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I'm the underachiever in my family. My parents also produced Harvard Medical School research director Thomas Stossel. Mom called him the one who had "a real job."
For years, my brother annoyed me by not embracing the libertarianism that changed my life. It bored him. He was comfortable in his Harvard cocoon. But then he realized that the anti-capitalist activists who fight with me on my TV show are also the people who make life more difficult for doctors, and for patients who want cures.
Lately, the anti-capitalists have become obsessed with "conflict of interest" in science—any trace of corporate money must poison honest medical research.
Obamacare includes a rule called the Physician Payment Sunshine Act. It orders companies that make medical products to disclose even bagels they serve doctors and anything valued above $10. On my TV show this week, Tom calls that "the conflict of interest mania … taking normal competition … into a witch hunt."
But doesn't corporate money tempt doctors to push inferior treatments and drugs? "People cheat for money," replied Tom. "But evidence that collaborations compromise clinical integrity and patient care is practically nonexistent. A voluminous 2009 Institute of Medicine report on 'Conflict of Interest in Medical Research' was unable to find evidence of a negative effect on patient outcomes."
How much good comes from corporate/research collaboration? I assumed that most new drugs and improved medical treatments come because of government-funded research. Tom's reply:
"I've lived off government-funded research my whole life. I've panhandled off your tax money. It's important. But the vast predominance of what gets products to patients comes from the private sector."
His epiphany came when he did work for the biotech company Biogen. Its board included Nobel Prize winners. One helped develop the hepatitis vaccine.
That probably wouldn't happen today, says Tom, because now the stock options the Nobel winner got are forbidden at research institutions like Harvard.
But without government regulation, what prevents greedy doctors and greedy medical device makers or drug companies from colluding?
Market competition. Other scientists will try to replicate dramatic findings and debunk false claims and sloppy scientists. Companies worry about scandal, lawsuits, the Food and Drug Administration, and recalls. They can't get rich unless their reputation is good.
The scientific process doesn't work through activists swooping in and pretending to be the guardians of careful research. As Tom writes in a forthcoming book, "Science's credibility derives from its delivery of durable discoveries." Similarly, sustained profits require products that actually work. Currently, the conflict of interest zealots have won the debate. Obamacare regulators are implementing the Sunshine Act. Who wins from the new regulation?
"The Sunshine Act is a boondoggle for accountants, compliance bureaucrats, and the legions of lawyers whom companies will hire to manage the regulations," says Tom. "These parasites will muddle through endless complexities, such as which entity of a global company actually pays physicians and must report the payments. There will be the questions of how to identify which physicians are being paid for what, such as how to account for $25 worth of bagels brought into a group practice office when it's unclear who actually ate the bagels."
Who loses? Patients. Few have the competence to interpret the disclosures, and because of the new rules, they'll have fewer new drugs. Hundreds of millions of dollars once applied to innovation will shift to "Sunshine" management.
"Do you want your doctor pilloried for eating a corporate bagel while getting useful product information that might benefit you?" asks Tom.
"Do you want your hospital hiring compliance officers instead of nurses or laboratory technicians? Do you want medical researchers censured for being paid by industry for discoveries that might save your life? … This will benefit predators: the media who want to embarrass doctors, the lawyers who sue doctors, and drug companies."
Markets do not automatically taint science. As with every other service the market provides, it is the anti-capitalist attitude that does more harm.
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