Uechi-Ryu.com

Wow, a voluntary withdrawal. Imagine that - a big, bad, money-hungry drug company doing the right thing.

What's the world coming to?

Is anyone naive enough to believe that this decision was made because it was "the right thing to do"? I assure you that no decision this big is made by a publicly traded company without first doing a risk/reward analysis. Every company I've worked for does this. At the end of the day it may look like they did this because "it was the right thing to do", but the reality of it is they thought it may cost them more $$ in the long run if they didn't voluntarily withdraw it. In other words, "it was the right thing to do... for our stock holders".

Capitalism 101: Money == Power
Politics 101: Power --> Corruption


Still not a lot of discussion on what should be done about these "problems". What can be done to incent companies and lawyers to act responsibly?


chewy

chewy

I disagree with your blanket assessment. You can no more say that Merck and other companies ONLY do things for money than I can say all lawyers are evil (however tempting it can be from the actions of a few).

I've worked for several very large (Fortune 500) companies now. If I was only in it for the money, I would have stopped my education at the bachelors or masters degree level. It takes too long to get a Ph.D. to make that path the most profitable one. My undergraduate engineering degree and the time value of money would have allowed me to retire a very rich man by now. I pursued a Ph.D. because in my working years I discovered I had a talent for research and I hated production work. In other words, MY WORK was my most important reward in the long run.

You don't get into a reputable company like Merck if all you want to do is turn a profit - particularly at the expense of others.

The Fortune 500 company I presently work for required me to go through weeks and weeks of ethics training. Why? Good ethics is a good business practice. Everyone who is half a human in a good healthcare company wants nothing more than to save lives, reduce pain and suffering, and make a good living while doing that.

Ask folks from GE - one of the largest and meanest/leanest companies around - what they think of ethical business practices. Ask them about their goal of staying off the front page of a major publication like the WSJ (for bad reasons...).

You are right to be concerned, and you are right to want all to engage in ethical behavior. My contention is that punitive actions which make all but the parties involved rich is not a legitimate part of that process. There's a more intelligent, creative, productive way to go about it.

Interesting story... In my building, every floor has a different set of businesses, and a different cleaning staff. Earlier this week, I happened to have been on the 1st floor taking a quick leak. I noted that someone (who had nothing better to do) had posted signs all over the mirrors and walls scolding people for throwing their towels on the floor by the door. So why does this happen? Because a lot of people in a room where bodily waste is dealt with would rather not touch the door handle after having washed their hands. So they take their towel, open the door, and discard it if the trash can isn't nearby. Well... Here on the 1st floor we have these signs with angry language plastered all over the walls and mirrors because someone was offended. The signs noted how everyone on the floor was offended by the activity of a few. And then there was writing all over the signs from someone complaining that these signs were littering the bathroom. Furthermore, it seems that many intentionally threw MORE trash on the floor near the door because they were offended by the scolding.

On the 4th floor where I work (identical bathroom layout), a janitor thought to put a trash can by the door. There is no floor litter in the 4th floor bathroom.

Amazing... Next time I need a new employee, I know who's on the list of candidates, and who is not.

- Bill

Ask them about their goal of staying off the front page of a major publication like the WSJ (for bad reasons...).

Yep, we had an unspoken 'Wall Street Journal' rule. Never do anything you would not want to see on the front page of the WSJ. Unfortunately, our prior CEO managed to violate that rule. It did not hurt GE but did damage an otherwise sterling reputation.

There is also somehing I perceive in the Marine Corps as the 'CNN' rule. In effect, do not do anything you would not want to be seen doing on CNN et al. This fear is rumored to be causing hesitation in lethal situatons and may be getting our troops killed. No statistics on this... all anecdotal.

However, the martial arts program, MCMAP, stresses the 'force continuum', and gives Marines many less than lethal tools to use.

If I was only in it for the money, I would have stopped my education at the bachelors or masters degree level.

Bill is absolutely correct on this point. I often refer to an example that illustrates the value of time when it comes to investing. If Bill and I had the same salary (adjusted for inflation) and I saved, say 10%, for the first ten years of my employment and stopped contributing but let the money earn interest, and Bill did not save anything for the first 10 years but then got religion and saved 10% religiously from then on, he would need to live and continue working and investing until he was 90 to match the value of my investment over just one decade made early in my career.

Heed this example all of you, especially the youngsters out there.

Rich

On the 4th floor where I work (identical bathroom layout), a janitor thought to put a trash can by the door. There is no floor litter in the 4th floor bathroom.

Amazing... Next time I need a new employee, I know who's on the list of candidates, and who is not.

Another GE management anecdote...

About 15 to 20 years ago, under the aforementioned CEO, a plant program of town meetings was institued. Not just for management, engineers, production etc but for everyone. This included the night janitorial staff, loaders on the dock, light bulb changers... everyone.

All kinds of stuff like this came up all over the company. The lower level folks were allowed to make inputs and were listened to. Management was amazed at what they found out from these employees. There were tremendous productivity improvents and cost savings made by what were called 'low hanging fruit' projects. The ones that made the really good suggestions got big $$$ rewards.

Then, the best ideas were declared 'best practices' by the CEO and shared across GE. Like Bill's example of the janitor solving a problem on his own with a trash can many really good ideas spread across the company. It had the extra benefit of tearing down a lot of walls across businesses.

Eventially the process of town hall meetings was formalized into sessions called 'work out' (ie. take work out) and truly benefitted the bottom line of employees and the company.

My daughter, 24, is into her third year at Philip Morris and now that she realizes dad is actually pretty smart she frequently asks me for advice on projects and just living in a large corporate environment (Fortune 10 or thereabouts). I share the appropriate nuggets of info with her and she takes them to work where they are declared amazing and revolutionary. She is on the fast track to senior management as a result.

Personally I am amazed that decades old ideas from GE still wow 21st century businesses.

rich

RACastanet wrote:Philip Morris

Not to take potshots, but Philip Morris is an excellent example of a company whose apparent policy is to hide as much as you can, and use money to delay as long as possible when you get caught. What can be done about this? Anything?

Good point, Justin. I think Rich gave good examples.

Rich knows I'm no fan of tobacco. I see the consequences of smoking in the populations I study, and I've seen the consequences in my own family (a grandfather and 2 uncles who died before their time of COPD and heart attack). I smoked briefly (Marlboro), and quit cold turkey when I realized I was a smoker (for several years) and didn't want to be one. Now I hate being around cigarette smoke, and work for a healthcare concern in a city that is the home of Philip Morris.

And I love Rich's daughter. I get a hug every time I see her, and have told her boyfriend he WILL treat her right.

PM learned its lesson. On the other hand, PM held information back and distorted the truth for years out of fear of litigation. The consequence of this was more people being killed because they were in denial. Now, tell me all those years of litigeous activity did us all good. I can't see it here. As much as I abhor the product they make, I cannot see where the greater good was served with years of class action suits chasing the big 4 tobacco companies.

Nope... Instead, a few law firms got stinking rich, long after people who could have used better information died from the lack of it. And you know what these lawfirms did? (And I can name names...) They took that money and started filing suits in search of class action status against healthcare companies. That in turn increased the cost of my health insurance premiums for so many reasons that it would take me several chapters of a book to explain why. So what does that say about the ethics of these "hero lawyers?" To me, it shows their true colors.

What would have happened if we had let Big Tobacco and the academic research community continue their coexistence? Nicotene is plenty addictive, and there are smokers all over the world. Plenty of people on this earth know how dangerous it is to ride a motorcycle, and still choose to do so (as I did for years). As long as we all know what the risks are and we can learn to get along (like not smoke in my favorite restaurant ), and smokers are willing to pay higher health insurance premiums (and the government cuts them a break on social security because they die earlier ) then I'm cool with it.

It's a difficult subject, but what are you going to do? The world doesn't have a very good track record with stopping people from consuming things that give them a buzz. Deny them their addictions and it just raises the unit price of the goods as well as increase criminal behavior associated with its distribution.

Our time, effort, and money would be better spent researching the physiology and psychology of addiction.

- Bill

Bill Glasheen wrote: I'm no fan of tobacco.

Well neither am I. On a personal level I hate being around the smoke, but that's not why I think Philip Morris is inethical. If people want to kill themselves in whatever clever and wonderous ways ways they want I say let them. But killing people while saying "no, it's all fine, it's just horrible lies" is wrong.

And I love Rich's daughter.

My comment wasn't meant as a condemnation of his daughter. I think it's kind of sad that anyone wants to work at a place like PM, but I'm far from thinking that everyone who does is a bad person.

PM learned its lesson.
...
I cannot see where the greater good was served with years of class action suits chasing the big 4 tobacco companies.

Because without those suits they would've just happily kept lieing forever? What would have stopped them? Reputation? PR concerns? How could PR be any worse than it was due to the lawsuits? Cigarette ads are very subtle and manipulative and even if they will no longer say, for example, that light cigarettes are healthy, they will imply it with every image they possibly can. They may not be lieing openly, but their still intentionally misleading people. And that's with the bad PR they got. This sort of thing is why I don't believe that the threat of bad PR is enough to really rely on.

What would have happened if we had let Big Tobacco and the academic research community continue their coexistence? Nicotene is plenty addictive, and there are smokers all over the world.

And how many of those smokers think they can quit anytime they want? How many believe that because the tobacco comapnies swore up and down for decades that cigarettes are not physically addictive? Scientists don't have the marketting budget, and most people don't have the time or inclination to spend hours trying to figure out what's true. Advertising is effective, and it's not that hard to plant lies in people's heads.

Take, for example, DeBeers, who I think is probably the most evil corporation there is. They simply created the market for diamonds. Before their succesful ad campaigns, nobody cared about diamonds. They have created a greatly exagerated sense of rarity. They have also created the impression that diamonds are an investment, while doing everything they can do undermine the resale value of them. Their production practices are simply horrendous as well, but that's not the aspect I'm talking about.

My point is that while I'm happy to let people choose to do stupid things if they want to, I think it's naive to pretend like billion dollar ad campaigns don't have a tremendous amount of impact on the decisions people make.

Vaulkenar

I have to agree.

People should be able to do all the stupid and dangerous things they wish.

The only thing I would say is that having the correct facts in hand is a "must" for such an outlook.

If you know all the risks and decide to smoke anyway--well thats YOUR choice.

(second hand smoke is another matter--you may be "ok" with the risks--its criminal for YOU to choose for ME)

Its not having the needed facts that creates the problem. As you pointed out, BT hid the dangers of smokeing for decades--deneying people the right to make an informed choice.

They knew that there product was both harmful and addictive and delibrately hide that info--in fact they presented it otherwise every chance they got.

And that IS evil--possibly not in the religious sense but as close to it as I would care to get.

What is the value of big tobacco? Why would anyone work for them? Well, they are a very productive member of society. They pay great wages and have great benefits. They pay an enormous amount of taxes. They employ thousands of people who pay all sorts of taxes. PM stock pays a huge dividend.

Justin? Do you invest in a 401K or some mutual fund through work or on your own? If you do, you are likely benefitting from PM's stock growth and dividend yields. PM is a blue chip company virtually every fund includes. Are you a green investor or a hypocrite or just clueless?

The product fuels the infrastructure and social agendas in many cities, states and the feds. PM for instance makes roughly $0.12 per pack. And then they pay taxes on that meager profit. New York (city + state), I believe, tacks on about $8 per pack in taxes. Other localities do the same but the Big Apple seems to have the most to gain in PM's continued success.

If I was BT (big tobacco), I would just go out of business. PM and RJ Reynolds have successful food products business (PM owns most of Nabisco) beside the tobacco business. I suspect the feds and states would pass a law to keep BT in business. They cannot afford to lose all of the easy money BT generates for them.

The big tobacco settlement, billions of dollars, was supposed to fund all kinds of good things in the states, such as health care, stop smoking education etc. Instead most goes into the general fund.

When Illinois was planning to sue BT last year for even more $$billions other states stepped in and stopped them as they feared Illinois was going to hog the revenue stream.

The states want BT around for a long time.

During WW2 and the Korean War the feds kept our troops all stoked up with smokes. Cartons of cigerettes were passed out to everyone as they headed into the fray. Is the US Federal government taking responsibility for making certain all the troops were hooked? Nope. They are suing BT for even more $$ even though they ensured that 2 generations were hooked.

Personally, I do not smoke and do not care to be around smokers. However, if someone chooses to smoke that is their business. No one can claim they were duped by BT nowadays. In fact, I say smoke more. Pay more taxes to ease my burden. Die young to help out SS and Medicare. It is individual choice.

Rich

Justin wrote: My comment wasn't meant as a condemnation of his daughter.

I know you better than that, Justin. No blood, no foul. You're a good man with a good heart.

Justin wrote: I don't believe that the threat of bad PR is enough to really rely on.

I agree, Justin.

But we need to be careful about what we put into place to "fix" things. Look what's happening in response to the patriot act. (Not very popular, is it?) Look what's happening in the UK with the new laws designed to curtail speech that incites terrorism? I heard a review of those laws on the news last night. I'm sure we'd get jorvik foaming at the mouth about them if he wasn't already booted off this forum for being naughty. (I'll represent your sentiments, jorvik. )

It's that damn law of unintended consequences. Be careful what you wish for.

It reminds me of an episode of All In The Family where Archie Bunker is allowed to get on the television and preach his solution to plane hijacking. His solution was for the flight attendents to hand out guns at the beginning of the flight, and collect them all at the end. Sounds good to me..

Justin wrote: how many of those smokers think they can quit anytime they want?

If you started smoking before the age of 19, the statistics are pretty grim. (I am an exception to that statistical rule of thumb.)

I'm all for a system that allows that information to get out ASAP, and reduces the likelihood that a product manufacturer will hide it for fear of litigation.

All information - even the bad stuff - is good. There are exceptions though. If your girlfriend ever asks you if she looks fat in this dress...

I don't have all the answers. I rely on society to find them in an atmosphere that encourages creative solutions.

- Bill

quote:
--------------------------------------------------------------------------------
Originally posted by Justin
My comment wasn't meant as a condemnation of his daughter.
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I know you better than that, Justin. No blood, no foul. You're a good man with a good heart.

Actually, I find you very offensive with your holier than though attitude Justin.

Rich

Rich

You bring up another very, very good point.

Watch how many people jump onto the gravy train. Watch Big Government tax the hell out of cigarettes to keep the little guy from smoking. Then see what the politicians later do if that tobacco money starts to dry up.

Take a look at what most states did with their tobacco settlement money. It didn't go where they said it would go. Instead, they spent it on general stuff, which just encourages all those state programs they funded - which rely on taxes. Meanwhile, this was a one-time settlement.

Have you noticed how much the states have jumped into the business of gambling? (a.k.a the lottery) This is more government profiteering off of the addiction business.

ALL these activities at the end of the day are regressive taxes. They hurt the little guy who can least afford it.

This is why I shudder when someone says they want to tax tobacco as a disincentive. No thank you. I WILL NOT put myself - or my government - on the addiction gravy train.

- Bill

You know the difference between these four and the ambulance chasers you so predictably defend, Gene? A law degree.

Sorry. Bill. You've really strayed kinda far from the pack on that one. The gang of four allegedly committed multiple crimes to get what they wanted, destroying along the way.

The lawyers for the Texas plaintiffs went in front of a judge every step of the way, used the rule of law to argue their case and win. They did not lie, cheat, rob, terrorize or steal to win their side. No more than Thurgood MArshall did in winning Brown v. Education. No more than Sarah Weddington did in winning Roe. No more than NRA lawyers do in protecting the gun ownership rights of its members and certainly no more than insurance company lawyers do in defending their client's decisions regarding payment for health care services.

Damn right I defend the role of lawyers in today's society, Bill. Without experts in the rules of law - the same rules you say were violated in the Texas case - there would be no rules at all. And this nation was founded on laws.

The fact that above board lawyers reap more than a few dollars when they win big cases like this does not bother me one bit. That is not, however, for discussion.

Seriously, Bill, you need to read my posts closer to find out where we agree, and where our opinions wildly diverge. At the very least you'll be able to spot where you profoundly misquote.

Gene

What can be done to incent companies and lawyers to act responsibly?

A long time ago, on his own forum, Bill posted a link to an article entitled "Addressing the Medical Malpractice Insurance Crisis". It had some excellent, common sense suggestions on how to reform medical malpractice laws yet still allow patients who are harmed recover for their injuries and remove the threat of frivolous lawsuits that are supposedly putting fear into health care providers.

I do not have a link (I've saved it to my hard drive), but maybe Billl can post it again? Instead of him trying to change my mind (which he won't do) and me trying to change his mind (which also isn't going to happen), we can talk about how to fix the supposedly broken system.

With regards,
Gene

First,

Re: my plan to keep future merck's blameless if they behave, the big difference is this: if the FDA finds that merck is behaving, no one may sue them. Experts--independent from, not being paid by merck--make recommendations with data, and if merck follows recs, then merck is blameless unless they weren't transparent with data.

Currently, anyone can sue merck and a huge lawsuit results even if they do the right thing. MANY losers in the process--everyone loses, in fact, except lawyers, who CREATE a false pile of supposedly well intentioned work for them to be well paid for. This kind of truth shouldn't be settled in court but out of it. That automaker i mentioned? It lost BOTH suits--i don't know what the decisions were, but they LOST big time, wasting time and energy dealing with BS suits brought out of anger and greed when introspection and planning were called for.

Second,

Bill, any comment on those questionable actions by Merck? Namely, to obstruct the process of informed discussions between physicians and their patients so they could decide for themselves if the heart risks were worth it? Plus, I really don't think we can decide big tobacco is good because its lucrative for governments. What about an assassination trade? if taxed, who knows... makes no sense. Further, research has shown that sin taxes predictably decrease smoking, just as gas prices predictably affect driving. I know you and rich are against hitting the rich specifically with taxes, so EVERYTHING else (taxes on a base income, food, gas, smokes, whatever) is "regressive." Pick one: target excess wealth or encourage good decisions among the population's members. I support gas and sin taxes to control problems and deal with consequences. If the money resulting is misspent that can be corrected with legislation--if anything can.

Third,

Gene, you keep talking about informed consent. Sadly, you do not know how this practice actually plays out. Some people want to read the trials and make their own decisions after lengthy discussions, but frankly, most people fall into two categories:

--people who want to have their doctors make recommendations for them (often revealed in the question, what would you do for yourself, or your family member?, and sometimes patently blurted out: "just tell me what i should do" or "i don't know, i trust you.") There are MANY people out there who are illiterate. Drug addicts. Mentally retarded, or if not retarded, of normal intelligence, or even above average intelligence, without a medical background or the time to get an honorary medical degree by researching every clinical question they're faced with. This is what I am paid to do: make decisions for people. Yes, people shold hear about risks, but that risk discussion has to be carefully tailored to the person.

(I think you missed my whole aldactone point: my RESIDENTS (trained physicians) needed over an hour to make a tentative position on aldactone and heart failure. A heart failure patient needs, usualy, a diuretic, digoxin, an ACEI, a betablocker, sometimes aldactone, a battery of tests, diet and exercise regimens, and treatment for the ten other conditions they have. If that person was a physician they'd still need 7 hours of discussion on CHF alone to meet your standards for informed consent. Your proposal is fantasy. These discussions are and will continue to be about a minute long and if you change that, regardless of your intentions, medicine will grind to a halt.)

2) the other group of people will BALK at any treatment if you tell them much about risks. Oh, antibiotics can cause renal failure, bone marrow failure, hepatitis, fatal anaphylaxis, rashes, vasculitis, serious diarrhea, stomach upset, dangerous superinfections? Then leave my serious pneumonia untreated!!! I'm not kidding. Your proposal will talk THESE people out of care. Eventually, some azzhole will sue us because we gave too many risks and a patient deferred a desirable treatment. There is so much going on in our interactions already--issues with trust, race, sex, age, money, death, fear, and so many time pressures, if the lawyers guide the way we interact with patients.

Gene, there are a lot of things every hospital needs to improve. It's a complicated, hectic, high stress, high potential for error industry PLUS everything is individualized and the objects of study are fragile. I do not think my division will step up any of its activities to improve patient care if you sue us for any of our present inadequacies. YOU might go to bed satisified and rich but you will not be making people safer.