Sunday's Funnies, Not So Funny

As the smoke settles from the former Stryker CEO Steve MacMillan's resignation, and, if the allegations are true that Stevie Wonder had a Wondering eye, questions must be asked of our readers, have we truly become a shameless society? Is leadership truly overhyped? And what does it say about Stryker?

Based on the latest stories that have graced major publications a la The Wall Street Journal and NY Times regarding POD's, POC's, the Blackstone and Orthofix DOJ settlements, the conviction of former Synthes executives and MacMillan's resignation, it has become evident that shameless behavior has become pandemic in our country.  Maybe, the fact is that "shamelessness" has become an accepted disease within the American gestalt.  Americans love to rationalize their shameless behavior.  As long as you win, haven't killed someone, or for that matter make lot's of money, it is okay to behave and act out in a certain manner.  As shameless behavior dominates our psyche what does it say about the direction this society and future generations are heading for? What kind of country are we becoming?  It's just not spine industry employees, it's athletes, entertainers, investment bankers, and CEO's, and worst of all politicians. We have lost our sense of humanity, we are slowly becoming that dystopian society that TSB once wrote about.

TSB is sure that the righteous will accuse us of being liberal, phony, or pandering to the weak, but the truth is that everyone must conduct oneself with some order for a society to truly prosper and for people to coexist. There must be balance when it comes to laws of the jungle. Man's selfish nature dictates why laws are necessary and government exists. You don't believe it? Wait until the curtain is pull backed on what's been going on in California in spine for years. Contrary to some of our readers opinions, there cannot be two sets of rules.  There cannot be one set of rules for you and another set of rules for us. Maybe there are too many companies, too many products and maybe money has come too easy becoming the driving force in many of your lives, but the reality is that contrary to popular opinion everyone cannot be a winner. Maybe that's part of the problem? Just look at your children, they are a reflection of your insecurities and behavior. Regardless of what you think, everyone cannot be a winner, no matter how far one stretches the rules or thinks that you are not breaking any laws. How many of you actually promulgate good citizenship and fair play all for the love of the Almighty Dollar? How many of you espouse free markets, yet use every tactic in your power to manipulate or rig the market? Disappointment is a part of life, making adjustments is reality. Too many people in this industry behave the same way that America raises its children, everyone must be a winner, everyone must succeed, everyone deserves a medal even if you finish in fifth place. You know what?  That's BS! That's why America has become what it is today. The bottom line is the pie is only so large and has to be shared by many people, some will win and some will lose and some will have to learn to live with the blues.

The recent California Dreamin' post exposes how many of you defend your unethical actions. Calling other commentators out on their anonymity, while you cloak yourselves in your own veil of secrecy, using sophomoric language, threatening libel as though some of you had a law degree, exposes your immaturity, insecurities and shamelessness. Justifying your behavior by casting aspersions onto the system doesn't excuse one from raping the system. Who do you think pays for someone buying implants at $3,000 and then selling them for $47,000?  We all do!  Who do you think will be hurt by this shameless behavior? The entire industry is effected! But you know who's to blame for this type of behavior?  We all are.  NASS, AANS, or CNS don't have the authority or the BALLS to step in and police its own members or peers. The companies CEO's and upper management teams look the other way using their best Wally Karew and Dave Lyons "Hear no evil, see no evil" defense because they have become the Streets bitch.  Surgeons and reps cannot control their urges or desires and hospitals have become nothing more than sweatshops for perpetuating an unhealthy society. This in itself exhibits our aberrant and sociopathic nature.  Don't believe it?

Let's use some examples. What would you do if you found out that a surgeon who had his license revoked was still practicing and collaborating with his peers to funnel workers' comp patients to a hospital, and the hospital was working with these people in concert to drive profits? How would you react if that was your mother or father, sister or brother, son or daughter? TSB is sure you would react with outrage.  How would you react if your family member went in with a degenerative problem at L5-S1 and was told that they needed a three or four level procedure? How would you react if your loved one went in for a simple ACDF and left the hospital in a hearse, because some surgeon used a product off label without truly understanding the consequences or biological response from using that product? Some of you may even go to extremes and take matters into your own hands. Well, this is why spine finally needs a thorough cleansing. The con artists, scam artists, the dealmakers, those that do nothing more than bilk the system for every nickel and dime that they can get out of the system while dragging the industry further and further into a death spiral. And yes fellow bloggers we have many people to thank, you know who you are, because we know who you are.

The waste and theft in our industry is enormous.  The U.S. spends twice as much for delivering medical care than the next most prosperous country.  The incentives for everyone involved is misaligned.  Fee for service is really not a healthcare system, it is a treatment sales system.  Don't believe it?  Come to California.  Patients must take control of their lives and health if medicine is going to change.  If 3% of all healthcare spending, an estimated $68-70 billion annually, is lost to fraud, California is definitely doing its best by contributing with its POC's and POD's.  Governor Brown should be proud that he oversees and encourages this illicit behavior.  Recently, it was reported that in the Sunshine State, aka Florida, Medicare fraud is bigger than the illegal drug trade. This is something that we should all be proud of.  Of course rather than reflection, many will respond that it is the politicians, insurance companies and lawyers fault.  And yes indeed, they do their best to add to the increasing cost of delivering healthcare.  Today, what we have is a market free-for-all.  Companies hire surgeon consultants and rationalize that this does not influence their decision making abilities, yet, behavioral research has proven that incentives create reciprocity.  So in closing, maybe its time for the DOJ, the OIG, and the FBI blow the lid off of this industry. But until some CEO's, surgeons or distributors don an orange jump suit, it will be business as usual. TSB wants to know what our readers think?  Maybe what many of us have found out is that it pays to commit white collar crime.  Some poor schlep rips off a gas station for $50 and serves 10-15 years, while some companies rip off the taxpayers and the government and they get a slap on the wrist and the proverbial whitewash in their settlement.

What I want, I want now, and it's a whole lot more anyhow
I wanna climb a mountain, I understand all destructive urges
it seems so perfect I see no evil