Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks
fortune.com
fortune.com
True, but it's not like if they did, the situation would be that much better. In a way for them they screwed up because the actually didn't bother playing the bribery sham all the way through like say political candidates do. For example, Hillary Clinton made $3M from speeches to large banks in just 2 years: https://theintercept.com/2016/01/08/hillary-clinton-earned-m... but they were actually organized enough to have "speechs". I remember the transcript of one was leaked, and you'd think they'd be some really deep insights and strategy laid out for the future that's worth $600k. But it was mostly "you all great, thanks for creating jobs etc etc". It is legal of course, but everyone know what it really is.
[1] https://www.salon.com/2013/07/17/the_buckraking_practices_of...
https://www.opendoctor.io/opioid/highest/?hn=1
From article, John Couch and Xiulu Ruan are on top of the list.
I have multiple herniated cervical disks and am going in for surgery soon because the pain is debilitating and unbearable. Among other specialists, I saw a pain management doctor to understand my non-surgical options. Many people with my condition choose to not get implants or disk fusions and instead opt for steroids, epidurals, and opioids.
Legitimate doctors at pain management clinics will rank high on these lists if they have a lot of really sick patients who don't want neurosurgery.
But then again, I don't think it is any of my business what other adults want to put into their own bodies, so even if some doc office were a pill mill I wouldn't care.
[1] Here's one off the top of my head: https://www.painnewsnetwork.org/stories/2017/12/28/tennant-p...).
[2] https://www.painnewsnetwork.org/stories/2017/9/4/how-chronic...
http://nymag.com/daily/intelligencer/2014/02/rise-and-fall-o...
>You in effect sold your medical license to a pharmaceutical company
The DEA should have nothing to do with this. Treating doctors like potential drug dealers is going to make them extremely anxious about prescribing any kind of drug with high abuse potential. They invested hundreds of thousands of dollars and years of their life on their medical license and residency programs; do you think they're going to risk it with the threat of the DEA busting them? The DEA getting involved is going to directly harm patients with chronic pain (opioid users) and people with ADHD (amphetamine users).
A not-so-bright outlook for actually holding Insys's CEO responsible. Why were charges not brought on middle level employees especially if the father-son relationship could be an easy access route to bribery.
EDIT: Even the court document does not list is full name, Rosenberg's son is simply referred to as Insys Rep A.R.
Perhaps this isn't true, but it certainly seems like it based on the events I've come across in my life, and in the news.
The thing where decade plus sentences are fairly common is unique in the first world: only in America. It’s barbaric and embarrassing.
The science is pretty unambiguous—a high likelihood of being caught and punished is a better deterrent than a low-probability but larger punishment.
So I don’t want to see this doctor get a 40-year sentence. I’d rather see lots of doctors who accepted gifts from opioid manufacturers get one-year sentences. Most important is that the pharma executives go to jail, too.
Criminal justice should never be about retribution. In this case, the purpose is to keep future patients safe.
He’s essentially already retired now.
I mean doctors in particular, but other high income earners in professional areas as well.
It sounds so foolish when people so close to retirement take undue risks and ruin it all at the end.
Greed can be a dangerous bait at times.
And the street dealers’ customers know full well that they’re buying a very addictive substance which is not medically indicated.
You're forgetting the large number of non-addictive substances that carry long sentences.
In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically:
> When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size.
I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported.
I’m not defending the doctor but the point being made doesn’t apply.
What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.
This is the exact kind of emotional thinking that makes it so easy to jack up sentencing to an unreasonable degree. It's why we spent so many millennia of human history insensitive to the torture and abuse of our fellow man so long as he could be labeled a criminal.
First, you're comparing a single doctor's sentence to the entirety of the misery caused by a crisis caused by many, many people and systems.
Second, what makes you think four years isn't a deterrent? Maybe it is, maybe it isn't, but we should be using evidence to decide that, not knee-jerk emotional reactions.
One's subjective feeling of deterrence is strongly influenced by one's natural subconscious desire for mob revenge. Cultural change away from mob revenge starts with changing the dialogue.
The cost to society is roughly linear in the number of years behind bars, and the deterrent factor gets dramatically sub-linear pretty quickly as number of years behind bars increases. That money spent on guards, etc. and opportunity cost (including lost taxable income) of having a potentially productive member of society behind bars are better spent on better monitoring and other measures that increase the likelihood that offenders are prosecuted. Increasing publicity of convictions would presumably also be a pretty cheap way to reduce crime by increasing the perceived chances of getting caught.
I would really like to see it be a common thing for criminals to cut plea deals including recording public service announcements publicizing that they got caught. Though, this would also probably make it harder for reformed ex-convicts to escape their pasts.
It is the abuse of a position of trust that aggravates this crime relative to that of a simple outlaw street dealer.
Commenters who are concerned with the effect on the convict's reputation and future employability are simply not in touch with reality....this was a grave breach of the basic ethics of the medical profession and seriously harmed the innocent patients involved. There is no return to work after something like this...any more than with a scientist who falsifies data, a teacher who sleeps with minor students, a lawyer who steals from escrow, etc.
I find it highly disturbing that there is more discussion in this thread as to the effect on the doctor's return on investment from his medical degree rather than on the individuals who bodies were damaged by someone they were supposed to be able to trust.
What point is there in discussing the so-obvious-it-goes-without-saying good-bad polarity of this situation? If we myopically give in to our emotions, rather than dispassionately examine the best course of action, then we'll miss an opportunity to improve the system and deter future incidents.
Stated another way, by attempting to redirect the course of this conversation, you are saying that virtue signaling by pitying current victims and demonizing the perp is more important than preventing future victims. If anything is highly disturbing, it's that.
A minimum wage fast food worker is constantly observed by a phalanx of cameras that will incriminate her should she attempt to steal five dollars from the till, but a surgeon in an operating room performs an infinitely more consequential task with nary a recording device in sight. Why? The immense trust and responsibility invested by society in medical doctors.
There is a common misconception that a medical license is basically just a reward for a demonstration of technical mastery, much as a developer job flows from passing a coding interview. But in reality the technical aspect is only secondary; the primary purpose of all those years of training is to ensure that the student understands the fullness of the obligations associated with the profession and is properly disposed to accept them.
In a case like this, the person understood and accepted those grave obligations, as well as all the privileges that came with them, only to toss them out the window when the opportunity arose to make a few extra dollars. That is what is being punished here. Four years is hardly too long, or cruelly retributive.
So yes, I stand by my claim that the original poster's point was an emotional reaction.
Had koolba instead said something like, "An adequate deterrent should be in proportion to the crime committed, and I believe 4 years in prison falls below that standard for reasons X, Y, and Z," then I would not have called that a knee-jerk emotional reaction. But he didn't.
What do you know? Do tell.
2 different opinions, neither sourced nor backed by data.
Of course, the only reason you can make millions of dollars illegally at this racket is because it's illegal in the first place, so never mind. Drug laws cause far more harm to society than the drugs themselves ever could. Any argument to the contrary can trivially be resolved to a special-pleading fallacy.
Is it possible he has enough cash hidden away to make this all worthwhile? Yes, but I'd bet against it.
http://pricetheory.uchicago.edu/levitt/Papers/LevittVenkates...
It suggests that $10 million of profit would be quite the success.
Prison sentences for dealing hard drugs should be in line with prison sentences for murder, otherwise the implication is that the lives of drug users are much less valuable than the lives of regular people.
In much the same sense as people who sell cigarettes do; perhaps we should, therefore, have life without parole for convenience store clerks.
Fourth stage cancer patients are now having a hard time getting them. Chronic pain patients that have been stable for decades are being heartlessly dropped by doctors that now fear the DEA. We are turning our backs as a society on the most vulnerable among us.
As if the US government agencies would ever let that happen. They seem to favor a "shock 'em straight" approach that's utterly ineffective.
BUT then you might face state charges for possession if the DA wants to bother.
Doctor: 4
Executive: .4
Also the doc loses his license and every single penny he has, between lawyers, years without being able to make a penny, and court fines. When you make a certain amount of money the trend is to live up to it: mortgages, fancy cars, club memberships, schools for kids and so on. When the money stops coming in, guess what happens?
You drop to the status of a boring working person who never took kickbacks to sell opiates? A fate worse than death, I guess.
The street dealer is also not likely to get 4 years. That's the point - 40 years was a number picked to illustrate a sentencing discrepancy argument. The fact that a 10x factor seems almost reasonable is the argument.
> a street dealer doesn't have 400 kilos of coke
What do you think Resenberg's prescriptions added up to, by weight? It's probably not fair to compare a street dealer to him.
Yeah, they don't look favourable upon those sorts of quantities.
Fortunately I only got caught with about five days worth of merchandise.
People suffer from relative poverty, so that would be pretty bad.
He's getting both. And he's losing everything: money, status, possibly family, ability to get another decent job... So he might rather do 10 years in jail but return to what it had before.
Are they? Those others knowingly and voluntarily took those drugs.
Edit: I can buy a damn gun when I'm 18, but have to be 21 to drink beer and will never be allowed to buy LSD which is pretty safe and not addictive. WTF?! I blame religion and Puritan nut jobs.
Bottom line is there are two people who I see who don't want to get clean: 1) the people that will never accept responsibility and want to blame everyone else for their problems. 2) the people who really don't have a desire or want to get clean. At least the second group is being honest with themselves and everyone else.
The smugness of people against Trump is even more worse than the smugness people had against George W.
They're not idiots. They're sharks who have a very clear aptitude at manipulating people and public perception. It's very bad strategy, and very human, to ascribe to your opponents victories as "luck" and to ascribe their mentality as "dumb".
W had a superficial dumbness that was largely cultivated. Beneath that he had at least a basic understanding of the issues.
You're taking his bait superbly by thinking that the truth wins you the game of democracy. To call him "dumb" is to severely underestimate the strategies potential president have used in their rise to power. Or in other words, did calling him an idiot get your side any concessions, any retaken ground?
Instead of taking Trump's bait, I'd highly recommend reading Robert Caro's books on Lyndon B. Johnson. You'll never look at politics the same way again.
Of course his dumbness has appeal. That’s why he won. That doesn’t mean he’s not an idiot.
I told you to read Robert Caro's series on Lyndon B.Johnson because it opens your eyes to the political process. Do you think Johnson campaigned as a Roosevelt man because he liked Roosevelt? Hell no, he was an opportunist.
Who will tell him though?
Didn't we declare a "War on Drugs", so that would make drug dealers enemy combatants and subject to tribunals and gitmo.
I should have been Alito.
He'd make a bloody awful King, by any measure. It's bad enough that he's a President.
> ... [his] son was an Insys sales representative for a year and made “substantial commissions” from his father’s willingness to prescribe the drug, according to prosecutors. The son wasn’t charged in the case.
Oh, gee, it's Purdue Pharma again, i.e. the Sackler family. How am I not surprised, and how are they not fined?
But bribes and kickbacks to doctors from big pharma are common for all top-selling drugs.