Watchdog Blog

About the Battle Between Small Donors And Big Spenders

Great post on The Wonk Room from guest blogger Lisa Gilbert, a Democracy Advocate for U.S. PIRG, on the Supreme Court's overreach in the Citizens United case, which may roll back a century of limits on corporate campaing spending. Visit DontGetRolled.org to learn more and Pledge to Protest on September 9th!

Don't Get Rolled!

On September 9th, the Supreme Court will hear a case that could roll back a century of limits on corporate campaign spending. Visit DontGetRolled.org  to learn more and Pledge to Protest on September 9th!

Defensive Medicine: Rhetoric Meets Reality

by Kiren Gopal

In his July 24th piece in the Washington Post, columnist Charles Krauthammer rails against “jackpot justice” and defensive medicine, which he calls “the greatest waste” in our health care system.  He contends that “doctors order [tests] for no good reason other than to protect themselves from lawsuits.”  But his self-righteous claims are more than suspect, considering that overwhelming evidence shows that so-called “defensive medicine” is not a meaningful cause of rising health care costs.  The Congressional Budget Office (CBO), which Krauthammer himself cites in his column to argue that not enough is being done to reduce Medicare spending, has concluded that the link between liability and defensive medicine is “weak or inconclusive” and “at best ambiguous.”  

A reader’s letter responding to Krauthammer’s exaggerated rhetoric presents an additional factor that contributes to health care costs, which he calls “offensive medicine.”  That is, doctors perform more tests and recommend more procedures, primarily because under the reigning fee-for-service model they benefit financially from each test and procedure ordered rather than on patient outcomes.  This and other incentives that the present system engenders have been estimated to cost $700 billion a year – a number that former CBO director Peter Orszag, has discussed often.   

Amendment Goes Down the Hatch

by Kiren Gopal

In a resounding defeat of Senator Hatch’s medical liability amendment, the Senate H.E.L.P. Committee voted 13-10 yesterday against imposing an arbitrary cap on damages.  This is an important signal to the Finance Committee that restrictive limits on medical liability will not address our rising health care costs or incentivize a reduction in avoidable medical errors.  The amendment would have also imposed contingency fee limits, restrictive statutes of limitations, and raised the burden of proof.  Measures like these do nothing to combat the very real problem of medical malpractice.  “Between three and seven Americans die from medical errors for every one who receives a payment for any malpractice claim,” according to Public Citizen’s latest study.  Given these staggering statistics, limiting negligent provider accountability is not a sensible solution.   

Ignoring Patient Safety = $1 Trillion Waste

Former Bush administration Treasury Secretary Paul O’Neill identified a simple but crucial element that should be front and center in the health care reform debate and legislation: improving patient safety, which would, in turn, reduce health care costs.

O’Neill rhetorically asked in this New York Times op-ed piece:

• Which of the reform proposals will eliminate the millions of infections acquired at hospitals every year?

• Which of the proposals will eliminate the annual toll of 300 million medication errors? 

• Which of the proposals will eliminate pneumonia caused by ventilators?

• Which of the proposals will eliminate falls that injure hospital patients?

• Which of the proposals will capture even a fraction of the roughly $1 trillion of annual “waste” that is associated with the kinds of process failures that these questions imply?

“So far,” O’Neill wrote, “The answer to each question is ‘none.’”

O’Neill calls it waste – that is, the unnecessary harms done to patients on a daily basis and, he estimates, a trillion dollars in annual costs to address those harms. He said that hospitals themselves can adopt simple processes, such as hand-washing and proper preparation of surgical sites, to cut down on costly injuries and deaths. He also suggested that members of Congress seek more information on the dire problem of hospital-acquired infections, provider errors and other similar “waste indictors.”  To sum up, he said: “(A)ny health care reform that does not address the pervasive waste and the associated burden of needless suffering for patients and staff alike will give us little to celebrate.”

Congress should heed O’Neill’s call. 

Misplaced Malpractice Reform

by Kiren Gopal

According to President Obama, health care reform should control costs, expand coverage, improve care, and guarantee choice.  As Congress works to find politically palatable solutions to achieve those goals and health care interests continue to lobby – to the tune of $1.4 million daily – some legislators instead choose to offer proposals to limit medical liability.

These proposals are based in part on the theory that frivolous malpractice claims are epidemic and represent a significant component of health care costs.  But according to the latest Public Citizen study of the National Practitioner Data Bank, nearly two-thirds of the individuals who were compensated in 2008 suffered an injury that resulted in “significant permanent injury, major permanent injury, quadriplegia, brain damage or the need for lifelong care, or death.” These claims can hardly be described as frivolous. Perhaps the most telling point from the NPDB study is that the medical malpractice liability system accounts for just 0.6 percent of national health care costs. Reducing accountability for medical malpractice is clearly an unsuitable focal point for reducing unnecessary costs. 

Sorry Works: Change We Can Believe In?

by Kiren Gopal

At a recent speech before the American Medical Association, President Obama expressed a concern for medical malpractice lawsuits and said that “we need to explore a range of ideas” to tackle the issue. However, the president hasn’t offered much in the way of clarification of his position on medical liability reform.  The only indication was a reported comment of a White House spokeswoman who “pointed to his support as a senator for a mediation program known as ‘Sorry Works.’”

In 2006, then-Senators Obama and Clinton introduced MEDiC (National Medical Error Disclosure and Compensation).  They wrote in the New England Journal of Medicine that the program would provide grant money to health care providers to “implement programs for disclosure and compensation.”  In practice, this means that health care providers would disclose medical errors to the patient, offer an apology, and then try to negotiate compensation.  Additionally, the data yielded from the program would be analyzed to determine best practices.  The potential benefits of such a program are manifold: improved quality of care, more effective doctor-patient communication, and lower administrative and legal costs.

Poll: Americans Oppose Forced Arbitration, Demand Corporations Be Held Accountable

Wide support exists across party lines for Arbitration Fairness Act; consumers, employees from around U.S. lobby lawmakers today

Washington, DC – Americans widely oppose corporations using mandatory binding arbitration clauses in the fine print of consumer and employment contracts, according to national polling of likely voters conducted by Lake Research Partners.

Forced arbitration clauses are hidden in the fine print of everything from cell phone, home, credit card and retirement account terms of agreement to employment and nursing home contracts. Just by taking a job or buying a product or service, consumers and employees are forced to give up their right to take their case to court if they are harmed by a corporation.

Victory! Lobbyist No Longer Up for DOJ Nod

The news is in:  Mark Gitenstein is no longer being considered as a candidate to head the DOJ's Office of Legal Policy, according to the Huffington Post, Roll Call, and several other sources.  The concerns about this longtime corporate lobbyist that we first raised on February 2 and reported in yesterday's post apparently have been heeded. 

According to Roll Call, this decision has been confirmed by an administration official.

It's encouraging to see the Obama Administration standing by its ethics policy.

Ian Millhiser deftly captured the significance of this decision in his Huffington Post article:

Hopefully, this decision will serve as a cautionary tale to other ambitious and talented individuals who, despite a long career of progressive accomplishments, are tempted to work in support of practices as abusive as binding mandatory arbitration.

Our sentiments exactly.

Likely DOJ Nominee Has Long History of Lobbying Against Consumer Rights

We've been keeping a close watch over the Obama Administration's potential nominees to ensure that members of the new administration will be advocates for consumer and taxpayer rights.

We recently issued an investigative report on Mark Gitenstein, a longtime corporate lobbyist, who may get the nod to head the DOJ's Office of Legal Policy.

Gitenstein's long list of corporate lobbying activities appear to directly violate President Obama's ethics policy prohibiting executive branch employees from becoming appointed to "issue areas" in which they have acted as lobbyists within the last two years.  A closer look at Gitenstein's lobbying reveals that he has sought to weaken or eliminate vital consumer protections, including the False Claims Act, which has saved billions of taxpayer dollars, and access to court to hold corporations accountable for bad behavior.

Gitenstein's past actions seem to be in stark contradiction with Obama's executive order governing conflicts of interest, and clash with Obama's regular calls for more accountability for government and corporations alike.

Public Citizen sent a letter to Obama raising concerns about Gitenstein's long history of corporate lobbying activities, and suggesting that the possible nomination be reconsidered.  We also joined forces with the Project on Government Oversight, Government Accountability Project, and other noteworthy organizations to make the Senate Judiciary Committee aware that this potential candidate does not have our endorsement.

Deadline tonight: Tell your reps to vote for accountability in government

President Obama has asked Congress for a federal spending bill to get the economy moving again. Billions of tax dollars are already being spent in the bailout and billions more are needed to begin to dig us out of this financial crisis. But before we agree to this massive spending bill, we must know that someone will be watching the store. We must ensure that federal employees can blow the whistle waste, fraud or abuse - without fear of retaliation or reprisals!

We now have a chance to protect whistleblowers and make sure there is real accountability in the economic stimulus package! But we have to act quickly!

Two champions of accountability, Representative Chris Van Hollen (D-MD) and Representative Todd Platts (R-PA), have offered an amendment to the stimulus bill that would restore and strengthen protections for federal workers who blow the whistle. This is the same bill that we have long supported and that passed the House with overwhelming support in 2007.

Congress is voting this evening on whether the economic stimulus should include protections for federal workers who blow the whistle on waste, fraud and abuse.

We need you to call your representative now and ask for support for federal government employees! You can find your member of the House here, or simply call the Capitol switchboard (202) 224-3121and ask for your representative.

Please tell your member of Congress to support federal employee whistleblower rights and vote yes on the Platts/Van Hollen Amendment today!

We’ve been fighting for these whistleblower protections for a long time. Passing the stimulus bill passes with these protections in place would be an outstanding victory for all of us who have fought for government accountability over the years. Please call your member of Congress today!

Let us know your thoughts on how your call went! Email us at action@citizen.org.