Broken Health Care System --> Charity Care Mess

In an incredibly biased piece, Jonathan Cohn writes about the problems some non-profit hospitals have in fulfilling their charity care obligations. He cites one case in particular and highlights that there are sometimes insurmountable obstacles for patients accessing charity care funds. Yes, it looks pretty bad when a hospital sues a grieving widow for an enormous amount of cash.

But Cohn's account is more cynical than accurate. For every case like the example he describes, there are thousands others that get done right. (Go check out the IRS's database of Form 990.) Non profit hospitals eat millions and millions of dollars of medical bills every year. In combination with shortfalls in reimbursements from medical assistance (Medicaid programs), and astronomical liability insurance premiums, charity care costs are often far more than the tax break non profits enjoy.

There is a distinction between indigent care- services provided to those who don't pay- and charity care- services provided to those who can't pay. Often the two groups are the same, but it takes some finesse in figuring out who's who at patient intake- a process riddled with problems indeed. Sick patients or their families don't want to fill out a stack of forms and disclose they are broke because they fear they will be denied care. No fault of their own, these folks often don't realize providing accurate financial information will make them eligible for charity care.

Really, the lesson here is our health system is broken. Providing medical care for the uninsured or underinsured should not fall to nonprofits only. A basic, universal and just health care system is the only way to fix this mess. - Dominic Sisti

Conflicts of Interest Everywhere

The Lancet is engaged in scandalous destruction and obfuscation of data on the relationship between abortion and breast cancer. So goes the story on Businesswire, in which an editorial by Ed Furton in Ethics and Medics journal is credited with making the charge. The story announces the finding by the ethics journal as though Lancet has been caught in a real moral morass. But ... Ethics and Medics, it turns out, is a publication of the National Catholic Bioethics Center, and their editorial was highlighted by the Coalition of Abortion and Breast Cancer. Now who would guess that the charges in the editorial involve the claim that the Lancet and cancer research community in general are deliberately "corrupting scientific research examining the abortion-breast cancer link."

JAMA is running a great set of articles on the relationship between ethics and the bioscience business; Psaty and colleagues review "Potential for Conflict of Interest in the Evaluation of Suspected Adverse Drug Reactions: Use of Cerivastatin and Risk of Rhabdomyolysis," and Brian Strom replies. Fontanarosa, Rennie and DeAngelis discuss drug withdrawals in an accompanying article. Jeremy Sugarman reviews Margaret Eaton's book Ethics and the Business of Bioscience. (subscription required).

Bioethics Journal Charges Lancet, Scientific Community with Cancer Cover Up

So goes the story on Businesswire, in which an editorial by Ed Furton. Ethics and Medics, it turns out, is a publication of the National Catholic Bioethics Center, and their editorial was highlighted by the Coalition of Abortion and Breast Cancer. Now who would guess that the charges in the editorial involve the claim that the Lancet and cancer research community in general are deliberately "corrupting scientific research examining the abortion-breast cancer link."