Re: Is Medical Research Trustworthy in a Profit-Driven World?
Posted: June 4th, 2024, 1:31 am
Sushan wrote: ↑June 3rd, 2024, 6:00 amI'm sorry that the system you're dealing with has the level of corruption you describe. Obviously much has been broadcast about the shortcomings of the US system, though generally corruption (out and out stealing) is uncommon, since companies and docs can get rich through less legally risky behaviors, such as doing semi-unnecessary procedures or refusing to see government insured patients. One positive of the US system is that the competition between corporations CAN but doesn't always, lead to true efficiencies (as in our case), as opposed to denying necessary care as a cost cutting measure to increase profits.LuckyR wrote: ↑May 26th, 2024, 12:53 pmI am quite impressed by your system. As you mentioned, motivations are crucial when dealing with humans. However, in my country, these motivations are often difficult to discern and are primarily driven by corruption, in stark contrast to your system. It's challenging to find individuals who neither take bribes nor offer them. Those who strive to work honestly often find themselves penalized by the corrupt majority. Unlike your capitated system, ours relies mostly on welfare, yet it seems the mindset of many is still geared towards maximizing personal gain. We also lack competition between organizations, which may be why every part of our system is deteriorating uniformly, creating a uniformly detrimental impact on everyone involved.Sushan wrote: ↑May 26th, 2024, 1:46 am That sounds like a robust system designed to ensure the efficacy and safety of drugs before they are widely used, and it clearly has its benefits for both the healthcare system and patients. In my country, we have a similar setup, though not as sophisticated due to limited resources and the lack of a fully computerized healthcare system.Like most things in Life involving humans, it's all about understanding motivations and designing systems to leverage that understanding. Our system is comprehensive (in the sense that the labs, pharmacies, insurance arm and ancillary services are all in the same corporation as the standard health delivery) and thus the various divisions are not in financial competition with one another. In addition as we started as a capitated system with provider paid for their time not procedures, there is no incentive to approve care beyond what is medically necessary. Since we're an individual corporation (not a whole country) no Pharma company is going to risk trying to bribe a Formulary Committee member to try to get a set of expensive drugs approved. The docs are financially tied to the financial health of the corporation since that's who provides their healthcare in their retirement. Thus everyone's incentives are aligned to provide only necessary, cost effective care.
However, we've faced significant challenges with breaches in the system. Recent investigations have uncovered corruption involving high-ranking officials, including the Health Minister, leading to breaches in the drug evaluation and approval process. Many of these corrupt individuals are now in jail, including the minister, but the trust in our system remains severely damaged.
Given these challenges, do you have any suggestions on how we could implement stronger measures to ensure the integrity of the drug evaluation and approval process? What steps can we take to rebuild trust in our healthcare system and prevent such corruption in the future?