By Gary Null, PhD and Jeremy Stillman
Each day, millions of Americans visit a physician. Whether they go to the office of a primary care physician, consult with a specialist or seek medical assistance at an outpatient clinic or hospital emergency room, in all cases, there is an underlying assumption that the quality of care they are given must be the best in the world because we spend nearly twice as much as any other country in the world on individual healthcare. Also, we are led to believe by our physicians and nurses, the media and the many federal agencies that oversee the medical-industrial complex, including the Centers for Disease Control (CDC), Food and Drug Administration (FDA), National Institutes of Health (NIH) and National Cancer Institute (NCI) that everything offered to patients is based upon scientifically proven therapies for safety and efficacy or science-based medicine.
At the same time, we are told that any approaches to health involving non-science-based medicine is to be rejected; these include homeopathy, ayurvedic medicine, acupuncture, acupressure, massage, aromatherapy, magnet therapy, chiropractic medicine and supplementation with vitamins. We are told that such modalities have no foundation in science and that they have an almost cult-like following. Our health authorities make it clear that patients pursuing these alternative therapies have never made any improvements, in any circumstances, simply because they aren’t dealing with science-based medicine. The medical establishment tells us that anyone who sees improvement in their health using a non-science-based therapy was either misdiagnosed in the first place or improved only because they were treated by some form of science-based medicine that they must have received before. Hence, all practitioners of alternative medicine must be at best delusional, and at worse, out-and-out frauds and quacks who should be disgraced and imprisoned.
This has been the existing medical paradigm for nearly a century. Confronted with this situation, we ask a few basic questions: Is science-based medicine safe and effective? If so, where is the proof? And if it is not safe and effective, where is the proof? We also ask are alternative therapies are safe and effective? If they are, where is the proof? If they are not, where is the proof? These are reasonable questions to ask.
Then comes the great disconnect: our country will spend $2.6 trillion on medical care this year yet virtually nothing is spent on prevention and there is no condemnation of diet contributing to disease. The only admonitions that we hear are “don’t smoke” and “drink in moderation.” Any evidence demonstrating that a disease may stem from processed foods and beverages, environmental chemicals, stress, or a lack of exercise is either not discussed or downplayed. As a result, the average American doesn’t pay a great deal of attention to what they feed themselves and their children; nor do they bother to devote much time in their daily lives to exercise or meditation.
Such ignorance contributes tremendously to America’s burgeoning healthcare crisis defined by nationwide epidemics of obesity, heart disease, cancer, and diabetes. This behavior has also helped the United States slip to 50th place on the life expectancy-by-country list.# It’s quite evident that throwing money at the problem won’t make it go away. A recent report by the Organization for Economic Cooperation and Development (OECD) discovered that the average American is spending $7,900 a year in healthcare costs; far more than any of the other 34 industrialized member nations.# The study also found that per capita, hospitals in the United States spend $2,922, or nearly double the amount spent in places such as Japan, Canada, and Germany.#
Perhaps the most disturbing part of this scenario is that the number one cause of death and injury in the United States is American medicine. You would think that after 20 years and at least 10 million deaths and 200 million injuries, all of which were preventable, that this would be important enough to warrant Congressional hearings and media attention. At the very least, shouldn’t it inspire some soul-searching at the editorial offices of publications such as the New England Journal of Medicine, the Journal of the American Medical Association or any of the 8,000 scientific medical journals throughout the United States? You might imagine there would be a great deal of discussion among the 900,000 physicians, 60,000 dietitians and hundreds of thousands of therapists about how clearly, something in the existing paradigm is wrong. Wouldn’t it seem logical for our federal health agencies, insurance companies, hospitals and providers of Medicare and Medicaid to ask just why staggering numbers of people becoming ill and dying? In point of fact, there is virtually no discussion anywhere in the United States in any medical organization aimed at addressing this incomprehensible medical failure.
This issue is so significant that we have decided to dissect it into component pieces to examine what went wrong and what is necessary to make it right. To begin, we will examine how our elected officials have and continue to betray us by choosing to serve a ruthless corporate cartel instead of promoting the health and livelihood of the American people. Next, we will investigate how the conventional approach to the treatment all major diseases espoused by our nation’s leading medical institutions right down to our local physicians and nurses, is guided not by what is best for the health of Americans, but rather what is most politically and economically advantageous for a few special interests. We will explore how proprietary science has been co-opted by the medical-industrial complex and precisely how we’ve become a nation where medicine is for sale.
Medicare Madness
At 3 o’clock in the morning on November 22, 2003, the United States House of Representatives voted to pass the now infamous piece of legislation known as Medicare Part D. The bill effectively overhauled the structure of Medicare’s prescription medication coverage for seniors. The more than 800-page final draft of bill was submitted to members of Congress just a few days before it was voted on and despite its far-reaching consequences, no lawmakers were able to read through the entire document. While the effects of Part D were debated in the aftermath, one thing was for certain: it put drug manufacturers in a position to profit tremendously.
A key component of Part D banned Medicare officials from negotiating the price of prescription medication with drug companies; this provision has significantly shifted the burden of medication costs for Medicare to taxpayers while empowering drug companies to rake in billions more each year. A report by Families USA compared the costs of various drugs for participants in Medicare Part D to the costs of those same drugs for veterans who receive coverage from the U.S. Department of Veterans Affairs; an agency that secures lower costs by negotiating with drug manufacturers. The report revealed that, for Medicare Plan D patients, the cost of a years-worth supply of the anti-cholesterol medication Zocor is $1,485.96 while the price for the same drug under the VA plan amounts to only $127.44.# For veterans, the price of a year’s treatment of the acid-reflux medicine Protonix, comes out to $214.52; at the same time, Medicare beneficiaries pay $1,148.40.#
A comparative analysis of these two prescription plans recently carried out by researchers at the Boston University’s School of Public Health and the University of Minnesota determined that individuals covered by the VA plan pay, on average, 40% less for prescription medication than those insured by Medicare.# Furthermore, the study found that if Medicare secured the same prices for prescription drugs as the VA, the program would save about $510 per beneficiary each year; this would amount to a total yearly savings of $14 billion.#
The American taxpayer has been saddled with huge costs as a result of this healthcare scheme and unless you are employed by the pharmaceutical-industrial complex, the economic outlook is bleak. In 2009, the cost of Medicare Part D was $62 billion- it is expected that this figure will reach $150 billion by 2019.# Since Plan D was instituted in 2006, the average cost of premiums paid by beneficiaries has risen by 57%; this figure is projected to increase by about 10% annually over the next nine years.#
Medicare Part D is a perfect example of how the medical lobby uses its influence to impose economically oppressive and morally corrupt healthcare policies on the American people. To better understand how the system is set up to exploit our health, we must examine how this bill came into being.
Legislating Medical Tyranny
A key player in the passage of the Medicare Part D was Representative Billy Tauzin (R-Louisiana) who served as the chairman of the House Energy and Commerce Committee. Congressman Tauzin had longstanding ties with the pharmaceutical industry; since his election in 1989, he received $218,000 in contributions from drug interests until the end of his term in early 2005.# It’s quite obvious that the congressman worked to ensure that the measures contained in the bill would be pleasing to his financial backers. In fact, in the final stages of the bill’s drafting process, Tauzin convened with drug industry lobbyists in private conference rooms where they made sweeping changes to the bill’s language.# In an interview with CBS news, representative Walter Jones (R-North Carolina) freely admitted that "the pharmaceutical lobbyists wrote the bill."# Tauzin also helped extend the House vote on the bill- a process which typically takes 15 minutes-to a record-breaking 3 hours. Describing the circumstances of the exceptionally long vote, Congressman Dan Burton (R-Indiana) stated the following:
"The votes were there to defeat the bill for two hours and 45 minutes and we had leaders going around and gathering around individuals, trying to twist their arms to get them to change their votes."#
Just a few months after leaving office 2005, Tauzin was hired as the President and CEO of the Pharmaceutical Research and Manufacturers’ Association (PhRMA). As one of the most well-funded lobbying groups in Washington, PhRMA has massive sway within our halls of power. In 2009, PhRMA officially spent a total of $26,150,520 to lobby numerous bureaucratic bodies including the FDA, the Department of Commerce, the White House and the Congressional Budget Office.# In fact, based on the number of quarterly activity reports filed with the Clerk of the U.S House of Representatives and the Secretary of the Senate, PhRMA stood out as the largest lobbyer in both houses of Congress for the entire year.#
PhRMA represents 48 different firms including Merck, GlaxoSmithKline and Johnson & Johnson. This special interest juggernaut employs twenty lobbyists to push their agenda, but also contracts out dozens public relations companies to do their bidding .## Furthermore, the watchdog group Public Citizen uncovered in 2004 that PhRMA had been surreptitiously funneling tens of millions of dollars to various organizations such as United Seniors Association and the Seniors Coalition.# In exchange for such generosity, these groups encouraged their members to vote for candidates sympathetic to the interests of the pharmaceutical industry.#
An article published in the New York Times discussing Tauzin’s time spent at the helm of PhRMA explained that he played a leading role in “beating back a phalanx of proposals to cut drug costs, including allowing foreign imports or government price negotiations.”# Tauzin’s victories for the industry didn’t go unrewarded; before he stepped down in 2010, his yearly compensation exceeded $2 million ( in 2009, his earnings were reported to be $4.6 million).##
It turns out that the cozy relationship between Tauzin and PhRMA is far from an isolated case of depravity between lawmakers and big pharma. Indeed, at least 25 different politicians, Congressional staffers, and bureaucrats who helped compose the 2003 Medicare bill went on to work with/for the pharmaceutical lobby.# Among them were Tauzin’s very own former chief of staff, Mimi Kneuer, who went on to become a lobbyist for PhRMA. #
Another architect of Plan D was Doug Badger, who served as the chief health policy advisor and Deputy Assistant to the President for Legislative Affairs under President George W. Bush. Badger later became a partner at the Nickles Group where he represents the interests of drug manufacturers such as Bristol-Meyers Squibb and Eli Lilly on Capitol Hill.#
Just a year after working on provisions to ensure that drug companies would be able to dictate the price of medication without interference from the federal government, former Senator John Breaux (D-Louisiana) went on to form his own lobbying firm, Breaux Lot Leadership Group. In 2009, Breaux’s enterprise was paid $600,000 to lobby on behalf of PhRMA.#
Another notable figure who helped pass Part D was Thomas Scully, a former director at Medicare. Scully gained notoriety for threatening to fire Medicare’s chief actuary if he dared to reveal to members of Congress the true cost estimate for Plan D.# Further, while helping to craft the Medicare bill, Scully received a special ethics waiver from Health and Human Services (HHS) Secretary Tommy Thompson; the waiver permitted him to seek future employment with private firms directly affected by the Medicare bill while he was still working for the government. # Less than a month after the bill was approved, Scully left his job with the government to work for two firms affected by the legislation.# The former administrator currently works at Alston & Bird, Scully, where he lobbies for groups such as the Generic Pharmaceutical Association and biotherapy giant CSL Behring.#
The Center for Public Integrity reported that between January 2000 and June 2005, Congressional lawmakers and their aides accepted more than $600,000 in free travel from pharmaceutical companies and drug industry trade organizations including PhRMA, the Advanced Medical Technology Association( AdvaMed) and the Biotechnology Industry Organization (BIO).# Not surprisingly, nearly all of legislators who were treated to free vacations ended up voting in favor of the passage of the 2003 Medicare bill.# One such politician was Senator Orrin Hatch (R-Utah), who, along with his aides, accepted $12,000 to pay for travel expenses to different destinations from medical trade groups as well as pharmaceutical companies Pfizer and GlaxoSmithKline.#
Bankruptcy by Medicine
The seemingly endless conflicts of interest surrounding this one piece of legislation illustrate the iron grip that the pharmaceutical-industrial complex has on Washington. This travesty has picked up momentum in recent years as Americans face deepening costs for health coverage while revenues for the drug industry continue to rise. This is seen in the current controversy brewing over the Independent Payment Advisory Board (IPAB), which was established after the passage of last year’s Affordable Care Act. Comprised of fifteen experts appointed by the president and approved by Congress, the bipartisan IPAB is empowered to make recommendations to lawmakers aimed at reducing the increasingly unsustainable cost of Medicare. By any measure, Medicare’s trust fund is in need of all the help it can get; an evaluation by programs’ trustees earlier this year estimated the entire program will be bankrupt by 2024.# Policy suggestions from the panel are meant to cut down on cases of fraud, waste and reduce the occurrence of medical errors. As it stands, the board’s proposals are implemented if Congress either approves them or does not vote on them. If the House or Senate vote against the panel’s recommendations and there is no presidential veto, the recommendation is nixed.
The pressure to scrap the IPAB is coming from many directions. Predictably, lobbyists representing insurance companies, the American Medical Association (AMA), the American Hospital Association (AMA), and the pharmaceutical industry, have come out in full force to oppose the IPAB. In fact, PhRMA declared the elimination of the committee its number one priority for 2011.# Politicians and members of the media are echoing the dubious claims that the panel’s recommendations will dramatically compromise access to healthcare for seniors.
In a letter to the Congressional deficit-cutting super committee in October, a coalition of various specialty medicine groups representing 350,000 physicians including the American Association of Neurological Surgeons, Society of Anesthesiologists and the Alliance of Specialty Medicine urged the repeal of the IPAB. Part of the letter stated “while we recognize the need to reduce the federal budget deficit and control the growth of health care spending, the IPAB is simply the wrong solution for addressing these budgetary challenges”.# Apparently ignorant of the their paradoxical request, the groups were calling on a governmental body charged with lowering the national deficit to eliminate a advisory panel tasked with reducing healthcare costs by billions of dollars.
Several Democrats have refused to join with President Obama in supporting the board and have aligned with Republicans to sponsor legislation that would repeal the panel. To no one’s surprise, nearly all of these officials have major ties to industries that could potentially see lower profits resulting from approved IPAB recommendations.# One such politician is Nevada’s Shelly Berkeley, whose largest industry donation last year, which totaled $240,000, came from health professionals. Also opposed to the IPAB is Allyson Schwartz (D-Pennsylvania). As it turns out, Schwartz counts both the pharmaceuticals/health products and health professionals industries among her top five campaign donors.# And the latest Democratic defector to join the fight against the IPAB is Congressman Barney Frank of Massachusetts.# An examination of Frank’s campaign contributors over the last few years shows that he enjoys generous financial support from dozens of insurance firms such as AFLAC Inc, MetLife Inc and Liberty Mutual Insurance. # From 2009 to 2010, Frank accepted more than $207,000 from various insurers - more than double the amount he received from any other industry.#
Controlling Your Health - State By State
Given that our national lawmakers are firmly in thrall to the special interests when it comes to healthcare policy, it is little wonder that state officials follow suit. This has been brought into focus in recent months as various watchdog organizations have cried foul over the activities of the non-profit American Legislative Exchange Council (ALEC). Despite touting itself as “the nation’s largest, non-partisan, individual public-private membership association of state legislators” dedicated to the promotion of Jeffersonian ideals of “limited government” and “individual liberty”, the truth is that ALEC actively manipulates public policy and subverts personal sovereignty by pushing corporate-friendly laws through state legislatures.
Almost 2,000 state legislators (almost one-third of the country’s state lawmakers) make up ALEC’s “Legislative Membership”. The organization’s legislators hail from all 50 states and, for the most part, are ideologically-conservative. The other main part of the ALEC apparatus is their “Private Sector Membership”; the group is made up of business leaders representing a wide range of corporate interests. Working together, ALEC’s lawmakers sit down with industry executives to create model legislation that serves as the basis for bills introduced in state houses throughout the country. The council’s website proudly declares that its members have composed almost 1,000 legislative templates.# ALEC openly discloses their strong alliance with corporate America on their website which states that “legislators welcome their private sector counterparts to the table as equals, working in unison to solve the challenges facing the nation.”# An article published on the Los Angeles Times website on July 13, 2011 stated that, according to ALEC spokeswoman Raegan Weber, “corporate leaders have a prominent role in drafting the group's bills and resolutions” ; the statement was later on retracted.#
A principal body within ALEC’s framework is the 24-member Private Enterprise Board; the group is dominated by a veritable who’s who of American big business. Companies currently represented on the board include Pfizer, Coca-Cola Company, Johnson and Johnson, Kraft, State Farm Insurance, Wal-Mart Stores, Koch Companies Private Sector, and PhRMA. The influence of the pharmaceutical lobby on the board is remarkable; the First Vice-Chairman is Sandra Oliver of Bayer Corp., and the Second Vice-Chairman, John Del Giorno, represents GlaxoSmithKline.
The presence of the Koch brothers’ energy conglomerate on the board is no coincidence. Charles and David Koch have provided ALEC with enormous infusions of cash for well over a decade. Two years ago, the billionaire brothers donated $200,000 to ALEC through the Claude R. Lambe Foundation and Charles G. Koch foundation; both of which are run by Charles Koch.# In fact, this figure doesn’t account for the undisclosed dues that Koch Companies hands over to ALEC each year.#
Over the years and especially today, ALEC has received considerable sponsorship from powerful medical trade groups and corporations. Among the groups listed as current or recent affiliates of ALEC on Sourcewatch.org are:
In addition to their tight alliance with the above corporate powerhouses, ALEC also has ties to a bevy of high-powered lobby groups and law firms with a history of representing big pharma. Furthermore, numerous former ALEC members have ascended to positions of national authority; this group includes House Speaker John Boehner, former defense secretary Donald Rumsfeld and former congressman turned lobbyist Billy Tauzin. # The council has also welcomed figures including George W. Bush, Dick Cheney and Newt Gingrich and as event speakers.#
As you follow the money trail, it quickly becomes evident who is in charge. In 2009, ALEC took in a reported $6.3 million- 98% of which came from corporate sponsors, not lawmakers, paying their yearly dues.## Along with paying very little in membership dues, ALEC lawmakers are treated to luxurious vacations and enjoy conventions at high-end resorts subsidized by the organization’s corporate patrons.# Perhaps the greatest evidence of ALEC’s corporate stranglehold on state legislators can be found in campaign donations. An investigation by the advocacy organization Common Cause uncovered that over the last ten years, “ALEC corporate leaders have invested more than $370 million in state elections”.#
An ALEC Whistleblower Speaks Out
The testimony of former ALEC legislator Nancy Argenziano sheds light on group’s power to promote health policies that favor big business. In an interview with the Orlando Weekly, Argenziano stated that the so-called committee on healthcare at the ALEC conference she attended was entirely dominated by the drug company Pfizer.# Argenziano didn’t mince any words when describing her erstwhile cohorts:
"They own the government. I knew that they owned a certain amount, that there were certain contributions and certain leaders they owned, but I didn't realize to what degree," she says. "Now I'm frightened because they really own a great deal of our government from state to state. I'm not anti-corporation, but I am anti them taking over the government."#
***
The extensive control exercised by this consortium is unmistakable, but what sort of impact has ALEC had on our health and what plans do they have in store for the future? An examination of the model legislation and resolutions produced by ALEC reveals that these bills are primarily intended to benefit the private insurers, physicians, hospitals and medical technology manufacturers and drug manufacturers at the expense of Americans’ health and prosperity. Let’s take a look at a few examples:
The Health Care Choice Act for States
The bill, which has already been enacted in Wyoming, Maine, and Georgia after its adoption four years ago, allows for health insurance providers to offer their plans to out-of-state customers. The dangerous aspect of the legislation surrounds state-mandated benefits which are typically offered to any in-state beneficiary. Under the act, such mandatory benefits are not extended to out-of-state purchasers, leaving them with incomplete healthcare policies. Not only does this scheme deprive patients of important benefits traditionally afforded to plan members, but it also drives up the cost of comprehensive policies offered in-state. It should come as no surprise that ALEC’s “legislator of the year” in 2009, Senator Leah Vukmir, is attempting to pass a bill very similar to this one in her home state of Wisconsin.#
The Non-Economic Damage Awards Act
Adopted in 2002, the bill sets a $250,000 cap on payments awarded to plaintiffs in malpractice lawsuits who experience “pain, suffering, physical impairment, disfigurement, mental anguish” and other damages.# A godsend to insurers and physicians, the bill would dramatically limit the number of cases brought against doctors because such a relatively low compensation would make it impractical for litigators to take on such cases. In January 2011, the AMA issued a statement to the Congressional Committee on the Judiciary calling on federal lawmakers to institute the very same $250,000 cap on non-economic damages.#
Tort Reform
Pro-business tort reform is a priority for ALEC. In 2009, the group set forth a resolution condemning “bad faith laws” - those statutes that fault insurance companies for wrongly denying claims.# A report by the Center for Justice & Democracy explained that ALEC has also undertaken efforts to defend drug immunity legislation passed in Michigan in 1995.# The precedent law forbids Michigan citizens from seeking any compensation from pharmaceutical companies from damages incurred from the use of unsafe FDA-approved drugs. A current bill now being considered in Wisconsin similarly seeks to grant immunity to drug manufacturers but builds on Michigan’s law by adding language to also protect medical device manufacturers.#
Single-Payer Opposition
Recent proposals to institute a government-run, universal healthcare system have been met with heated opposition by ALEC since shifting the burden of healthcare costs to the federal or state government would significantly curb profits for a number of special interests aligned with council. Consequently, ALEC has taken swift action to try to prevent anything resembling a single-payer plan from coming into existence. This opposition has been crystallized in the organization’s Freedom of Choice in Health Care Act . Created in 2008, the model bill strips states of the right to implement a federally-administrated single payer system by declaring it unconstitutional for Congress to carry out healthcare reform on a national level. In fact, the only thing unconstitutional in this picture is the Freedom of Choice in Health Care Act itself; but that hasn’t prevented ALEC lawmakers from pushing the bill through their state legislatures. To date, the act has been either introduced or announced in 44 state legislatures and 8 states have passed it into law.#
ALEC recently teamed up with the Health Care Compact Alliance to endorse an initiative known as The Health Care Compact. On November 30 of this year, ALEC announced the adoption of the compact as a legislative template aimed at minimizing interference by the federal government in the administration of statewide healthcare. Under the proposed bill, pillars of American healthcare system including Medicare and Medicaid would be wiped out and replaced with federal block grants apportioned to each state. The truth is that the enactment of such a bill would only fuel the country’s medical crisis. Healthcare plans utilizing block grants like The Health Care Compact would place a cap on such federal reimbursements that, in turn, would force state governments to compensate by limiting healthcare eligibility and cutting back on benefits. Of course, the enactment of this legislation would produce a massive windfall for ALEC’s financial backers. The Health Care Compact closely resembles other ALEC resolutions in previous years that have called for replacing Medicaid and Medicare with a block grant system ##
Since February, the bill has been introduced in 13 states and according to ALEC, is being considered by lawmakers in 20 other states.# In September, Republican presidential candidate and Texas Governor Rick Perry threw his support behind the compact; # An ALEC-alumnus himself, Perry stands out as the largest single recipient of contributions from groups associated with ALEC over the last ten years; reportedly receiving more than $1.9 million since 2001. #
***
A critical analysis of our healthcare system turns up overwhelming evidence that our politicians, by and large, are beholden to the interests of a corporate medical mafia. The influence of this crooked alliance has become more entrenched over the last decade and today, virtually all healthcare-related bills passed at a national and state level contain provisions designed to further the interests of our lawmakers’ corporate sponsors. As a consequence, Americans face rapidly increasing healthcare costs and less access to medical care.
But before we consider how to remedy this broken system of healthcare, we must go deeper and look at the factors that shape the science behind the prevailing medical paradigm. Given the pervasive influence of the medical-industrial complex, it stands to reason that their power extends to the realm of science. In the rest of this report, we will highlight the glaring conflicts of interest existing between our major medical institutions and corporate interests and the profound effect this relationship has on our health. We will see how our health authorities’ allegedly impartial recommendations and conclusions are, in fact, largely based on what will maximize corporate revenues, rather than solid scientific fact. Disease by disease, we will examine how, as a nation, we’ve been deceived into buying a brand of medicine that is long overdue for a recall.
ENDNOTES
[1] "COUNTRY COMPARISON :: LIFE EXPECTANCY AT BIRTH." CIA.gov. N.p., n.d. Web <https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html>.
2 "WHY IS HEALTH SPENDING IN THE UNITED STATES SO HIGH?."oecd.org. www.oecd.org/dataoecd/12/16/49084355.pdf
3 Ibid
4 "No bargain: Medicare Drug plans Deliver High prices." familiesusa.org. www.familiesusa.org/assets/pdfs/no-bargain-medicare-drug.pdf
5 Ibid
6 Frakt, Austin, Pizer, Steven D. and Feldman, Roger, Should Medicare Adopt the Veterans Health Administration Formulary? (April 14, 2011). Health Economics, April 2011. Available at SSRN: http://ssrn.com/abstract=1809665
7 Ibid
8 THE 2010 ANNUAL REPORT OF THE BOARDS OF TRUSTEES OF THE FEDERAL HOSPITAL INSURANCE AND FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUNDS." CMS.gov.
www.cms.gov/ReportsTrustFunds/downloads/tr2010.pdf
9 Klein, Ezra. "Does Medicare Part D make the case for Paul Ryan’s plan?." WashingtonPost.com. www.washingtonpost.com/blogs/ezra-klein/post/does-medicart-part-d-make-the-case-for-paul-ryans-plan/2011/05/19/AGfPbyLH_blog.html
10 Julie Hirschfeld Davis, From Capitol to K Street: Hill lawmakers retire, reap millions as lobbyists, BALTIMORE SUN,January 4, 2005, citing Center for Responsive Politics
11 The Institute for America's Future. "BILLY TAUZIN: Case Study in Corruption ." medicalsupplychain.com. www.medicalsupplychain.com/pdf/Medicare%20Part%20D%20Reform%20&%20Coruption%20Issues.pdf
12 Singer, Michelle. "Under The Influence ." CBS News. http://www.cbsnews.com/stories/2007/03/29/60minutes/main2625305.shtml
13 Ibid
14 "Lobbying Spending Database - Pharmaceutical Rsrch & Mfrs of America, 2009 | OpenSecrets." OpenSecrets.org. http://www.opensecrets.org/lobby/clientsum.php?id=D000000504&year=2009
15 "Lobbying Spending Database-Pharmaceutical Rsrch & Mfrs of America, 2009 | OpenSecrets." OpenSecrets.org. http://www.opensecrets.org/lobby/firmagns.php?id=D000000504&year=2009
16 "Lobbying Spending Database-Pharmaceutical Rsrch & Mfrs of America, 2011 | OpenSecrets." OpenSecrets.org: Money in Politics -- See Who's Giving & Who's Getting. http://www.opensecrets.org/lobby/firmlbs.php?id=D000000504&year=2011
17 "Lobbying Spending Database - Pharmaceutical Rsrch & Mfrs of America, 2008 | OpenSecrets." OpenSecrets.org. http://www.opensecrets.org/lobby/clientsum.php?id=D000000504&year=2008
18 "PhRMA Appears to Have Funneled Up to $41 Million To “Stealth PACs” to Help Elect a Drug Industry-Friendly Congress." Public Citizen Home Page.http://www.citizen.org/pressroom/pressroomredirect.cfm?ID=1789
19 Ibid
20 Kirkpatrick, David. "One Deal Too Many Costs Billy Tauzin His Job - NYTimes.com." The New York Times - Breaking News, World News & Multimedia.http://www.nytimes.com/2010/02/13/health/policy/13pharm.html
21 Ibid
22 "Internal Revenue Service form." guidestar.org. www.guidestar.org/FinDocuments/2009/530/241/2009-530241211-069c47da-9O.pdf
23 Pierce, Olga. "Medicare Drug Planners Now Lobbyists, With Billions at Stake." ProPublica. http://www.propublica.org/article/medicare-drug-planners-now-lobbyists-with-billions-at-stake-1020
24 Ismail, M. Asif. "Pushing Prescriptions - The Center for Public Integrity." iWatch News | Investigation. Impact. Integrity.. http://projects.publicintegrity.org/rx//report.aspx?aid=823
25 "Doug Badger." The Nickles Group. http://www.nicklesgroup.com/bios/badger.php
26 "Lobbying Spending Database-Breaux Lott Leadership Group, 2009 ." OpenSecrets.org. http://www.opensecrets.org/lobby/firmsum.php?id=F25069&year=2009
27 Krugman, Paul. "A Serious Drug Problem." The New York Times . http://www.nytimes.com/2005/05/06/opinion/06krugman.html
28 "CONFLICT OF INTEREST OF FORMER MEDICARE CHIEF THOMAS SCULLY." Public Citizen Home Page. http://www.citizen.org/congress/govt_reform/ethics/scully/
29 Ibid
30 Pierce, Olga, Sabrina Shankman, and Jeff Larson. "Chart: Medicare Drug Plan Architects Now Drug Company Lobbyists - ProPublica." ProPublica.http://www.propublica.org/special/medicare-drug-plan-architects-now-drug-company-lobbyists-102009
31 Brodsky, Robert, and Kaitlin Hasseler. "Power Trips - The Center for Public Integrity." iWatch News | Investigation. Impact. Integrity.. http://projects.publicintegrity.org/powertrips/report.aspx?aid=715
32 Ibid
33 Ibid
34 Wolf, Richard. "Medicare, Social Security running out of money faster." USATODAY.com. http://content.usatoday.com/communities/theoval/post/2011/05/medicare-social-security-obama-geithner-republicans/1
35 Wilson, Duff. "Industry Targets Medicare Board ." NYTimes.com. http://prescriptions.blogs.nytimes.com/2010/11/04/industry-targets-medicare-board/
36 "Letter to the Super Committee." AANS.org. www.aans.org/~/media/Files/Legislative%20Activities/IPAB_Supercommittee_Letter.ashx
37 Khimm, Suzy. "All Dems Opposing Medicare Panel Have Major Industry Ties | Mother Jones." Mother Jones | Smart, Fearless Journalism.http://motherjones.com/mojo/2011/04/all-dems-opposing-medicare-panel-have-major-industry-ties
38 "Allyson Schwartz: Campaign Finance/Money - Industries - Representative 2012 | OpenSecrets." OpenSecrets.org.http://www.opensecrets.org/politicians/industries.php?cycle=2012&type=I&cid=N00001579&newMem=N&recs=20
39 Stiles, Andrew. "Barney Frank Backs IPAB Repeal - By Andrew Stiles - The Corner - National Review Online." National Review Online.http://www.nationalreview.com/corner/284368/barney-frank-backs-ipab-repeal-andrew-stiles
40 "Barney Frank: Campaign Finance/Money - PAC Data - Representative 2010 | OpenSecrets." OpenSecrets.org. http://www.opensecrets.org/politicians/pacs.php?cid=N00000275&cycle=2010
41 Ibid
42 "Legislative Membership ." ALEC – American Legislative Exchange Council | Limited Government · Free Markets · Federalism. http://www.alec.org/membership/legislative-membership/
43 "Private Sector Membership ." ALEC . http://www.alec.org/membership/private-sector-membership/
44 Hamburger, Tom, and Neela Banerjee. "ALEC: State legislative bills raise conservative group's profile - Los Angeles Times." The Los Angeles Times.http://articles.latimes.com/2011/jul/13/nation/la-na-epa-states-20110714
45 Ibid
46 Ibid
47 "American Legislative Exchange Council ." SourceWatch. http://www.sourcewatch.org/index.php?title=Alec
48 "ALEC Politicians." SourceWatch. http://sourcewatch.org/index.php?title=ALEC_Politicians
49 Ibid
50 Hamburger, Tom, and Neela Banerjee. "ALEC: State legislative bills raise conservative group's profile ." The Los Angeles Times. http://articles.latimes.com/2011/jul/13/nation/la-na-epa-states-20110714
51"A CMD Special Report on ALEC's Funding and Spending | Center for Media and Democracy." Center for Media and Democracy .http://www.prwatch.org/news/2011/07/10887/cmd-special-report-alecs-funding-and-spending
52 "ALEC." CitizenVox. http://www.citizenvox.org/?s=alec
53 "Legislating Under the Influence." commoncause.org. www.commoncause.org/atf/cf/%7BFB3C17E2-CDD1-4DF6-92BE-BD4429893665%7D/MoneyPowerAndALEC.pdf
54 Manes, Billy. "Hiding the sausage ." Orlando Weekly. http://orlandoweekly.com/news/hiding-the-sausage-1.1203271
55 Ibid
56 "ALEC Bills in Wisconsin | Center for Media and Democracy." Center for Media and Democracy | Publishers of PR Watch. http://www.prwatch.org/news/2011/07/10880/alec-bills-wisconsin
57 "Non-economic Damage Awards Act." AlecExposed.org. alecexposed.org/w/images/5/59/0G3-Noneconomic_Damage_Awards_Act_Exposed.pdf
58 " Statement of the American Medical Association to the Committee on the Judiciary United States House of Representative." ama-assn.org. www.ama-assn.org/ama1/pub/upload/mm/399/ama-statement-medical-liability-reform-2011.pdf
59 "White Paper: AMERICA’S WORST TOP MODEL; ALEC’s Model Civil Justice Legislation | centerjd.org." centerjd.org. http://www.centerjd.org/content/white-paper-america%E2%80%99s-worst-top-model-alec%E2%80%99s-model-civil-justice-legislation
60 Ibid
61 "White Paper: Repeating a Tragic Blunder: Wisconsin's Drug and Devise Immunity Bill | centerjd.org." centerjd.org. http://centerjd.org/content/white-paper-repeating-tragic-blunder-wisconsins-drug-and-devise-immunity-bill
62 Potter, Wendell. "ALEC Exposed: Sabotaging Healthcare Reform, Single-Payer Efforts | Common Dreams." Common Dreams.http://www.commondreams.org/view/2011/07/13-13
63 "Resolution on Medicaid Funding Through a Federal Block Grant." Alecexposed.org. alecexposed.org/w/images/2/28/5V5-Resolution_on_Federal_Medicaid_and_Welfare_Block_Grants_Exposed.pdf
64 "Resolution on Medicaid Funding Through a Federal Block Grant." Alecexposed.org. http://alecexposed.org/w/images/4/41/5V6Resolution_on_Medicaid_Funding_Through_a_Federal_Block_Grant_Exposed.pdf
65 " ALEC Adopts Health Care Compact as Model Legislation -- ALEXANDRIA, Va., Nov. 30, 2011 /PRNewswire-USNewswire/ --." PR Newswire.http://www.prnewswire.com/news-releases/alec-adopts-health-care-compact-as-model-legislation-134761598.html
66 Wollam, Allison. "Houston providers worry about financial impact of new multistate compact - Houston Business Journal." Business News .http://www.bizjournals.com/houston/print-edition/2011/09/02/houston-providers-worry-about.html
67 "Legislating Under the Influence." commoncause.org. www.commoncause.org/atf/cf/%7BFB3C17E2-CDD1-4DF6-92BE-BD4429893665%7D/MoneyPowerAndALEC.pdf
Dr. Gary Null is the host of the nation’s longest running public radio program on nutrition and alternative medicine, and a multi-award-winning director of progressive documentary films, including Vaccine Nation (2008) and Autism: Made in the USA (2009)
Jeremy Stillman is a Research Associate with the Progressive Radio Network.