
Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks - MilnerRoute
http://fortune.com/2018/03/10/jerrold-rosenberg-opioid-kickbacks/
======
anonymous5133
FYI, there is a new episode on american greed which pretty much shows how
these type of operations worked. Insys basically gave the kickbacks by having
the doctors give "speeches" but it turns out no speeches were given and the
doctors got the checks anyways.

[https://www.youtube.com/watch?v=h2WBKkyFpRo](https://www.youtube.com/watch?v=h2WBKkyFpRo)

~~~
rdtsc
> it turns out no speeches were given and the doctors got the checks anyways.

True, but it's not like if they did, the situation would be that much better.
In a way for them they screwed up because the actually didn't bother playing
the bribery sham all the way through like say political candidates do. For
example, Hillary Clinton made $3M from speeches to large banks in just 2
years: [https://theintercept.com/2016/01/08/hillary-clinton-
earned-m...](https://theintercept.com/2016/01/08/hillary-clinton-earned-more-
from-12-speeches-to-big-banks-than-most-americans-earn-in-their-lifetime/) but
they were actually organized enough to have "speechs". I remember the
transcript of one was leaked, and you'd think they'd be some really deep
insights and strategy laid out for the future that's worth $600k. But it was
mostly "you all great, thanks for creating jobs etc etc". It is legal of
course, but everyone know what it really is.

~~~
ggg9990
It’s not clear what it really is. People pay hundreds of thousands of dollars
to Hollywood celebrities for appearances too, with no expectations of
political favors.

~~~
xor1
Are those appearances private?

~~~
disillusioned
I mean, I'm in EO and our chapter spends about $150k/year on appearances from
popular speakers. We're not buying influence or lobbying, and they're private
appearances, yes. They're on a variety of topics from a variety of people that
the organization thinks we'll find valuable, and the market has set a pretty
steep price for some of the better speakers. /shrug

~~~
ggg9990
What is EO?

~~~
sarabande
Entrepreneurs' Organization
([https://www.eonetwork.org/](https://www.eonetwork.org/)).

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ransom1538
As a side project I sorted the doctors based on opioid prescribe count. It
isn't hard to see who the pill shops are -- I am sure the DEA can do a sql
command. IMHO they (DEA) prefers kicking down doors in poor areas.

[https://www.opendoctor.io/opioid/highest/?hn=1](https://www.opendoctor.io/opioid/highest/?hn=1)

From article, John Couch and Xiulu Ruan are on top of the list.

~~~
chime
As bad as pill mills are, wouldn't 'Pain Management' clinics rate high in this
query since they give out pills to manage legitimate pain?

I have multiple herniated cervical disks and am going in for surgery soon
because the pain is debilitating and unbearable. Among other specialists, I
saw a pain management doctor to understand my non-surgical options. Many
people with my condition choose to not get implants or disk fusions and
instead opt for steroids, epidurals, and opioids.

Legitimate doctors at pain management clinics will rank high on these lists if
they have a lot of really sick patients who don't want neurosurgery.

~~~
ransom1538
Yes! 'Pain Management' would be a high subscriber. But being the top 5 in the
US? Maybe, but that is pretty strange - definitely worth a DEA trip. 'Family
Medicine' in the top 40? Hm....

~~~
freedomben
"A DEA trip" is not a small thing. It's a terrifying thing. It can be the end
of your livelihood if you're a doctor, even if you've done nothing wrong.
There is no shortage of stories about that happening (and what about the
hundreds of patients who are suddenly left stranded with debilitating chronic
pain?)[1]. I wouldn't call for you to have an "IRS trip" or some other jack-
booted government agency, nor do I think you should call for the DEA to visit
other people. It's this type of attitude that is literally killing pain
patients [2].

But then again, I don't think it is any of my business what other adults want
to put into their own bodies, so even if some doc office were a pill mill I
wouldn't care.

[1] Here's one off the top of my head:
[https://www.painnewsnetwork.org/stories/2017/12/28/tennant-p...](https://www.painnewsnetwork.org/stories/2017/12/28/tennant-
patients-live-in-fear-of-dea)).

[2] [https://www.painnewsnetwork.org/stories/2017/9/4/how-
chronic...](https://www.painnewsnetwork.org/stories/2017/9/4/how-chronic-pain-
killed-my-husband)

~~~
ransom1538
Really? A Dentist recommends 16311.0 opioids during an epidemic and someone
shouldn't at least check receipts? I don't think people should loose
livelihoods, but, let's at least look at an excel sheet right? Check out the
office make sure people are not piled into the streets waiting for drugs?

[http://nymag.com/daily/intelligencer/2014/02/rise-and-
fall-o...](http://nymag.com/daily/intelligencer/2014/02/rise-and-fall-of-nycs-
biggest-pill-mill.html)

------
omgPhysics
"Rosenberg’s son was an Insys sales representative for a year and made
“substantial commissions” from his father’s willingness to prescribe the drug,
according to prosecutors. The son wasn’t charged in the case."

A not-so-bright outlook for actually holding Insys's CEO responsible. Why were
charges not brought on middle level employees especially if the father-son
relationship could be an easy access route to bribery.

EDIT: Even the court document does not list is full name, Rosenberg's son is
simply referred to as Insys Rep A.R.

~~~
aaronmdjones
Perhaps this is an indication that the son flipped.

------
1ris
How many years would a street dealer have gotten? 40 years?

~~~
dcposch
That just means we should treat low level criminals humanely. Four years is
plenty.

The thing where decade plus sentences are fairly common is unique in the first
world: only in America. It’s barbaric and embarrassing.

The science is pretty unambiguous—a high likelihood of being caught and
punished is a better deterrent than a low-probability but larger punishment.

So I don’t want to see this doctor get a 40-year sentence. I’d rather see lots
of doctors who accepted gifts from opioid manufacturers get one-year
sentences. Most important is that the pharma executives go to jail, too.

Criminal justice should never be about retribution. In this case, the purpose
is to keep future patients safe.

~~~
namelost
Street dealers, "low level" or not, do actually kill their clients.

Prison sentences for dealing hard drugs should be in line with prison
sentences for murder, otherwise the implication is that the lives of drug
_users_ are much less valuable than the lives of regular people.

~~~
ajmurmann
If I buy drugs from a street dealer I know what I'm getting into. If I get
prescribed opioids from a supposedly trained professional whom I'm supposed to
be able to trust I don't. So as far as I'm concerned adults should be allowed
to take whatever drugs they want. However, it should be illegal to bullshit
them into taking them. Especially as a medical professional.

~~~
freedomben
Don't worry, we've so over-corrected this thing as a society due to our knee-
jerk emotional reactions and mob mentality, you won't be getting any opioids
prescribed.

Fourth stage cancer patients are now having a hard time getting them. Chronic
pain patients that have been stable for decades are being heartlessly dropped
by doctors that now fear the DEA. We are turning our backs as a society on the
most vulnerable among us.

~~~
ajmurmann
Oy! What I really want is all drugs to be legal and people being properly
educated about them. Starting in school.

~~~
matheusmoreira
>people being properly educated about them

As if the US government agencies would ever let that happen. They seem to
favor a "shock 'em straight" approach that's utterly ineffective.

------
efini
Will Trump support the execution of this man and other legal drug dealers like
him as well?

~~~
astura
This is getting down voted but I don't think that's fair, it's not off topic.
Trump said yesterday he's in favor of the death penalty for drug dealers
because they are responsible for the death of others. It's a fair question to
ask if there should be a distinction between street dealers and these doctors
and executives.

~~~
onetimemanytime
Trump is the President, not a King. This doc has been convicted and was
sentenced based on the laws in place when he commuted the crimes.
[https://en.wikipedia.org/wiki/Ex_post_facto_law](https://en.wikipedia.org/wiki/Ex_post_facto_law)
and all. Also Trump cannot force the US Congress and Senate to pass the laws.
Or the courts to judge that this is compatible with
[https://en.wikipedia.org/wiki/Cruel_and_unusual_punishment](https://en.wikipedia.org/wiki/Cruel_and_unusual_punishment)

~~~
mikeash
The question is whether he would support it, not whether he would enact it by
decree.

~~~
enraged_camel
Yes, exactly. And I think we already know that the answer is no, he wouldn't
support it. Trump has a very childish perception of the world, and a doctor
undoubtedly does not fit his mental image of the drug dealer stereotype.

~~~
UrukParthian
It's almost like politicians manage their perception and image in strategic
ways where they lull their enemies into being emotionally caught up with minor
character flaws rather than the tactics and orientation of their actions.

The smugness of people against Trump is even more worse than the smugness
people had against George W.

They're not idiots. They're sharks who have a very clear aptitude at
manipulating people and public perception. It's very bad strategy, and very
human, to ascribe to your opponents victories as "luck" and to ascribe their
mentality as "dumb".

~~~
mikeash
I agree with you when it comes to most politicians, but I’m pretty sure Trump
is actually dumb. He’s the only person I’ve ever seen contradict himself three
times in a single sentence. When he speaks, he almost never displays any
indication that there’s any understanding of the subject at hand.

W had a superficial dumbness that was largely cultivated. Beneath that he had
at least a basic understanding of the issues.

~~~
UrukParthian
Do you think he cares about you the coherence of his statements when they
provoke a strong emotional reaction from a dumb population addicted to
emotionally reacting and addicted to signaling alliegence to some vague social
grouping?

You're taking his bait superbly by thinking that the truth wins you the game
of democracy. To call him "dumb" is to severely underestimate the strategies
potential president have used in their rise to power. Or in other words, did
calling him an idiot get your side any concessions, any retaken ground?

Instead of taking Trump's bait, I'd highly recommend reading Robert Caro's
books on Lyndon B. Johnson. You'll never look at politics the same way again.

~~~
mikeash
Are you under the impression that I’m calling him “dumb” as some sort of
political strategy? I’m just describing the facts as I see them. Pointing out
that it works for him is not any sort of argument against what I’m saying.

Of course his dumbness has appeal. That’s why he won. That doesn’t mean he’s
not an idiot.

~~~
UrukParthian
Your facts is what he says to the public. That's not a "fact", that's taking
politics at face value. I told you, such men are sharks. Not merely the men
you back on your own political aisle.

I told you to read Robert Caro's series on Lyndon B.Johnson because it opens
your eyes to the political process. Do you think Johnson campaigned as a
Roosevelt man because he liked Roosevelt? Hell no, he was an opportunist.

~~~
mikeash
I still don’t get what about this is supposed to contradict what I’ve said.
And there’s plenty of evidence for Trump’s idiocy from stuff that wasn’t
supposed to be public.

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umanwizard
Shkreli got 7 years for financial fraud that didn’t end up costing anyone any
money, and this guy only got four years for actually threatening people’s
lives. Seems out of whack - what gives?

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mattnewton
That’s great: where are the cases against Insys?

~~~
dgacmu
Scheduled for trial in 2019 according to the article

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username223
> [Doctor], who lost his medical license and was ousted from his post as a
> Brown University professor, pleaded guilty to taking more than $188,000 in
> kickbacks disguised as speaker fees and creating false patient records to
> dupe insurers into covering Insys’s Subsys pain medication...

> ... [his] son was an Insys sales representative for a year and made
> “substantial commissions” from his father’s willingness to prescribe the
> drug, according to prosecutors. The son wasn’t charged in the case.

Oh, gee, it's Purdue Pharma again, i.e. the Sackler family. How am I not
surprised, and how are they not fined?

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RobLach
While his victims get a life sentence of addiction.

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mirimir
This got lots of attention because it involves opiates.

But bribes and kickbacks to doctors from big pharma are common for all top-
selling drugs.

