Drug firms release payment information

Excerpted from “Drug and device firms paid $3.5B to care providers,” Associated Press. September 30, 2014 — Drug and medical device companies paid doctors and leading hospitals billions of dollars last year, the government disclosed Tuesday in a new effort to spotlight potential ethical conflicts in medicine. The value of industry payments and other financial benefits totaled nearly $3.5 billion in the five-month period from August through December 2013, according to the Centers for Medicare and Medicaid Services, which released the data.

It's part of a new initiative called Open Payments, required by President Barack Obama's healthcare law. It was intended to allow patients to easily look up their own doctors online, but that functionality isn't fully developed. In future years, the information will cover a full 12 months and will be easier to search, officials said.

Consumer groups said it's a step toward much-needed transparency. But doctors and industry said the government rushed to release the data, and they raised questions about accuracy and lack of context.

The American Medical Association said it remains "very concerned" about release of the payments file, adding that the data may contain inaccuracies and lacks context to help the average person evaluate the information. Consumer groups say disclosure is overdue. "Research has shown over and over that these financial relationships influence doctors, even a meal," said John Santa, medical director for health projects with Consumers Union. "Studies also show that doctors believe it does not affect them, but strongly believe it affects other doctors."

Commentary

CMDA Member John Dunlop, MD: “Wow! $3.58 billion spent by pharmaceutical and device manufactures to directly influence physician choice is an impressive amount. I naively thought that these payments and gifts went out with the free lunches and logos on pens several years ago. It appears that those restrictions do not have much substance and thus the potential for ethical abuse persists as a real threat. The number comes from the website “Open Payments,” a project of Obamacare intended to bring accountability to the heretofore undisclosed inducements given by industry to practicing physicians. It should be noted, however, that just two days after this article was released, another article pointed out many potential flaws in this data.

“As Christians, when faced with the possibility of receiving incentives from industry, we must remind ourselves that our primary responsibility is not to make money but to provide the best, compassionate and cost effective care to our patients. In Proverbs 19:6, Scripture warns that receiving gifts influences our behavior, and this may be true even when those gifts do not obligate the recipient to prescribe the products involved.

“The CMDA Ethics Statement on Doctor & Pharmaceutical/Medical Device Industry Relationships states the ethical principle: ‘Doctors should consider carefully the basis of their therapeutic decisions to assure that they are made in accordance with best possible evidence applied to the welfare of the patient. Personal gain must never be the compelling reason for our decisions. Incentives from industry, intended to influence therapeutic choices, can compromise doctor integrity and behavior.’”

Resources

Christian Physician’s Oath
Doctor & Pharmaceutical/Medical Device Industry Relationships Ethics Statement
Professionalism in Peril - Part 3: Professional Adultery

Congress eyes charitable giving

Excerpted from "Protect giving: A chance for real bipartisanship," commentary by Vikki Spruill in The Hill, September 15, 2014 - Foundations and charities face a pivotal moment. In July, the U.S. House of Representatives passed the America Gives More Act (H.R. 4719) with a bipartisan vote of 277 to 130. Now it needs to pass the Senate. It will give individuals and private foundations the certainty that allows for more charitable giving.

The America Gives More Act makes permanent three important provisions that have been part of the “extenders package” for a number of years. Though they are proven to increase giving and have broad bipartisan support, it’s become the norm for Congress to allow these provisions to expire, then retroactively reinstate them. This inconsistency from Congress leaves donors uncertain of how much they can contribute.

The bill addresses this uncertainty in three key areas:

• Gifts from IRA distributions (referred to as the “IRA charitable rollover”) where generous donors are directing their mandatory distributions directly to charity.
• Gifts of property, specifically conservation easements, which are complicated transactions that can take more than a year to plan and execute.
• Gifts of food inventory, which are often perishable and so demand quick action.

The strong bipartisan alignment around this bill is rare these days in Washington. The vote in the House showed that both Democrats and Republicans understand the importance of supporting charitable giving. Still, this uncommon consensus is at risk of being undermined by Washington gridlock.

Commentary

CMA VP for Government Relations Jonathan Imbody: “In dozens of visits focused on this topic with Congressional leaders and their staff, I have been impressed with a bipartisan, general commitment to charitable giving. Still, the temptation for our deficit-spending Government to tap into new revenue sources is great, and the potential remains for Congress to unwittingly trim giving by fiddling with charity incentives and protections in the tax code.

“Why would Congress take steps that would make fewer Americans able to deduct charitable gifts, or subject givers to stingier limits on how much they give? Don't lawmakers realize that charities provide billions in social services—such as through faith-based medical and dental clinics that care for needy patients—that Government would otherwise have to fund?

“Government always seeks more money, due to the sheer pull of the power derived from money. Many politicians also redistribute our tax dollars to their constituents and pet projects as a means of retaining political power. Years of undisciplined spending now threaten Government's power and politicians' futures, so they are turning to previously sacred sources such as charity for more tax revenue.

“When I visit Members of Congress to persuade them to preserve our charitable gift deductions, I make the following simple points:

1. Government should not tax individuals for giving their money away to help others.
2. Charities can provide services much more efficiently and effectively than Government bureaucracies and save billions that the Government would otherwise have to fund.
3. Any cuts to charitable giving will ultimately penalize the needy individuals served by charities.”

Action
Use our Freedom2Care easy form to let your legislators know that Government should not tax us for money we give away to help others, and that you want your charitable gifts to remain tax-deductible.

Resources
Fact sheet on charitable giving
Itemized Deductions State-by-State - Pew Charitable Trusts

CMA lobbies senators to protect charitable gift tax deduction

Excerpted from "Religious Charities Ask Congress To Save Charitable Deduction in Tax Overhaul," The Chronicle of Philanthropy, July 22, 2013 -- Members of a newly formed coalition of religious charities visited Capitol Hill last week to persuade members of the Senate to back the charitable deduction as they draft recommendations for a massive federal tax overhaul that must be submitted by Friday. In a face-to-face meeting, members of the new Faith and Giving Coalition told lawmakers—including Sen. Orrin Hatch, a Utah Republican, and Sen. John Thune, a South Dakota Republican—that the charitable deduction meets that three-pronged standard.

“We feel it’s important that [Congressional] members hear from the faith-based community because of the importance of private giving to what we do,” said Steven Woolf, senior tax policy counsel at the Jewish Federations of North America.

The coalition was formed two months ago by John Ashmen, president of the Association of Gospel Rescue Missions, and the National Christian Foundation. Its members include such groups as the National Association of Evangelicals, Salvation Army and World Vision. Jonathan Imbody, vice president for government relations with the Christian Medical Association, said his organization had not previously lobbied to protect the charitable deduction. But the approach taken by Sen. Max Baucus and Mr. Hatch spurred his group to join the coalition.

“When you read the letter that says they’re starting with a blank slate,” Mr. Imbody said, “that’s enough to get you going. If you want something included you’d better speak up.”

President Obama has failed in repeated efforts since 2009 to impose a 28 percent limit on the value of itemized deductions for such expenses as mortgage interest, state and local taxes and gifts to charities as a way to help tame the federal budget deficit. Non-profit advocates say the proposal could reduce donations by as much as $9 billion annually.

Obama administration officials have said that the change would affect single people with incomes of more than $200,000 and married couples with incomes above $250,000. Taxpayers with incomes below those levels who do not itemize deductions would not be affected.

Commentary

CMA Vice President for Government Relations Jonathan Imbody: "Behind closed doors, Members of Congress have been proposing charitable gift deduction cuts that would severely harm giving, charities and those they serve. That's why I joined several colleagues from leading nonprofit organizations last week to meet at the Capitol with four U.S. senators and staff, to urge them not to kill tax breaks for donations to charities--a move that would hurt donors, cripple faith-based charities and deprive those they serve of desperately needed services.

"A person gives from the heart, of course, but tax policies can significantly influence how much donors feel able to give. The charity deduction is unique in that it simply acknowledges that a person is giving away income to help others in need. The charitable gift deduction is not a loophole--it's a lifeline.

"With the self-imposed deadline for Congressional action--i.e., a draft bill by the end of the month--fast approaching, we need to explain clearly and quickly why the proposed cuts to charitable giving would harm millions of Americans. Please visit CMDA's Freedom2Care website now to learn more and take action on this issue that impacts your charitable tax deductions, ministries like CMDA and, most importantly, the millions of individuals served at home and abroad through American charities."

Take Action

Use the easy form at CMDA's Freedom2Care legislative action web page to tell your legislators to protect charitable giving