A Senate campaign brought some transparency to medicine, but problems persist in science and much more needs to be done.

By Paul D. Thacker

I gave a lecture last week to students in MIT’s Health Sciences and Technology (HST) graduate program about exposing and trying to fix problems of bias and corruption in science and medicine. Many of these students are pursuing both medical degrees and doctorates and all of them will be entering the workforce as leaders in biomedicine—and I was hoping to help them understand problems they will encounter in their futures, as well as possible solutions.

My talk can also help readers understand how corporations influence decisions made in biomedicine and other areas of science. During the lecture, I discussed multiple investigations I ran while employed as a Senate Investigator—uncovering corruption while trying to fix problems at agencies and also advancing legislation. Few people outside of this specialized field of congressional investigations understand how committees seek to find and fix problems in society, so let me explain.

From around 2007 to 2010 I worked as a Senate Investigator for Senator Charles Grassley on the Finance Committee. Grassley made a name for himself in the early 80s exposing bloated defense contracts and cost overruns at the Department of Defense. If you’ve ever read about the Pentagon paying $450 for hammers, $640 for toilet seats or $7,600 for coffee pots, that was stuff Grassley investigations made public. Since those years, Grassley has always employed staff to sniff out corruption, and when I was hired, he was the top Republican on the Finance Committee.

A committee’s jurisdiction gives you power, and Finance is the most powerful committee in the Senateo—overseeing tax policy, trade, Social Security, and the two federal healthcare programs—Medicare and Medicaid. These two healthcare programs now spend more money than the Pentagon, and investigators on the Committee had been digging into corruption inside the pharmaceutical industry.

Pharmaceuticals make up about 15% of healthcare costs, and the United States federal government is the world’s largest customer for the pharmaceutical industry—paying for about 1/3 of all the drugs bought in America. In fact, the federal government is such an important customer, that during one interview with a pharmaceutical executive, he explained to us that drug companies will study diseases based on how much money they think they can get the federal government to pay for the drugs.

Think about this the next time you hear a pharmaceutical executive argue that they research diseases to save lives. The reality is that they do research to make money. There’s nothing wrong with this, but that’s the reality.

Pharmaceutical companies know they have a desperate audience. People are willing—eager, even—to pay top dollar for drugs, because they have always valued their health. To say this isn’t anything new, you just need to look at these two quotes that go back well before anyone had heard of Pfizer or GlaxoSmithKline:

It is health that is real wealth and not pieces of gold and silver.

                                                            —Mohandas Gandhi

A wise man should consider that health is the greatest of human blessings.

                                                            —Hippocrates

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