Death of the public option

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Mr. Ross, when you headed KPR Informedia, did you submit articles to medical journals that were ghostwritten?

Mr. Chairman, I honestly can't remember.

Mr. Ross, as head of one of the leading medical information companies, is it likely that you did?

Yes, Mr. Chairman, but even now that the practice is being criticized, so the context has obviously changed, I fail to see what's wrong with it.  We would never change the data or the conclusions, merely edit for clarity. But no matter how extensive the editing, it would not have occurred to us to ask for byline credit.                             

Let me explain further.

If a client sent us a manuscript written by one of their clinical investigators and asked us to put it in shape for publication we would have been likely to question why they would ask us for such a freebie service, but some of our competitors listed “editorial services” as one of their areas of competence.

So, had we been asked, I might have wondered how we would get compensated, but I doubt we would have asked for byline credit. That would have seemed presumptuous. Now that ghostwriting is the pharma scandal du jour, I might feel differently.

The New York Times, for instance, headlined a story about the practice, putting a negative spin on it: Ghostwriting Is Called Rife in Medical Journals.

Right away you know that the editors consider it a questionable practice, and the lead paragraph reinforces the hint of something corrupt or at least suspect.

And the next paragraph spells it out: “Among authors of 630 articles who responded to an online questionnaire created for the study, 7.8% acknowledged contributions to their articles by people whose work should have qualified them to be named as authors on the papers but who were not listed.” You don't “acknowledge” something you don't feel is wrong.

That appears to me an editorial judgment, not a question of ethics. 

Though if you read the recent column by the Times public editor in the Sunday paper, you know that they not only set themselves impossibly high journalistic standards, but then bend over backwards and tie themselves in knots trying to live up to them. Which is as hard to do metaphorically as it would be anatomically.

As standards change, they shouldn't be applied retroactively. And now that everything the pharma industry does is being scrutinized, that is exactly what is happening.   

Speaking of ghosts, Ted Kennedy continues to haunt the healthcare debate. His passing left Max Baucus of Montana as chair of the Senate committee in charge of healthcare legislation.

The immediate effect was the death of the public option. It also didn't help that President Obama referred to it as “useful but optional,” leaving it without an effective champion in either the White House or Congress. The few senators who still support it simply lack Kennedy's clout.

Whether you agreed with Kennedy or not, you can't deny that his passing has caused a decisive change in the healthcare debate, leaving public option proponents leaderless and giving a boost to those who oppose it, as well as to healthcare reform opponents generally.

Baucus is no Kennedy, and Montana is no Massachusetts.

Warren Ross is editor at large of MM&M
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