Patrick vetoes raise questions

What is Deval Patrick is thinking  these days? Other than his campaigning for President Obama, of course.   At issue are the Governor’s support of loosening a ban on gifts to doctors from pharmaceutical companies and medical device manufacturers and his move to veto legislative reforms of the use of welfare debit cards.

Big pharma has long plied doctors with goodies to spur interest in their products.  Such marketing – from advertising to entertainment, “educational seminars,” paid trips and meals –  gets reflected in the costs of drugs and ideally should play little to no part in a doctor’s decision to prescribe one drug or another.  One would hope that no doctor would  automatically  be corrupted by being entertained by a drug manufacturer.  But, according to American Prospect,  there’s increasing evidence that the marketing practice “may be guiding the pen across the prescription pad.”

Also, appearance counts when medical decisions seem to hinge on pharmaceutical industry perks.  That, in turn, affects the doctor-patient relationship. The resulting breach of trust is why a bunch of medical students, interns and residents pushed for the ban, which has been on the books in Massachusetts since 2008. The PharmFree Campaign wants prescription decisions to be evidence-based, free of conflicts of interest. And isn’t that what we all would benefit from? 

The Governor is quoted as saying he favored a less strict version that is preferred, on a voluntary basis,  by the American Medical Society and pharmaceutical manufacturers trade association.  But, if using a national standard were the standard for developing Massachusetts policies and programs, this state would never have passed Romneycare or any number of environmental or consumer protections.  If the meals and entertainment allowed under those voluntary national standards are truly modest, as Harvard medical student David Tian is quoted in the Globe, “then doctors shouldn’t have trouble paying for these meals themselves.”

The Governor’s behavior is also puzzing when it comes to vetoing new controls on EBT (Electronic Benefits Transfer) cards used by welfare recipients. On a bipartisan basis, the legislature passed a reform barring the use of the card in buying guns, pornography, tattoos, jewelry and manicures.  The Governor agreed the cards shouldn’t be able to be used in certain stores, like gun shops, tattoo parlors, strip clubs and adult entertainment centers, but he didn’t want to ban the specific products involved from being paid for with taxpayer money.  This, when the program already bars specific products like cigarettes, alcohol and lottery tickets.

So, if I understand it correctly, taxpayer dollars couldn’t be spent in a gun store, but the welfare recipient could buy a gun at Walmart.  He also didn’t want recipients to be barred from getting manicures or buying jewelry.  Now, I’m very partial to getting manicures, but I can’t with a straight face say that they are a necessity of life. No wonder working folks (and isn’t that most of us?) are disenchanted with government. 

I guess the Governor would put my reaction in the same category as his assessment of the legislature, whom he accused of grandstanding.   (Speaker DeLeo was quite reserved in expressing his “disappointment” in the Governor’s language.)  I don’t think so.

The Department of Health and Human Services says welfare is for basic needs, “survival level resources including food, housing, material goods, transportation and temporary financial assistance for low and fixed-income, indigent or elderly people or people with disabilities who are otherwise unable to adequately provide for themselves and their families.” That doesn’t include manicures, tattoos, guns and the like, no matter where they are sold or provided.  It offends me that the Governor thinks otherwise.

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