Tags: The | CYA | Medical | Syndrome

The CYA Medical Syndrome

Tuesday, 19 April 2005 12:00 AM

In the matter of medical care, your government considers you a fool and is determined to protect you from every possible mistake that you, your health care providers or the pharmaceutical industry might make. They do so by hyper-regulation, micro-management, yanking drugs off the market on the basis of dubious evidence of harm, and prosecuting physicians whose only crime may have been giving patients what they needed.

At the same time, the trial lawyers are just hoping that doctors, hospitals and drug companies screw up and you get hurt, so they can profiteer off your misery.

One result is that medical care gets more and more expensive as everybody practices "defensive" medicine, that is, ordering all those unnecessary tests and procedures to cover one's gluteus maximus.

Another result is that necessary medical care gets harder and harder to come by as doctors let fear govern their practices and practice the 'ultimate' in defensive medicine: refusing to perform certain procedures or prescribe certain drugs, or moving to where the insurance premiums are lower and the lawsuits less ferocious, or by getting out entirely.

Meanwhile, federal caution and meddling creates endless whatever-I-do-will-be-wrong situations for patients.

Consider the following:

A recent report by noted human resource consultants Tillinghast-Towers Perrin finds that every American pays a "lawsuit tax" of $845 per year, or $3,380 for a family of four. This is the amount that the cost and fear of lawsuits adds to everyday consumption. In other words, it is the amount of money you pay for the privilege of living in a lawsuit-terrified, cover-your-behind medical system and society legally out of control. A goodly chunk derives from medical care and product liability.

Jim Copland notes (San Francisco Examiner, April 14, 2005) that "far bigger than any of the biggest of businesses [in California] are the operations of the plaintiffs' attorneys [we] at the Manhattan Institute have dubbed 'Trial Lawyers, Inc.,' who rake in over $46 billion a year from their American operations. ...

"'This is a hidden cost that everyone pays. ... Lawsuits increase the cost for food, healthcare, and services that we use everyday,' said Maryann Maloney, Executive Director of Orange County [California] Citizens Against Lawsuit Abuse (OCCALA)."

That hurts. But don't expect to get much pain relief.

Indeed, the government has been making sure that relief keeps getting harder to find. Of late, the FDA has maneuvered drug companies into taking pain-killing drugs off the market because of what might happen, or because of studies that show linkages that might prove to be significant.

To ensure future patient pain and non-prescribing of legal prescription pain medications by physicians, in a northern Virginia courtroom on Thursday, April 14, a federal judge sentenced Virginia pain management doctor William Hurwitz, M.D., to four 25-year sentences and more than $1 million in fines for prescribing legal painkillers. Dr. Hurwitz will be eligible for release at age 84.

In the area of prescription non-steroidal anti-inflammatory drugs (NSAIDs), Merck has pulled Vioxx and Pfizer has pulled Bextra because they contain "cox-2 inhibitors," which may raise the risk of heart disease and stroke. Another cox-2 inhibitor, Pfizer's Celebrex, remains on the market but with major stark warnings. Mobic was recently immobilized.

Meanwhile, the FDA has decided that almost an entire category of non-prescription NSAIDs might carry a risk of cardiovascular damage and should now carry warnings. These NSAIDs include ibuprofen drugs such as Motrin, Advil and Medipren; naproxens such as Aleve; and ketoprofen (Orudis, Actron).

Aspirin does not get a warning and gets an A.

They call this erring on the side of caution. But the question arises: Even if elevated risk levels are proven, who decides whether or not the risks are worth it? A man or woman in chronic, debilitating pain or a few people on an FDA panel? For many patients, the choice is easy and they want the freedom of choice. Life without pain is worth it. Some patients are already ignoring warnings.

And has anyone considered:

Maybe it is time to infuse some fresh blood into the FDA. It appears the "Mighty FDA Medical Players" have thrown in the towel after realizing that they can't win in our current second-guess-later system. Vioxx lawyers now infect the Net with every click and byte.

The time has come for us as a nation to start making intelligent decisions and stop the harmful practice of always having to cover our posteriors in health-care delivery and society. But first we have to end the legal blackmail that now rules our lives and land.

The situation is serious but not hopeless. The choice to speak up or squeak up is yours!

Robert J. Cihak, M.D., is a Senior Fellow and Board Member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues.


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In the matter of medical care, your government considers you a fool and is determined to protect you from every possible mistake that you, your health care providers or the pharmaceutical industry might make. They do so by hyper-regulation, micro-management, yanking...
Tuesday, 19 April 2005 12:00 AM
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