Revisions in the Physician Payments Sunshine Act (S. 2029) will now make it a Class D federal felony for physicians to accept more than $25 annually in gifts or other rewards from pharmaceutical companies or biological product and medical device manufacturers.
The revised bill, introduced last fall by Senators Chuck Grassley, Republican of Iowa, and Herb Kohl, Democrat of Wisconsin, requires full disclosure of gifts, through a Department of Health and Human Services online system, by both companies and individual physicians, and it revokes caps on non-disclosure penalties for companies.
The legislation targets offending individual physicians, hospitals, schools, and other medical institutions that deal directly with patients. It also makes it a federal offense for medical industries to circumvent customary gift-giving practices through third parties, such as lawyers and insurance companies, or via “educational” events.
It reverses earlier legislation that would have preempted more stringent physician sunshine laws passed by the states. The previous version of the law limited penalties to $10000 for non-disclosure, and $100000 for companies that “knowingly” fail to disclose gifts to physicians. The new bill establishes a lower limit for fines, but not an upper limit, and requires that that penalties make into account histories of gift-giving, product specifics and histories, overall corporate revenue, and other variables, before appropriate fines can be assessed.
Patients' rights and medical ethics groups, like the New England Medical Ethics Commission in Boston, are exultant. “It's not like the A. M. A or [pharmaceutical trade association] PhRMA were ever going to comply with their own stated standards,” says Patty Williams, Director of Communications for the commission. Williams is referring to the American Medical Association's 1991 guidelines on gifts to physicians from industry, which stemmed a tide of blatant gift-giving in the 1960s, but have been criticized for allowing new byways for abuse: free lunches and dinners, travel and honoraria, and the hemorrhaging of complimentary pens, coffee mugs, and other product-related paraphernalia into doctors' offices.
“What we really need is a sea change in the medical profession wherein physicians realize that it is not ok to get gifts or fill our offices with advertisements for products. It demeans patient care,” says Mount Sinai School of Medicine professor Dr. Joseph Ross. While programs like the Prescription Project, which scrutinize pharmaceutical company information and sales practices, have been in place for several years in states like Massachusetts and Pennsylvania, their effect is limited by the willingness of doctors to abide by ethical standards.
“This will definitely make it a lot harder for us to get out products to customers,” says Sampson Browning, spokesperson for Eli Lilly, which anticipates large losses of revenue due to the new legislation.
“I haven't paid for lunch since last February, and I think I ate at home that day,” says Dr. Bruce Arbogast, Director of Pine Grove Medical Center in Chicago. “Do the math. Do you think I can afford to say no when the drug reps knock on my door?” From now on, doctors will have to, or risk up to ten years imprisonment.
1. Which one of the following statements is NOT true of the revised bill?
[A] The revised bill gives those who have direct connections with patients a serious warning.
[B] The revised bill withdraws the upper limits on non-disclosure penalties for companies.
[C] The revised bill is more severe since there is neither lower nor upper ultimate for the penalty.
[D] The revised bill requires full disclosure of gifts via an online system operated by the Department of Health and Human Services.
2. What's the main function of the revised bill?
[A] It requires that penalties take into account histories of gift-giving, product specifics and other variables, before appropriate fines can be assessed.
[B] It makes some contributions to the patients' rights and medical ethics.
[C] It ends the tide of blatant gift-giving in the 1960s.
[D] It completely changes the medical profession.
3. What Patty Williams wants to express is that _____.
[A] the earlier legislations are useless
[B] he agrees with the revised bill
[C] the revised bill will not be under criticism
[D] any new methods to get benefits from medical profession will be prevented by the revised bill
4. Why does Sampson Browning take a pessimistic attitude towards his Company's future?
[A] Because most of its revenue comes from those ways the revised bill prohibits.
[B] Because its products can't be sold to the customers any more.
[C] Because the revised bill sets a lot of limits for his company.
[D] Because he thinks there are no other ways for his firm to make money.
5. From what Dr. Bruce Arbogast says, we can infer that _____.
[A] before last February, he always had lunch for free
[B] he can reject any drug salesmen
[C] to some extent, the revised bill has worked
[D] since the punishment is so severe, he and other doctors wouldn't take risks
1. Which one of the following statements is NOT true of the revised bill?
[A] The revised bill gives those who have direct connections with patients a serious warning.
[B] The revised bill withdraws the upper limits on non-disclosure penalties for companies.
[C] The revised bill is more severe since there is neither lower nor upper ultimate for the penalty.
[D] The revised bill requires full disclosure of gifts via an online system operated by the Department of Health and Human Services.
1. 關(guān)于這部修正法案,下列哪個(gè)陳述是錯(cuò)誤的?
[A] 這部修正法案給那些與病人直接打交道的人提出了嚴(yán)重警告。
[B] 這部修正法案撤銷了對(duì)不公開(kāi)信息的公司的懲罰上限。
[C] 由于這部修正法案既沒(méi)有懲罰下限,也沒(méi)有懲罰上限,所以相對(duì)來(lái)說(shuō)更為嚴(yán)厲。
[D] 這部修正法案要求通過(guò)衛(wèi)生與公眾服務(wù)部的在線系統(tǒng),全面公開(kāi)送出或接受的禮品。
答案:C
分析:細(xì)節(jié)題。文章第三段提到:該法案鎖定的是那些與病人直接打交道的醫(yī)生、醫(yī)院、學(xué)校和其他醫(yī)療機(jī)構(gòu)。換句話說(shuō),也就是給這些人和機(jī)構(gòu)提出了嚴(yán)重警告,因此選項(xiàng)A說(shuō)法正確。第二段最后一句提到:該法案還撤銷了對(duì)公司隱瞞行為的懲罰上限,與選項(xiàng)B意思相同而說(shuō)法不同。文章第四段提到:新的法案降低了罰款金額下限,但上不封頂,可見(jiàn),并非沒(méi)有下限,只是有所降低。因此,選項(xiàng)C說(shuō)法不正確。第二段提到:要求公司和醫(yī)生個(gè)人均通過(guò)衛(wèi)生與公眾服務(wù)部的在線系統(tǒng),全面公開(kāi)其送出或收受的禮品。因此,選項(xiàng)D說(shuō)法正確。故正確答案為選項(xiàng)C。
2. What's the main function of the revised bill?
[A] It requires that penalties take into account histories of gift-giving, product specifics and other variables, before appropriate fines can be assessed.
[B] It makes some contributions to the patients' rights and medical ethics.
[C] It ends the tide of blatant gift-giving in the 1960s.
[D] It completely changes the medical profession.
2. 該修正法案的主要作用是什么?
[A] 修正法案要求在確定罰款金額前,包括送禮歷史、禮品詳情和其他的可變因素都要納入考慮范圍。
[B] 修正法案對(duì)保衛(wèi)患者權(quán)利以及維護(hù)醫(yī)德做出了一些貢獻(xiàn)。
[C] 修正法案遏制了20世紀(jì)60年代公然送禮的風(fēng)潮。
[D] 修正法案徹底改變了整個(gè)醫(yī)學(xué)行業(yè)。
答案:B
分析:細(xì)節(jié)題。文章第四段提到:修正法案要求在確定罰款金額前,包括送禮歷史、禮品詳情和來(lái)歷、公司總收益所得和其他的可變因素都要納入考慮范圍。但這并非該修正法案的主要作用,而只是其中的一項(xiàng)規(guī)定。因此,選項(xiàng)A不符合題意。第五段提到:病人權(quán)利和醫(yī)學(xué)倫理團(tuán)體,像位于波士頓的新英格蘭醫(yī)療職業(yè)道德委員會(huì),感到非常高興。由此可見(jiàn),該法案對(duì)保衛(wèi)患者權(quán)利以及維護(hù)醫(yī)德有一定作用。選項(xiàng)B正確。根據(jù)文章第五段可知,是美國(guó)醫(yī)學(xué)協(xié)會(huì)1991年頒布的準(zhǔn)則遏制了20世紀(jì)60年代公然送禮的風(fēng)潮,而非該修正案,選項(xiàng)C主體搞錯(cuò),因此不正確。第六段提到,約瑟夫·羅斯醫(yī)生希望醫(yī)療行業(yè)能夠發(fā)生翻天覆地的變化,而不是該修正法案已經(jīng)改變了整個(gè)醫(yī)療行業(yè),選項(xiàng)D以偏概全,因此說(shuō)法不正確。故正確答案為選項(xiàng)B。
3. What Patty Williams wants to express is that _____.
[A] the earlier legislations are useless
[B] he agrees with the revised bill
[C] the revised bill will not be under criticism
[D] any new methods to get benefits from medical profession will be prevented by the revised bill
3. 帕蒂·威廉姆斯想要表達(dá)的意思是_____。
[A] 之前的法案都沒(méi)用
[B] 他贊同修正法案
[C] 修正法案將不會(huì)受到批評(píng)
[D] 有了修正法案,任何新的想要從醫(yī)療行業(yè)獲得好處的方式都將被禁止
答案:B
分析:推斷題。第四段和第五段講述了之前的其他法案的弊端,但是帕蒂·威廉姆斯并沒(méi)有說(shuō)其他法案一點(diǎn)兒作用都沒(méi)有,因此,選項(xiàng)A不正確。文章第五段開(kāi)頭提到,對(duì)于該項(xiàng)法案,波士頓的新英格蘭醫(yī)療職業(yè)道德委員會(huì)感到非常高興。而帕蒂·威廉姆斯正是此委員會(huì)的傳訊總監(jiān),因此這也代表了他的意思,選項(xiàng)B正確。第五段提到,之前的法案因?yàn)榇偈剐碌呐蚤T左道的濫用而備受爭(zhēng)議。但是這部修正法案在之后的實(shí)施過(guò)程中會(huì)出現(xiàn)什么狀況我們也不得而知,因此無(wú)法得出“不會(huì)受到批評(píng)”的結(jié)論,更無(wú)法得知該項(xiàng)修正法案是否可以禁止一切從醫(yī)療行業(yè)撈取好處的旁門左道。故選項(xiàng)C、D錯(cuò)誤。因此,正確答案為選項(xiàng)B。
4. Why does Sampson Browning take a pessimistic attitude towards his Company's future?
[A] Because most of its revenue comes from those ways the revised bill prohibits.
[B] Because its products can't be sold to the customers any more.
[C] Because the revised bill sets a lot of limits for his company.
[D] Because he thinks there are no other ways for his firm to make money.
4. 為什么桑普森·勃朗寧對(duì)他公司的未來(lái)持悲觀態(tài)度?
[A] 因?yàn)楣敬蟛糠质杖攵紒?lái)自修正法案禁止的行為。
[B] 因?yàn)樗墓镜漠a(chǎn)品再也不能向顧客出售了。
[C] 因?yàn)樾拚ò附o他的公司帶來(lái)很多限制。
[D] 因?yàn)樗J(rèn)為他的公司沒(méi)有其他的賺錢途徑。
答案:C
分析:細(xì)節(jié)題。第七段提到,禮來(lái)制藥公司發(fā)言人桑普森·勃朗寧卻說(shuō):“這無(wú)疑會(huì)使我們公司對(duì)客戶的產(chǎn)品銷售更加困難。”該公司預(yù)測(cè),其財(cái)政收入將會(huì)因這項(xiàng)新法案而損失巨大。選項(xiàng)A文中并未提及。桑普森·勃朗寧說(shuō)新法案會(huì)阻礙向顧客出售產(chǎn)品,并非再也不能,因此,選項(xiàng)B太過(guò)絕對(duì),不正確。選項(xiàng)C是對(duì)桑普森·勃朗寧所說(shuō)內(nèi)容的整體概括,最全面得體。選項(xiàng)D文中并未提及,而且公司賺錢的途徑并非只有一條,只是盈利多少的問(wèn)題。因此,選項(xiàng)D不正確。故正確答案為選項(xiàng)C。
5. From what Dr. Bruce Arbogast says, we can infer that _____.
[A] before last February, he always had lunch for free
[B] he can reject any drug salesmen
[C] to some extent, the revised bill has worked
[D] since the punishment is so severe, he and other doctors wouldn't take risks
5. 從布魯斯·阿伯加斯特醫(yī)生的話中,我們可以推斷出_____。
[A] 去年二月份之前,他的午餐總是免費(fèi)的
[B] 他能拒絕任何一個(gè)藥品推銷員
[C] 修正法案在一定程度上已經(jīng)起了作用
[D] 既然懲罰措施如此嚴(yán)厲,他和其他醫(yī)生將不會(huì)冒險(xiǎn)去觸犯法律
答案:C
分析:推斷題。最后一段布魯斯·阿伯加斯特醫(yī)生說(shuō):“自去年二月份開(kāi)始,我就沒(méi)有再為午餐開(kāi)支了。我想那天我在家吃飯了。”這說(shuō)明修正案在一定程度上已經(jīng)起了作用,他已經(jīng)不再接受別人的好處(被請(qǐng)吃午餐)而選擇在家吃飯。因此,正確答案為選項(xiàng)C。
《醫(yī)生報(bào)酬陽(yáng)光法案》(S. 2029)中的修訂部分現(xiàn)在規(guī)定,如果醫(yī)生每年從醫(yī)藥公司或者生物制品以及醫(yī)療設(shè)備生產(chǎn)商那里收受價(jià)值超過(guò)25美元的禮物或者其他報(bào)酬,將被聯(lián)邦定為D級(jí)重罪。
去年秋季,愛(ài)荷華州的共和黨參議員查克·格拉斯利和威斯康星州的民主黨參議員赫伯·科爾提出了修訂法案,要求公司和醫(yī)生個(gè)人均通過(guò)衛(wèi)生與公眾服務(wù)部的在線系統(tǒng),全面公開(kāi)其送出或收受的禮品。該法案還撤消了對(duì)公司隱瞞行為的懲罰上限。
這部法案鎖定的是那些與病人直接打交道的醫(yī)生、醫(yī)院、學(xué)校和其他醫(yī)療機(jī)構(gòu)。對(duì)于醫(yī)療行業(yè)照例送禮,卻通過(guò)第三方規(guī)避自己責(zé)任的行為,也被視為觸犯了聯(lián)邦法律,第三方可能是律師和保險(xiǎn)公司,或者是通過(guò)“教育”活動(dòng)。
該法案推翻了早期法律。早期法律會(huì)優(yōu)先于各州頒布的更為嚴(yán)格的醫(yī)生陽(yáng)光法案。之前的法律將不公開(kāi)信息的行為的最高處罰金額限定為一萬(wàn)美金,對(duì)故意隱瞞給醫(yī)生禮品的公司的最高處罰金額限定為十萬(wàn)美金。新的法案降低了罰款金額下限,但上不封頂,并要求在確定罰款金額前,包括送禮歷史、禮品詳情和來(lái)歷、公司總收益所得和其他的可變因素都要納入考慮范圍。
病人權(quán)利和醫(yī)學(xué)倫理團(tuán)體,像位于波士頓的新英格蘭醫(yī)療職業(yè)道德委員會(huì),感到非常高興。“因?yàn)樗幌衩绹?guó)醫(yī)學(xué)協(xié)會(huì)或[醫(yī)藥商業(yè)行業(yè)協(xié)會(huì)]藥品與制造商協(xié)會(huì)那樣總是按照自己的標(biāo)準(zhǔn)行事。”委員會(huì)傳訊總監(jiān)帕蒂·威廉姆斯這樣說(shuō)道。威廉姆斯指的是美國(guó)醫(yī)學(xué)協(xié)會(huì)1991年頒布的行業(yè)向醫(yī)生送禮的準(zhǔn)則,這個(gè)準(zhǔn)則遏制了20世紀(jì)60年代公然送禮的風(fēng)潮,卻因?yàn)榇偈剐碌呐蚤T左道的濫用而備受爭(zhēng)議:免費(fèi)的午餐和晚餐、旅游、謝禮以及源源不斷送往醫(yī)生辦公室的贈(zèng)品,如鋼筆、咖啡杯和其他與產(chǎn)品有關(guān)的大量用品。
“我們真正需要的是醫(yī)療職業(yè)翻天覆地的變化,醫(yī)務(wù)人員能意識(shí)到收受禮物或者在辦公室里擺滿產(chǎn)品廣告都是不好的行為,這有辱我們的天職:照顧病患。”西奈山醫(yī)學(xué)院教授約瑟夫·羅斯醫(yī)生說(shuō)。像處方計(jì)劃等一些項(xiàng)目,會(huì)仔細(xì)檢查制藥公司的信息以及銷售慣例。盡管它們已經(jīng)在馬薩諸塞和賓夕法尼亞等州運(yùn)行了幾年了,但其效果卻因醫(yī)生是否愿意恪守職業(yè)道德而受到影響。
禮來(lái)制藥公司發(fā)言人桑普森·勃朗寧卻說(shuō):“這無(wú)疑會(huì)使我們公司對(duì)客戶的產(chǎn)品銷售更加困難。”該公司預(yù)測(cè),其財(cái)政收入將會(huì)因這項(xiàng)新法案而損失巨大。
“自去年二月份開(kāi)始,我就沒(méi)有再為午餐開(kāi)支了。我想那天我在家吃飯了。”芝加哥派恩·格羅夫醫(yī)療中心主管布魯斯·阿伯加斯特醫(yī)生說(shuō):“想想看,你覺(jué)得當(dāng)醫(yī)藥推銷員敲響我家的門時(shí),我能拒絕得了嗎?”從現(xiàn)在起,醫(yī)生們將不得不拒絕,否則,他們要面臨長(zhǎng)達(dá)10年的牢獄之災(zāi)的風(fēng)險(xiǎn)。