Health Care Conflicts Of Interest Growing

Suppose your doctor prescribed a particular drug to treat your high blood pressure, headaches or arthritis. Would it matter to you if the doctor owned the company that manufactured the drug?

Sure it would. To rely on your doctor’s advice, it is important you know that, as far as the doctor is concerned, your best interest comes first.

So why is it that the news media and those in the health care professions have had so little to say about the enormous potential conflicts of interest that are surfacing as companies that manufacture drugs and other health care products begin buying hospitals, nursing homes and health maintenance organizations?

On April 13, Zeneca Pharmaceutical, a giant British drug company with revenues of $6.5 billion worldwide, bought Salick Health Care, a Los Angeles-based health service chain. Salick provides kidney dialysis and cancer care nationwide to the tune of $150 million per year.

Why might Zeneca want to own Salick?

Salick operates 10 cancer centers around the country at teaching and community hospitals. The company, according to an eye-opening article by Greg Borzo in American Medical News, also owns and operates a health maintenance organization in the Miami area and nine dialysis clinics in California, and it provides dialysis services in 21 hospitals scattered throughout the country.

Meanwhile, Zeneca sells drugs that many of the doctors, nurses and pharmacists working in the fields of cancer and kidney dialysis might use. Cancer drugs accounted for 30 percent of the company’s sales last year.

Since billions of dollars are spent each year in the United States on drugs to battle cancer and kidney disease, it is not hard to imagine Zeneca executives drooling at the prospect of owning a company whose doctors prescribe drugs for thousands of patients.

But the advantages to Zeneca of owning Salick do not stop with gaining control of what is in the medicine cabinet at dozens of cancer clinics and dialysis centers.

Zeneca now has direct access to information on patients in the Salick system. That means the pharmaceutical company can see what other drugs patients are using.

The prescription practices and levels of care provided by different doctors, clinics and hospitals now will be subject to direct scrutiny by Zeneca corporate officials.

When critics were eviscerating President Clinton’s health care reform plan last year, they argued that there was no need for government intervention - that the market would work to contain costs and assure the quality of medical care.

When politicians in states such as Washington and Tennessee voted during the past few months to scuttle state efforts at health care reform, they did so mouthing all manner of rhetoric about freedom from government bureaucracy and the right of Americans to choose their doctors.

Baloney.

The current health care system rapidly is moving toward the kind of integrated corporate monopolies that the old turn-of-the-century robber barons of oil, steel and railroads could only dream about.

Unless some oversight and public accountability are put into our health care system, the only choices you and your doctor will make about the medications you can get and the treatments you can receive will be made by business executives using calculators to diagnose what is wrong with you.

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The following fields overflowed: CREDIT = Art Caplan King Features Syndicate