. The thing is: TSA deployed SPOT nationwide before first determining whether there was a scientifically valid basis for using behavior and appearance indicators as a means for reliably identifying passengers as potential threats in ai... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3603572 Thu, 27 May 2010 12:50:25 +0100 3603572 http://www.medworm.com/index.php?rid=3595540&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F05%2Fstewards-of-elite-university-or.html We have postulated that one of the key reasons US health care has become so dysfunctional is that the leaders of some of the most august health care institutions have strayed from, if not totally abandoned their organizations' fundamental missions.  There are many possible reasons for this phenomenon, but one is that the ultimate stewards of not-for-profit health care organizations, their boards of directors or trustees, have become uninterested in the mission, or impotent to uphold it.  So, we have tried to figure out what has happened to these boards that has lead to this sorry state.Dartmouth College: the Packing of the Board of TrusteesOne example we have come frequently discussed (beginning here) is that of Dartmouth College, despite its name, really a university, and o... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3595540 Mon, 24 May 2010 19:27:00 +0100 3595540 http://www.medworm.com/index.php?rid=3546833&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F05%2F19-million-means-never-having-to-say.html Johnson and Johnson, the giant diversified health care company, recently shut down a factory that manufactured non-prescription childrens' medication, and recalled its products.  The findings from a US Food and Drug Administration (FDA) inspection of the plant were striking.  As described by Reuters,The company recalled 40 widely used children's pain and allergy medications, saying some may have a higher concentration of their active ingredients, while others may be contaminated. J&J has had four recalls in the past year of over-the-counter medicines.In an FDA report issued on Tuesday, inspectors said they found thick dust, grime and contaminated ingredients at the J&J plant that produces Children's Tylenol and dozens of other products recalled last week.This infuriated t... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3546833 Sat, 08 May 2010 19:05:00 +0100 3546833 http://www.medworm.com/index.php?rid=3526728&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FHFuMi-8Iq7k%2F By Tad DeHavenJim O’Brien, a vice-president at Time Inc. and chairman of the Mailers Council, recently guest-blogged on the U.S. Postal Service’s inspector general’s web site on the subject of “automation refugees.” O’Brien explains the origination of the term: Back in 1990, Halstein Stralberg coined the term “automation refugees” to describe Postal Service mail processing employees who were assigned to manual operations when automation eliminated the work they had been doing. Since the Postal Service couldn’t lay off these employees, they had to be given something to do, and manual processing seemed to have an inexhaustible capacity to absorb employees by the simple expedient of reducing its productivity. The result was a sharp decline in mail processing productivity and... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3526728 Mon, 03 May 2010 12:42:31 +0100 3526728 http://www.medworm.com/index.php?rid=3482882&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FWXg7JW-CY10%2F By Tad DeHavenComments from members of the House Oversight and Government Reform Committee at a recent hearing on the U.S. Postal Service’s woes indicate they don’t appreciate the USPS’s union problem. Postmaster General John Potter went before the committee to make his case for restructuring the postal operation, including greater labor flexibility. From GovExec.com: “You have to find people meaningful work, or no matter how compassionate you are, you’re not doing them any favors,” said Rep. Darrell Issa, R-Calif., the ranking member of the House Oversight and Government Reform Committee, criticizing holding rooms where underemployed postal workers wait until there are tasks for them to perform. “How many billions of dollars would have been saved if you&#8217... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3482882 Mon, 19 Apr 2010 12:35:37 +0100 3482882 http://www.medworm.com/index.php?rid=3471771&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FcUXnA_fCNyk%2F By Julian SanchezIt is more than three years since the Office of the Inspector General first brought public attention to the FBI’s systematic misuse of the National Security Letter statutes to issue fictitious “exigent letters” and obtain telecommunications records without due process. Nobody at the Bureau has been fined, or even disciplined, for  this systematic lawbreaking and the efforts to conceal it. But the bipartisan outrage expressed at a subcommittee hearing of the House Judiciary Committee this morning hints that Congress may be running out of patience—and looking for some highly-placed heads to roll. Just to refresh, Committee Chairman John Conyers summarized the main abuses in an opening statement: The IG found that more than 700 times, such information was... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3471771 Wed, 14 Apr 2010 20:38:11 +0100 3471771 http://www.medworm.com/index.php?rid=3463543&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F04%2Fvery-well-paid-boob-on-harvard.html The ongoing investigation of the global financial collapse may also shed some indirect light on what has gone wrong with health care.  Consider the recent testimony by two leaders of the nearly failed, then bailed out global financial giant Citigroup, as reported by the New York Times. One of the leaders was Robert Rubin, Robert E. Rubin, the former Treasury secretary, faced withering questions from the panel, the Financial Crisis Inquiry Commission, for his spare expressions of remorse. Repeatedly playing down his role as chairman of the executive committee of Citigroup’s board, he was met with anger and disbelief.'You were either pulling the levers or asleep at the switch,' Philip N. Angelides, the committee’s chairman, told him. Mr. Rubin stopped short of accepting personal res... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3463543 Mon, 12 Apr 2010 20:28:00 +0100 3463543 http://www.medworm.com/index.php?rid=3448806&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F04%2Fwhat-me-worry-leaders-prosper-despite.html There were two examples in the recent news about how the leaders of health care organizations seem to prosper no matter what questions are raised about their organizations' ethics or performance.WellPointIt seemed that anger over a rate increase by a subsidiary of the huge insurance company/ managed care organization WellPoint was one reason for the revival of efforts in the US to enact some sort of health care reform legislation.  In our comment on this controversy, we noted that questions about the ethics of WellPoint's actions have appeared again and again.  Wellpoint...settled a RICO (racketeer influenced corrupt organization) law-suit in California over its alleged systematic attempts to withhold payments from physicians (see post here).subsidiary New York Empire Blue Cross ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3448806 Thu, 08 Apr 2010 16:19:00 +0100 3448806 http://www.medworm.com/index.php?rid=3395109&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fhuyy64224MU%2F By Tad DeHavenA recent Senate Appropriations subcommittee hearing on the U.S. Postal Service’s dire financial prospects found little enthusiasm for the USPS’s idea to eliminate Saturday mail service. Financial Services subcommittee chairman Sen. Richard Durbin (D-IL) said “serious questions need to be asked and answered,” and ranking member Sen. Susan Collins (R-ME) expressed concern that it would send the USPS into “a death spiral.” The USPS is already in a death spiral due to changes in technology, high labor costs, and costly congressional mandates that have left it facing a projected $238 billion in losses over the next ten years. The USPS says dropping Saturday service would save the USPS $3 billion a year. However, the Postal Regulatory Commission believes the savings wou... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3395109 Tue, 23 Mar 2010 12:32:53 +0100 3395109 http://www.medworm.com/index.php?rid=3370396&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FPjy9E8Y0mO4%2F By Neal McCluskeyThis morning the Obama Administration officially released its proposal for reauthorizing the Elementary and Secondary Education Act (aka, No Child Left Behind). The proposal is a mixed bag, and still one with a gaping hole in the bottom. Among some generally positive things, the proposal would eliminate NCLB’s ridiculous annual-yearly-progress and “proficiency” requirements, which have driven states to constantly change standards and tests to avoid having to help students achieve real proficiency.  It would also end many of the myriad, wasteful categorical programs that infest the ESEA, though it’s a pipedream to think members of Congress will actually give up all of their pet, vote-buying programs. On the negative side of the register, the proposed r... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3370396 Mon, 15 Mar 2010 21:17:33 +0100 3370396 http://www.medworm.com/index.php?rid=3366177&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FDHBQX-lT1GA%2F By Tad DeHavenThe Pentagon has informed Congress about another of its procurement projects that is plagued by cost overruns. In other news, the sun will rise and set today, and the pope is Catholic. Pentagon officials told the Senate Armed Services Committee on Thursday that costs for the F-35 Joint Strike Fighter have jumped more than 50 percent since the program began in 2001. Testifying before the committee, the Government Accountability Office noted that it has reviewed the JSF effort five times and the findings haven’t been positive: We have consistently reported on the elevated risk of poor program outcomes from the substantial overlap of development, test, and production activities and our concerns about the Government investing in large numbers of production aircraft before varia... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3366177 Mon, 15 Mar 2010 16:50:34 +0100 3366177 http://www.medworm.com/index.php?rid=3322629&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FbOW8qNg2sho%2F A report from the General Accountability Office found that among all Medicare Part D beneficiaries who used at least one specialty tier–eligible drug in 2007, 55 percent reached the catastrophic coverage threshold, after which Medicare pays at least 80 percent of all drug costs. In contrast, only 8 percent of all Medicare Part D beneficiaries who did not use a specialty tier–eligible drug reached this threshold in 2007. Specialty tier–eligible drugs accounted for 10 percent, or $5.6 billion, of the $54.4 billion in total prescription drug spending under Medicare Part D plans in 2007. And Medicare beneficiaries who received a low-income subsidy accounted for most of the spending on specialty tier–eligible drugs—$4.0 billion, or 70 percent of the total, according to the GAO. High-c... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3322629 Tue, 02 Mar 2010 17:21:36 +0100 3322629 http://www.medworm.com/index.php?rid=3302299&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FBwBkOzSBOP8%2F By Neal McCluskeyYesterday, Andrew Coulson and I wrote a bit on President Obama’s little talk with the nation’s governors about potential changes to federal education policy. The root of the President’s proposal — and we’ve probably only seen fragments of what will eventually come out – is a requirement that states adopt common “college- and career-readiness standards” to qualify for large chunks of federal money. This certainly puts in place the “standards” part of  “standards and accountability” reform, which has dominated education for roughly the last fifteen years. But where’s the ”accountability” part? So far, nowhere. Yes, a state would have to adopt common standards — or, int... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3302299 Tue, 23 Feb 2010 20:58:32 +0100 3302299 http://www.medworm.com/index.php?rid=3175853&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FG6ERfjCc-hA%2F By Tad DeHavenOMB director Peter Orszag is blaming the inefficiencies of the federal government on outdated personal computers. That is hard to understand given that federal IT spending amounted to $200 million a day last year. A new GAO report on cost overruns at the Department of Energy undercuts Orszag’s argument that the solution to government incompetence is new computers. DOE cost overruns are nothing new. As far back as 1982 the GAO was reporting that “DOE lacked sufficient guidance to provide to its contractors for developing cost estimates.” A 2007 GAO report found that eight of 12 DOE projects it examined had exceeded their initial cost estimate by almost $14 billion due to “ineffective DOE project oversight and poor contractor management.” In 2008, GAO reported that ni... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3175853 Fri, 15 Jan 2010 14:40:59 +0100 3175853 http://www.medworm.com/index.php?rid=3171881&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FIPwhuJiGAXw%2F By Neal McCluskeyWashington Post education columnist Jay Mathews has done it again: lifted my hopes up just to drop them right back down. In November, you might recall, Mathews called for the elimination of the office of U.S. Secretary of Education. There just isn’t evidence that the Ed Sec has done much good, he wrote. My reaction to that, of course: “Right on!” Only sentences later, however, Mathews went on to declare that we should keep the U.S. Department of Education. Huh? Today, Mathews is calling for the eradication of something else that has done little demonstrable good — and has likely been a big loss – for American education: the No Child Left Behind Act. Mathews thinks that the law has run its course, and laments that under NCLB s... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3171881 Wed, 13 Jan 2010 20:51:12 +0100 3171881 http://www.medworm.com/index.php?rid=3164045&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F5e3LVc2RQzY%2F Between 2000 and 2008, the prices for 321 different brand-name drugs soared between 100 percent and 499 percent, and the actual number of ‘extraordinary’ price hikes more than doubled each of those years, according to a report issued by the General Accountability Office. More than half were in just three therapeutic classes - central nervous system, anti-infective, and cardiovascular. Most of the price hikes were for brand-name meds costing less than $25 per unit. Depending on the condition treated and length of treatment, the full cost could total several thousand dollars. A lack of therapeutically equivalent drugs, both generics and other brand-name drugs, may contribute to extraordinary price increases, according to the report. And the limited availability may be due to pate... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3164045 Tue, 12 Jan 2010 12:58:31 +0100 3164045 http://www.medworm.com/index.php?rid=3096826&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FPOXrOhebBeI%2F By Neal McCluskeyI’ve been fretting for some time over the growing push for national curricular standards, standards that would be de facto federal and, whether adopted voluntarily by states or imposed by Washington, end up being worthless mush with yet more billions of dollars sunk into them. The primary thing that has kept me optimistic is that, in the end, few people can ever agree on what standards should include, which has defeated national standards thrusts in the past. So far, the Common Core State Standards Initiative – a joint National Governors Association/Council of Chief State School Officers venture that is all-but-officially backed by Washington — has avoided being ripped apart by educationists and plain ol’ citizens angry about who’s wri... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3096826 Thu, 17 Dec 2009 16:07:30 +0100 3096826 http://www.medworm.com/index.php?rid=3096841&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FsUITgFNxEJ8%2F By Edward H. CraneIn his ongoing effort to micromanage the U.S. economy President Obama used his Dec. 12 weekly radio address to promote his proposed Consumer Financial Protection Agency.  It will be filled with bureaucrats second-guessing entrepreneurs and is sure to improve the performance of our financial institutions — much in the manner of the SEC’s bureaucrats alertly nailing Bernie Madoff just 30 years into his Ponzi scheme.  Never mind that the federal government had much more to do with the financial meltdown than the banks did, the real knee-slapper in his address was his claim that the CFPA “would bring new transparency and accountability to the financial markets…” This, from a man demanding passage of a 2000-page health care reform bill that no one, incl... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3096841 Wed, 16 Dec 2009 16:59:23 +0100 3096841 http://www.medworm.com/index.php?rid=3071464&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FfPOglsBJyHI%2F In 2004, Merck withdrew its Vioxx painkiller, prompting intense scrutinty of the FDA’s review process. But the agency has not yet restructured its staff to better monitor drug safety, even though experts recommended several key changes back in 2006, the Associated Press reports. Although FDA officials have made some changes to drug oversight, a Government Accountability Office report finds the agency FDA continues to give the bulk of its decision-making power to scientists who approve new drugs, rather than those who monitor the side effects of drugs on the market. “It is not yet clear if or when FDA’s decision-making process will be substantially improved as a result of its efforts,” according to the GAO report, a copy of which was obtained by The Associated Press.... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3071464 Wed, 09 Dec 2009 14:02:36 +0100 3071464 http://www.medworm.com/index.php?rid=3008064&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F_bcLjY-XE4Q%2F The Obama administration and its allies in Congress want the federal government to expand its role in subsidizing health care. We are told that this expansion will restrain rising health care costs. But an OMB report yesterday that the government made $98 billion in improper payments last year — $55 billion of which came from Medicare and Medicaid — ought to raise suspicions about that claim. According to Reuters, OMB Director Peter Orszag told reporters that the embarrassing figures from Medicare and Medicaid demonstrate the need for health care reform. I would concur if “reform” meant reducing the government’s role in health care. However, he means the opposite, which raises the question of how giving more money to an already waste-prone and bureaucratic federal health ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3008064 Thu, 19 Nov 2009 15:56:49 +0100 3008064 http://www.medworm.com/index.php?rid=3008402&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FigpCGfon0IA%2F In the wake of reports that drugmakers raised prices by as much as 9 percent, on average, this year, the House Ways and Means and Energy and Commerce Committees sent a letter to the Government Accountability Office requesting a report on recent trends in prescription drug pricing. The letter also requests that GAO submit a proposal to ensure ongoing monitoring of pricing practices (back story). The price hikes came as health care reform legislation was crafted, suggesting drugmakers raised prices in anticipation that a bill would hurt their ability to raise prices in the future. The letter was signed by Charles Rangel, who chairs of the House Ways and Means Committee; Henry Waxman, whos chairs the Energy and Commerce Committee; Pete Stark, who chairs the Ways and Means Health Subcommittee;... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3008402 Thu, 19 Nov 2009 12:40:42 +0100 3008402 http://www.medworm.com/index.php?rid=3003725&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FOMyfED4MxVw%2F The U.S. Postal Service reported that it lost $3.8 billion last fiscal year and that it expects to lose $7.8 billion this year. The loss occurred despite cost-cutting measures and legislation that allowed the USPS to forgo $4 billion in required payments to pre-fund retiree health benefits. From the Associated Press: The post office has been struggling to cope with a decline in mail volume caused by the shift to the Internet as well as the recession that resulted in a drop in advertising and other mail. Total mail volume was 177.1 billion pieces, compared to 202.7 billion pieces in 2008, a decline of almost 13 percent. For the fiscal year that ended Sept. 30 the agency had income of $68.1 billion, $6.8 billion less than in 2008. Expenditures were down $5.9 billion to $71.8 billion. The rec... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3003725 Wed, 18 Nov 2009 14:11:41 +0100 3003725 http://www.medworm.com/index.php?rid=2992681&cid=t_113006_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F11%2F14%2Fthe-ultimate-ems-protocol%2F I don’t handle the card much anymore. It stays inside a plastic sleeve in my planner. The edges are worn and the words are faded. It wasn’t printed on kind of paper that travels well in a wallet for twenty plus years. But it’s been worth carrying. It is, quite simply, the ultimate EMS protocol. I don’t read it often. I’ve read it enough times over the past two decades to have it pretty well memorized. It’s my STAR CARE card. I got it back when I was a paramedic student at Baystar Ambulance in San Mateo California. It was 1992. I always believed the original author was none-other-than EMS guru Mike Taigman. Mike had signed on to be the quality care guy at the fledgling service and I knew the cards had originated in his office. The idea was simple. We can&... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2992681 Sat, 14 Nov 2009 12:00:08 +0100 2992681 http://www.medworm.com/index.php?rid=2954497&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FpH5Xnpti8uA%2F National Public Radio’s All Things Considered ran a series on “The End of Privacy” all last week that’s worth a listen. They’re primarily concerned with the ways private companies have access to vast quantities of information about individuals in the digital age—something that civil libertarians have traditionally been less concerned about than government access, for many perfectly valid reasons.  But it’s worth noting how porous that distinction can be.  A 2006 survey by the Government Accountability Office found that just four government agencies—the Justice Department, Department of Homeland Security, State Department, and Social Security Administration—spent at least $30 million annually on contracts with information resellers like Choicepoin... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2954497 Mon, 02 Nov 2009 18:24:52 +0100 2954497 http://www.medworm.com/index.php?rid=2927564&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FfYyJca0pmg8%2F The agency has allowed drugs to remain available even when follow-up studies showed they didn’t save lives, according to a report from the General Accountability Office. And the FDA has never pulled a drug off the market due to a lack of required follow-up about its actual benefits — even when such info is more than a decade overdue, the Associated Press reports. FDA officials tell the AP they have no plans to get more aggressive.The FDA responded that the report paints an overly negative picture of its so-called “accelerated approval” program, which is only used to approve drugs for the most serious diseases. “Millions of patients with serious or life-threatening illnesses have had earlier access to new safe and effective treatments,” the FDA responded. The... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=2927564 Mon, 26 Oct 2009 12:24:24 +0100 2927564 http://www.medworm.com/index.php?rid=2883217&cid=t_113006_151_f&fid=35822&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FWhatWinnersDo%2F%7E3%2FS-2jKcA37CI%2F Ultimately in order for someone to have success in addiction recovery they need to have a sense of accountability towards themselves. With that said, it's also beneficial to feel accountability towards someone/something outside of yourself. In very early recovery just being accountable to ourselves doesn't always work out very well. We are usually still plagued with addictive thinking. That is why learning self accountability through being held accountable to sources outside of ourself is so important in addiction recovery. My personal experience with learning accountability in early recovery came when I was in an outpatient drug rehabilitation program. In this program I met with the same group of people for 2 weeks. During that 2 weeks we were informed that we were going to be given a sch... What Winners Do blogs http://www.medworm.com/rss/comments.php?id=2883217 Sat, 10 Oct 2009 18:20:14 +0100 2883217 http://www.medworm.com/index.php?rid=2832171&cid=t_113006_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F09%2F24%2Fthings-my-kids-taught-me-about-ems%2F I’m blessed with two kids. They are amazing. Kids change your whole perspective on the world. They re-frame your purpose. It’s wonderful, the way a few minutes with your kids can put an entire bad day in perspective. They also force you to evaluate some of your own behaviors. (If your lucky.) Here are a few of the more valuable lessons I’ve learned from my kids.           1.) Test Your Limits. Kids know this instinctively. The moment you create a boundary they begin testing it. There is no running in this area. How fast is running? Can we just walk really fast? What about jogging?  It’s like they just instinctively know that life is more fun when you’re testing the limits. Sure there are boundaries that we all have to live within but when was the l... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2832171 Fri, 25 Sep 2009 04:38:34 +0100 2832171 http://www.medworm.com/index.php?rid=2796368&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F09%2Fmaking-health-care-more-representative.html On Health Care Renewal, we have often shown how the governance of health care organizations may be unaccountable, unrepresentative of relevant constituencies, opaque, and not subject to ethical standards. Conversely, we have repeated the need to make the governance of health care organizations accountable, representative, transparent, and ethical. Meanwhile, our US debate about health care reform seems to be driven by leaders of powerful health care organizations, while common citizens need to scream to be heard.Maybe we could benefit from a lesson from another country. As reported in the Bulletin of the WHO, Thailand seems to have found a way to get ordinary citizens and members of civil society involved in a civil, organized health care discussion.For Dr Suwit Wibulpolprasert, chairman o... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2796368 Mon, 14 Sep 2009 20:48:00 +0100 2796368 http://www.medworm.com/index.php?rid=2662534&cid=t_113006_109_f&fid=36089&url=http%3A%2F%2Fthesituationist.wordpress.com%2F2009%2F08%2F02%2Fa-situationist-view-of-criminal-prosecutors%2F Barbara O’Brien has recently posted her interesting article, “A Recipe for Bias: An Empirical Look at the Interplay between Institutional Incentives and Bounded Rationality in Prosecutorial Decision Making” (forthcoming in Missouri Law Review, 2009) on SSRN.  Here’s the abstract. * * * Prosecutors wield tremendous power, which is kept in check by a set of unique ethical obligations. In explaining why prosecutors sometimes fail to honor these multiple and arguably divergent obligations, scholars tend to fall into two schools of thought. The first school focuses upon institutional incentives that promote abuses of power. These scholars implicitly treat the prosecutor as a rational actor who decides whether to comply with a rule based on an assessment of the expected ... The Situationist blogs http://www.medworm.com/rss/comments.php?id=2662534 Sun, 02 Aug 2009 04:01:23 +0100 2662534 http://www.medworm.com/index.php?rid=2616673&cid=t_113006_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F20%2Ffrom-feast-to-famine-reforming-the-nhs-for-an-age-of-austerity%2F Title: From Feast to Famine: Reforming the NHS for an age of austerity The Skinny: The thintank Social Market Foundation have completed a piece of worke supported by NHS Connecting for Health, Bupa, Pfizer & Standard Life Healthcare.   It identifies that following recent massive in vestment in the  National Health Services it now finds itself in period when major savings are to be made, but they must be driven by high quality local commissioners, with central government taking far less responsibility for health services. This will mean a political shift away from the idea of a uniform National Health Service towards an acceptance of locally varied, diverse procision. Only through empowering locally accountable commissioners and managing demand can the health service survive the chal... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2616673 Mon, 20 Jul 2009 10:00:57 +0100 2616673 http://www.medworm.com/index.php?rid=2610866&cid=t_113006_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F16%2Fpower-in-peoples-hands-learning-from-the-worlds-best-public-services%2F Title: Power in People’s Hands: Learning from the World’s Best Public Services The Skinny: Looks at leading edge innovations in world-wide public services, and highlights more than 30 case studies from 15 countries. Emphasises that innovation and productivity come from forging stronger relationships with citizens and finds the most successful services have five distinguishing characteristics: Using entitlements to put power in the hands of users of services Transforming accountability of services through real time, highly local information Incentivising the creation of tailor made, integrated, personalised services which citizens can shape Answering people’s ambition for prevention rather than cure New professionalism in front-line staff and leaders, with new organisational ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2610866 Thu, 16 Jul 2009 14:38:33 +0100 2610866 http://www.medworm.com/index.php?rid=2510285&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F6HVyQZl27Os%2F For years we’ve been told that charter schools are the future of public schooling. The reverse is true. The pattern in publicly funded education, both domestically and internationally, has always been one of increasing regulation over time, and of the triumph of producer interests over the interests of parents and children. Public schools in the late 1800s had considerably more autonomy than do most modern charter schools. Over time, public schools have come under the sway of centralized bureaucracies dominated by employee unions. That same pattern is playing out in the charter school sector. As the Associated Press reports today, the American Federation of Teachers has just signed several more collective bargaining agreements for charter school teachers in New York City and Chicago.... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2510285 Tue, 23 Jun 2009 13:23:53 +0100 2510285 http://www.medworm.com/index.php?rid=2511157&cid=t_113006_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F22%2Fyou-have-the-right-to-your-health-data%2F I sometimes feel like we take one step forward and two steps back as we embrace technology. Because with the advances in providing people with access to their own health care data (including mental health data), there seems to be inevitable stumbling blocks along the way. Insert your data into Company A’s personal health record or electronic medical record and you’ll find no easy or accessible way to get it back out. Explore the health data kept by your hospital about you and you may find important pieces missing, or just plain wrong, with no accountability or record of who put that in there. Want to get Doctor XYZ to see your health data? Be prepared to sign a release and then play the waiting game. Better yet, want to get a copy of all of the health data kept in your recor... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2511157 Tue, 23 Jun 2009 00:55:03 +0100 2511157 http://www.medworm.com/index.php?rid=2415707&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2009%2F05%2F15%2Fbridge-building%2F Discipline is the bridge between goals and accomplishments. ~Jim Rohn There are times when you have the choice to move through or stall out. It is not so much that {one} moment of choice — but the countless choices made before … Choices that fortify our resolve and propel us in the direction of our dreams. Or leave us in Park. Most of the us log on to the day’s activities, incorporating both existing {to-do’s} as well as any new {to-do’s}, without a thought of what we actually have time to accomplish. We shift into gear — gas pedal pressed to the floor — without sorting through and determining priorities, separating the miscellany and trivial. Why? Our most commonly used “reason” … “I don’t have time.” Which is not true. Whe... The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=2415707 Fri, 15 May 2009 14:12:03 +0100 2415707 http://www.medworm.com/index.php?rid=2405118&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F05%2Firs-changes-form-990-to-make-not-for.html In the US, many important health care organizations are not-for-profit organizations. Many US medical schools, and other health educational institutions, along with their parent universities are not-for-profit. (Essentially all the exceptions are supported by local or state government.) The majority of US hospitals and hospital systems, including academic medical centers, are not-for-profit. Some managed care organizations are not-for-profit. Medical and professional societies, health care advocacy groups, health care charities, and a variety of other groups are not-for-profit.Not-for-profit health care organizations here have hardly been immune from leadership and governance problems. We have discussed numerous instances of ill-informed, conflicted, and even corrupt leadership of these or... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2405118 Mon, 11 May 2009 19:15:00 +0100 2405118 http://www.medworm.com/index.php?rid=2389667&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F_BxbhtPro0g%2F Fordham Foundation president Checker Finn notes today that recent upticks on the National Assessment of Educational Progress cannot be reasonably credited to the No Child Left Behind act (hat tip to Bill Evers). The NCLB, President Bush’s signature education initiative, was supposed to improve student achievement through bureaucratic accountability measures. But after noting that NCLB’s proponents can’t back up their claims that the law is working, Finn suggests that we need an “education-achievement ‘audit agency’ to sort out the claims and counterclaims about student performance.” Maybe. But Amazon.com didn’t have to be told by a federal product quality audit czar to allow its customers to rate the products it sells. They’ve done it... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2389667 Tue, 05 May 2009 12:37:44 +0100 2389667 http://www.medworm.com/index.php?rid=2380782&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F04%2Fblogscan-accountable-academic.html On The Torch blog, hosted by FIRE (Foundation for Individual Rights in Education), this post by Kyle Smeallie summarized the travails of "petition candidates" for the boards of trustees of two elite American universities (Dartmouth and Harvard). As we have noted, at most universities, the boards of trustees, the bodies ultimately responsible for upholding the universities' missions, are closed shops. At most universities, the boards appoint new members to replace departing ones, without input from alumni, parents, students, faculty or anyone else who might be considered constituents. Thus, at most universities, even though the boards are ultimately responsible for the stewardship of the institutions, and upholding the institutions' missions, practically, they are accountable to no one. At ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2380782 Thu, 30 Apr 2009 15:42:00 +0100 2380782 http://www.medworm.com/index.php?rid=2364986&cid=t_113006_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F04%2Fpension-fund-scandals-payment-agents.html As we get closer to graduation season for most institutions of higher education, another story about the leadership and governance of higher education, involving an institution housing a prominent medical school, has come into view, albeit indirectly. Let me try to explain this complex story, which on its surface has something to do with the ongoing financial crisis, but nothing to to with academia, by quoting, as usual, from media coverage.We start with an article from the New York Times last week:The man leading the Obama administration’s efforts to restructure the auto industry has been described in Securities and Exchange Commission documents as having arranged for his investment firm to pay more than $1 million to obtain New York State pension business.Although he is not named in th... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2364986 Fri, 24 Apr 2009 15:43:00 +0100 2364986 http://www.medworm.com/index.php?rid=2364921&cid=t_113006_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FEEwxPca-7E0%2F At Capitol News Connection, brought to you each morning by your tax dollars, they reported this morning: With more than a trillion tax dollars tied up in the Troubled Asset Relief Program and stimulus spending, Congress is trying to figure out how to account for every penny. Uh-huh. Congress is always on top of our federal dollars. Coincidentally, just hours after the CNC report, the Government Accountability Office released a report warning about the lack of oversight procedures in the kitchen-sink stimulus bill. And a few days earlier the inspector general for the TARP program reported that Treasury has no real details on how TARP funds are being spent. In fact, IG Neil Barofsky told Congress that there were 20 criminal investigations into possible TARP fraud already underway. Two mont... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2364921 Thu, 23 Apr 2009 23:38:18 +0100 2364921 http://www.medworm.com/index.php?rid=2284165&cid=t_113006_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F03%2F21%2Fimproving-the-quality-of-nhs-clinical-governance%2F Tackling Concerns Locally: report of the Working Group and supporting reports sets out the principles of best practice on how local systems for clinical governance could be strengthened to promote continuous improvement in the quality of care and enable healthcare organisations to identify and deal with those healthcare professionals whose performance, conduct or health could put patients at risk. Also available: Report of the Clinical Governance subgroup Report of the Information Management subgroup Review of the Performers List system and recommendations At a national level Tackling Concerns Nationally: establishing the Office of the Health Professions Adjudicator (Impact assessment) makes recommendations to Ministers on the establishment of an independent body to adjudicate (i.e., t... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2284165 Sat, 21 Mar 2009 13:32:29 +0100 2284165 http://www.medworm.com/index.php?rid=2236122&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2009%2F03%2F03%2Fgot-pruners%2F We can’t do everything … But we can prune back! I confess. (In the event you don’t already know …) I am a dreamer. Pruning is not something that comes naturally for me — by any stretch of the imagination! However, I am ever-so slowly learning to prune back the distractions and errant limbs [...] (Source: The Dessert Years . . . (the sequel)) The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=2236122 Wed, 04 Mar 2009 02:33:44 +0100 2236122 http://www.medworm.com/index.php?rid=2200394&cid=t_113006_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F02%2F20%2Ftransactions-manual%2F The Transactions Manual is a system management tool introduced in the 2008/9 Operating Framework aimed at SHAs, PCTs, NHS Trusts, NHS Foundation Trusts and independent sector organisations where they are involved or considering involvement in a transaction and where one of the parties to the transaction is an NHS Trust or PCT. Covered in the Manual are acquisitions divestments or disposals demergers joint ventures franchises and statutory mergers It guides parties through a best practice approach via guidance  to the transaction process and provides technical detail to the various areas of law, policy and practice that may be needed to complete the transaction successfully. The Manual also incorporates mandatory practice required by law or by policy that may change from time to tim... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2200394 Fri, 20 Feb 2009 10:25:10 +0100 2200394 http://www.medworm.com/index.php?rid=2196346&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2009%2F02%2F18%2Frhythms-of-grace-how-to-avoid-crashing-waves-and-other-adventures%2F Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you’ll recover your life. I’ll show you how to take a real rest. Walk with me and work with me—watch how I do it. Learn the unforced rhythms of grace. I won’t lay anything heavy or ill-fitting on [...] (Source: The Dessert Years . . . (the sequel)) The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=2196346 Wed, 18 Feb 2009 22:03:30 +0100 2196346 http://www.medworm.com/index.php?rid=2192507&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2009%2F02%2F16%2Fare-you-a-people-pleaser%2F Ever have shining moments of blinding revelation? I had one this morning. Said revelation actually started dawning on me last summer … It had to do with a comment made to me by a close friend. Her exact words escape me at the moment — probably because I was in a state of semi-shock when she [...] (Source: The Dessert Years . . . (the sequel)) The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=2192507 Mon, 16 Feb 2009 21:05:16 +0100 2192507 http://www.medworm.com/index.php?rid=2054836&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2008%2F12%2F19%2Fnew-day%2F Ever carry baggage from the previous day with you into the “today”? As I sip on my mug of café mocha (will post some recipes later …) I am pondering this about myself. Why do we do that? Why do we insist of beating ourselves over yesterday? Today has quite enough worries and anxieties of [...] (Source: The Dessert Years . . . (the sequel)) The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=2054836 Fri, 19 Dec 2008 14:04:30 +0100 2054836 http://www.medworm.com/index.php?rid=2036246&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2008%2F12%2F15%2Fwe-cant-do-everything-but-we-can-set-priorities%2F Winter Sky During the past couple of months, I have challenged myself to live up to my bio. What does that mean? Well, if I say I am a gardener, that means I enjoy time in my gardens. Other selected habits in my bio: writing; photography; beading; collage art; various activity and miscellany regarding social entrepreneurism. That [...] (Source: The Dessert Years . . . (the sequel)) The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=2036246 Mon, 15 Dec 2008 15:10:27 +0100 2036246 http://www.medworm.com/index.php?rid=1980526&cid=t_113006_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2008%2F11%2F21%2Fsocial-enterprise-making-a-difference-a-guide-to-the-right-to-request%2F (summary leaflet) is part of a bigger vision for the future of the NHS as set out in High Quality Care For All: NHS Next Stage Review Final Report published in June 2008. This recognised that frontline NHS staff  need to be given the freedom to use their talents to find innovative ways to improve quality of care for patients, and the need to enable NHS services everywhere to best respond to the needs of their local communities to develop a new accountability. This guide aims to support NHS staff who are thinking of taking up the ‘right to request’ and setting up a social enterprise to deliver healthcare services to NHS patients, free at the point of delivery, answering some the questions about setting up a social enterprise, the benefits, and the risks and challenges involved.  It g... Fade Library blogs http://www.medworm.com/rss/comments.php?id=1980526 Fri, 21 Nov 2008 11:16:18 +0100 1980526 http://www.medworm.com/index.php?rid=1807414&cid=t_113006_136_f&fid=37858&url=http%3A%2F%2Fdessertyears.wordpress.com%2F2008%2F09%2F19%2Fassessing-in-order-to-progress%2F Apparently, I am completely unable (unwilling?) to sort my proverbial To-Do without blogging it here. I have been pondering the realities of the universe — especially my universe — for most of two hours now and … Well, I simply must blog to think sometimes! So … here we go! First of all, [...] (Source: The Dessert Years . . . (the sequel)) The Dessert Years . . . (the sequel) blogs http://www.medworm.com/rss/comments.php?id=1807414 Fri, 19 Sep 2008 15:07:09 +0100 1807414 http://www.medworm.com/index.php?rid=1660992&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F348569058%2F The FDA takes an average of seven months to issue warnings to drugmakers for off-label marketing, and the drugmakers take an average of four months to address violations, according to the Associated Press, citing a draft report compiled by the Government Accountability Office. The report also found the FDA has no one assigned to specifically monitor off-label violations. The agency’s Division of Drug Marketing, Advertising and Communications, which has 44 employees reviewing DTC ads, monitors off-label marketing. The division examined about 68,000 ads last year, but lack a system to track all info received by FDA, according to the report. From 2003 to 2007, DDMAC issued 42 notices of potential violations related to off-label use, most of which prompted drugmakers to end misrepresent... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1660992 Mon, 28 Jul 2008 17:00:43 +0100 1660992 http://www.medworm.com/index.php?rid=1440012&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F289358497%2F The FDA continues to be slow in sending warning or untitled letters when the agency suspects drugmakers violated DTC rules, according to a report by the Government Accountability Office, FDAnews reports. Last year, the agency took an average of six months to issue regulatory letters citing DTC violations, Marcia Crosse, who heads the GAO’s healthcare division, told a House subcommittee last week. In one case, the agency took more than three years to issue a regulatory letter, FDAnews notes. Before 2002, when the FDA decided that all draft warning or untitled letters had to undergo legal review — a policy for which there was no apparent need — it took less than a month to send such letters, Crosse told the committee. (Here’s her testimony). The FDA hasn’t improved since 2... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1440012 Tue, 13 May 2008 10:59:47 +0100 1440012 http://www.medworm.com/index.php?rid=1391299&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F275349371%2F Although the FDA increased inspections of foreign drug plants last year, the agency still checked only 11 percent of the sites that supply pharmaceutical ingredients to the US market. That’s what GAO health care director Marcia Crosse will tell the House Energy and Commerce Committee this morning at a hearing to discuss the FDA’s oversight of foreign manufacturing, according to Reuters. Concern about FDA oversight has risen since the finding of a contaminant in some batches of Heparin that were made with raw ingredients from China, where officials are now are voicing doubts that a contaminant identified in Heparin was the root cause of 81 deaths and severe allergic reactions in hundreds of Americans. “FDA’s plans represent a step forward in filling the large gaps ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1391299 Tue, 22 Apr 2008 12:12:47 +0100 1391299 http://www.medworm.com/index.php?rid=1258225&cid=t_113006_87_f&fid=35052&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FWomensBioethicsBlog%2F%7E3%2F241574960%2Fshortcomings-of-compassion.html Dispatches from the Culture Wars reports on a lesbian couple who were denied visitation rights and a chance to provide medical information when one woman fell ill and was taken to a hospital. The... [[ This is a content summary only. Visit my website for full links, other content, and more! ]] (Source: Women's Bioethics Blog) Women's Bioethics Blog blogs http://www.medworm.com/rss/comments.php?id=1258225 Tue, 26 Feb 2008 16:32:47 +0100 1258225 http://www.medworm.com/index.php?rid=1237810&cid=t_113006_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F236535598%2F Joanne Jacobs, educator, blogger and author of Our School: The Inspiring Story of Two Teachers, One Big Idea and the Charter School That Beat the Odds, participates today in our Author Speaks Series with an excellent article on how "Schools won’t improve until administrators and teachers can admit the problems, analyze what’s going wrong and try new strategies. Students won’t improve if they think they’re “special” just the way they are." Enjoy, and feel free to add your comment to engage in a stimulating conversation. ----------------------- The First Step Is Failure By Joanne Jacobs When self-esteem became an education watchword in 1986, I thought it was a harmless fad. I was wrong: It wasn’t harmless. Many teachers were persuaded that students should be pumped u... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=1237810 Sun, 17 Feb 2008 16:38:14 +0100 1237810 http://www.medworm.com/index.php?rid=1146555&cid=t_113006_140_f&fid=35438&url=http%3A%2F%2Fwrithesafely.wordpress.com%2F2008%2F01%2F12%2Fintersections-what-intersections%2F At Psych Central Dr. Grohol makes a much needed point about the very fucking idea of relationship. He begins with the recent Lancet Journal study that shows the use of anti-psychotics as a useless option for subduing aggressive behaviors: Medicating People Because It’s Easier Than Talking To Them. Of course, this works too: Officer Claudia [...] (Source: Writhe Safely) Writhe Safely blogs http://www.medworm.com/rss/comments.php?id=1146555 Sat, 12 Jan 2008 23:00:15 +0100 1146555 http://www.medworm.com/index.php?rid=1136994&cid=t_113006_151_f&fid=35822&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FWhatWinnersDo%2F%7E3%2F213270070%2F Ultimately in order for someone to have success in addiction recovery they need to have a sense of accountability towards themselves. With that said, it’s also beneficial to feel accountability towards someone/something outside of yourself. In very early recovery just being accountable to ourselves doesn’t always work out very well. We are usually still plagued with addictive thinking. That is why learning self accountability through being held accountable to sources outside of ourself is so important in addiction recovery. (more…) (Source: What Winners Do) What Winners Do blogs http://www.medworm.com/rss/comments.php?id=1136994 Tue, 08 Jan 2008 16:35:48 +0100 1136994 http://www.medworm.com/index.php?rid=992033&cid=t_113006_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F177362131%2F That’s one of the take-away messages contained in a 68-page report that reviews the Bush administration’s approach to trade agreements and intellectual property protection, specifically as it pertains to pharmaceuticals. The report, of course, looks at the White House track record since 2001, when a new intellectual property agreement was reached under World Trade Organization auspices and used measured language to assess the White House track record. And the findings weren’t all negative. For instance, the GAO determined that the US Trade Rep took a measured approach toward Thailand, which caused a ruckus for issuing compulsory licenses for several drugs. Several key observations, however, took the Bush administration to task for the way trade protections were balanced a... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=992033 Tue, 30 Oct 2007 20:57:34 +0100 992033 http://www.medworm.com/index.php?rid=658890&cid=t_113006_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2007%2F06%2Fphrma-report-on-dtc-everythings-coming.html PhRMA has just released its second annual report on comments it has received regarding violations of its Guiding Principles for DTC Advertising (see "DTC Advertising Improvements Observed In Two New Reports").PhRMA did a wonderful job of "white washing" or glossing over any negative criticisms with statements like the following peppered throughout the report:"The comments on Principle 1 [DTC Ads should be educational] were both positive – with many patients having favorable reactions to the educational component of an ad – and negative – primarily with regard to specific actors used in the advertisement.""Many consumers were appreciative of the information provided while others stated confusion about the details of the advertisement and asked for further clarification. All companies ... Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=658890 Tue, 05 Jun 2007 11:59:00 +0100 658890 http://www.medworm.com/index.php?rid=551378&cid=t_113006_133_f&fid=35452&url=http%3A%2F%2Fwww.graphictruth.com%2F2007%2F04%2Fbush-cant-keep-his-lies-straight.html Keith Olbermann lists all the various reasons and excuses Bush has used to justify the Iraq war.I had a roommate once who was a total sociopath, and it took me less than a month to realize that all his "reasons" were really excuses. In fact, he did what he did because he wanted to do it and gave whatever excuse he thought would work that moment. He really had no clue that sane people keep track of these things.It's been clear for a long, long time that whatever reason exists in George Bush's mind for the war - if any mind or reason exists in any commonly understood sense - it probably isn't one of his utterly disposable excuses.I stopped keeping score long ago, so I hadn't realized how very damming the sum of his lies had become. But it is truly damning, and indicative of someone utterly i... Graphictruth blogs http://www.medworm.com/rss/comments.php?id=551378 Tue, 10 Apr 2007 04:00:00 +0100 551378 http://www.medworm.com/index.php?rid=551379&cid=t_113006_133_f&fid=35452&url=http%3A%2F%2Fwww.graphictruth.com%2F2007%2F04%2Fof-ships-of-state-riverboat-races-and.html I'm no fan of big government, so the siren song of Thatcherism seduced me for a while - back when the Iron Lady was still in office and Ronald Reagan was best buddies with her and "Lyin' Brian" Mulroney of Canada.Both Commonwealth leaders were allowed to give both nations a solid dose of Conservative medicine and then shown the door. They did not achieve the cult status Regan has, and yet, I believe both will be shown in the historical view to have done more for their nations - and for less personal reward - than Reagen or any of his intellectual heirs. And I don't mean individually; I mean, in toto.The Parliamentary tradition has certain strengths - and one of those is sort of a genetic memory of why it came to be and in the United Kingdom, especially, what happens when it is set aside in... Graphictruth blogs http://www.medworm.com/rss/comments.php?id=551379 Sat, 07 Apr 2007 04:00:00 +0100 551379