David Saltzman on Health: Oh, The Temerity!

Commentary January 23, 2012 at 11:29 AM
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Temerity. It is an old fashioned word, dating back to the 15th century. Rooted in Latin, the modern definition is "excessive confidence" or "audacity". To be sure, there are other, more colloquial terms that are usually applied to actions that are so outrageous that they defy polite description.

Regardless of the terminology you prefer, a little-noticed provision in PPACA should be added to every dictionary's definition of temerity. While poring over the forced marriage ("You'll learn to love it") that is ObamaCare, you may have overlooked the Physician Payments Sunshine Act. Many were unaware until the Centers for Medicare and Medicaid Services (CMS) published draft guidelines last month.

Concerned about conflicts of interest in physician-industry relationships and fretting over the additional costs such conflicts might bring, CMS will require any company that manufactures medical products to disclose anything valued at more than $10 that is given to a physician. According to CMS, such disclosures must be posted on a public website.

Thomas Stossel, professor of medicine at Harvard says, "Having failed to detect substantive corruption due to physician-industry relationships over a quarter century, they will spend taxpayer-provided grant money promising to find it by trolling in the Sunshine database." A government that is itself awash in waste and fraud (estimates range from $70 billion to $120 billion in Medicaid and Medicare alone) is going to police doctors lest they accept a $12 lunch from someone representing the most current technology – technology that saves lives and lowers costs.

Stossel wonders how the government will "account for the $25 worth of bagels brought into a group-practice office when it's unclear who actually ate the bagels." Since we're on the subject of bagels, let's swap "temerity" for a Yiddish term from the 10th century: Chutzpah. One definition seems particularly on point. Chutzpah is when a child who has killed his parents pleads for clemency from the court – on the grounds that he is an orphan." Or, as my grandmother used to say, "Oy!"

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