Instead, they showcase the worst abuses of the American healthcare system: a hospital that told a comatose patient\u2019s family<\/a> they\u2019d ship her out of the country if they didn\u2019t start paying them $500 per day; surgeons who encouraged experimental, risky surgery on low-income patients of color<\/a> in order to earn compensation from a medical device company; hospitals that wheeled homeless patients outside and dumped them onto the sidewalk<\/a>, still dressed in their medical gowns; an OB-GYN who sexually assaulted patients for over 20 years<\/a> while the university he worked at ignored escalating complaints against him; the controversial business of encouraging babies to have \u201ctongue ties\u201d cut unnecessarily; an infant who went into severe respiratory distress not long after open-heart surgery but whose insurance refused to cover the emergency air ambulance to hospital<\/a>, saddling the parents with a $100,000 debt. <\/p>\n The cases that have \u201cwon\u201d these awards detail almost everything that can go wrong in the U.S. healthcare system. From predatory practices at the insurance level to CEOs who decimated community hospitals in the pursuit of profit, to doctors incentivized to over-diagnose or over-prescribe, to healthcare centers refusing to provide life-saving treatment to poorer patients. <\/p>\n And it\u2019s a situation, says Dr. Vikas Saini, that is getting \u201cworse and worse\u201d. Saini is the president of the Lown Institute and a clinical cardiologist trained at Harvard by the institute\u2019s namesake, Bernard Lown, a Nobel Peace Prize winner and life-long social justice advocate. Of his many jobs, judging the Shkreli Awards is the one that Saini finds the most emotionally taxing.<\/p>\n open image in gallery<\/p>\n The awards showcase the worst abuses of the American healthcare system including an infant who went into severe respiratory distress not long after open-heart surgery but whose insurance refused to cover the emergency air ambulance to hospital, saddling the parents with a $100,000 debt (PA)<\/p>\n \u201cAs a physician, the behavior of the physicians strikes a deep, deep chord,\u201d Saini says. Although there are some more objectively shocking stories, one where a heart doctor placed coronary stents in people\u2019s arteries for no good reason has stayed with him. <\/p>\n \u201cI find that very, very upsetting personally because I\u2019m a cardiologist,\u201d he adds. \u201cI\u2019m not sure it\u2019s necessarily the most striking or shocking ever [example], but that\u2019s the one that speaks to me the most.\u201d<\/p>\n In Saini\u2019s view, medicine is as much an art as it is a science \u2014 and it is this intimacy, this reliance on trust, that makes its abuse so morally corrosive. \u201cI don’t think the public understands the number of things we do that are discretionary, where the evidence could go either way \u2014 maybe it works, maybe it doesn’t,\u201d he says. \u201cThere’s a lot more of that than I think the public understands\u2026 That’s why in general, there’s such leeway and such discretion, and I think you need some moral underpinnings to help you.\u201d Without a firm ethical framework, medicine risks becoming a money game, with the patient reduced to a pawn. In a profession defined by discretion, the opportunities for corruption are everywhere.<\/p>\n And therein lies an uncomfortable truth: RFK Jr., anti-vaxxer conspiracies, and an anti-science movement disguised as \u201cwellness\u201d didn\u2019t come from nowhere. Few healthcare systems have been as volatile or as politically fraught as in America. Within the space of a single year, a health insurance CEO was shot dead by a disgruntled patient<\/a>, while a Health and Human Services Secretary with no medical training fired the CDC\u2019s entire vaccine advisory board<\/a> shortly after taking office. If nothing else, these events testify to a system under deep strain.<\/p>\n Skepticism toward long-established public health measures such as vaccination has been deeply damaging. It has helped usher in the return of polio, three decades after its eradication<\/a> in the US, and led to the first death of a child from measles<\/a> in a decade. But distrust toward doctors and pharmaceutical companies has been building for almost a century.<\/p>\n open image in gallery<\/p>\n Health and Human Services Secretary Robert F. Kennedy Jr. has announced new diet guidelines that will be released next month as part of the ‘war on saturated fats’. Kennedy fired the CDC\u2019s vaccine board as soon as he took office, leading to the decision last week that Hepatitis B vaccines would no longer be recommended at birth for babies across the US (Kevin Dietsch\/Getty Images)<\/p>\n Black Americans, for example, are more likely than white Americans to express vaccine hesitancy<\/a> \u2014 a disparity that was especially visible during the pandemic rollout. Research suggests this reflects lived experience as much as ideology: Black patients are more likely to report negative interactions<\/a> with doctors, while Black women are more likely than any other group<\/a> to have their pain and health concerns dismissed, and they are three times more likely<\/a> to die in childbirth than their white counterparts. Layered onto this is a legacy of medical abuse and dismissal, including the infamous Tuskegee Syphilis Study<\/a>. Add to this the fact that women of all races worldwide wait years longer for diagnosis<\/a> of a range of health conditions, from cancer to heart disease, and it\u2019s clear that suspicion toward mainstream healthcare institutions has had reason to exist long before Facebook conspiracies and the notorious \u201ccrunchy-to-alt-right pipeline\u201d.<\/p>\n \u201cWhat we see in the [Shkreli] Awards is that the chasing of money is kind of endemic and ubiquitous in the American healthcare system,\u201d says Saini. \u201c…Now, there’s always a tendency to have a fantasy of a golden age, and I don’t expect or believe that there was ever a real golden age. But it is true, I think, that the degree of aggressiveness with which people are chasing the money has accentuated in the last decade or two.\u201d<\/p>\n Saini believes that people who think healthcare runs best as a privatized, competitive marketplace are making a \u201cfundamental error in logic\u201d. <\/p>\n \u201cI think almost anybody, when they take off all their different social masks and they’re just quiet with themselves as a human being, I think everyone understands that\u2026 healthcare is very different,\u201d he says. He\u2019s spoken to a lot of people during his career who think that the solution to the healthcare situation in America is more privatization; that a Reagan-style \u201cmagic of the marketplace\u201d will happen if red tape is slashed, and high prices will come down while care would get better. <\/p>\n \u201cAs much as I understand that logic, I would just submit that I think it’s incorrect,\u201d he says. \u201cBecause just as there are no atheists in foxholes, similarly, I don’t think there are a whole lot of capitalists when they or their family are seriously sick. I think people just want to be taken care of, and they want to be able to afford it, and they want to not have to think about it. They certainly don’t want to go around shopping as if they were buying a car.\u201d<\/p>\n How to change a broken system<\/p>\n Can the system be changed \u2014 and if so, how? Saini argues that change is inevitable, because the current system not only permits corruption but actively incentivizes it. Certainly, there are genuinely malicious cases of malpractice, the kind lampooned by the Shkreli Awards. But, as he puts it, \u201cthe vast majority are not as explicitly bad as that.\u201d More often, he says, \u201cthe vast majority are tales they tell themselves and data that they skew to justify it.\u201d<\/p>\n People are corruptible; doctors are no exception. And in a system that exerts pressure from every direction \u2014 from TV ads for cancer drugs and promotions in medical trade magazines, to pharmaceutical-funded conferences, financial incentives, and a culture that rewards unnecessary tests or even surgeries if patients demand them \u2014 it is hardly surprising that bad actors emerge. More unsettling still is how often the system produces something worse: well-intentioned professionals who have convinced themselves that their bad actions are justified, and beyond reproach.<\/p>\n \u201cIt will take a movement of people\u201d to change the system for good, Saini says. \u201cIt will take organized effort. And I’m sorry to say, it’ll probably require pressure from outside of the healthcare industry because the status quo is serving too many people. There’s still enough people who are really doing very well and are not going to want to rock the boat that it is going to take some kind of\u2026 externality, I think.\u201d<\/p>\n He doesn\u2019t think it will be Bernie Sanders-style Medicare for All, nor will it look like the Canadian universal healthcare system or Britain\u2019s National Health Service. And he also doesn\u2019t think the stars will align in the next few years, because politics has become so divisive that politicians are unlikely to work together to get something through. Most Republicans are fundamentally opposed to raising taxes and committed to the idea of allowing people a market-style \u201cchoice\u201d about where they go and who they see (although, Saini notes, there is a certain irony in the right talking so incessantly about the importance of choice in healthcare while simultaneously legislating against a woman\u2019s right to choose.) <\/p>\n open image in gallery<\/p>\n Outgoing Speaker of the House John Boehner, Republican of Ohio, uses his gavel to call a vote for a new Speaker in the House Chamber at the US Capitol in Washington, DC, on 29 October 2015. Boehner described in a candid interview after stepping down how he had never once seen his party agree on a single health-related initiative ((AFP via Getty Images))<\/p>\n Democrats are divided throughout the party, with the furthest left insistent about a single-payer system (\u201cbehavioral psychology tells us\u201d that this probably won\u2019t work, says Saini, because an electorate will never get on board with having something taken away) and the furthest right fully supportive of the status quo. Obamacare was the middle ground, but it hardly solved every issue \u2014 and Republicans have talked loudly about replacing it for decades.<\/p>\n Not that that talk has translated into anything. A little less than a decade ago, John Boehner, having recently stepped down as Republican Speaker of the House, reflected on why his party had failed to create an alternative to Obamacare, despite so many claims that they would.<\/p>\n “In the 25 years I served in the United States Congress, Republicans never, ever, one time, agreed on what a healthcare proposal should look like,\u201d he said. \u201cNot once.”<\/p>\n Ideally, Saini says, a movement that changes healthcare in America will unite patients, community leaders and business leaders. All of them will need to be honest about the fact \u201cthat healthcare \u2014 how we pay for it, how we make serious decisions about it \u2014 is much too important to be left either to the industry itself or even to politicians.\u201d The solution will have to involve entirely new structures, new formats and new overseers, as well as much improved affordability.<\/p>\n \u201cIt may sound utopian,\u201d he says, \u201cbut I will say I\u2019ve been thinking about this for a long, long time. I don\u2019t see any other way.\u201d<\/p>\n The Shkreli Awards are announced on December 11th<\/p>\n","protected":false},"excerpt":{"rendered":"Every December, The Lown Institute, a nonpartisan healthcare think tank, holds an awards ceremony. The recipients are unlikely…\n","protected":false},"author":2,"featured_media":310899,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":{"0":"post-310898","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom","12":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/310898","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=310898"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/310898\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/310899"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=310898"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=310898"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=310898"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"The](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2025\/12\/PA-71913659.jpg\")
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