Publication Date: February 12, 2014
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Last month, we posted Part I of our interview with Public Citizen’s Dr. Michael Carome, who is the director of the Health Research Group (HG). He shared some of the watchdog group’s efforts to hold pharmaceutical and medical device companies accountable.

On this second and final part of the two-part show, Carome discusses the role the government and physicians play in keeping citizens safe. In addition, Carome shares Public Citizen’s position on the Affordable Care Act.

Physicians Have a Responsibility to Their Patients

Carome said one of the ways physicians can look out for the best interests of their patients is to act independently of the drug reps who often show up at doctor’s offices.

“Too often, physicians welcome their relationships with some of these product manufacturers. They will promote the products to their patients, particularly in the realm of devices, and that’s not always in the best interest of patients,” Carome said.

Some of the studies that drug reps present to physicians are conducted by their own researchers and might be biased. Carome says that physicians should be proactive in staying independent when it comes to information as well.

Ethics in Clinical Trials

As a physician himself, Carome has always worked to uphold the ethical treatment of patients not just in the doctor’s office, but also in clinical trials. Prior to joining Public Citizen, he worked for more than a decade at the Office for Human Research Protections. There, Carome fought to keep participants of human clinical trials from being exploited.

He continues this work with Public Citizen. Recently, the organization spoke out about a change in the wording of some of the regulations involving clinical trials and the money paid to participants. Prior, the long-standing policy was that the money paid out should never be so high that people who would not otherwise participate in a trial would do so solely for the money.

Offering too much money in these cases may cause those who are “economically disadvantaged” to take health risks they would otherwise not take.

“The Office for Human Research Protections issued a revised policy … basically saying it’s OK to pay people to accept risks that they wouldn’t otherwise accept,” Carome said.

Public Citizen wrote to the secretary of Health and Human Services, Kathleen Sebelius, asking her to direct the Office for Human Research Protections to rescind the policy.

Public Citizen and the Affordable Care Act

The Affordable Care Act remains controversial. Millions of Americans are still caught in the middle, making too much money to qualify for subsidies, but making too little money to afford coverage.

Parts of the law are fraught with problems that cause delay. Just this week, the Obama administration announced that it would delay implementing a requirement that businesses with more than 50 employees but less than 100 provide health care coverage to their employees, until 2015.

Public Citizen doesn’t feel that the Affordable Care Act is the health care solution America needs.

“We are ardent advocates and champions for a single-payer health insurance,” Carome shared. “Although more people will get coverage (under Obamacare) and that is a good thing, ultimately it is going to fall way short and leave tens of millions of people uninsured or underinsured.”

Until for-profit businesses are eliminated from the health care insurance system, Public Citizen feels Americans won’t get the health care system they need. Carome points out that Medicare overhead is about 3 percent, far lower than that of private insurance companies.

Ideally, a revamped version of Medicare would be a good model for national health insurance, he said.