FYI, there is a new episode on american greed which pretty much shows how these type of operations worked. Insys basically gave the kickbacks by having the doctors give "speeches" but it turns out no speeches were given and the doctors got the checks anyways.
> it turns out no speeches were given and the doctors got the checks anyways.
True, but it's not like if they did, the situation would be that much better. In a way for them they screwed up because the actually didn't bother playing the bribery sham all the way through like say political candidates do. For example, Hillary Clinton made $3M from speeches to large banks in just 2 years: https://theintercept.com/2016/01/08/hillary-clinton-earned-m... but they were actually organized enough to have "speechs". I remember the transcript of one was leaked, and you'd think they'd be some really deep insights and strategy laid out for the future that's worth $600k. But it was mostly "you all great, thanks for creating jobs etc etc". It is legal of course, but everyone know what it really is.
It’s not clear what it really is. People pay hundreds of thousands of dollars to Hollywood celebrities for appearances too, with no expectations of political favors.
Seems like paid speeches (and charities) are a form of bribery vehicle, not sure which English-speaking country this was first pioneered, but American politicians seem to be most active users of this method. [1]
Greed and stupidity. A regular "speech" isn't that hard to organize. It's like the leading edge of medical-pharmaceutical industry has devolved from the legal corruption of payments informally coupled to favors to the illegality of payments directly so tied out of laziness and impatience. Perhaps these folks are sampling their own wares too much.
As a side project I sorted the doctors based on opioid prescribe count. It isn't hard to see who the pill shops are -- I am sure the DEA can do a sql command. IMHO they (DEA) prefers kicking down doors in poor areas.
As bad as pill mills are, wouldn't 'Pain Management' clinics rate high in this query since they give out pills to manage legitimate pain?
I have multiple herniated cervical disks and am going in for surgery soon because the pain is debilitating and unbearable. Among other specialists, I saw a pain management doctor to understand my non-surgical options. Many people with my condition choose to not get implants or disk fusions and instead opt for steroids, epidurals, and opioids.
Legitimate doctors at pain management clinics will rank high on these lists if they have a lot of really sick patients who don't want neurosurgery.
Yes! 'Pain Management' would be a high subscriber. But being the top 5 in the US? Maybe, but that is pretty strange - definitely worth a DEA trip. 'Family Medicine' in the top 40? Hm....
I hope you at least tried steroidal epidurals. I had 2 fully herniated lumbar disks and was unable to even get off the floor for 6 months but I've gotten mostly back on feet without surgery.
A doctor who specializes in pain management for late stage cancer patients will prescribe thousands of times more opiates than a family doctor. More context is needed
Interesting, though a bit dangerous to look just for outliers. Medecine advances by having physicians trying new things. You don't really want to end up with fully standardised prescriptions.
"Rosenberg’s son was an Insys sales representative for a year and made “substantial commissions” from his father’s willingness to prescribe the drug, according to prosecutors. The son wasn’t charged in the case."
A not-so-bright outlook for actually holding Insys's CEO responsible. Why were charges not brought on middle level employees especially if the father-son relationship could be an easy access route to bribery.
EDIT: Even the court document does not list is full name, Rosenberg's son is simply referred to as Insys Rep A.R.
I have this entirely unscientifically-gathered impression that could be erroneous, but it certainly appears there is not just a divide in justice between rich and poor, but also across professions. Someone on Mars would swear there is an unwritten law in the US that doctors be held to higher standards than average. And some are held to lower standards, such as police officers.
Perhaps this isn't true, but it certainly seems like it based on the events I've come across in my life, and in the news.
That just means we should treat low level criminals humanely. Four years is plenty.
The thing where decade plus sentences are fairly common is unique in the first world: only in America. It’s barbaric and embarrassing.
The science is pretty unambiguous—a high likelihood of being caught and punished is a better deterrent than a low-probability but larger punishment.
So I don’t want to see this doctor get a 40-year sentence. I’d rather see lots of doctors who accepted gifts from opioid manufacturers get one-year sentences. Most important is that the pharma executives go to jail, too.
Criminal justice should never be about retribution. In this case, the purpose is to keep future patients safe.
The deterrent and long term way to keep patients safe is not just the 4 years in prison, it is losing his medical license in perpetuity throughout the USA. Not sure if his sentence includes this but it should be in public records. My PCP in MA was busted for a different charge and lost his ability to practice medicine FOREVER throughout the USA. Way to throw all those years of med school in the dustbin!
It’s really not. Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague.
What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.
Street dealers, "low level" or not, do actually kill their clients.
Prison sentences for dealing hard drugs should be in line with prison sentences for murder, otherwise the implication is that the lives of drug users are much less valuable than the lives of regular people.
You would fall under 'trafficking' which is federal (Schedule 1 or 2 depending). Schedule 1 that is up to 20 years in federal prison. You would probably plea down maybe get 14. There is no good time in federal prison so you do the full 14 years. Schedule 2 maybe 15 years plea down to 9 years. THAT is if things work out and you don't get a crazy federal prosecutor that wants to file multiple charges (unlikely). This is federal prison (traffickers, embezzlers, wire-fraud) so it isn't that bad compared to state (state is where they keep murders and rapists). EG Guys in for trafficking can probably hold a good game of chess and discuss current world events.
BUT then you might face state charges for possession if the DA wants to bother.
Not really comparable. The street dealer is not likely to get 40 years, although many may have gotten it (Assuming that a street dealer doesn't have 400 kilos of coke in his stash house. If he does, he's no street dealer)
Also the doc loses his license and every single penny he has, between lawyers, years without being able to make a penny, and court fines. When you make a certain amount of money the trend is to live up to it: mortgages, fancy cars, club memberships, schools for kids and so on. When the money stops coming in, guess what happens?
> When the money stops coming in, guess what happens?
You drop to the status of a boring working person who never took kickbacks to sell opiates? A fate worse than death, I guess.
The street dealer is also not likely to get 4 years. That's the point - 40 years was a number picked to illustrate a sentencing discrepancy argument. The fact that a 10x factor seems almost reasonable is the argument.
> a street dealer doesn't have 400 kilos of coke
What do you think Resenberg's prescriptions added up to, by weight? It's probably not fair to compare a street dealer to him.
This is getting down voted but I don't think that's fair, it's not off topic. Trump said yesterday he's in favor of the death penalty for drug dealers because they are responsible for the death of others. It's a fair question to ask if there should be a distinction between street dealers and these doctors and executives.
Shkreli got 7 years for financial fraud that didn’t end up costing anyone any money, and this guy only got four years for actually threatening people’s lives. Seems out of whack - what gives?
> [Doctor], who lost his medical license and was ousted from his post as a Brown University professor, pleaded guilty to taking more than $188,000 in kickbacks disguised as speaker fees and creating false patient records to dupe insurers into covering Insys’s Subsys pain medication...
> ... [his] son was an Insys sales representative for a year and made “substantial commissions” from his father’s willingness to prescribe the drug, according to prosecutors. The son wasn’t charged in the case.
Oh, gee, it's Purdue Pharma again, i.e. the Sackler family. How am I not surprised, and how are they not fined?
Readit News
https://www.youtube.com/watch?v=h2WBKkyFpRo
True, but it's not like if they did, the situation would be that much better. In a way for them they screwed up because the actually didn't bother playing the bribery sham all the way through like say political candidates do. For example, Hillary Clinton made $3M from speeches to large banks in just 2 years: https://theintercept.com/2016/01/08/hillary-clinton-earned-m... but they were actually organized enough to have "speechs". I remember the transcript of one was leaked, and you'd think they'd be some really deep insights and strategy laid out for the future that's worth $600k. But it was mostly "you all great, thanks for creating jobs etc etc". It is legal of course, but everyone know what it really is.
Dead Comment
[1] https://www.salon.com/2013/07/17/the_buckraking_practices_of...
https://www.opendoctor.io/opioid/highest/?hn=1
From article, John Couch and Xiulu Ruan are on top of the list.
I have multiple herniated cervical disks and am going in for surgery soon because the pain is debilitating and unbearable. Among other specialists, I saw a pain management doctor to understand my non-surgical options. Many people with my condition choose to not get implants or disk fusions and instead opt for steroids, epidurals, and opioids.
Legitimate doctors at pain management clinics will rank high on these lists if they have a lot of really sick patients who don't want neurosurgery.
Deleted Comment
Deleted Comment
A not-so-bright outlook for actually holding Insys's CEO responsible. Why were charges not brought on middle level employees especially if the father-son relationship could be an easy access route to bribery.
EDIT: Even the court document does not list is full name, Rosenberg's son is simply referred to as Insys Rep A.R.
Perhaps this isn't true, but it certainly seems like it based on the events I've come across in my life, and in the news.
The thing where decade plus sentences are fairly common is unique in the first world: only in America. It’s barbaric and embarrassing.
The science is pretty unambiguous—a high likelihood of being caught and punished is a better deterrent than a low-probability but larger punishment.
So I don’t want to see this doctor get a 40-year sentence. I’d rather see lots of doctors who accepted gifts from opioid manufacturers get one-year sentences. Most important is that the pharma executives go to jail, too.
Criminal justice should never be about retribution. In this case, the purpose is to keep future patients safe.
And the street dealers’ customers know full well that they’re buying a very addictive substance which is not medically indicated.
What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.
Prison sentences for dealing hard drugs should be in line with prison sentences for murder, otherwise the implication is that the lives of drug users are much less valuable than the lives of regular people.
BUT then you might face state charges for possession if the DA wants to bother.
https://fas.org/sgp/crs/misc/RL30722.pdf
Doctor: 4
Executive: .4
Also the doc loses his license and every single penny he has, between lawyers, years without being able to make a penny, and court fines. When you make a certain amount of money the trend is to live up to it: mortgages, fancy cars, club memberships, schools for kids and so on. When the money stops coming in, guess what happens?
You drop to the status of a boring working person who never took kickbacks to sell opiates? A fate worse than death, I guess.
The street dealer is also not likely to get 4 years. That's the point - 40 years was a number picked to illustrate a sentencing discrepancy argument. The fact that a 10x factor seems almost reasonable is the argument.
> a street dealer doesn't have 400 kilos of coke
What do you think Resenberg's prescriptions added up to, by weight? It's probably not fair to compare a street dealer to him.
Are they? Those others knowingly and voluntarily took those drugs.
> ... [his] son was an Insys sales representative for a year and made “substantial commissions” from his father’s willingness to prescribe the drug, according to prosecutors. The son wasn’t charged in the case.
Oh, gee, it's Purdue Pharma again, i.e. the Sackler family. How am I not surprised, and how are they not fined?