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The largest health care fraud settlement in history: Is it big enough?

George Lundberg, MD
Meds
August 18, 2012
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A law is a rule of conduct or action formally recognized as binding and enforced by a controlling authority. Law enforcement broadly refers to any system by which some members of society act in an organized manner to promote adherence to the law by discovering and punishing persons who violate the rules governing that society.

The purposes of punishment for crimes include:

1. Punishment will stop them from committing further crimes.
2. Punishment tells the victim that society disapproves of the harm that he or she has suffered.
3. Punishment discourages others from doing the same thing.
4. Punishment protects society from dangerous or dishonest people.

But what if the alleged crimes are committed by corporations?

Do you believe that? Of course not. No corporations commit crimes. Human beings within corporations commit crimes.

Case at point: According to the U.S. Justice Department, GlaxoSmithKline LLC has agreed to plead guilty and to pay $3 billion to resolve liabilities arising from (a) the company’s unlawful promotion of certain prescription drugs for uses not approved by the FDA, (b) its failure to report certain safety data, and (c) its civil liability for alleged false price reporting practices.

This resolution is the largest healthcare fraud settlement in U.S. history and the largest payment ever by a drug company.

The Associated Press has reported that the improper marketing to doctors included expensive resort vacations, European hunting trips, high-paid speaking tours, and even tickets to a Madonna concert.

Did the punishment fit the crime and meet the purposes described above? I don’t think so.

The problems include:

1. The penalty sounds like a lot of money but that company made probably 10 times that much from its illegal actions.
2. This report sounds like a broken record, same bad behavior, different companies, same fines.
3. Companies like this with new leaders (the old guilty ones already took the money and ran free) just keep playing the same broken record, and the fines are nothing more than the “cost of doing business,” money regained by pricing practices.
4. The myriad docs who took the bribes also run free.

It is the recidivism of this whole industry behavior pattern that makes a cruel joke of Eric Holder’s (and his predecessors) Justice Department’s non-prosecutorial actions.

It seems to me that something like Racketeer Influenced and Corrupt Organizations (RICO) laws are going to have to be applied to the people who make these corporate decisions if the country really wants to change bad corporate behavior.

And not only for Big Pharmas.

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One time Alabama Governor and third party Presidential candidate George Wallace, himself a lawyer and one time judge, when discussing appropriate punishment for certain particularly egregious crimes, used to say that the jail was too good a place for certain criminals; they should be placed “under the jail.”

How about trying that kind of punishment for some guilty CEOs, Board Chairs, COOs and CFOs?

I’ll bet that would improve behavior really fast.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

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The largest health care fraud settlement in history: Is it big enough?
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