Thursday, December 29, 2011

Medicaid Fraud Watchdogs Under Fire At House Hearings

Fierce Government has;

Medicaid Fraud Watchdogs Under Fire At House Hearing

December 13, 2011 — 12:31pm ET | By


Medicaid issued $21.9 billion in improper payments in fiscal 2011, but the program's improper payment rate of 8.1 percent in fiscal 2011 was still an improvement from the 9.4 percent improper payment rate in fiscal 2010, according to a Centers for Medicare and Medicaid Services official. Angela Brice-Smith, director of CMS's Medicaid integrity program, was one of several oversight officials who faced sharp criticism from lawmakers Dec. 7, at a House Oversight and Government Reform joint subcommittee hearing.


"That's really nice; but what I'm trying to tell you is that your normal is not good enough," Rep. Elijah Cummings (D-Md.) told the panel.


Gary Cantrell, assistant inspector general for investigations within the Health and Human Services Department, said fiscal 2011 Medicaid fraud enforcement efforts set records across the board with over 400 criminal convictions and $1.1 billion in expected recoveries.


But lawmakers were unimpressed with Brice-Smith and Cantrell's testimony before the government organization, efficiency and financial management subcommittee and the healthcare, District of Columbia and National Archives subcommittee.


Rep. Paul Gosar (R-Ariz.) asked them to grade themselves on their performance policing Medicaid waste, fraud and abuse. Brice-Smith responded by giving herself a C, "in light of the youngness of our program." Cantrell gave himself a B, to which Gosar shot back, "On behalf of the American people and I doubt that they would give you above a D. Don't you agree with me? I think so."


Lawmakers said they were frustrated with the slow pace of progress to reduce improper payments, especially in light of increased funding to oversight programs under the Affordable Care Act.


Cantrell's office hired close to 100 new investigators with funding provided under the law. Brice-Smith said that with or without the law improper payments will continue to be an issue. A repeal of the law, however, would affect the growth and expansion of oversight programs, she said.


For more:
-
go to the hearing page (included prepared testimonies and archived video)


Related Articles:
DOL: IT programs will help slash improper payments
Most states only partially verify Medicaid EHR subsidy eligibility, says HHS OIG
Guest Commentary: Scott Schumacher on cutting HHS improper payments


Thank You FierceGovernment and Ms Walker.

CMS Inaction Leaves System Holes For Fraud, Abuse

Fierce Healthcare has;

December 19, 2011 — 12:34pm ET | By


The Centers for Medicare & Medicaid Services (CMS) has been slow to respond to contractor-identified weaknesses in the system that allow for fraud, waste and abuse, according to a report by the Office of Inspector General (OIG), issued Friday. CMS needs to take prompt action to fix potential leaks in the system, the OIG recommended.

As of January, CMS has not resolved or taken action on more than three-fourths (77 percent) of identified vulnerabilities--mostly having to do with coding/billing and provider identifiers--reported by Program Safeguard Contractors, Zone Program Integrity Contractors and Medicare Drug Integrity Contractors in 2009. Out of the 62 vulnerabilities, CMS has not resolved 48 of them, according to the OIG report. CMS said 20 of them are "currently under review," and three require more analysis. OIG determined that CMS either didn't take action or took insufficient action in the remaining 25 identified weaknesses, but the federal agency did take action on 14 of the total 62 potential vulnerabilities.

CMS' inaction on these vulnerabilities could cost $1.2 billion, according to contractors who reported the financial impact for only a third of the vulnerabilities.

"Because monetary impact was reported inconsistently or not at all, the actual monetary impact of the vulnerabilities reported in 2009 could be significantly greater than $1.2 billion," the OIG report states.


CMS noted that it's labor intensive for contractors to determine the dollars at risk for all vulnerabilities and not all vulnerabilities have a monetary impact.

Although CMS has started to develop procedures to consistently track and review vulnerabilities, it still lacks procedures to ensure they are resolved, according to OIG. Contractors have been submitting vulnerability reports for several years, but CMS did not begin developing procedures until June 2010.

CMS stated that it continues to actively manage reported vulnerability on a monthly basis and that it can establish time frames for resolution on a case-by-case basis.

To learn more:
- here's the OIG
press release
- read the OIG
report (.pdf)

Related Articles:
Feds' $5.6B fraud collection hits record high
Hospitals worried about Medicare RAC prepayment audits
Gov't saves $17.6B in waste and errors, launches new fraud preventions
CMS struggles to monitor Medicare contractors due to inaccurate data
Feds triple recovered money from Medicaid scams


Thank You Fierce Healthcare and Ms Cheung



But don't you Worry about CMS, because It's Been Fixed, (
as the Congressional Fix Is In for Pfizer and J&J) by our Glorious President his very own self, who has never run a business nor met a payroll his Very Own Self.


YessireeBob, we have Top People on the case, ...... only the Very finest. And we're Certain that Our Glorious President's Dr. Seuss can STOP all this Medicare FRAUD from inside CMS with just a single serving of her "Green Eggs and Ham" investigatory expertise.

She Ought to know how to Stop the FRAUD, ....... having worked for a company that Committed so much of the FRAUD.

photo cred of Jim Grinch Carry to Universal Pictures

"As of January, CMS has not resolved or taken action on more than three-fourths (77 percent) of identified vulnerabilities"



And you Wonder why we're $15 Trillion in debt.

Wednesday, December 28, 2011

Shell Companies Steal Millions In Medicare Fraud

FierceHealthcare has;


December 22, 2011 — 1:10pm ET | By

"
Shell companies--sham firms on paper with no real operations--are a prime tool for fraudsters to scam Medicare out of millions of dollars, according to a Reuters investigation. Medicare's current pay-and-chase system has holes that allow providers (or imposter providers) to bill Medicare for services and then steal millions of dollars from the federal health program.


For instance, Florida authorities charged Michel De Jesus Huarte for his role in setting up fake AIDS clinics in Florida, but not before he billed Medicare for more than $4.5 million and formed at least 29 other shell companies in Florida, Georgia, Louisiana, North Carolina and South Carolina, Reuters reports. Huarte and co-conspirators formed clinics purported to treat HIV and AIDS patients and submitted claims for expensive drugs such as Infliximab and Rituxan, costing Medicare as much as $7,800 per dose.

"This is a 'Catch Me If You Can' environment," said Ryan K. Stumphauzer, a former assistant U.S. attorney with the Department of Justice in Miami who prosecuted Huarte. "We had no clue who Huarte was. We had no idea there was some mastermind out there."

The strategy of shell companies can go unnoticed for years. Scam artists use fake names and addresses for corporations or real information from others. In Florida, Federal Bureau of Investigation agents said almost every Medicare fraud case involved a shell company.

Florida, where the fake AIDS clinic scheme took place, is one of five states that tops the list for the most Medicaid fraud activity, according to a recent Office of Inspector General report issued in October; the other states are New York, Texas, California and Ohio.

The Centers for Medicare & Medicaid Services (CMS) last month announced that hospitals soon will be subject to prepayment audits, with aims to fix the traditional pay-and-chase method. Effective January 2012, Medicare recovery audit contractors (RAC) in 11 states will conduct reviews of inpatient claims before payment. Those states will be areas that have high fraud and error-prone providers (Florida, California, Michigan, Texas, New York, Louisiana and Illinois), as well as those states with high claims volumes of short hospital stays (Pennsylvania, Ohio, North Carolina and Montana).

Although the government has expanded its Medicare Strike Force with increased focus on acute-care and critical access hospitals, senators this week are pushing for better assessment of Medicare fraud detection.

CMS plans to launch a new predictive modeling program nationwide this summer, in which the analysis tool will flag common patterns of Medicare fraud, such as suspicious billing patterns or a great distance between the hospital where treatment occurred and the claimant's home address, reports Nextgov.

Senate Federal Financial Management Subcommittee Chairman Tom Carper (D-Del.), Ranking Member Scott Brown (R-Mass.) and Senator Tom Coburn (R-Okla.) on Tuesday requested CMS outline its plans to launch the predictive analytics technology and stated that CMS may not have sufficient metrics and processes in place as part of a comprehensive plan to ensure the success of identifying and preventing fraud.

For more information:
- read the
press release on Huarte's charges
- read the Reuters
article
- read the
Nextgov article
- here's the Senate
press release
Related Articles:CMS inaction leaves system holes for fraud, abuse
Gov't recovers record-high $2.8B in whistleblower fraud cases
Home health owners plead guilty to $1M Medicare fraud
Feds' $5.6B fraud collection hits record high
Hospitals worried about Medicare RAC prepayment audits


Thank You Fierce Healthcare and Ms Cheung


And California made the list.

We´re Shocked, I tell you. Shocked and Amazed. Simply Shocked: when San Francisco blew $200 Million in 1 year dispensing Opinions of Mystic, Dual Diagnosed Incurables, .....


under the watchful eye of a Chief Psychiatrist, Dr Francis G Lu, who actually believes that his Movie Reviews, and disappearing brick and mortar Hospitals non staffed by non-existent Psychiatric Psychiatrists, qualify him to tell the world, ..... that he's an Illuminati.

You Might want to contrast San Francisco's $200 Million epidemic of Disease Mongering with the State of Illinois carping that it couldn't Afford to Investigate 85% of the Complaints it got, about Hospitals, ...... because it could only scrape up, ..... even WITH matching Federal Funds, ..... just under a $Half Million.



Fierce Healthcare has;
November 9, 2011 — 12:46pm ET | By
"Due to limited state funds, the Illinois Department of Public Health declined to investigate 85 percent of the 560 hospital complaints it received last year, reported the Chicago Tribune this week. Some of the complaints included reports of serious patient abuse and poor infection control, according to the article.


"These are serious complaints," said Lisa McGiffert, director of the national Consumers Union Safe Patient Project. "If the regulatory system is collecting these complaints and not responding, that is a massive failure of oversight."
The state in 2010 spent $498,000 on hospital oversight with half the funds coming from the federal government and the other half from the state. Article


Thank You Fierce Healthcare and Ms Cheung.
Does anyone still have a problem spelling Protectionist?

Thursday, December 15, 2011

Congressman Ron Paul Fights MANDATORY Mental Health Screening of Children

Congressman and Presidential Candidate Ron Paul has;

No Mandatory Mental Health Screening For Children!

"Maryanne Godboldo, a mother in Michigan, noticed that pills prescribed by her daughter's doctor were making her condition worse, not better. So Mrs. Godboldo stopped giving them to her. That's when the trouble began. When Child Protective Services (CPS) bureaucrats became aware that the girl was not receiving her prescribed medication, they decided the child should be taken away from her mother's custody on grounds of medical neglect. When Ms. Godboldo refused to surrender her daughter to the state, CPS enlisted the help of a police SWAT team! On March 24 of this year a 12 hour standoff ensued and young Ariana was taken into custody. The drug involved was Risperdal, a neuroleptic antipsychotic medication with numerous known side effects. Ms. Godboldo had decided on a more holistic approach for her daughter. She is still engaged in a costly legal battle with the state over Ariana's treatment and custody.

This is one example of how government's increasing proclivity to medicate children with questionable psychiatric drugs violates the rights of parents. Just recently, the Government Accountability Office released a report on the astonishingly high rate of prescriptions for psychotropic drugs for children in the foster care system. It is absolutely astounding that nearly 40% of kids in foster care are on psychotropic drugs, some of them taking up to 5 different pills at a time. Some of these children are under one year of age - too young to safely take over the counter cold medication!

To fight this dangerous trend I reintroduced the Parental Consent Act of 2011, HR 2769, which prohibits federal funds from being used to establish or implement any universal or mandatory mental health or psychiatric screening program. The previous administration pushed hard for this type of federal intrusion into the medical decisions of families through its wildly misnamed "New Freedom Commission on Mental Health." Everyone interested in parental rights and true health freedom must fight to make sure the commission's findings and dubious psychiatric science are never used as justification to force mental health screening on American kids at school without their parents' consent.

There has been a persistent lobbying effort, funded by pharmaceutical companies, to increase the number of these prescriptions to even more children. A universal screening program is the stated goal of these lobbyists. I would not be at all surprised to see the recent attention to the issue of schoolyard bullying used as a tool towards these ends.

Imagine the potential ramifications of a universal, mandatory psychiatric health screening program in a public school, considering how some bureaucrats are wont to behave! The diagnostic criteria for many mental illnesses remain vague and subjective. Therefore it is all too easy for a bureaucrat in a white coat to label a child with some sort of psychiatric syndrome simply because they were having a bad day, or behaving as a typical rambunctious child. That label could follow them around the rest of their school career and come with a number of prescriptions attached, which the state, as in the Godboldo case, may try to force the parents to administer, whether they want to or not.

I plan to continue the fight to ban federal funding of any universal screening program that imposes mental healthcare screening on children without express informed consent from parents.


Thank You Congressman Paul

In San Francisco They're After EVERY Child.

There's only one choice in this election. America is a Constitutional Republic. Not a Democracy, and Not an Empire.

It's time to put America Through its Constitution back onto its feet.

Wednesday, December 14, 2011

Off Topic: Anyone But Romney in 2012

Someone at Fox News is to be commended.

Medical Freedom Zones

The problem with Psychiatry, aside from the fact that it's a FRAUD which Can't be fixed and shouldn't even Exist, is Government redistributing everyone Else's money. If those bowls of everyone Else's money weren't out on the table to begin with, the Psychiatric dispensers/inflictors of Political Illnesses wouldn't be scrambling to snatch up that money.

And since the Devil Invariably lurks in the Details, let's have another look at Why Government Healthcare Itself is a rotten idea.

MichiganCapitolConfidential has;

Medical Freedom Zones

Medical Freedom Zones

America’s health care system is a dysfunctional mess for a fundamental reason: There is no real market in health care. It was wrecked by a combination of incentive-skewing federal tax policies, innovation-killing “fee for service” payment systems in the two federal programs that pay for practically half of all health care consumed (Medicare and Medicaid), restrictive state policies that create limited cartels of health care professionals and facilities (reducing supply and so increasing price), and more.

It all seems a hopeless quagmire, in part because instead of going to the root cause of the dyfunctions to find solutions, politicians have instead “doubled down” on market-killing policies, most recently with the monumentally destructive Obamacare law, which comes on top of innumerable other counter-productive government intrusions enacted on a bipartisan basis at both the state and federal levels.

An interesting proposal from a Mackinac Center sister-think tank in Wyoming seeks to cut this Gordian knot of perverse incentives and pernicious restrictions with something called “medical freedom zones”: a “legally recognized geographic area where health care professionals may provide services and conduct research governed by professional associations and private contracts.”

Here’s more from the paper on the idea authored by the Wyoming Liberty Group:

Both the federal and state governments hamper doctors’ ability to innovate in medicine and to offer more affordable or alternative care. While the federal government delays innovative medicine, state governments make affordable care more difficult by limiting the number of doctors and saddling those who do practice with difficult liability rules. Similarly, the ability of care providers and patients to fashion their own agreements governing medical procedures is entirely hamstrung through state regulation. The result? More than 500,000 Americans fled the United States in 2008 for medical tourism. The time for innovative reform is now.

Alas, even this creative solution cannot get to the root of the problem, because the “freedom zones” don’t fix the two “original sins” primarily responsible for wrecking health care, and which can only be fixed in Washington: Allowing unlimited employer tax deductions for the cost of employee health insurance, and Medicare and Medicaid’s “fee for service” payment model.

The first of these, the tax code, is responsible for the third-party payment system under which, unlike areas where markets truly exist, consumers don’t behave like frugal, prudent value seekers, and providers aren’t forced by competition to respond by becoming innovative, efficiency-generating value-maximizers. The second source of the dysfunctions, Medicare and Medicaid’s payment system, imposes price controls in a way that mostly takes away any reward for providers reducing costs through innovation, destroying the incentive for them to even try.

Fix those two things, and our health care delivery system can finally begin to heal itself by becoming a real market. Leave them untouched, or worse yet pile a huge new layer of regulation, subsidy and rationing on top of them (Obamacare), and no fundamental improvement can ever be expected to occur in our health care system.

It’s in our hands to make this right — but this requires forcing the politicians in Washington to undo these core sources of dysfunction. If they did, medical freedom zones could have the potential to accelerate the healing process for our health care system.




Thank you MichiganCapitolConfidential and Mr McHugh

And if you think Psychiatry can even Be fixed, we refer you back to Professor Frederick Crews masterful deconstruction of the FRAUD of Psychoanalysis:

Monday, December 12, 2011

ObamaCare Insurance Exchanges Graded "F"

Andrew Breitbart's BIG GOVERNMENT has;

Independent Study:ObamaCare Health Insurance Exchanges Get A Grade of 'F'

by Dr. Susan BerryThe independent Mercatus Center at George Mason University has given a grade of “F” to the ObamaCare Health Insurance Exchanges regulation. The center studies the anticipated results and economic effects of proposed regulations. In other words, their researchers evaluate whether regulations are likely to accomplish what their supporters say they will.

The Mercatus center delivered its “Regulatory Report Card” on the Health Insurance Exchanges, the set of rules that states will use to set up online health insurance marketplaces. These virtual marketplaces will allow individuals and small employers to compare available private health insurance options on the basis of price, quality, and other factors. The Exchanges, which are scheduled to be in effect by January 1, 2014, are, next to the individual mandate upon which ObamaCare is based, crucialto the law’s ability to achieve its stated goal of expanding access to health insurance to the currently uninsured. Ultimately, they will be used to distribute $460 billion in federal health subsidies, through the year 2019.

The Health Insurance Exchanges regulation received only 42% of potential points (25 out of 60) on the Mercatus “Report Card.” The score of 25 points is the second lowest score the Mercatus Center has issued for 2011 regulations. The Exchanges were measured according to 12 criteria covering three broad categories: Openness, Analysis and Use. For each criterion, the researchers assign a score ranging from 0 to 5, with “5″ being the highest score on any given criterion. Some of the highlights are below:

In the Openness category, ObamaCare’s Exchanges received the lowest score of “2″ on the ease with which someone could find the regulation online. Verifiability of the assumptions used in the regulation’s analysis and the data used to support it were both given scores of “3,” with comments that the regulation relies heavily upon analyses performed by agencies such as the Congressional Budget Office (CBO). The regulation received a score of “4″ on its ability to be understood by an informed layperson. Interestingly, the researchers comment that the Health Insurance Exchanges regulation is “light reading” for someone who is “informed,” but due, in part, to the fact that there is little detail provided. However, as we have come to discover in ObamaCare, the devil is, indeed, in the details.

In the category of Analysis, the regulation received an overall score of “3″ on the criterion measuring how well the analysis behind the rule identifies desired outcomes and demonstrates that the regulation will, in fact, achieve them. HIgh and low points: a score of “5″ for the criterion reflecting whether the regulation’s analysis clearly identified outcomes that affect citizens’ quality of life, i.e., the intention to improve public health, to improve financial security of citizens, etc., but a score of “2,” for the criterion which measures whether the regulation’s analysis presents “credible empirical support for the theory” behind it. The study highlights that, in writing the rule for the Exchanges, the Department of Health and Human Services (DHHS) based evidence for its anticipated success on evaluation of an expansion of a 2008 Medicaid program, through a lottery, in Oregon, and a 2002 Institute of Medicine report that found that having health insurance improves health outcomes. Are we surprised that a far-reaching law like ObamaCare is based on two dinky studies?

On the criterion of how well the Exchanges rule analysis assesses the effectiveness of alternative approaches to addressing the needs of the uninsured, the overall score was “2,” with a subscore of “1″ given for the issue of whether the regulation addresses other methods, besides federal intervention, to fix the same problem. In other words, tort reform, competition among insurance companies across state lines, and other free market solutions were not even considered. No surprise again.

The ObamaCare Exchanges received an overall score of “2″ on the criterion of how well the regulation’s analysis assessed costs and benefits, with a “0″ given for the regulation’s ability to identify the cost-effectiveness of alternatives presented.

In the Use category, the regulation fared extremely poorly, with a “0″ score given for DHHS’s failure to indicate which data it will use to evaluate the regulation’s performance in the future. As we have come to discover with ObamaCare, DHHS will likely not evaluate whether the Health Insurance Exchanges work.

According to The Washington Post, about a third of the states have not progressed in setting up ObamaCare’s state-based health exchanges. Several states- Florida, Louisiana, and Kansas- have decided not to set up the exchanges at all, an interesting dilemma for the Obama administration. AsReason.com points out, if a state does not participate in ObamaCare, the federal government will have to move in and set it up, a situation which will give further credibility to the notion that the federal government is taking over healthcare.

Two other sticky problems with the exchanges: first, the federal government has no funds set aside to set up the health insurance exchanges in the states. Second, ObamaCare allows insurance subsidies to be given to those who purchase insurance through the “state-run” exchanges, so those in states that oppose ObamaCare will end up with the requirement to purchase health insurance, but no subsidies from the federal government.

Finally, the Mercatus Center evaluators note that the ObamaCare Health Insurance Exchanges rule expends “no effort to determine who ultimately bears burdens (taxpayers, consumers or producers). The implicit assumption appears to be that all citizens gain (lower insurance premiums, better public health), but this is never directly stated.”

Of course, we now know that the “assumption” is nothing more than a fantasy. Last summer, Medicare actuary Richard Foster told us the truth about ObamaCare: the president’s signature legislation will triple the growth rate of net insurance costs. That’s an “F” in any book.

Mountebank: Vocabulary Building Word Of The Day 12/12/2011

Dictionary

mountebank
|ˈmountiˌba ng k|
noun
a person who deceives others, esp. in order to trick them out of their money; a charlatan. See note at quack .
• historical a person who sold patent medicines in public places.
DERIVATIVES
mountebankery |-ˌba ng kərē| noun
ORIGIN late 16th cent.: from Italian
montambanco, from the imperative phrase monta in banco! ‘climb on the bench!’ (with allusion to the raised platform used to attract an audience).

Thesaurus
mountebank
noun
that mountebank is going to rue the day he ever set foot in our fair town: swindler, charlatan, confidence trickster, fraud, fraudster, impostor, trickster, hoaxer; informal con man, flimflammer, snake oil salesman, sharp, grifter, bunco artist. See note at quack .

Wiki has;


Patent medicine refers to medical compounds of questionable effectiveness sold under a variety of names and labels. The term "patent medicine" is somewhat of a misnomer because, in most cases, although many of the products weretrademarked, they were never patented (most avoided the patent process so as not to reveal products' often hazardous and questionable ingredients). Perhaps the only "patent medicine" ever to be patented was Castoria.[1] In ancient times, such medicine was called nostrum remedium ("our remedy" in Latin). The name patent medicine has become particularly associated with the sale of drug compounds in the nineteenth century under an array of colourful names and even more colourful claims.

The promotion of patent medicines was one of the first major products highlighted by the advertising industry, and many advertising and sales techniques were pioneered by patent medicine promoters.[2] Patent medicine advertising often talked up exotic ingredients, even if their actual effects came from more prosaic drugs. One memorable group of patent medicines — liniments that allegedly contained snake oil, supposedly a panacea — made snake oil salesman a lasting synonym for a charlatan.

Contents

[hide]

[edit]Patent medicines and advertising

Mugwump, an invented name

The phrase "patent medicine" comes from the late 17th century[3] marketing of medical elixirs, when those who found favour withroyalty were issued letters patent authorising the use of the royal endorsement in advertising. Few if any of the nostrums were actually patented; chemical patents did not come into use in the United States until 1925. Furthermore, patenting one of these remedies would have meant publicly disclosing its ingredients, which most promoters sought to avoid.

Instead, the compounders of such nostrums used a primitive version of branding to distinguish their products from the crowd of their competitors. Many familiar names from the era live on today in brands such as Luden's cough drops, Lydia E. Pinkham's vegetable compound for women, Fletcher's Castoria and even Angostura bitters, which was once marketed as a stomachic. Though sold at high prices, many of these products were made from cheap ingredients. Their composition was well known within thepharmacy trade, and druggists would sell (for a slightly lower price) medicines of almost identical composition which they had manufactured themselves. To protect profits, the branded medicine advertisements laid great emphasis on the brand names, and urged the public to accept no substitutes.

At least in the earliest days, the history of patent medicines is coextensive with scientific medicine. Empirical medicine, and the beginning of the application of the scientific method to medicine, began to yield a few orthodoxly acceptable herbal and mineral drugs for the physician's arsenal. These few remedies, on the other hand, were inadequate to cover the bewildering variety ofdiseases and symptoms. Beyond these patches of evidence-based application, people used other methods, such as occultism; the "doctrine of signatures" — essentially, the application of sympathetic magic to pharmacology — held that nature had hidden clues to medically effective drugs in their resemblances to the human body and its parts. This led medical men to hope, at least, that, say, walnut shells might be good for skull fractures. Given the state of the pharmacopoeia, and patients' demands for something to take, physicians began making "blunderbuss" concoctions of various drugs, proven and unproven. These concoctions were the ancestors of the several nostrums.

Touting these nostrums was one of the first major projects of the advertising industry. The marketing of nostrums under implausible claims has a long history. InHenry Fielding's Tom Jones (1749), allusion is made to the sale of medical compounds claimed to be universal panaceas:

As to Squire Western, he was seldom out of the sick-room, unless when he was engaged either in the field or over his bottle. Nay, he would sometimes retire hither to take his beer, and it was not without difficulty that he was prevented from forcing Jones to take his beer too: for no quack ever held his nostrum to be a more general panacea than he did this; which, he said, had more virtue in it than was in all the physic in an apothecary's shop.
Lydia Pinkham's Herb Medicine (circa 1875) remains on the market today.

Within the English-speaking world, patent medicines are as old as journalism. "Anderson's Pills" were first made in England in the 1630s; the recipe was allegedly learned in Venice by a Scot who claimed to be physician to King Charles I. Daffy's Elixir was invented about 1647 and remained popular in Britain and the USA until the late 19th century. The use of "letters patent" to obtain exclusive marketing rights to certain labelled formulas and their marketing fueled the circulation of early newspapers. The use of invented names began early. In 1726 a patent was also granted to the makers of "Dr. Bateman's Pectoral Drops"; at least on the documents that survive, there was no Dr. Bateman. This was the enterprise of a Benjamin Okell and a group of promoters who owned a warehouse and a print shop to promote the product.

A number of American institutions owe their existence to the patent medicine industry, most notably a number of the olderalmanacs, which were originally given away as promotional items by patent medicine manufacturers. Perhaps the most successful industry that grew up out of the business of patent medicine advertisements, though, was founded by William H. Gannett in Mainein 1866. There were few circulating newspapers in Maine in that era, so Gannett founded a periodical, Comfort, whose chief purpose was to propose the merits of Oxien, a nostrum made from the fruit of the baobab tree, to the rural folks of Maine. Gannett's newspaper became the first publication of Guy Gannett Communications, which eventually owned four Maine dailies and several television stations. (The family-owned firm is unrelated to the Gannett Corporation that publishes USA Today.) An early pioneer in the use of advertising to promote patent medicine was New York businessman Benjamin Brandreth, whose "Vegetable Universal Pill" eventually became one of the best-selling patent medicines in the United States.[4] “…A congressional committee in 1849 reported that Brandreth was the nation’s largest proprietary advertiser… Between 1862 and 1863 Brandreth’s average annual gross income surpassed $600,000…”[5] For fifty years Brandreth’s name was a household word in the United States[6]Indeed, the Brandreth pills were so well known they received mention in Herman Melville's classic novel Moby Dick.[7]

Kickapoo Indian "Sagwa", sold at medicine shows

Another method of publicity undertaken mostly by smaller firms was the "medicine show," a traveling circus of sorts which offeredvaudeville-style entertainments on a small scale, and which climaxed in a pitch for the nostrum being sold. "Muscle man" acts were especially popular on these tours, for this enabled the salesman to tout the physical vigour offered by the potion he was selling. The showmen frequently employed shills, who would step forward from the crowd and offer "unsolicited" testimonials about the benefits of the medicine for sale. Often, the nostrum was manufactured and bottled in the same wagon in which the show travelled. TheKickapoo Indian Medicine Company became one of the largest and most successful medicine show operators. Their shows had an American Indian or Wild West theme, and employed many Native Americans as spokespeople. The "medicine show" lived on inAmerican folklore and Western movies long after they had vanished from public meeting places.

[edit]Ingredients and their uses

Sick Made Well, Weak Made Strong, Elixir of Life, etc. Typical ad for patent medicine.

[edit]Supposed ingredients

Kilmer's Swamp Root

Some level of exoticism and mystery in the contents of the preparation was deemed desirable by their promoters. Unlikely ingredients such as the baobab fruit in Oxien were a recurring theme. A famous patent medicine of the period was Dr. Kilmer's Swamp Root; unspecified roots found in swamps had remarkable effects on the kidneys, according to its literature.

Native American themes were also useful; Natives, imagined to be noble savages, were thought to be in tune with nature, and heirs to a body of traditional lore aboutherbal remedies and natural cures. One example of this approach from the period was Kickapoo Indian Sagwa, a product of the Kickapoo Indian Medicine Companyof Connecticut (completely unrelated to the real Kickapoo Indian tribe of Oklahoma), supposedly based on a Native American recipe. This nostrum was the inspiration for Al Capp's "Kickapoo Joy Juice," featured in the comic strip, "Li'l Abner". Another benefit of claiming traditional native origins was that it was nearly impossible to disprove. A good example of this is the story behind Dr. Morse's Indian Root Pills which was the mainstay of the Comstock patent medicine business. According to the text printed on a wrapper that accompanied every box of pills, Dr. Morse had been a trained medical doctor who enriched his education by travelling extensively throughout Asia, Africa and Europe. He also supposedly immersed himself among the natives of North America for three years during which time he discovered the healing properties of the various plants and roots that would eventually combine to yield Dr. Morse's Indian Root Pills. It is unknown if Dr. Morse ever actually existed.[citation needed]

Other promoters took an opposite tack from timeless herbal wisdom. Just about any scientific discovery or exotic locale could be used as a key ingredient in a patent medicine. Consumers were invited to invoke the power of electromagnetism to heal their ailments. In the nineteenth century, electricity and radio were gee-whiz scientific advances that found their way into patent medicine advertising, especially after Luigi Galvani showed that electricity influenced the muscles. Devices meant to electrify the body were sold; nostrums were compounded that purported to attract electrical energy or make the body more conductive. "Violet ray machines" were sold as rejuvenation devices, and balding men could seek solace in an "electric fez" purported to regrow hair. Albert Abrams was a well known practitioner of electrical quackery, claiming the ability to diagnose and treat diseases over long distances by radio. In 1913 the quack John R. Brinkley, calling himself an "Electro Medic Doctor," began injecting men with colored water as a virility cure, claiming it was "electric medicine from Germany." (Brinkley would go on to even greater infamy through transplanting goat testicles into men's scrotums as a virility treatment.)

Towards the end of the period, a number of radioactive medicines, containing uranium or radium, were marketed. These apparently actually contained the ingredients promised, and there were a number of tragedies among their devotees. Most notoriously, steel heir Eben McBurney Byers was a supporter of the popular radium water Radithor, developed by the medicalcon artist William J. A. Bailey. Byers contracted fatal radium poisoning and had to have his jaw removed in an unsuccessful attempt to save him from bone cancer after drinking nearly 1400 bottles of Bailey's "radium water." Water irradiators were sold that promised to infuse water placed within them with radon, which was thought to be healthy at the time.

[edit]Actual ingredients

Contrary to what is often believed, many patent medicines did, in fact, deliver the promised results, albeit with very dangerous ingredients. For example, medicines advertised as "infant soothers" contained opium, and those advertised as "catarrh snuff" contained cocaine. While various herbs, touted or alluded to, were talked up in the advertising, their actual effects often came from procaine extracts, or grain alcohol. Those containing opiates were at least effective in relieving pain, though they could result in addiction. This hazard was sufficiently well known that many were advertised as causing none of the harmful effects of opium (though many of those so advertised actually did contain opium). In the case of medicines for "female complaints", the principal "complaint" that the medicine was intended to treat was early pregnancy[citation needed]; such products contained abortifacients[citation needed], such as pennyroyal, tansy and Juniperus sabina.

Until the twentieth century alcohol was the most controversial ingredient, for it was widely recognised that the "medicines" could continue to be sold for their alleged curative properties even in prohibition states and counties. Many of the medicines were in fact liqueurs of various sorts, flavoured with herbs said to havemedicinal properties. Peruna was a famous "Prohibition tonic," weighing in at around 18% grain alcohol. A nostrum known as "Jamaican ginger" was ordered to change its formula by Prohibition officials. To fool a chemical test some vendors added a toxic chemical, cresyl phosphate, an organophosphate compound that had effects similar to a nerve agent. Unwary imbibers suffered a form of paralysis that came to be known as jake-leg. Some included laxatives such as senna ordiuretics, in order to give the compounds some obvious medical effects. The narcotics and stimulants at least had the virtue of making the people who took them feel better, and in the eyes of the advertisers this was scored as a "cure."

Clark Stanley, the "Rattlesnake King", produced Stanley's snake oil, publicly processing rattlesnakes at the World's Columbian Exposition in Chicago. His liniment, when seized and tested by the federal government in 1917, was found to contain mineral oil, 1% fatty oil, red pepper, turpentine and camphor. This is not too unlike modern capsaicin and camphor liniments.

When journalists and physicians began focusing on the narcotic contents of the patent medicines, some of their makers began substituting acetanilide, a particularly toxic non-steroidal anti-inflammatory drug, discovered in 1886, for the laudanum they used to contain. This ingredient change probably killed more of the nostrum's users than the narcotics did, since the acetanilide was toxic to the liver and kidneys.

[edit]Supposed uses

Bonnore's Electro Magnetic Bathing Fluid was claimed to help many unrelated ailments.

Patent medicines were supposedly able to cure just about everything. Nostrums were openly sold that claimed to cure or prevent venereal diseases, tuberculosis, and cancer. Bonnore's Electro Magnetic Bathing Fluid claimed to cure cholera, neuralgia, epilepsy, scarlet fever, necrosis, mercurial eruptions, paralysis, hip diseases, chronicabscesses, and "female complaints." William Radam's Microbe Killer, a product sold widely on both sides of the Atlantic in the 1890s and early 1900s, had the bold claim 'Cures All Diseases' prominently embossed on the front of the bottle. Ebeneezer Sibley ('Dr Sibley') in late 18th and early 19th century Britain went so far as to advertise that his Solar Tincture was able to "restore life in the event of sudden death", amongst other marvels.

Every manufacturer published long lists of testimonials in which all sorts of human ailments were cured by the compounds. Fortunately for both their makers and users, the illnesses that they claimed were cured were almost invariably self-diagnosed, and the claims of the writers to have been healed of cancer or tuberculosis by the nostrum should be considered in this light.

[edit]The end of the patent medicine era

Clark Stanley's Snake OilLiniment.

Muckraker journalists and other investigators began to publicize instances of death, drug addiction, and other hazards from the compounds. This took some small courage on behalf of the publishing industry that circulated these claims, since the typical newspaper of the period relied heavily on the patent medicines, which founded the U.S. advertising industry. In 1905, Samuel Hopkins Adams published an exposé entitled "The Great American Fraud" in Collier's Weekly that led to the passage of the firstPure Food and Drug Act in 1906.[8] This statute did not ban the alcohol, narcotics, and stimulants in the medicines; it required them to be labeled as such, and curbed some of the more misleading, overstated, or fraudulent claims that appeared on the labels. In 1936 the statute was revised to ban them, and the United States entered a long period of ever more drastic reductions in the medications available unmediated by physicians and prescriptions. Morris Fishbein, editor of the Journal of the American Medical Association, who was active in the first half of the 20th century, based much of his career on exposing quacks and driving them out of business.

The patent medicine makers moved from selling nostrums to selling deodorants and toothpastes, which continued to be advertised using the same techniques that had proven themselves selling nostrums for tuberculosis and "female complaints." One survival of the herbal exoticism that once characterized the patent medicine industry is the marketing of shampoos, which are often promoted as containing perfumes such as vetiver or ylang-ylang, and foods such as mangoes, bananas, or honey; consumers are urged to put these ingredients in their hair despite lack of any evidence that these ingredients do anything other than make the hair smell like the ingredients.

In more recent years, also, various herbal concoctions have been marketed as "nutritional supplements". While their advertisements are careful not to cross the line into making explicit medical claims, and often bear a disclaimer that asserts that the products have not been tested and are not intended to diagnose or treat any disease, they are nevertheless marketed as remedies of various sorts. Weight loss "while you sleep" and similar claims are frequently found on these compounds (cf., Calorad, Relacore, etal.). One of the most notorious such elixirs, however, calls itself "Enzyte", widely advertised for "natural male enhancement" — that is, penis enlargement. Despite being a compound of herbs, minerals, and vitamins, Enzyte formerly promoted itself under a fake scientific name Suffragium asotas. Enzyte's makers translate this phrase as "better sex," but it is in fact ungrammatical Latin for "refuge for the dissipated."[9]

[edit]Surviving consumer products from the patent medicine era

A number of brands of consumer products that date from the patent medicine era are still on the market and available today. Their ingredients may have changed from the original formulas; the claims made for the benefits they offer have typically been seriously revised. These brands include:

A horse drawn Bromo Seltzer wagon.

A number of patent medicines are produced in China; among the best known of these is Shou Wu Chih, a black, alcoholic liquid which is claimed to turn gray hair black.

[edit]Products no longer sold under medicinal claims

Some consumer products were once marketed as patent medicines, but have been repurposed and are no longer sold for medicinal purposes. Their original ingredients may have been changed to remove drugs, as was done with Coca-Cola. The compound may also simply be used in a different capacity, as in the case of Angostura Bitters, now associated chiefly with cocktails.

[edit]See also

Receipt from 1900 for a patent medicine claiming a "Positive Cure for Dyspepsia,Heartburn, Gastritis, Threatened Cancer and all Stomach Troubles" with "Relief in five minutes."

[edit]References

  1. ^ Walker, W.O., "Patent Medicines", Journal of Chemical Education, Vol.4 No.8, (August 1927), pp.960–963; p.960.
  2. ^ See Conroy, (2009), passim. for an account of E. Virgil Neal, patent medicine manufacturer and promoter (e.g., the tonic, "nuxated iron", which was supposedly used by Ty Cobb, Jack Dempsey, and Pope Benedict XV), significant Madison Avenue pioneer, and mentor of Carl R. Byoir.
  3. ^ NMAH | Object Groups
  4. ^ Atwater, Edward (2004). An Annotated Catalogue of the Edward C. Atwater Collection of American. New York: Boydell & Brewer. pp. 117. ISBN 1580460984.
  5. ^ Atwater, Edward (2004). An Annotated Catalogue of the Edward C. Atwater Collection of American. New York: Boydell & Brewer. pp. 118. ISBN 1580460984.
  6. ^ White, James Terry (1895). The National Cyclopaedia of American Biography. United States: J.T. White. pp. 166. ISBN 0403012716.
  7. ^ Melville, Herman (1892). Moby-Dick; Or, The White Whale. Boston: L.C. Page & Co.. pp. 386. ISBN 1587299062.
  8. ^ Adams, Samuel Hopkins (1905). The Great American Fraud (4th ed., 1907). Chicago: American Medical Association. Retrieved 2009-07-30.
  9. ^ "Why is this man smiling? It's not Viagra". USA Today. 2002-04-17. Retrieved 2010-05-21.

[edit]Further reading

[edit]External links

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