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Medicine in the dark age of money

A cardiologist flaunts a stent firm’s wares at a medical conclave. A doctor is punished for exposing the pharma-doc nexus

Published: 08th May 2017 04:00 AM  |   Last Updated: 08th May 2017 05:35 AM   |  A+A-

This is the latest whiz kid among cardiac stents. Nowhere else in the world you will have a stent like this. I have done 56 so far. No complications at all, affordable too.” This is how a cardiologist started his live streaming video at the National Interventional Council (NIC) conference in a five-star hotel in Delhi where the conference organisers received several crores of rupees for the extravaganza.

Paper advertisements and TV commercials are old hat now: The medical advertisements there look like kindergarten stuff. Now, live streaming by a flamboyant cardiologist in a so-called medical conference where normally the science of medicine has to be debated is the in-thing. Even the Chinese device-maker whose stent is not passed by the “great” FDA is one of the sponsors and must have also paid crores. How much will this brand ambassador, the flamboyant cardiologist, get?
Where is medical ethics? Where is our great Medical Council of India (MCI), the watchdog which is supposed to keep a watchful eye on medical ethics? What ethics does the MCI itself follow in regulating medical education? What have we come to and what about the safety of our rich patients who go to the hospitals?

Today, a case can be made out for angioplasty in any one of any age who goes to the hospital as coronary artery blocks (not coronary artery disease) can be demonstrated in anyone, including children. In this scenario, who is safe?
Pharmaceutical companies ‘plotted to destroy cancer drugs to drive up prices’, the Independent reported. After purchasing five different cancer drugs from GlaxoSmith Kline, Aspen Pharmacare tried to sell them in Europe for up to 40 times their previous price, the paper said quoting a report in the Sunday Times on April 15, 2017. Busulfan is an old hat in treating leukaemia. It used to sell for 5.20 pounds a couple of years ago in England. It now sells at 65.20 pounds there. This is an old drug and there is nothing new or exciting about it.
While bargaining over drug prices in Spain, the company wanted to raise the price by 4,000 times. When the government did not agree, it threatened to stop cancer drug supply in Spain in an attempt to take the country for a ride. In fact, it would have been a great boon for the Spaniards to live without the dangers of these anti-cancer drugs.

The cover story of Outlook magazine on April 17, 2017 is still worse. We have been fighting a losing battle against vaccinations for decades. The Outlook cover reads: When a baby is a business opportunity. “Scared middle-class India buys unwanted vaccines, some 15 of them, as big pharma helps doctors rake in the moolah with 30-300% mark-ups,” it adds. The more dangerous trend is that the IAP (Indian Academy of Paediatrics), the apex body of child specialists in the country, has now been found to be a partner in this venal business. On January 20, 2017, Dr Vipin Vashista, a former convener of IAP, was unceremoniously eased out of IAP for blowing the whistle on the big-money nexus in the body.
The health ministry, I am told, is in the know of things, but prefers to do nothing. The ministry is maybe afraid of the bigwigs in the vaccine business. Are we ready to bring forth a full generation of Indians with crippled immune systems thanks to so-many useless and dangerous vaccines being used when they are born? Parents get lost in the cacophony of vaccine threats and advertisements and the hapless victims do not have a voice in the true sense of the word. Another good soul fighting for the voiceless infants is Dr Jacob Puliyal in Delhi. He is a good friend and a fellow traveller in the fight against useless vaccines.

We are already in the dark ages of money which James Kennedy, a journalist, calls monetary fascism. “Milton Friedman and the Chicago School of Economics claimed to have refined and developed modern,  scientific tools of ‘free market capitalism’, capable of unlocking ever greater rewards from Adam Smith’s simple, primitive concept of free markets ... In truth, it was nothing more than a cloak of deception —providing cover for the unscrupulous behaviour of investment bankers, corporate raiders, speculators, off-shore corporation, debt mongers and bubble pushers (typically one and the same). The enhanced rewards came from the pilfering of capital investments and technology from generations past, the liquidation of employees and off-shoring of production, the pilfering of pension accounts and the termination or spin-out of R&D departments and option packages to executives and directors that focused on short term stock price targets,” says Kennedy and gives the example of AT &T: Bell Labs, once part of AT&T. The father of all modern telecommunication and electronics technology today “morphed into Lucent Technology”. Lucent quickly “looted the legacy portfolio of Bell Laboratories” to enrich themselves and shareholders, leaving a worthless shell that was eventually merged with Alcatel.
So far so good but these do not deal with human life and health. But when monetary fascism comes to medical business, life becomes difficult for humans and the human race is threatened with slow annihilation for the sake of making money for the few. Today we have seen only a few of the glaring dangers of monetary fascism in medicine but this is only the tip of the iceberg.
The big belly under the water is the whole gamut of corporate monstrosity in medicine which is for another day.  I am reminded of what Benjamin Rush, a founding father of the US, warned about not letting any one system of healthcare dominate and monopolise medical care. They did not pay heed to his warning and we are suffering the consequences today.

Prof. B M Hegde
Cardiologist and former vice chancellor of Manipal University
Email: hegdebm@gmail.com

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