by Dr. Joseph Mercola
Dishonesty and fraud in the health care system,
including its academic and research communities, are
significant barriers to the implementation of
universal health coverage, yet this corruption is
rarely if ever discussed, let alone addressed in any
The less transparent a health system is, the more
corrupt it becomes. Weak adherence to the rule of
law and few accountability mechanisms further invite
corruption and, with it, health system performance,
quality and efficiency plummet
The amount of corruption found in any given system
is dependent on three variables:
monopoly on the supply of a product or service
the level of discretion enjoyed by suppliers
the supplier's accountability to others
Three factors governing the engagement in corrupt
practices in the health care system are:
being in a position of power
financial, peer and/or personal pressures
cultural acceptance of corruption
In order for anticorruption measures to succeed,
these three factors all need to be addressed
Drug research is beset by an astoundingly high
incidence rate of scientific misconduct, with 72% of
retracted drug studies being retracted due to things
like data falsification, fabrication, unethical
conduct and plagiarism
Investigations assessing the prevalence of scientific fraud and/or
its impact show the problem is widespread and serious, to the point
of making most of "science-based" medicine a genuine
Conflict of interest is
another pervasive problem that threatens the integrity and
believability of most studies.
We've been repeatedly faced with study findings that are clearly
tainted with industry bias.
For example, a 2014 study
1,2,3 funded by the American Beverage Association
purported to have found that diet soda makes you lose more weight
than drinking no soda at all.
Its findings blatantly contradicted a massive body of research
artificial sweeteners disrupt your body's
metabolism and lead to greater weight gain than regular sugar.
Scientific Fraud Has
Another example is
Dr. Don Poldermans' fraudulent
beta blocker study, which is
suspected of having led to the deaths of as many as 800,000
I wrote about this
scandal in "Beta
Blockers Killed 800,000 in 5 Years - Good Medicine or Mass Murder?"
paper had a profound influence as it served as the basis for
establishing the use of
beta blockers in noncardiac surgery patients
as "standard of care." 4
Poldermans - who
was fired for scientific misconduct in 2011 - was also the chairman
of the committee that drafted that guideline.
This case is a
sobering example demonstrating the need for maintaining strict
scientific integrity, and why the issue of conflicts of interest
really needs to be more widely understood and addressed.
Sadly, there are
enough cases like this to fill several books.
misconduct can have a very real impact on your health, or someone
you love, as doctors routinely use published research to implement
or alter treatment protocols.
As noted in a 2012
paper in the American Journal of Medicine: 6
"Recent allegations of fraud
committed by one of the most prolific researchers in
perioperative medicine, Don Poldermans, have left many
clinicians in a state of disbelief...
The effects of fraud in
perioperative medicine are particularly caustic owing to a
profound domino effect. Many investigators devoted their
academic careers to following the footsteps of investigators
such as Poldermans.
Similarly, funding agencies
supported this line of enquiry, incurring significant cost and
Most importantly, hundreds of patients were exposed to
treatments that may have been harmful in an effort to advance
this research agenda...
Because research misconduct in
perioperative medicine can be so damaging, we present strategies
to prevent such events in the future. Without such reform, fraud
in research may very well continue.
The price for such
misconduct is simply too great to pay."
Conflicts of Interest
Threaten Public Health
conflicts of interest are present at all levels, including our most
prestigious public health agencies, as discussed in my November 19,
2019, article, "CDC
Petitioned to Stop Lying about Pharma Funds."
While the U.S.
Centers for Disease Control and Prevention has long fostered the
perception of independence, claiming it does not accept funding from
the agency has in fact made itself beholden to the drug industry by
accepting millions in corporate donations through its
government-chartered foundation, the CDC Foundation, which funnels
those contributions to
the CDC after deducting a fee.8
groups, including the,
U.S. Right to Know (USRTK)
Knowledge Ecology International
on Government Oversight,
...recently filed a petition,
9 urging the CDC to cease making these false
According to the
the CDC accepted $79.6 million
from drug companies and commercial
manufacturers between 2014 and 2018 alone.
Since its inception in
1995, the CDC Foundation has accepted $161 million from private
The CDC is supposed
to be a public health watchdog. It has tremendous credibility within
the medical community, and part of this credibility hinges on the
idea that it's free of industry bias and conflicts of interest.
By accepting money
from drug companies and
vaccine makers, one has to wonder whether
that money might be having an impact on the agency's health
recommendations, as investigations have repeatedly and consistently
shown that funding plays an enormous role in decision-making and
Corruption in Global
Health Is an Open Secret
In a December 7,
2019, article (Corruption
in Global Health - The Open Secret) 12
in The Lancet, Dr.
Patricia Garcia Funegra - affiliate
professor of global health at
Cayetano Heredia University in
Lima-Peru and a former minister of health
13 - points out that,
embedded in health systems..."
In it, she argues
that dishonesty and fraud in the health care system as a whole,
including its academic and research communities is,
"one of the
most important barriers to implementing universal health
corruption is rarely if ever discussed, let alone addressed in any
"Policy makers, researchers, and
funders need to think about corruption as an important area of
research in the same way we think about diseases. If we are
really aiming to achieve the Sustainable Development Goals and
ensure healthy lives for all, corruption in global health must
no longer be an open secret,"
Garcia writes. 14
"Corruption is an open secret
known around the world that is systemic and spreading. Over
two-thirds of countries are considered endemically corrupt
according to Transparency International...
Corruption in the health sector is
more dangerous than in any other sector because it is literally
It is estimated that, each year,
takes the lives of at least 140,000 children
undermines all of our efforts to
control communicable and non-communicable diseases
Corruption is an ignored
Corruption Is a Cancer
In her paper,
Garcia summarizes the history of corruption, how it got started and
what allows it to spread.
As a general
commonsense rule, the less transparent a health system is, the more
corrupt it becomes.
Weak adherence to
the rule of law and few accountability mechanisms further invite
corruption into its midst and, with it, health system performance,
quality and efficiency plummet.
"It is estimated that the world
spends more than US$7 trillion on health services, and that at
least 10-25% of global spending is lost directly through
corruption, representing hundreds of billions of dollars lost
These billions lost to corruption
WHO's estimations of the amount needed annually to fill
the gap in assuring universal health coverage globally by 2030.
However, the true cost of
corruption for people is impossible to quantify because it can
mean the difference between wellness and illness, and life and
death," Garcia writes.
3 Variables That
research showing the amount of corruption found in any given system
is dependent on three variables:
(M) on the supply of a product or service
of discretion (D) enjoyed by suppliers
supplier's accountability (A) to others
The amount of
corruption (C) can thus be expressed as:
C = M + D – A
"This equation shows that the
more concentrated a supply of a good or service is, the
higher the discretionary power of those that control the
supply is, and the lower their accountability to others is;
therefore the amount of corruption will be higher,"
"Unfortunately, these are the
characteristics of health systems.
The complexity of the system,
high public spending, market uncertainty, information
asymmetry, and the presence of many actors (i.e.,
regulators, payers, providers, consumers and suppliers)
interact at different levels, increasing susceptibility to
presents itself in a variety of ways.
theft, embezzlement, nepotism, the exertion of undue influence,
favoritism, medical services done for financial gain rather than
medical necessity, kickbacks, price inflation, manipulation of data
and fraudulent billing are all examples given by Garcia.
and misconduct also belong on this list.
As detailed in "Why
Your Doctor's Advice May Be Fatally Flawed," drug research is
beset by an astoundingly high incidence rate of scientific
misconduct, with 72% of retracted drug studies being retracted due
to things like data falsification, fabrication, unethical conduct
and plagiarism. 16,17
Only 28% of
retracted drug studies were retracted due to actual errors.
also has a severe replication problem, with a vast majority of
studies being impossible to replicate.
How Can We Control
Corruption can be
controlled, but it requires both good governance and a change in
social norms, which can be difficult to achieve.
theorize that if institutions were strong, people wouldn't even
be tempted to participate in corruption.
The second group of theories,
those concerning the way that people think, focus on the way
people process rule breaking or an individual's decision to
engage in corruption.
This process can be represented by
the following equation:
+ pp (Ccrim + Csoc) + Cfav
In this equation,
the perceived benefit of an act of corruption
psychological costs, pp the perceived probability
Csoc the social
costs to the individual
Cfav the costs
of doing the corrupt act
From this equation, a corrupt act
is more likely to happen if the perceived benefit (Bp)
is higher than the sum of the psychological costs (or how the
person will feel, which has to do with their personal values),
the perceived probability of the criminal costs and social costs
to the individual (which has to do with social norms), and the
costs of doing the corrupt act (how easy or difficult it would
This theory highlights the
importance of social norms. Experts agree that the two theories
converge because social norms are assured through institutions.
The challenge is how can strong
institutions be created, and how can social norms be changed, to
3 Factors That Govern
She also cites
research suggesting the three factors governing the engagement in
corrupt practices in the health care system are:
Being in a
position of power - Systems with poor oversight invite abuse
peer and/or personal pressures
acceptance of corruption
In order for
anticorruption measures to succeed, these three factors all need to
measures suggested by experts include the following:
incentives to reward good performance and sanctioning poor
transparency (active disclosure of how decisions are made
and performance measures)
involvement and providing a platform for citizen feedback
enforcement by law enforcement
conflicts of interest
policies and processes for investigations and the
penalization of corrupt acts
platforms for active surveillance
The use of
data mining and
pattern recognition to identify fraud
or abuse profiles
Still, Garcia notes that
when searching the academic literature, she found,
"an absence of
evidence on what works to reduce corruption in the health
sector," and there's no data showing how well any of these
measures actually work.
"There are already several authors who have highlighted open
research questions that need to be addressed: we need to start
working on them," she says.
"We can start by
designing and testing anti-corruption interventions for the
health sector, for global health. We could start from the bottom
up, taking small steps.
We need rigorous research methods to prove or disprove that a
Addressing and ending
corruption will require the participation of researchers from
several disciplines and multiple approaches, and the commitment
of funders to supporting serious research.
Corruption in global
health should not continue as an open secret, it has to be
confronted and brought to light."
For all the scientific breakthroughs we've been gifted with over the
past century, modern medicine still leaves an awful lot to be
desired, and the corruption permeating the whole system is one of
the primary reasons for why it delivers such abysmal results.
In her book, "Death by Modern Medicine," 20 Dr.
Carolyn Dean talks about how, for well over a century, the
treatment of symptoms with drugs has dominated the definition of
It's a deliberately
schemed and manipulated paradigm that's been packaged and sold
industry's (including Medicare's and Medicaid's) methodology
for payment, which doesn't recognize nutritional care or
proven naturopathic approaches to health care
Direct-to-consumer drug advertising
physicians and other health care providers through gifts,
honoraria for speaking engagements, and financial support
for training programs, which is simply another form of
PhRMA - a leading biopharmaceutical trade group - and
individual drug makers
The end result is a
sickness industry that kills an enormous amount of people each year.
In 2000, Dr. Barbara
Starfield published a paper 21 showing 225,000 Americans die each
year from iatrogenic causes, ,
their death is caused by a
physician's activity, manner or therapy...
I read her article in the print in the July 2000 copy of JAMA and
from it created the viral meme that took off, yet has rarely been
attributed to me, that
doctors were the third leading cause of
herself died from a medical error over 10 years later, when she
suffered a lethal reaction to an inappropriate antiplatelet drug.
Remarkably, matters have not improved one whit since then.
Research 22 published in
2013 estimated that preventable hospital errors kill 210,000
Americans each year, and a 2016 study 23 published in the BMJ
estimated that medical errors kill 250,000 Americans each year.
That's an annual increase of about 25,000 people from Starfield's
estimates, and these numbers may still be vastly underestimated, as
deaths occurring at home or in nursing homes were not included.
Indeed, when they included deaths related to diagnostic errors,
errors of omission and failure to follow guidelines, the number of
preventable hospital deaths skyrocketed to 440,000 per year, which
begins to hint at the true enormity of the problem.
Procedures and Treatments Are Unnecessary
Overtesting and overtreatment are part of the problem and corruption
plays a role here as well.
Instead of dissuading
patients from unnecessary or questionable interventions, the system
rewards waste and incentivizes disease over health.
According to a PLOS ONE
report 24 published in 2017, 20.6% of all medical care is
The top three most
commonly cited reasons by doctors for overtreatment were:
accessing medical records (38.2%)
A majority of respondents
(70.8%) also agreed that unnecessary procedures are more likely to
be performed when the doctor profits from them, and,
believed that de-emphasizing fee-for-service physician
compensation would reduce health care utilization and costs."
To learn which tests and
interventions may do more harm than good, browse through the
Choosing Wisely website. 25
Good Judgment in an Era of Conflicting Interests
Ultimately, the take-home message here is that even if a drug or
treatment is "backed by science," this does not guarantee that it's
safe or effective.
Likewise, if an
alternative treatment has not been published in a medical journal,
it does not mean it is unsafe or ineffective.
On the whole, modern medicine grossly undervalues and often flat out
ignores the influence of diet and lifestyle factors such as sleep,
exercise, time-restricted eating and exposures to the sun and nature
(which are beneficial) and electromagnetic fields and toxins (which
This is why it's crucial to have a philosophical framework to assist
you in evaluating health and medical recommendations.
Consider the funding and
look for evidence of replication and the building of consensus
Anytime you're trying
to address a health issue, make full use of all the resources
available to you, including your own sense of common sense and
Since it is well
established that most drugs do absolutely nothing to treat the
cause of disease, it would be prudent to exercise the
precautionary principle when evaluating a new drug claim, as it
is likely to be flawed, biased or worse.
Also, if you're facing a health challenge, seeing a competent
conventional physician to rule out a serious condition is just
It would be in your
best interest to also identify a qualified natural health
consultant, someone who really understands health at a
foundational level, to make sure you're addressing the root of
Sources and References
1 - Obesity
2 - CNN
May 27, 2014
3 - NPR
May 28, 2014
4 - European
Heart Journal (2009) 30, 2769–2812
5 - Forbes
November 23, 2011
6 - American
Journal of Medicine 2012 Oct;125(10):953-5
7 - CDC.gov
Petition to the CDC, November 5, 2019 (PDF), Page 3
9 - USRTK
Petition to the CDC, November 5, 2019 (PDF)
10 - USRTK
November 5, 2019
Lancet December 7, 2019; 394(1014): 2119-2124
13 - Department
of Global Health, Patricia Garcia
14 - The
Lancet December 7, 2019; 394(1014): 2119-2124, Summary
16 - Pharmacotherapy
17 - Newswise
May 29, 2012
18 - The
Lancet December 7, 2019; 394(1014): 2119-2124,
19 - The
Lancet December 7, 2019; 394(1014): 2119-2124,
Corruption Control, and Research in Anti-Corruption
Measures in Global Health in the Real World
20 - Amazon.com,
Death by Modern Medicine by Dr. Carolyn Dean
21 - JAMA
July 26, 2000; 284(4): 483-485 (PDF)
22 - Journal
of Patient Safety September 2013: 9(3); 122-128
23 - BMJ
24 - PLOS
ONE 2017; 12(9): e0181970
25 - Choosingwisely.org