Accuracy in Media

Or read the transcript below:
(Transcription by J. C. Hendershot)


Interview with Dr. Robert Goldberg by Roger Aronoff

The “Take AIM” show on BlogTalkRadio, January 27, 2011.

ROGER ARONOFF: Our guest today is Dr. Robert Goldberg, author of the book Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit.  In this book he reveals how the media, trial attorneys, anti-industry activists, and politicians work together to create a shadow campaign of doubt and fear about the safety of medical treatments, and how the Internet is used to scare the public and hide a political agenda while preying on people’s insecurities.  Dr. Goldberg also investigates the rise of the “instant expert,” and shows how this new style of medical debate allows sensationalism and celebrity status to outweigh science and knowledge.  Good morning, Dr. Goldberg—“Bob,” if I may call you that—

DR. GOLDBERG: Absolutely!

ARONOFF: We’re pleased to have you here with us today on Take AIM.  Thank you.  Now, before we discuss your book and several related topics, I want to tell our listeners a little bit more about you.  Dr. Goldberg is President and co-founder of the Center for Medicine in the Public Interest, a nonprofit institute dedicated to promoting the use and understanding of technologies that make health care more predictive and personalized.  Previously, he was a Senior Fellow at the Manhattan Institute, where he was also Director of the Institute’s Center for Medical Progress, and Chairman of the Center’s 21st Century FDA Reform task force.  He’s written for many publications, including The Wall Street Journal and The American Spectator, where he broke the story about President Obama’s Medicare and Medicaid Director Donald Berwick’s admiration for Britain’s National Health Service.  First, let’s define what we’re talking about: What is “tabloid medicine”?

DR. GOLDBERG: I use the term “tabloid medicine” based on the tabloid journalism of the turn of the century, where you take exaggerated stories of risk and danger, or celebrities exposed, and you plaster them all over the Internet, in this case, in our time, to create a perception that medical products such as vaccines—and, most recently, this FDA report about the so-called “link” between cancer and breast implants—as a way of driving and discouraging support for medical innovation, and organizing opposition to the producers and commercializers of these advances.

ARONOFF: Now, what is your background? You’re not a medical doctor—

DR. GOLDBERG: That’s right. And I don’t play one on TV, either! Roger, for the last twenty years, I’ve been trying to use my platform at either the Center for Medicine in the Public Interest or the Manhattan Institute to identify the ways that we can allow people to keep control of their health care using science-based information.  I approach this with neither fear nor favor to anybody.  I took on the Clintons when they tried to nationalize the vaccine industry, and I went after drug companies that tried to keep generic drugs off the market.  I’ve also looked at the efforts of the EPA to take asthma inhalers away from poor kids in order to reduce global warming.  The point of all this, along with the work I’ve done to try to give people information on Internet-based ways to monitor the safety and benefits of their drugs, or the prices—is that people need to have the information delivered to them in an unfiltered, scientific way so they can partner with their doctors to do what’s best for them.  I’m afraid that not only do we have interest groups and trial attorneys trying to use the Internet to shape people’s perceptions of medicine, but under ObamaCare the government is launching an unprecedented effort to crowd out other voices, other forms of information so that doctors and patients sort of fall into step with the quality guidelines under ObamaCare.  So that’s what I’ve been doing.  In my particular case, I wrote in my introduction to my book that this book Worst Pills, Best Pills, which was on the Internet and produced by Public Citizen, scared many people nearly to death, including my daughter.  I didn’t write my book out of that immediate concern, but I also wanted people to know that the Web can be a great place to get health information, but you just have to pick out the people that are trying to scare you for fear or profit.

ARONOFF: Elaborate on what happened with your daughter, if that’s not too personal.

DR. GOLDBERG: No, no—it’s in the introduction! Basically, my daughter was battling an eating disorder called bulimia.  She needed a specific medication to help stabilize her condition.  She went on the Internet, as any consumer does now—72% of us do that before we do anything medically related—and she read on the Internet all the scary stuff about a drug called Abilify, and how it would cause kidney damage and so on.  So she freaked out, and it really took the intervention of my colleague and friend, Fred Goodwin, who ran the National Institute of Mental Health, to tell her, “Look: This is a drug that can save your life.”  So she went ahead and took the medicine.  The second time around, she was kicked out of the hospital based upon an insurance company pointing to a study made by the government—the same government agency that’s going to make all these rationing decisions, so to speak—which said that hospitalization for this disease wasn’t really very cost-effective.  Ironically, by putting a one-size-fits-all cap on treatment—because some girls only need a week of care, and some people need six, it’s individualized—it created a revolving door which I found very objectionable.  Now, I don’t believe in suing, but, in this case, we presented evidence to the insurance companies that what they were doing was not in the best interests of the patients, and they conceded.  So I have personal experience with this.  Since I’ve written the book, I’ve gotten, where I’ve spoken, or through Twitter, people giving me their own experiences of assuming the Internet’s going to be this objective store of information, but, unfortunately, the “instant experts,” the ones who are there to scare you for a living, are giving the same—they appear more often than the objective science.  And, pertinent to your organization, the media then picks up on the scare story because it’s anti-industry, and then runs with that angle.

ARONOFF: What is the motive of these instant experts, like the ones who would tell you, as your daughter read, “Don’t use this drug”?  Is it ideological?  Are they paid by someone?  What are their motives, generally?

DR. GOLDBERG: Let’s take Public Citizen for instance—that’s Sid Wolfe’s organization.  Public Citizen has been around since 197[1].  They have always had an ideological antipathy towards the commercialization of medical discoveries to the point that Worst Pills, Best Pills, which is their publication and is widely distributed, if you go back over the years, they’ve said that every new diabetes drug which has been introduced since the 1970s has been “Unsafe” and a “Do Not Use” medicine.  So if you were a diabetic and you followed their advice over the last 30 years, all you’d have is insulin—and the incidents of stroke, heart failure, and amputation from diabetes would be enormous!  Now, the fact is, while they say that they’re a nonprofit group and they don’t think people should make money off of medications, they’ve sold over two million copies of this book, and then they have a subscription on the Internet which charges you $15 a month.  They’re making about $30 million off of this one enterprise.  It’s a way of building support, it’s a way of driving their agenda, and, in the case of some people, they’re just looking to—in the case of this guy Andrew Wakefield, who tried to fraudulently claim that vaccines cause autism, he was in it for the fame—

ARONOFF: Right . . .

DR. GOLDBERG: —and the money.

ARONOFF: Hmm.  Characterize the ideology behind Public Citizen.  You’ve described how much money’s in it for them, but you also talk about it like it’s a political agenda, or an ideology.


ARONOFF: What would be the logic behind that?

DR. GOLDBERG: There is this narrative—it’s not just a liberal narrative, though it does emerge from the Left primarily—that goes back even to the environmental movement of the ’70s, that corporations poison people in the pursuit of profits.  So, whether it’s nuclear power or clean coal or automobiles that supposedly have faulty brakes—like the ones from Toyota—or vaccines which are the hidden cause of autism or antidepressants causing suicide, there is a firm ideological belief that corporations are not a healthy contributor to the political ecology of this planet, to the point where—

ARONOFF: To the point where they deny the science and the studies that prove the effectiveness of these things?

DR. GOLDBERG: Absolutely!  They’ll go to the point of saying, “Since scientists partner with industry, they, too, are corrupt!  And since doctors or engineers use this science, they, too, are corrupt!”  They paint this one-size-fits-all black-and-white notion that the only solution is, of course, for these groups, who are individuals, to come in, take over, issue top-down commands, and purify the system, restore balance, and achieve justice.

ARONOFF: Now one thing you just were telling me, the other side of your daughter’s story about how the insurance turned her down, or wasn’t going to provide the support for that—that would be an example that someone supporting ObamaCare might cite to say why we need ObamaCare.  “Look at what these insurance companies do!  They’re already rationing!  We’re going to at least do it without the profit motive!”


ARONOFF: So what would you say to that?

DR. GOLDBERG: I’ve heard that, and my answer to that is as follows: I was able to, with other patients, engage the insurance companies, and, if we wanted to, we could even sue them.  When the government takes over the entire marketplace, you have no recourse.  You have no other form of appeal—specifically, under ObamaCare, you can’t sue the government, you can’t sue HHS, and, to a certain extent, that protection will extend to the insurance companies as well.  Moreover, the fact that the government’s now getting into the business of establishing these one-size-fits-all standards just makes it that much more difficult to navigate on these issues.  One immediate issue that comes to mind is the FDA deciding not to provide a label for Avastin, which is for women with breast cancer, even though some women are high responders.  So what’s happened?  The government’s weighed in and said, “Well, we’re not going to pay for it,” and then the insurance companies followed suit.  So when they’re all fused together, it makes it that much more difficult to fight tabloid medicine.  There’s an ideological orientation towards using those techniques, and once a government gets behind it, with the money and regulatory authority, it becomes pretty hard to fight.

ARONOFF: Yeah.  That example—Avastin—that you just talked about, there was this FDA decision last month, I believe—


ARONOFF: —that basically said that the side effects are severe, and the upside isn’t that great, but, really—I saw the Wall Street Journal editorial saying, “Look, it’s because it’s so expensive, that’s the reason they rejected it, and then created this rationale for it.”  Would you agree with that?

DR. GOLDBERG: I think what happened is, at least with respect to the FDA, price might have been in the back of their minds.  They changed the rules of the game.  What they did—and we’re going to get into the weeds here a little bit—is, initially Avastin was approved by measuring how it affected tumor growth, because without really knowing how each individual—we don’t have tests right now to figure out how Avastin affects each individual woman, so if you measure how well it prevents tumor growth, then you’re able to sort of say, on average, “Well, gee, there’s a certain group of patients that are really benefitting from it.”  What the FDA did—and this is a hallmark of tabloid medicine—is, they said, “Uh-uh, no, no, we want to look at average survival between those who receive it, and those that don’t.  That sort of masked the benefit to the people who might be high responders.  Any time you do a one-size-fits-all analysis, you’re going to show more risk than benefits to be the case, and, that said, it feeds into the kind of economic and medical decision making that’s part and parcel of ObamaCare, and consistent with tabloid medicine.  If you go on the Internet, and if you read about a drug called Avandia, for diabetes, you’ll find that they went back and looked and cherry-picked the people that had the highest risks of heart disease, who were on [Avandia], and compared them to everybody else.  That heightened the possibility of risk.  That itself has been part of the approach—and then the second part of it is taking that information and repeating it again and again and again.  In the words of one government official, “We want to embed this information into medical decision making.” That’s a real concern that I have.

ARONOFF: This ties into another issue you talk about, personalized medicine.  Right?


ARONOFF: Is that an example?  Tell us about that.  What is that?  How does that figure in to tabloid medicine and ObamaCare and what we’re talking about here?  You’re an advocate for personalized medicine, I take it, right?

DR. GOLDBERG: Right.  What I mean by “personalized medicine”—it could be something as simple as knowing yourself, knowing your family history, knowing your lifestyle, and so on, and using that to make a decision about the risks and benefits of treatment or prevention.  But, also, we’re now at a time when we can test ourselves, with a simple blood test, to see how well we respond to certain medications, whether we have risks of certain diseases, particularly in areas like cancer or rheumatoid arthritis—we’re able to sort of monitor, from point A to point B, how well we’re doing, and we can make adjustments.  Personalized medicine is not one-size-fits-all—it’s just the opposite, and, moreover, it’s kind of like when you go on your computer and there’s a software update.  These updates help improve the performance of the computer.  As patients, we should be getting, should have access to, updates that are tailored to who we are and where we are with our illness or lifestyle choices.  Those kinds of tools could be exploding on the Internet.  I’m just concerned that they’re going to be continually crowded out by the tabloid medicine adherents who find it in their interest to keep risks unpredictable—because when they’re unpredictable, we try to avoid uncertainty at all costs, and that means we’ll just use less of a certain product.  So I’m a big advocate of personalized medicine because I think it’s a counterweight to tabloid medicine.

ARONOFF: Coming back to tabloid medicine: You talked about groups like Public Citizen, who have an ideological and financial interest in their positions.  Who are the other culprits that are sustaining this?  I think you talked about trial lawyers, for one.  Talk about them.  Who else—


ARONOFF: —are the ones who really drive this thing?

DR. GOLDBERG: The trial lawyers—some trial lawyers use the Internet so that when you go on the Web for a search, your first three pages of a search for a particular illness or medication will highlight all the risks from instant experts, and, in some cases, they link back to a 1-800 number or a “sue me” website, a website.  There are these natural—the folks who say, “Don’t trust the drug companies, all they want to do is make money—but buy my product!”, like Suzanne Somers and Joseph Mercola, Mike Adams—and sometimes they work in unison.  Then there are these other groups—I call them the “so-called consumer advocates,” such as Consumers Union, which puts out a list of best buys for all medications which is completely based upon the Worst Pills, Best Pills approach.  There’s a group called the Prescription Project which is funded by George Soros and trial attorney money, which is designed to basically tell people, “Take a generic first and foremost.”  Those are some of the main perpetrators of this activity.  Finally, there are the anti-vaccine groups—Jenny McCarthy and Generation Rescue.  It’s really a sort of sad state of affairs when, instead of talking about Jonas Salk and vaccines, you talk about Jenny McCarthy and vaccines! But that’s where we are.  That says a lot about the level of our scientific discourse when it comes to risks and benefits.  So we have people like Jenny McCarthy or Dr. Oz, for example—who actually has a solid science and medical background—talking about getting toxins out of our kids’ bodies by lengthening the vaccine schedule.  So there’s a lot of that in the popular media which is driving this, and there is an element of anti-capitalist bias in a lot of this as well, although people make a good buck pushing that viewpoint.

ARONOFF: What is the role that the government might be playing to stop this?  I guess, being on the Internet, they can do it in the Bahamas or wherever, and it’s out of reach of U.S. jurisdiction, but what role does the government play—and what role should they play?  In a way, it sounds like most of these are ideologically compatible with, say, the Obama administration and ObamaCare, so they might not be as determined to try to block some of this stuff.

DR. GOLDBERG: Yes. The good news is that my book—and there’s a book by Seth Mnookin, and Paul Offit talking about the panic over vaccines—and the fact that Wakefield was exposed as a fraud—for your listeners, Andrew Wakefield was the British doctor—well, he’s no longer a doctor—who claimed that vaccines cause autism.  It’s all gotten people to pay attention, to be more skeptical of media coverage and Web-based information about health risks.  So that’s one good thing.  I think it’s up to the government not to regulate the Internet—we have enough government regulation as it is—and to be responsible.  One example is, I thought that the FDA tried to do a very good job yesterday, when they noted that there were 60 women that had a cancer-like disease associated with breast implants, and they went out of their way to say that you’re more likely to be struck by lightning than to have this illness if you get breast implants.  Now that’s very, very responsible.  What’s irresponsible has been the media’s coverage of it, which hyped the danger.  So government’s doing that role, but scientists have to step up to the plate.  Skeptical bloggers, like myself and Bill Heisel of the California Endowment for Journalism, have to step up to the plate, look at these things with a very fine eye.  I think members of Congress and their Congressional staff have to be much more educated.  We need more scientific literacy.  Those are the things.  They do happen, Roger, over time.  I think that’s what they can do.  We can also defund all the stuff that ObamaCare’s doing to promote tabloid medicine or create a government-run medical information monopoly.

ARONOFF: You wrote in the book about something called the “precautionary principle”—

playing a role in this and what you called the “cult of safety” that exists within it.  Explain that.  How does it relate to tabloid medicine and issues?

DR. GOLDBERG: Well, the “precautionary principle” really is “Better to be safe than sorry” on steroids.  You say that unless you can find that something’s 100% safe, we shouldn’t let it on the market, and that we should have a presumption that something is risky if it’s not proven 100% safe.  So the precautionary principle is, you’re guilty until proven innocent, and the burden of proof is on the producer to show that there’s safety.  Unfortunately, safety’s a two-way street.  It’s how people use products.  There’s individual differences, and so on—and by keeping stuff off the market, or not using it, you create other risks.  If you don’t use vaccines, infectious diseases go up.  If you don’t use diabetes medication, your diabetes will go up.  If we impose the precautionary principle as a standard for proving new medications, as the FDA has done, you have fewer new medications, fewer people taking them, and—surprise, surprise!—for the first time in five years, life expectancy has not increased in the United States.  I feel that that’s associated with the fact that we have scared people from taking medicines, and we’re not bringing enough new medicines to market to make a meaningful difference to people.  That is a consequence of tabloid medicine, that you have to ask, at the end of the day, what is the ultimate impact, upon you or society, of not doing something because some instant expert said, “Well, it might not happen, but then again, it might.”  You might as well just stay in the house and drink tea all day!

ARONOFF: Right.  But some people are concerned that too many people say, “Hey, my child is hyperactive, let me find a pill for him!”—


ARONOFF: —that we’re overmedicated, which is kind of the other side of that—


ARONOFF: —issue that happened with your daughter, and we certainly don’t want that to happen, either.  So where do you find that happy medium?

DR. GOLDBERG: Well, I think, in some respects, it’s having a very good diagnosis, and then finding out whether something works or not.  For example, in the case of ADHD, some children are misdiagnosed with having ADHD, and they don’t have it.  In other cases, children will have ADHD, and they may not need the medication to do it, maybe an app—there are now iPhone apps that will allow people that are ADHD, or just disorganized, like me, to remind them to do certain things.  In the case of cholesterol, we are finding out, through genetic-based testing, that if a woman has high cholesterol, but no history of heart disease, she may not be a candidate for statins, because women get heart disease and blockages differently than men.  So inflammation is more important than a high cholesterol level if there’s no previous history of heart disease, and in that case, in many cases, statins may not be indicated.  It goes back to my point about personalized medicine—let’s find out what’s right for everybody.  Sometimes you get the decision right the first time, sometimes you don’t, but the goal of medicine is to try to increase your batting average the first time you’re at the plate.

ARONOFF: What is your view of mood-altering drugs, in the context of tabloid medicine and in the context of the book Brave New World?

DR. GOLDBERG: Oh, right!  Aldous Huxley’s world.  Yes.  You know, there’s always this hype, that you can take a pill and be totally happy—that’s a misnomer.  For anyone that suffers from mental illness, particularly schizophrenia—of course, this guy in Tucson seems like he had that—medication is one step in the process of staying well mentally.  There’s exercise, therapy, attitude changes, and so on, and no one, I don’t think, will ever produce a pill that will produce instant happiness—unless you count Viagra in that category.

ARONOFF: Mm-hmm.

DR. GOLDBERG: What we find with the mood-altering drugs is that they do work, they are highly effective, but it only gets half the job done.  The old adage “No one can make you happy except yourself” has been proven by the fact that we’ve given people that have mental disorders an opportunity to sort of re-enter the world on their own terms, and the rest, of course, is up to who they are and what they do.

ARONOFF: Let’s touch on another thing: Donald Berwick.  Now, this is something that is associated with you.  Tell us about that.  What did you know when you first heard that name?  What did you find out?  Tell us who he is, and what position he has—


ARONOFF: —and what the potential of that is.

DR. GOLDBERG: Donald Berwick is now Director of Medicaid and Medicare Services, appointed by the President through a recess appointment back last year.  I knew about Berwick’s work with the NHS (National Health Service, the publicly funded health care service in England)  a long time ago, so when I was doing the research on him, I typed in “Berwick NHS,” and, lo and behold, a lot of stuff popped out.  Now, interestingly, the article that I wrote just touched a little bit on his fawning admiration for the National Health Service.  I focused on the fact that he is considered to be a wizard in improving health quality, but nothing he’s done has improved health quality.  He was there in England to help implement their quality initiatives in reducing hospital infections and waiting times, yet they’ve gotten worse!  He developed this rapid response approach to people coming in, having heart trauma in the hospital, and when it was finally put to the test, more people died than lives were saved!  My real concern with Berwick is that he is an authoritarian when it comes to medical decisions.  He believes that a “centralized integrator”—his words—ought to decide how much we spend and what we spend it on, and then people can use as much up to that point.  But the evidence that he uses, again, is tabloid medicine—these one-size-fits-all approaches that don’t account for individual differences.  He is hell-bent on driving it through and using the Web and electronic medical records to pound that message to the rest of the medical community.  I just think that he’s a total sham, and the fact that he loves the NHS just only indicates a bias that we should have expected from anyone that would work with the Obama administration on health care!  I’m concerned about the damage that he’ll do with all the gimmicks and toys that he’s going to try to impose upon health providers and consumers in the future.

ARONOFF: Now, the media have really fallen down on this one.  I mean, he got some coverage in the conservative media but the mainstream media basically ignored this one.  They didn’t want to touch this issue.  But didn’t he go before a Senate committee in November?  Do you expect he’ll have to go before House committees now that the Republicans are in charge?

DR. GOLDBERG: Exactly.  He got up there, he was there for, literally, an hour and a half.  The Democrats on the committee ran the clock out by using up most of the time for opening statements, so Berwick didn’t answer more than four questions.  It’s going to be a little different this time around, because you’re going to have a Republican House asking him questions, and then the Senate Finance Committee is a bit more balanced.  So he is going to have to do a lot more dancing before these committees.  Hopefully, members of Congress will ask some serious, science-based questions of him—in particular, “Where is the evidence that all these things you want to do empowers consumers and improves health?”  Where is the evidence? And the other question is, “Why would you want to restrict the decisions of doctors and patients by replacing their judgment with the one-size-fits-all guidances produced and delivered by the same group that said that women under 50, across the board, should not have a mammogram, which discriminates against Hispanics and African-Americans?”  So there’s lots of questions there—

ARONOFF: What does his appointment tell you about Obama’s intentions?  Is he going to be able to stay on, since he’s a recess appointment, beyond the one year?  Give us your take on ObamaCare, where this is heading, and what you think of the Republican effort to repeal it and dismember it.

DR. GOLDBERG: First of all, I support the repeal effort, because I think it’s a way of clearing the board and starting over again with something that’s sensible and consumer-driven.  I know that the repeal vote is going to go to the Senate—I think that’s going to happen, despite Harry Reid’s intentions, or best efforts—and I think, going forward, the Republicans will focus on the individual mandate, because the individual mandate drives people into all these systems.  That’s a good thing.  But I also think they ought to pull the plug on the mainframe, or the main server, of ObamaCare, and pull the plug on this handful of bureaucrats and consultants who are coming up with what they think is medicine best for us.  As tabloid medicine shows, with a little bit of money and strategic placement of information using digital technologies, you can have a really powerful impact on prescribing behaviors and so on.  Do you know, Roger—here’s a time where drug companies, as we move towards an era of personalized medicine, are cutting the number of drug reps that they send out to doctors, because doctors want different information based upon individual patient needs—the Obama administration is spending $15 million to hire government-appointed drug representatives to go to doctors and tell them to prescribe away along the lines of ObamaCare.  They’re spending another $30 million to run an ad campaign to promote the adherence to the kinds of guidelines that almost killed my daughter.  It is, to me—it’s not a lot of money, but it’s going to have a tremendous impact.


DR. GOLDBERG: Cutting that budget, $600 million dollars over ten years, that’s $6 billion dollars.  That’s a good chunk of change that could be spent on keeping taxes lower, or health saving accounts—or restoring the tax break that people get when they want to buy medication over the counter, which, in some cases, will save them a trip to the doctor!  Listen—now you got me on a subject that’s almost as near and dear to my heart as tabloid medicine! Again—

the media is complicit in this.  They don’t examine it.  They don’t analyze it, with rare exception—there were a couple of good pieces in The New York Times, actually, on all this.  Ultimately, the Web is going to have to be a tool—and it is a tool—for fighting back.  And it’s a good thing that you have outlets like BlogTalkRadio to do it!

ARONOFF: How do you explain that The New York Times had a couple of good articles on that?  Is that against their ideology

DR. GOLDBERG: I could say that a broken clock is right twice every day.


DR. GOLDBERG: A friend of mine wrote a very good piece in The New England Journal of Medicine, sort of taking a whack at all this stuff.  He’s very well-respected, he doesn’t have any conservative—quote, unquote—“bias,” and I think that got the Times reporters to follow it.  That sort of exploited—I don’t think that means they’re going to go against ObamaCare, but I think there is some kind of skepticism in some circles—not enough—about this vaporware, that if we somehow give everybody the same medicine in the same way, at the lowest common denominator, that’s going to improve our health and reduce cost.  That is health equivalent of saying, “We’re going to increase the number of people that we’re going to put on Medicare and Medicaid, and reduce the deficit.”

ARONOFF: You’ve written a couple of pieces recently about what happened in Tucson, Jared Loughner—


ARONOFF: —and in a piece you wrote last week, you say this: “While we can’t be sure a ‘better’ mental healthcare system could stop an obsessed schizophrenic from committing violence, we can be sure that ObamaCare will shred mental health treatment in America.”  How so?

DR. GOLDBERG: The incentives in Medicaid that are in ObamaCare encourage states to spend more money on primary care, and their match for that—it’s all about the money—their federal share of that is higher for primary care.  It is going to be lower for mental illness, which means that the states will have more of a burden on their own to provide that care.  And since, over the last twenty years, most people that are mentally ill have been pushed into Medicaid, it leaves them with less care and less choice, as opposed to what many of the states want to do—including Mitch Daniels in Indiana and Governor Christie in my state, New Jersey—which is to give patients the cash equivalent to buy insurance in the open market suited to their needs.  Believe it or not, Roger, when that was proposed by the state of Rhode Island on January 21st, 2009, the Obama administration went to Rhode Island and started auditing their Medicaid program.  If that’s not intimidation, I don’t know what is.

ARONOFF: Amazing.  Any final thoughts?  Anything I left out?  Tell us where people can get your book, where they can find your articles, and—


ARONOFF: —I also want to mention that we had some break-ups a few times, but the full transcript will be on the AIM website next week, with a little write-up of this interview, and so I hope people who aren’t listening now will get a chance to read—I know it’ll get picked up by a number of websites, get a lot of attention—


ARONOFF: —but in the meantime, any final thoughts?  Where can people read your book?  Where can they get this book?

DR. GOLDBERG: Well, they can go to my website,, follow me on Twitter at Tabloidmed.  I would just leave people with rules of the road, if you will.  If somebody says that something’s dangerous, and tries to sell you something at the end of that pitch, don’t believe them.  If it’s something that comes out of the Agency for Healthcare Research and Quality, known as AHRQ, don’t believe it—it’s one-size-fits-all medicine.  By the same token, when it comes to medications or treatments, you can use the Internet to get a second opinion from leading experts in the field—it’s a very powerful tool for that because people, in real time, will answer you.  So you can use the Web to empower you, to find the right clinical trials, just avoid one-size-fits-all solutions.

ARONOFF: Our guest today has been Dr. Robert Goldberg, author of the book Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit.  I want to thank you so much for being with us, and I want to thank my great producer, Melissa Barnhart, for always coming through for me.  Bob—Dr. Goldberg—thank you so much for being with us today on Take AIM!

DR. GOLDBERG: Well, thank you!  Considering especially all the stuff you’ve done in the past, it’s been an honor to speak with you.

ARONOFF: Thank you so much.

DR. GOLDBERG: Take care!

ARONOFF: Take care, and we’ll be back next week with another edition of Take AIM.

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