Even so, America’s strength and resilience still rests largely within the indefatigable optimism that drives innovators, entrepreneurs, workers and immigrants to scale the ladder of prosperity.
Americans cherish freedoms of speech, press and religion. U.S. capitalism encourages people from all walks of life to create wealth and achieve the rewards offered by free enterprise. Bargain hunters would agree the two essential elements of a good buy are the same for a robust economy: consumer choice and competition in the marketplace.
In the U.S. Senate, I use my legislative and oversight authority to work to strengthen the rights of property owners, taxpayers, consumers, pensioners, patients, and investors.
Consumers armed with accurate, timely information are able to make better decisions and minimize buyer’s remorse. Whether buying big-ticket items such as a car or home or looking for the best surgeon to perform a life-saving transplant, the most informed consumer is likelier to end up a satisfied customer at the end of the day.
I work to foster accountability and transparency in the public and private sectors. This includes efforts to advance reforms to the nation’s pension laws aimed at preventing bad actors from promising more than they could deliver (remember the Enron scandal); strengthen consumer-friendly comparison tools for family members searching for a quality nursing home; and, let the sun shine in on the financial relationships between medical device makers, pharmaceutical companies, medical professionals and non-profits.
The federal government’s system of checks and balances is meant to prevent overreach by the executive, legislative and judicial branches. That’s why I am a strong supporter of sunshine and whistleblower protection laws. Representing Iowans in Washington, I also have worked to keep close tabs on taxpayer dollars. Taxpayers deserve to get the most bang for their buck when their hard-earned money is used to build roads, advance medical research, strengthen national security, pay for the military and fund recovery efforts caused by natural disasters.
Transparency also can improve America’s health care delivery system. Policymakers have long debated ways to improve quality and rein in the so-called spending curve of U.S. medicine. On the Senate Finance Committee, I also channel efforts to improve effective medicine and patient safety by promoting better transparency between patients, health care providers, pharmaceutical companies and medical device manufacturers.
I have pressed the National Institutes of Health (NIH) to fully exercise its authority to achieve public disclosure between industry and the doctors who conduct $31.2 billion annually in federally sponsored medical research. In response to what I exposed about the dramatic disparity between what a number of influential NIH-funded research physicians reported and what they received from pharmaceutical companies, the NIH drafted new guidelines for grant recipients to manage conflicts of interest. A proposal has been waiting to be processed at the White House Office of Management and Budget since March. The administration needs to move on this. The NIH is in a pivotal position to help establish greater accountability in this area through disclosure. Good stewardship of the tax dollars that back medical research requires it.
In addition, keeping consumers or medical providers in the dark about those with financial ties to medical device makers, as an example, does not help build trust or improve patient outcomes.
A patient having spinal surgery places trust in the doctor’s experience and expertise. The surgeon relies on the current medical literature regarding safety, complications and adverse affects of a medical device or drug when making an informed decision about risks and benefits for the patient. Troubling reports indicate that severe side effects may have been unreported or under-reported by clinical investigators with financial ties to a bone-growth product they had reviewed.
A patient who is considering surgery has a right to know if his or her physician has a financial relationship with the medical device the doctor is suggesting. Likewise, a physician using the product deserves to know if the medical professionals who researched and prepared the literature on it have financial ties or consulting arrangements with that company. Public disclosure documenting such financial ties will promote accountability within the industry and allow the public to draw its own conclusions. Legislation that I co-authored, the Physician Payment Sunshine Act, was enacted into law last year. It will compel pharmaceutical, biotechnology, medical device and medical supply companies to disclose payments to physicians to the public, starting March 31, 2013, for all payments in calendar year 2012. That will increase payment transparency.
Transparency and accountability throughout the public and private sectors are standards of good governance that I will continue to champion. Transparency fosters goodwill in the marketplace and buoys consumer confidence. Just as American consumers have a right to know where their meat and vegetables are grown, they also have a right to know if their doctor has financial ties to a pharmaceutical company or medical device manufacturer, and their doctors have a right to know about the financial ties of leaders in their profession.
For generations, American consumers have rewarded big thinkers and innovators to out-think and out-innovate the competition. Protecting the public’s right to know is as all-American as apple pie and fireworks on the Fourth of July.