Deep Conflicts at the NIH

The Times is to be congratulated for the remarkable “Stealth Merger: Drug Companies and Government Medical Research” and for its strong editorial stand on fees paid by drug companies to National Institutes of Health scientists (Dec. 7). David Willman, who skillfully reported the Rezulin drug scandal, has once again highlighted an issue of deepest significance: the subversion of objective science by conflicts of interest so deep they cannot be tolerated.

His article raises the issue of the role of the marketplace in health care. The marketplace can function only when an informed consumer has a real option of whether to buy or not. There is no source of valid information to judge health-care quality, and the sick have no real option of whether to buy.

We have found no way to resolve the conflict of interests that exists between the for-profit-employed health-care professionals and the stockholders they are pledged to enrich and those of the patient who is totally dependent on their judgment. Not-for-profit hospitals, insurance companies and health-care systems successfully operated our health-care services until the last 35 years. We need look only to the scandals associated with the names of HCA Inc., National Medical Enterprises and Tenet Healthcare Corp., to name a few, to recognize the hazards of wholesale greed in health care.

Now we can add that the pharmaceutical industry, which dominated the decisions on the recent Medicare legislation, works to prevent importation of less-expensive drugs from Canada and has severely contaminated our vital medical research community. The Times is right to call for congressional action on the Bayh-Dole Act. The investigation should raise serious questions about the role of for-profit business in the most basic parts of the health-care system. There, the welfare of the patient must always be the sole concern, never the profits of the stockholders.

Robert E. Tranquada MD

South Pasadena

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Thank you for your in-depth article on top NIH scientists who are also on drug company payrolls. It doesn’t take an NIH scientist to figure out that what these folks are doing is not only ethically wrong, it’s dangerous to the public and should be illegal.

Linda Winters

Culver City

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Let’s clear up a misconception. The U.S. health-care system is not about health. It is a market-driven system that does not aim to cure people; it aims to sell them stuff that offers hope of a cure, however slim. Exposing corruption and quackery should be avoided. Let’s grow up and support measures like the recent Medicare “reform” that enhance cash flow and increase expenditures for health insurance, drugs and other health “benefits.”

Sid Siegel MD

Covina

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By shifting research and development costs to the public tab through NIH grants, drug producers reduce their entrepreneurial risk. By approving NIH grant budgets with their votes and taking pharmaceutical company campaign contributions with an outstretched hand, elected officials in Congress collude in a very cozy arrangement.

First taxed to finance this unconscionable transaction, citizens pay again as their health insurance costs spiral upward, driven in large part by the rising cost of prescription drugs. Industry will argue that advances in medicine would dry up without this stream of largess. As consumer groups pressure legislators to end the NIH’s graying of the line between public interest and private gain, let the first question asked be: How many drug trials would go wanting in the absence of NIH money if companies saw even marginal chances of profitable gain? Let the government invest only where the free market cannot venture; for everything else, let private owners and shareholders assume the risk.

Paul Vandeventer

Los Angeles

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So now we read about public NIH employees who are being paid as consultants by the drug firms they are supposed to be overseeing. Then we hear about an energy bill allegedly being drafted with the help of the energy companies. Then we hear about a public employee who helps negotiate a contract with the very same company she is negotiating her own employment contract with. Then we hear about our own federal legislators allegedly breaking the federal law against bribery right in the halls of Congress. Then we hear about two senior administration officials also breaking federal law by exposing a CIA operative.

Whatever happened to “public service”?

Norman Pell

Los Angeles