This week, we published the 3rd annual Shkreli Awards, our yearly roundup of the top ten worst actors in health care! There were some Shkreli nominees that didn’t make the top ten but are still worth highlighting, so we’re giving them “Dishonorable mentions,” and sharing comments from the Shkreli judges’ panel. Enjoy!
Fake insurance sold to 100,000 people by supposedly “faith-based” organization.
Aliera Healthcare claimed to be a health care sharing ministry, a faith-based co-op in which members share the cost of their medical bills. But Aliera marketed their product to thousands of people as insurance, making enrollees believe they were covered. Enrollees received a rude awakening when they needed medical care and Aliera didn’t pay. An investigation found that Aliera is not affiliated with any religious group and was falsely representing the company as a “sharing ministry.”
Source: Jenny Deam, The Houston Chronicle
Thanks to Lown Weekly reader Bonnie Sheeren for the nomination!
$3,300 for a single stitch: What one hospital charged an uninsured patient
Zuckerberg San Francisco General Hospital makes an appearance in the Shkreli Awards two years in a row! After Conan Mattison received a single stitch in his hand for a knife wound, a procedure that lasted five minutes, he received a bill from Zuckerberg Hospital for $3,321.47. While ZSFG has ended its practice of “balance billing” for patients with private insurance (for which it received a Shkreli Award last year), the hospital still charges uninsured patients the full 437% markup.
“I don’t think we need anything more than this as a rallying cry for single payer, with 100% price transparency, across the American healthcare systems,” said Casey Quinlan, patient advocate and founder of Mighty Casey Media LLC.
Source: Joe Eskanazi, Mission Local
Patients got 20 injections per visit, while the clinic profited.
Government officials have accused PainMD, a pain management company with clinics in Tennessee, North Carolina and Virginia, of pressuring patients to get unnecessary injections. Patients regularly received up to 20 injections per visit. PainMD staff were also instructed to mislabel these injections in order to increase their reimbursements.
“More evidence that pain management is just another name for profit management in many cases,” said Deborah Blum, Director of the Knight Science Journalism Program at MIT.
“Apart from the outright fraud, this illustrates the need for more active and educated patients and consumers to ask questions about their care and recognize the perverse incentives that may influence providers,” said Emma Hoo, director of the Pacific Business Group on Health.
Source: Brett Kelman, Nashville Tennessean
Toronto ob/gyn secretly induced labor in his patients on weekends so he could bill more
Nurses at the North York General Hospital in Toronto discovered that esteemed OB/Gyn Paul Schuen had been inducing labor in pregnant women using medication without their consent. He induced patients so they would deliver on weekends when the hospital was short-staffed and he could charge more.
“Even in a universal Medicare for All system, the fee-for-service model creates the wrong incentives,” said Lown president Vikas Saini.
Source: Madeleine Aggeler, The Cut
Dangerous narcotic forced on communities in massive quantities by drug distributors.
Documents released in 2019 show how drug distributors Cardinal Health, McKesson and AmerisourceBergen saturated U.S pharmacies with 76 billion opioid pills while the country battled an addiction crisis. Distributors engaged in unethical practices to keep profiting from these deliveries, such as not reporting suspicious opioid orders to authorities and helping pharmacies bypass limits on how many opioids they were allowed to buy.
“The individuals responsible for this should be prosecuted as if they were dealing heroin on street corners,” said John Sellers, co-founder of The Other 98%.
Sources: Scott Higham, Sara Horwitz, and Steven Rich, The Washington Post ; Danny Hakim, William K. Rashbaum and Roni Caryn Rabin, The New York Times