Drug Company Support of Continuing Medical Education II

Officious, left wing ideologue hypocrite Robert Steinbrook, MD of left wing, Hate America, Dartmouth University, goes apoplectic over sponsored continuing medical education. Meanwhile, he has no trouble taking money from the left wing Macy Foundation to further their left wing agenda. They fund only politically correct grants, under their Harvard indoctrinated graduate infiltrated administration. So Steinbrook' s credibility is nil by his bias. This article has the credibility of a Ford salesman criticizing Toyota cars. The criticism is pretextual and self-interested.

He shows no harm to patients nor to doctors. Yet, the remedies gets threatening. Educational grants by drug companies will be violating Federal anti-kickback statutes, and the False Claims Act. They risk fraud and abuse. How can these be avoided? Funnel pooled grants through agencies such as presumably his own, eliminating the competition to medical school CME activities from far more competent commercial providers.

Meanwhile, JAMA, that left wing propaganda organ, is filled with drug company advertising. No mention of that anywhere. JAMA also provides its own CME, and is a competitor to those it attacks.

Here. I am still looking for the disclosure statement of the conflicts of interest of Dr. Steinbrook, the Macy Foundation, and of JAMA.

Court Rules in Favor of the Lethal Injection

This ruling is in accordance with the Rent Seeking Theory of Appellate Decisions. Had the Court ruled otherwise, all executions would have stopped. That would have stopped the huge lawyer business of appealing death penalty convictions. Each murderer is worth a $ million to both sides of the death penalty.

Here is an alternative. Three strikes, and you're dead. One, two, three convictions for a violent crime, Sayonara. The main theory supporting that approach is that the deceased have a low rate of recidivism for violent crime. That approach would also end the dilemna of the high rate of death penalty convictions of innocent people, roughly 20%. Even if the death penalty gets applied to a person innocent of the third crime, he merits the penalty by the other two violent crimes. The count should start at the earliest age tolerable to the public. Fourteen, the demarcation of biological adulthood, carries a lot of logic. This ends the injurious career of vicious people before they have had a chance to commit their hundreds of crimes a year. This is a victim safety approach. Gangs would end by attrition.

The problem is that lawyers would have no customers left. But the current balance of terror maintained by the lawyer, especially oppressive to minorities, would shift from the victim to the violent predator.

Suit Opposes Denial of Off Label Prescribing by Medicare

Here.

The cancellation of a prescription by refusing to pay for it is the practice of medicine.

The Supreme court has held a half dozen times, clinical judgment has presumptive validity and requires deference.

There is interference with the contracts in effect between doctor and patient, CMS. That is an intentional tort. The contractor of Medicare should not have government immunity from such a claim.

Yale Clerks Correlate with Reversal of Judge Decisions on Appeal

Here. Comments by former students confirm the ideological use of the law taught at Yale Law School. It should lose its tax exempt status, and all its government funding should stop.

Review of Malpractice Maldistribution

Here, and here, by Ted Frank.

And by Eugene Volokh, here.

With regard to the lawyer statistics, including Volokh's statistical sophistry.

If 100% of the medmal plaintiff lawyers are responsible for the 75% failure rate of their weak cases, shouldn't they all lose their licenses? I like a three strikes law. Lose three, become a high school history teacher.

This is even better. To deter. Oppose corporatist tort reform, an ineffective lawyer Trojan horse. End all self-dealt lawyer and judge immunities. Then sue them personally into stopping their misconduct. All lawyers and judges carry massive insurance policies to make whole the victims of their lawyer carelessness. This includes the victims of a false verdict, breaching res judicata, as warranted. Classes get covered. So the 1000's of chemical workers losing their jobs after the company bankrupting false breast implant verdict get compensated for lost wages.

These lawyers sure have dozens of duties to the defendant, enumerated in the Rules of Conduct, Evidence, Civil and Criminal Procedure. These are formal statutory duties and settled Supreme Court holdings. Deter the self-dealing tort feasors.

Drug Company Support of Continuing Medical Education

The left has been on a campaign to end such support. The efforts get reviewed, here. These include self-regulation by companies, anti-kickback enforcement by the Justice Department. They further propose ending all commercial support, refusing to accredit any sponsored activity, allowing contributions only to central depositories, to be run by left wing ideologues and to plunder them, increasing disclosure requirements. The JAMA authors find the current situation, "... at best very troubling."

There is only thing missing. The fact of any harm shown either to patients, or to costs.

There are a couple of problems not discussed in the left biased JAMA.

1) These measures interfere with clinical judgment, and violate about 6 Supreme Court decisions holding for a presumption favoring clinical decisions. The most famous is Roe v Wade.

2) There is a racist component. No one cares about the use of brand medications for middle class white people. When it comes to minorities on the public insurance, doctors cannot be trusted to control themselves. They helplessly write for brand names after receiving a pen or a sandwich. This implies that minorities need only generic medications with troubling side effects, that could not get approved by the FDA with today's standards, that pet owners would refuse.

Valid Point: Every Penny of Health Costs Comes from Workers

Here. The employer gets his health insurance funds from the productivity of the workers, as does government. There is no shared responsibility. The rise of health costs faster than wages and productivity increases cannot be sustained.

There is one thing the article does not mention. Allowing workers to control their health expenditures entirely, instead of tyrannical government officials. Workers would then have a vested interest in pushing costs down. The biggest savings in health costs comes from improved health.

The Lawsuit is a Product

The lawsuit complaint is a product, like a toaster. It can thus be “defective.” Several features support this assertion.

1) The complaint is not a written expression protected by the First Amendment. It is a tool to make money. When a writing is a tool and not an expression, it becomes a product subject to standard of care. Aviation maps that were incorrect and resulted in a crash were deemed to be defective products (1).

Mushroom textbooks that caused poisoning resulting from error in the illustration were deemed to be expression and protected by the First Amendment (2). They were said to be like books about aviation maps, not the aviation map product itself. One does not peruse nor read a complaint to learn of the author’s feelings and ideas. The complaint is a tool that is used for an effect, as a map is used to find a landing strip.

2) The dictionary definition supports (3): “a thing produced by labor.”

3) The legal dictionary supports (4): “something that is distributed commercially for use or consumption that is usually 1) tangible personal property 2) the result of fabrication or processing and 3) an item that has passed through a chain of commercial distribution before ultimate use or consumption.”

4) The Supreme Court agrees it is manmade items (5). “... respondent's microorganism is the result of human ingenuity and research.” The lawsuit is similar to a weaponized virus and artificial microbes, originating in human manufacture and having similar effect.

5) Intellectual property law supports (6). One will likely not be able to copyright a lawsuit complaint, as one might a pantomime or a book. Once a lawsuit has been committed to paper or other medium, one may apply for an utility patent a lawsuit if the complaint has originality (7).

6) A patent is a legal filing similar to a lawsuit. A patent holder was sued for product liability for a faulty design. The appellate court threw the case out for policy reason to avoid discouraging the filing of patents. It indicated that a patent was not an expression protected by the First Amendment, as claimed by the defendant (8, 9). On the other hand, the placement of a trademark, without involvement in any aspect of production, led to liability for a defective gift umbrella (10).

7) The lawsuit is heavily advertised and solicited.

8) It is manufactured on a custom but mass basis, using a format similar to the chassis of a car, upon which custom requests of the customer are loaded.

9) It is portable and delivered.

10) It is for the purpose of increasing income of lawyers.

11) It is purchased by the plaintiff, and made the subject of a contract with the lawyer.

12) It is aimed at the defendant like a gun. As does a gun, it requires a license.

References

1. Brocklesby v. United States, 767 F.2d 1288, 1294-95 (9th Cir. 1985), cert. denied 474 U.S. 1101 (1986) (mushroom encyclopedia protected by First Amendment); Saloomey v. Jeppesen & Co., 707 F.2d 671, 676-77 (2d Cir. 1983); Aetna Casualty & Surety Co. v. Jeppesen & Co., 642 F.2d 339, 342-43 (9th Cir. 1981); Fluor Corp. v. Jeppesen & Co., 170 Cal. App. 3d 468, 475, 216 Cal. Rptr. 68, 71 (1985). http://www.hsba.org/HSBA/Legal_Research/Hawaii/sc/15263.cfm (travel guide did not have duty to warn huge Pacific surf of Hawaii could be dangerous)

2. Winter v. G.P. Putnam's Sons, 938 F.2d 1033, 1038 (9th Cir. 1991)

3. http://dictionary.reference.com/search?q=product

4. Black’s Law Dictionary, 7th Ed., West Group, St. Paul, MN. p. 1225.

5. Diamond v Chakrabarty, 447 U.S. 303, 100 S Ct 2204, 65 L Ed 2nd 144 (1980).
http://caselaw.lp.findlaw.com/scripts/printer_friendly.pl?page=us/447/303.html

6. http://www.copyright.gov/circs/circ1.html#wwp

7. 35 USCA Section (102). http://www4.law.cornell.edu/uscode/35/102.html

8. Principles reviewed in: http://www.autm.net/pubs/journal/92/liability92.html

9. Case decision: [still looking]

10. Kennedy v Guess, Inc., 806 N.E.2d 776 (Ind. 2004)

http://www.state.in.us/judiciary/opinions/archive/04210401.rts.html

Formula to Pass the MPRE

Here. The left side of the equation is always the distractor to snare the simp law student.

Lawyers in Self-Help

Nice. I wonder if any lawsuit will follow.

Indemnity Clause in Internet Terms of Service

This is what I will be watching in this case . Rommates.com may seek costs and consequential damages from its posters, after their signing the Terms of Service.

1) The indemnity clause is condemned by the UCC if between unequal parties.

2) Contracts of adhesion with a disparate parties is unconscionable per se, according to the UCC.

3) The indemnity clause represents free corporate liability insurance provided to the offeror, by the offeree, without disclosure of this effect.

4) Let's say the offeree has $100,000 in assets. Let's say, I could buy such a corporate liability insurance policy covering $100,000 of liability for $1000 a year. Then, the offeror has received a liability insurance equal to the assets of the offeree, and has been unjustly enriched by $1000 a year. That unjust enrichment should be disgorged in a class action lawsuit to retrieve the value of all the corporate liability insurance provided for free. Because this is insurance, it does not require that the offeror tried to collect on the liability coverage.

5) The provision of insurance by an unlicensed, unregulated offeree breaks the insurance laws of the state. The contract indemnity clause promises to perform an illegal act, unregulated, unapproved insurance.

Korean University Sues Yale

Here. I have always wondered about the $trillions in the endowments of top tier schools. These are Hate America indoctrination camps. Their law schools cause massive damage to our nation. The sedition peddled gets taxpayer subsidy. Why are they not targeted by the lawyer in massive class action claims? At the very least, they should all lose their tax exemptions.

A Brief Reply to the Question, What is Wrong with Torts Law?

From here.

1) It has a supernatural power as its core doctrine. The foreseeability of rare accidents element violates the Establishment Clause.

2) It relies on the gut feelings of twelve strangers off the street as a lie detector. OK. What about the wisdom of the crowd effect? No. The lawyer excludes that potential advantage by the automatic disqualification of anyone with knowledge. In 1250 AD, the jurors had walked the boundaries of the disputed land at the time of transfer of title. They knew the litigants for years.

3) Most cases are weak. These are economic growth wreckers. They deter business startups. They deter IPO's. They consume massive blocks of time of business leaders.

4) All the goals of torts are in failure. All safety enhancements stem from technology progress. No correlation between litigiousness and safety has been shown.

5) Whatever the masking ideology, they are punishment, revenge, and expressions of animus. As such, discovery in torts violates the Self-Incrimination Clause of the Fifth Amendment. The lawyers on the bench allow it so their profession may plunder all productive sectors. If making people whole were the purpose, Medicaid for the injured would suffice.

6) Whatever the advantages of torts, the lawyer profession has selflessly forsworn them. They are the sole group that have maintained a privity obstacle to a legal malpractice claim by the adverse third party. If the filing of a weak is legal malpractice, they are not getting the profession improving benefit of torts. This immunity privilege is unique and self-dealt.

7) Beyond legal malpractice, the tort lawsuit itself is a product, dangerous, and harmful in its ordinary intended use. It merits becoming a target of product liability, and fulfills all common law requirement for strict liability.

8) The process is corrupt. Paid off experts cancel each other out. The jury is left with likability of the parties as a basis of judgment. So, the trial is a Broadway production and a contest of fairy tales.

9) Judges and lawyers have dealt themselves absolute immunity for their ubiquitous incompetence. Self-help has full moral and intellectual justification. Only force and Army Airborne validates the torts judicial system.

10) The lawyer has implanted bunches of take backsies into the self-written, self-dealing rules, for any embarrassing error. Res judicata freezes all injustices and false results. So smokers save state Medicaids money, by their early and quick deaths. The entirety of the tobacco settlement should be returned to the tobacco companies, with interest. This return should, by statute, be passed on to the buyers in the form of lower tobacco prices. Silicone implants caused no harm. The fired workers from the bankrupted chemical company should get compensation from the outrageously incompetent court and its owner. If a financial relationship can be shown between the judge and the legal profession, jail all around. Res judicata should end by a Constitutional Amendment, as should all self-dealt immunities of the little caesars on the bench.

11) No one who has passed 1L should sit on a bench, in any legislative seat, or policy position in the Executive. Pass a law, as the felon is excluded now. After 1L, the indoctrination cannot be taken back. The person is lost. No judgment. Belief in supernatural doctrines. Self-deluded policy benefits of the torts system, really in utter failure. Accepts all self-dealt advantages of the lawyer profession. Blocks out the failure of government, totally under the charge of the lawyer. Deniers the devastation done by the lawyer, especially to minority populations. Accepts the discipline of a tyrannical but idiotic hierarchy.

Promotion of Off-Label Drugs

Here. It makes these points. Over half the scripts in the US are off label. The disparity between use and validated studies is greatest in psychiatry and in allergies.

JAMA is a biased, left wing, clinician bashing organ of the idiotic AMA. Here is what these left ideologues do not say.

1) The most scientific validation of medication prescribing is the good response of the individual patient. Shows placebo in a study helps half of patients and harms none. Show drug helps 1% of patients and harms 99%. The clinician's patient responds, and worsens after every attempt to stop the medication. The proven response rate is 100% in the on-off single case experiment.

2) Parametric studies validly apply to the greater population, if the random selection assumption has been faithfully maintained. It does not apply to clinical decision making, which has a binomial and Bayesian distribution.

3) Verispan and other prescribing tracking services define the standard of care the most reliably, far more validly than any artificially conducted study.

Both the FDA and the clinician bashing AMA should be enjoined to obey Supreme Court holdings in a half dozen decisions mandating deference to clinical decision making.

Alum: Yale Law Has Changed

And, not for the better. See the comments as well. Here.

Should a Remedy Have Mutuality?

They want to post medmal claims. The overwhelming majority of these lawsuits are weak and frivolous. So the complaints are lies, for the most part.

Here .

http://www.canada.com/ottawacitizen/news/story.html?id=446a7711-f015-422d-8fbc-2e38ac075667&k=68504

There should be a public database of horrible patients, of horrible lawyers, and horrible judges. These should then be boycotted, as this database idea implies.

Change the Number of All Appellate Court Seats to Even Numbers

1) An even number prevents decisions with a margin of one. Such close votes bring opprobrium on the court. Everyone feels robbed by a close call. It implies the question remains unsettled.

2) If the vote is tied, the lower court decision stands. The lower court most often obeys a prior decision of the higher court.

3) The number of people on appellate courts should markedly increase to legislature size. If these out of control judges will legislate from the bench, the larger number will bring the wisdom of the crowd, more diverse expertise, and greater legitimacy.

4) Exclude lawyers from all appellate benches. These are internal traitors to our nation. They serve only the interest of the criminal cult enterprise that is their profession.

No Laughing, This Is Not Funny.

Here.

North Carolina Underlawyered, Says Self-Dealing Cult Criminal

Here. The report.

Like all remedies, the number of lawyers
in a place has an underdose and an overdose.

All remedies are human experimentation.

They should be proven safe and effective
in pilot studies.

The dose response curve that includes the above
ineffective and dangerous ranges
should be provided by those proposing the remedy.

No such data are needed. The criminal cult enterprise
controls the three branches
of government and sees no need for data.

EBay Lessons for the Law

EBay has an internal legal system superior to that of the lawyer and government.

1. Contracts. If one does not keep one's promise on EBay, ratings warn others. The risk results in lower bids. If one fails to deliver several times, one may be excluded from this multi-billion dollar market. Fraudulent purchasers get excluded, as well as sellers. Small disputes get resolved by communication, and the fear of poor ratings. In contract law, only the biggest contracts get enforced by the law, because legal fees are not worth an action for under $10's of 1000's. Performance on EBay takes place in the overwhelming majority of cases. In the world of contract law, the rate of performance is unknown, and likely to be low.

2. Torts.

3. Evidence. In the law, one must produce an expert to testify to the value of a product, an opinion, a guess, a biased view paid for by the hiring attorney. On EBay, the selling price is a fact for the product, at that time. The price reflects the sincerest value of a worldwide market.