Healthcare, Journalism, And The Mad Dash For 'The Scoop'

from the getting-back-to-insights dept

As you may have heard, when the Supreme Court came out with its ruling on healthcare, CNN and Fox News jumped the gun and incorrectly reported that the Court had struck down the individual mandate. Fox News corrected the mistake pretty quickly. CNN took a bit longer (and spread the false "breaking news" story far and wide). The whole thing even had President Obama confused for a little while.

It was, of course, also great for late night television. People are referring to this as cable news' "Dewey defeats Truman" moment, while others are arguing that "breaking news is broken." Of course, being a part of the "blogging" world which is often accused by "old media" types of publishing untrue things... there is some element of schadenfreude in being able to see it made clear that the mainstream media is often no better at publishing incorrect things. Of course, some tried to flip this around, and suggest that the problem actually came about because of "new media" thinking around things like "process journalism," though there's a strong argument that reporting before reading something isn't process journalism, it's just bad journalism (i.e., process journalism is about reporting things as additional news comes out -- but in this case, the news was out, the problem was people reporting it before reading it).

A few years ago, uber-blogger Mike Arrington said something that has quite a lot of truth to it: to get attention as an online media player, you generally have to be first, funny or insightful -- and being first is often the easiest, so lots of people concentrate on that. It's the chase for "the scoop." Being funny is powerful, but very, very difficult. And... being insightful takes a lot of time and effort, and is no guarantee of attention. Generally speaking, our goal here has never been to be first with news (in fact, we often wait for others to publish so that we can link to their reports in what we write up). Personally, I like that much better. Focusing just on "the scoop" may be good for traffic in the short term, but especially for big stories like this one, I'm not sure how much value it creates in the long term.

Of course, the realities of gaining traffic often support the quick "scoop" over deeper insight. For example, Reddit -- a potential major firehose of traffic these days -- has its algorithm designed to reward quick, early votes, meaning that longer, thoughtful, insightful pieces almost have no chance, because by the time people have read and thought through them, it's "too late" to have the votes really count.

Some will argue, of course, that this is just a sign of the "bad" side of the internet: valuing quick, dirty and sometimes wrong reporting over longer, more thoughtful work. But I'm not convinced that's true. Again, there are plenty of historical examples of this in pre-internet times as well -- with Dewey Beats Truman being just one of many such examples.

Instead of just mocking those who messed up, or using a bit of confirmation bias to insist that it shows how awful things are in this "real time era," I'd be much more interested to see if we could have a discussion on how to change the incentives. How do we better reward insight and thoughtful commentary over the quick hit-scoop? Is it possible? And, if so, what needs to be done?

Filed Under: first, healthcare, hot news, scoop, scotus, traffic
Companies: cnn, fox news, reddit

Another Boost For Generics: Brazilian Judge Annuls Patent On Key AIDS Drug

from the keep-taking-the-medicine dept

Last week Techdirt reported on an important decision in India to allow the production of a generic version of a kidney and liver cancer drug, with huge savings for the Indian health system, and major effects in terms of lives likely to be saved. Now Intellectual Property Watch has news of a court case in Brazil that could have equally important consequences for the local use of generics:

Word is spreading of a recent decision by a Brazilian judge to annul a patent on a key AIDS drug, effectively allowing less expensive generic versions into the country, and calling into question other such patents.

Here's why the case is setting a precedent:

A leading feature of the case is that the patent was granted under the "pipeline" process, which allowed "revalidation" of patents granted in other countries while Brazil was modifying its patent law for certain new areas including pharmaceuticals.

The judge in this case ruled that the pipeline process was unconstitutional, according to sources.

The "pipeline" process refers to a mechanism for granting patents in technological fields that had earlier been excluded under Brazilian law, using the date of the first filing for patents elsewhere. This allowed companies to extend the reach of patent monopolies already obtained outside Brazil without needing to go through that country's patent application process.

Lack of constitutionality had been raised back in 2008 because of the way that pipeline patents diminished the public domain:

"The concession of pipeline patents also violates the acquired right of the collectivity by removing from the public domain knowledge belonging to everyone, which once again goes against society’s interest," said Renata Reis, an attorney at the non-governmental Brazilian Interdisciplinary AIDS Organization.

Among the drugs that were removed from the public domain by the pipeline process is the ritonavir/lopinavir combination, the subject of the judge's order annulling Abbott Laboratories' patent. Not surprisingly, the company has said that it will appeal the decision. But if the ruling is upheld it may lead to other patents granted to drugs through the pipeline process being invalidated too.

Taken together with the Indian decision, this latest ruling emphasizes the increasingly important role of generics in global healthcare. That's another reason why both ACTA and the Trans-Pacific Partnership agreement are problematic.

ACTA, for example, allows generics to be seized in transit on the basis of complaints about names that are "confusingly similar" to a brand-name drug. TPP, meanwhile, would bring in a range of measures to make it substantially harder for companies to produce generic versions of patented drugs in signatory nations. The divergence between what the BRICS countries are doing in this area, and what plurilateral treaties like ACTA and TPP seek to mandate, is another reason why it is unlikely the former will ever sign up to the latter.

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Filed Under: access to medicines, aids, brazil, generics, healthcare, patents, pipeline
Companies: abbott labs

Doctors Discover Copyright Law: Cognitive Screening Test Killed Over Infringement Claims

from the horrifying dept

We've certainly talked about how ridiculous patents have gotten in the way of health care professionals and doctors providing the best care they can. Beyond basic things like gene patents, the idea that diagnostic tests are patentable is somewhat horrifying for anyone with any sense of decency when it comes to trying to keep people healthy. But, apparently the issue doesn't stop there, and the medical community is suddenly grappling with some doctors using aggressive copyright enforcement to block competing diagnostic tests from being available.

The story comes from Dr. John C. Newman and lawyer Robin Feldman in the respected New England Journal of Medicine, where they recount the story of the Mini–Mental State Examination (MMSE). A simple 30-item screening test that was first published in 1975 basically became a defacto standard that was used (and published!) widely. As the authors note, it was available in textbooks, pocket guides and websites -- and "memorized by countless residents and medical students." All in all, it sounds like a useful tool that was being put to good use. But then, decades after it was created, the authors of the diagnostic test discovered copyright. And that's when the trouble began:

In 2000, its authors, Marshal Folstein, Susan Folstein, and Paul McHugh, began taking steps to enforce their rights, first transferring the copyright to MiniMental, a corporation the Folsteins founded, and then in 2001 granting a worldwide exclusive license to Psychological Assessment Resources (PAR) to publish, distribute, and manage all intellectual property rights. A licensed version of the MMSE can now be purchased from PAR for $1.23 per test. The MMSE form is gradually disappearing from textbooks, Web sites, and clinical tool kits.

Clinicians' response to this "lockdown" has been muted. A few commentators have expressed concern about continuing to use a now-proprietary tool in training or about implications for the developing world, echoing debates about patented pharmaceuticals. In our experience, many clinicians are either unaware of the MMSE's copyright restrictions or simply ignore them, despite the risk of copyright infringement.

But then in March 2011, a promising new cognitive screening tool that was to be available through "open access," the Sweet 16 -- a 16-item assessment of thinking, learning, and memory developed by Harvard's Tamara Fong -- was removed from the Internet at the request of PAR in an apparent copyright dispute. The Sweet 16 includes orientation and three-object recall items, similar to the MMSE's, along with a digit-span item. This action, unprecedented for a bedside clinical assessment tool, has sent a chill through the academic community; clearly, clinicians and researchers can no longer live in blissful ignorance of copyright.

It's difficult to see how this isn't copyright abuse in the extreme. The copyright on the MMSE is not on the "idea" of a "3 object recall" test, but the specific expression. If you look online there are a few different versions of the MMSE that you can find pretty easily and the content at issue seems really basic. For example, the "three-object recall test" appears to consist of this:

Name 3 objects: 1 second to say each. Then ask the patient all 3 after you have said them. Give 1 point for each correct answer. Then repeat them until he/she learns all 3. Count trials and record.

Then, a couple questions later, it says you should ask the patient to repeat the same 3 objects. This is pretty straightforward -- a direction. Suggesting a similar test, by itself, should not infringe at all in that it's not making use of any "creative expression" from the original (if there even is any creative expression in the original). And that's outside the question of whether or not there would be a fair use defense even if the sentence was used exactly and in its entirety.

But, even just getting beyond the copyright issue here, the very fact that Marshal Folstein, Susan Folstein, and Paul McHugh, along with their partner, Psychological Assessment Resources (PAR), are using copyright to stifle important and useful processes for diagnosing cognitive states should simply be repugnant to all.

The NEJM article goes on to talk about various copyright issues, and explain why it's important for doctors to understand concepts like open access, the public domain, Creative Commons and open source licenses.

We suggest that authors of widely used clinical tools provide explicit permissive licensing, ideally with a form of copyleft. Any new tool developed with public funds should be required to use a copyleft or similar license to guarantee the freedom to distribute and improve it, similar to the requirement for open-access publication of research funded by the National Institutes of Health. The solution can be as simple as placing a copy of the tool on the authors' Web site, with a statement naming or linking to the license. Clinicians and researchers would be free to use, copy, and improve the tool; improvements would have to offer a similar copyleft license, perpetuating the benefits. Yet authors would maintain ownership and copyright of their tool and could profit by licensing it for a fee to commercial users or publishers who wished to include it in a non-copyleft work.

We've certainly talked about the importance for folks in other professions to recognize the importance of open access. It's honestly tragic (and just a bit horrifying) that this should even be an issue in the medical space at all. Either way, it's yet another sad reminder of the state of "ownership culture" driven by copyright maximalists, pushing people into believing that ideas can and should be owned and limited.

Filed Under: copyright, diagnostic tests, healthcare, marshal folstein, paul mchugh, susan folstein, tamara fong
Companies: minimental, par, psychological assessment resources

SOPA Will Have Grave Effects On The Health Of Hundreds Of Thousands Of Americans

from the conflating-legal-and-rogue-foreign-pharamacies dept

This is a guest post from Lee Graczyk, lead organizer of RxRights, a national coalition of individuals and organizations concerned about the high cost of U.S. pharmaceuticals.

The House Judiciary Committee today is holding a hearing to examine the Stop Online Piracy Act (SOPA), a bill that proposes to address online copyright and trademark infringement by denying services to registrants, owners or operators of Internet sites. There has been much discussion on the technological implications of this bill, but Congress and the media have overlooked SOPA's major health implications--it would take away Americans' access to safe, affordable prescription medications from licensed, legitimate Canadian and other international pharmacies.

No one would disagree that websites illegally distributing "knock-off" goods, which include rogue online pharmacies, are a public menace. However, SOPA's definition of an Internet site that endangers public health (even worse than in its Senate counterpart, the PROTECT IP Act) is so vague and broad that safe, legitimate Canadian and other international pharmacies could be shut-down "in the dark of night."

This is because SOPA inappropriately groups together real pharmacies--licensed, legitimate pharmacies that require a doctor's prescription and sell brand-name medications--and the rogues, who sell everything from diluted or counterfeit medicine to narcotics without a prescription.

This oversight is extremely dangerous for Americans (I am one of them) who rely on legitimate Canadian and other international pharmacies to import safe, affordable prescription medications they need to survive. For example, 90,000 people in Florida alone would lose access to safe, affordable prescription medications because of SOPA.

Each year, hundreds of thousands of Americans import safe, affordable prescription drugs because they cannot afford the same brand-name medications that are sold in the U.S., which cost at least twice as much. Others refuse to pay the exorbitant costs of prescription medications when there is a more economical way that is just as safe.

The bottom line is that pharmacies accredited through organizations such as the Canadian International Pharmacy Association, Pharmacy Accreditation Services and Pharmacy Checker are the "real deal." They sell brand-name prescription medications made by top manufacturers.

A recent study by the Commonwealth Fund highlights the need for drug importation. According to the survey on health insurance coverage, a staggering 48 million Americans ages 19-64 did not fill a prescription due to cost in 2010, which represents a 66 percent increase since 2001.

Americans, especially those without insurance and seniors living on fixed incomes, should not have to make choices like whether to fill their prescriptions or buy groceries for the week. Everyone, including those in the tech community with whom we agree on the overall negative impact of SOPA, should bear in mind the severe health implications of this bill, which would affect the well-being of patients across the U.S.

If Americans don't take action to protect their right to safe and affordable medications, they could lose their access to safe, legitimate pharmacies and, therefore, vital medications they need to stay alive.

Filed Under: canada, drugs, health, healthcare, pharmacies, sopa
Companies: rxrights

Is The Gates Foundation Really Looking At New Ways To Tackle Big Health Problems When It's Hiring Pharma Execs?

from the doesn't-seem-right dept

The Gates Foundation has plenty of opportunities to do some amazing things with the size of its fund and the ability of Bill Gates, in particular, to command attention. And, yet, hearing that it's now hired a former Big Pharma exec to run its Global Health Program has to make you wonder if the Gates Foundation is focused on increasing health in the world... or increasing the health of big pharmaceutical companies, which have been struggling lately. One of the biggest problems with healthcare today is making the debate pharmaceutical-centric, rather than health centric. Yes, drugs are a part of a comprehensive healthcare plan, but, too often, policymakers and groups let pharma firms drive the debate, when they're an (extremely) biased party that has a long history of not doing what's best for everyone's health, but what's best for their own profits. And, to be clear, I have no issue with pharmaceutical firms looking to maximize profit. But I do have issues when they use unfair or questionable means to do so, when that can create serious harm and limited access to medicines. The Gates Foundation could have totally changed the debate. But, instead, it seems to be doing the opposite.

Filed Under: healthcare, innovation, pharma
Companies: gates foundation

Obama Administration Trying To Move Away From Allowing Countries To Ignore Patents To Save Lives

from the sickening dept

Well here's another depressing one. For about a decade, there's been something known as the Doha Declaration, under the World Trade Organization (WTO), which effectively said that since public health and "access to medicines for all" was important, countries could have some "flexibility" in dealing with patented medication. In practice, this has meant that in order to deal with health issues, countries can ignore patents when necessary to make sure there is more medicine and that the medicine is reasonably priced. This is good for public health.

Of course, the pharmaceutical companies hate it.

KEI is tracking how the Obama Administration has been quietly backing away from the Doha Declaration and limiting the types of diseases that can be covered under Doha. Even though Doha is pretty clear that it can cover any kind of medicine in the interest of public health, a recent draft text for new agreements clearly (but quietly) tries to make sure that "Non-Communicable Diseases" (NCDs) are not considered to be covered by Doha. In other words, if you're talking about cancer, diabetes or heart disease... countries won't be able to use Doha to provide cheap and necessary drugs to people.

There's apparently a negotiation going on about an agreement on NCDs which, not surprisingly, has been driven by people representing the pharmaceutical industry. In one particularly egregious situation, according to the KEI report, a group representing the pharma industry was "grouped as civil society" at one of the meetings. Yes, for the purposes of one of the meetings, pharma lobbyists were labeled as a consumer interest group.

The end result is that, as it stands right now, the draft text around NCDs does not mention the Doha Declaration any more. This may not seem like a big deal, in that it still mentions "flexibilities," but trying to carve out what is and what is not covered by Doha clearly appears to be a means of ratcheting back the ability of countries to do the right thing in protecting public health:

By seeking to eliminate any references to the Doha Declaration, the U.S. appears to be asserting that the "access to medicine for all" provisions in the Doha Declaration do not apply to drugs for cancer and other non-communicable diseases.

[....]

Why is this controversy important? The US has conceded that compulsory licenses can be used for NCDs, an issue of no controversy legally, but politically sensitive. However, by removing the reference to the Doha Declaration, and maintaining the political position that the Doha Declaration does not apply to NCDs, the White House seeks to eliminate the "access to medicine for all" standard, and to raise doubts about the application of other elements of the Doha Declaration, including paragraphs 5, 6 and 7 to NCDs, if not legally, at least politically.

It's tough not to be cynical about this kind of stuff. But I'm having trouble seeing this as anything other than doing a favor for the pharma industry.

There was some hope that the administration might clarify its position and answer some questions related to this in a USTR paper that was recently released, but the actual release turned out to be nearly totally devoid of substance, angering plenty of consumer groups concerned about access to medicine. Even worse, the paper appears to suggest that greater patent protection may make more sense. The summary from Tido von Schoen-Angerer makes all this clear:

The leaked papers reveal a number of U.S. objectives: to make it impossible to challenge a patent before it is granted; to lower the bar required to get a patent (so that even drugs that are merely new forms of existing medicines, and don't show a therapeutic improvement, can be protected by monopolies); and to push for new forms of intellectual property enforcement that give customs officials excessive powers to impound generic medicines suspected of breaching IP.

And there's more.

The U.S. will also reportedly introduce measures to make it harder and more expensive for generic drugs to get regulatory approval, and to lengthen patent monopolies for pharmaceutical firms so that they keep generics out and prop up drug prices for longer. All of these measures are known to hit the availability of affordable medicines in developing countries hard.

The really amazing thing is how incredibly short-sighted this is. Even if you wanted to argue that it's somehow "good for the economy" to artificially prop up pharma companies with longer and stronger patents, if it comes at the expense of public health, that's not going to help the economy at all. A healthy population is a consuming population. Letting people die around the world is not good for the economy.

Filed Under: access to medicines, healthcare, patents

Why Is The Obama Administration Putting Billions Of People At Risk With Patent Pressure From The USTR?

from the what-a-shame dept

We've already noted what a complete joke the Special 301 report is. It's the process by which the White House, via the USTR, basically "launders" the complaints of industry lobbyists who want foreign countries to prevent competition by ratcheting up patent and copyright laws to better clear the market for American companies and their products. As people digest the details, it again is apparent what a corrupt society we live in. As Michael Geist notes, the US seems to be saying that 4.3 billion people live in countries without "adequate" copyright and patent laws. Many of those countries are poor, and almost everyone who has studied developing economies has noted that strict patent laws do significant harm both to the health of citizens in those countries and to their opportunities to develop. The US, of course, should know this. In order to help develop our own economy, we were quite good at ignoring the intellectual property of other countries.

But the details are where it gets really disgusting. For all the talk about the vague and undefined language found in ACTA, it really comes through when you look at how the USTR names and shames some countries for trying to implement a patent plan that actually keeps their citizens healthier:

That said, it was a disappointment to read that USTR is pressing so hard on the pharmaceutical test data issue, including even for a Least Developed Country (LDC), and that the USTR cites the Philippines for tying patentability of certain chemical forms unless the applicant demonstrates increased efficacy, and complains that India does not patent "temperature-stable forms of a drug or new means of drug delivery." During the hearings, public health groups made it quite clear that it was important for developing countries to continue to have the flexibility to limit the evergreening of pharmaceutical products via these types of patents.

In other words, lots of countries know that they need less expensive drugs to keep their populations healthy (and to make them economically productive). And yet the USTR is trying to clamp down and enforce stricter patent laws in those countries, which would force them to buy life-saving drugs from big pharma firms at massively inflated prices. That costs lives. Why does the White House want to put so many lives at risk?

It's really economically stupid as well. We want these countries to have healthy populations and growing economies, because they're future markets for other things that the US sells. The US government is so short-sighted on this that it's happy to have a bunch of poor people die if they can't buy some expensive drugs, not realizing how much that harms so many other US industries.

Filed Under: healthcare, patents, special 301, ustr

Hospitals Argue That More Transparency On Medical Errors Will Decrease Dialogue On Fixing Them

from the uh,-what? dept

Tim O'Reilly points us to a bizarre story about how some hospital and medical officials in both Canada and Denmark are fighting against efforts to make data on medical errors more open to the public because it might "decrease frank and open dialogue" about how to correct those errors.
Huh?

This makes absolutely no sense, and seems to be one of those things that people say when they have no good excuse for stifling the free flow of information, but figure that if they just answer the question with complete nonsense, maybe it'll take time for people to realize it's nonsense, and everyone can move on:

Health Minister Deb Matthews has defended the move to exempt information related to quality of care from public release. According to the Free Press, Matthews believes subjecting hospitals and doctors to greater scrutiny would prevent open dialogue about problems and how to fix them. “They must have a very open and frank discussion,” she said.

Of course, there are situations in which you could see certain types of information being revealed might hold back open discussion... but how is that true here? If anything, it seems likely that the reverse would be happening here. Keeping this kind of data private is how you avoid having to have those "frank and open dialogues" about fixing the problems. It's how you sweep the problems under the rug and pretend they don't exist.

As the author of the linked blog post, Paul Levy, notes:

It is time for health care professionals to understand that patients can be trusted to be active partners in process improvement. Disclosure of clinical outcomes is a first and necessary step along that path.

Filed Under: healthcare, hospitals, medical data, transparency

Drug Firms Freaking Out Over Expiring Patents

from the live-by-the-patent... dept

Glyn Moody points us to a discussion about how the big pharma firms are freaking out because their key patents are expiring, and they've failed to develop any new patentable drugs in a while. This is leading the usual patent supporters to worry and fret. Of course, the whole thing is backwards. As Moody points out, expiring patents should be a cause for celebration, not dismay. It means the public is getting access to all sorts of important medicines at much more reasonable prices. That's good news.

The real issue here is that for years patents massively distorted the healthcare market. It hasn't been about keeping people healthy at all. It's been about finding patentable drugs to extract monopoly rents (often at the expense of actually keeping people healthy). Perhaps, if we can get past this silly and short-sighted focus on patentable medicine as being the key component of healthcare, we can start seeing smarter companies develop smarter business models that actually align interests: firms that recognize there's tremendous value in actually keeping people healthy, rather than trying to sell them a tiny pill.

If you start looking at the economic research behind healthcare, you begin to realize that the economic incentives around healthcare are totally screwed up. The reports have shown that keeping people healthy for longer contributes billions, if not trillions to the economy. If firms can't figure out how to profit from keeping people healthy, they're not paying attention. But that's never been the focus of our healthcare policy, and it's a shame. If today's drug companies are felled by their overreliance on patents, perhaps we can finally move on to rethinking healthcare towards making people healthy and improving the economy at the same time... rather than the current structure that appears to do neither of those things all too often.

Filed Under: business models, drugs, health care, healthcare, patents, pharma

The New Children's Health Plan Is Videogames?

from the well,-that's-one-way dept

theodp writes "Remember how Catbert once declared 'The new company health plan is Google'? Well, for some kids, the new health plan may be videogames. While health insurer Humana has opted out of 'child-only' health insurance coverage to skirt around requirements of President Obama's health reform, uninsurable children with pre-existing conditions are still presumably welcome to use Trainer, the Humana-bankrolled-and-branded videogame that took home $20,000 last month as the Grand Prize winner in First Lady Michelle Obama's Apps for Healthy Kids Competition. Over at the USDA site, Humana is praised for having 'generously provided a gift to fund the development of the [Trainer] game...that will help children and their families live healthier, happier lives. No child is alone on the road to better health.'"

There is, of course, nothing wrong in general with using video games as one part of helping kids stay healthy, but it does seem especially sleazy to do this while pulling child-only health insurance.

Filed Under: health insurance, healthcare, video games
Companies: humana