The sordid tale of “dirty money” behind healthcare policy

Oh, what a tangled web they weave …

If you take nothing else away from today’s message, I hope you’ll remember this: The health industry does not exist to make you healthy. It is an industry. And what drives industry? Money. Industry doesn’t care about whether or not we’re healthy (in fact, it makes more money when we’re not). It is a game of politics, lobbyists, and all sorts of back-room dealings that they don’t want us to know about.

So it’s on us to stay vigilant. Especially on occasions like this one, when we get a rare glimpse into those shady relationships that drive the healthcare industry.

According to research published online in JAMA Internal Medicine (not some conspiracy rag, mind you), the people writing our healthcare guidelines are in the pockets of drug companies and other money-makers in the industry.

Members of key guideline committees and patient advocacy groups have substantial ties to industry, the researchers found. Which means that industry has a seat at the table in designing those groups’ decisions, guidelines, and recommendations.

Take the cholesterol guidelines, for instance. They were written in 2013 by the American College of Cardiology and the American Heart Association. And they have had sweeping effects on how millions of people’s healthcare is managed. As a result, risky statin medications have been prescribed to countless people who don’t need them.

For thinking doctors like me, and for informed patients like you, these guidelines don’t make any sense on the surface. Why would two organizations ostensibly concerned with keeping people’s hearts healthy be recommending medications that do anything but?

As always, you’ll find the answer by following the money.

The study found that one of the three chairs/co-chairs of the guidelines committee had commercial conflicts of interest. Among the 16 committee members, seven (that’s nearly half!) disclosed commercial conflicts of interest. Every one of those had reported industry-sponsored research, and six of them had even served as industry consultants.

It would be funny if it weren’t so tragic.

Is it any wonder that statin meds are recommended to every breathing human over the age of 40? Is it any wonder they want these drugs to go over-the-counter…side effects be damned?

You might be asking, “Isn’t this against the rules?” And the disturbing answer is, “Only sorta.”

The Institute of Medicine (IOM), says no guideline committee chairs or co-chairs should have commercial conflicts of interest. So the fact that the cholesterol guideline committee had any industry-sponsored chairs (let alone three) is a no-no.

But the rest of it is perfectly fine, according to our government. As long as no more than half of committee members have industry ties, the IOM has no objection.

It’s a mystery to me why anyone writing the guidelines that affect the health of millions of Americans should be allowed to have conflicts of interest. But, hey, I’m just a doctor…not a politician.

And let’s not forget, it’s not just guideline committees that are corrupt. Patient advocacy groups are too. Two-thirds of them receive industry funding, and one in 10 receive more than half of all their funding from industry. It’s no surprise, then, that 8 percent of the leaders of these organizations felt pressured to put out positions that furthered the interests of their donors.

That’s a problem, because patient advocacy organizations are increasingly influential in setting healthcare policy. In addition to providing education and counseling for patients, they’re also a strong organizing force behind research priorities and media coverage.

You might be reading this and thinking that this sort of thing happens in all industries. While that may be true, it shouldn’t occur when this type of collusion is shaping the way we all think about disease. Money should not be the driving factor behind how we diagnose, treat, and even define disease.

Keeping people alive, and healthy, should be priority No. 1.