The New England Journal of Medicine purports to take no position, pro or con, on Obamacare. The Editor-in-Chief and Executive Editor have come out in favor, yet, somehow, despite their biases--they claim--the Journal itself has not staked out a position. This is risible. I subscribe to and very much like the NEJM, but ever since the Affordable Care Act (ACA) was first proposed, the Journal has been flogging Perspectives and other articles written by advocates as if it were a journal of politics and political policy: routinely publishing articles that could just as easily be found on the Op-Ed pages of newspapers or in any number of--primarily left-leaning--political/policy journals. Yes, they have published articles written by skeptics here and there (I can recall only one right now), but basically the Journal has been pushing Obamacare since the get-go: it's not subtle.
No forum for pro-ACA writings would be complete without an essay or two from the egregious Jonathon Gruber. The NEJM's conflict of interest policies has spared the Journal criticism for not disclosing Gruber's financial links to the ACA: if readers took the time and looked closely enough, they could find the NEJM's mandated disclosure (there has typically been no disclosure elsewhere he has been published or quoted). However, I doubt that even NEJM readers who found the disclosures knew at the time of the magnitude of Gruber's financial interests in the ACA. These amounted to millions of dollars: $400,000 from the feds alone. Would the Journal let a consultant being paid millions of dollars by Amgen write a perspective advocating for more Epogen use? If so, would a hard-to-notice financial disclosure statement be adequate, or would perhaps a disclosure need to be included in the text?
One final question: now that we know that Gruber has intentionally obfuscated important facts about Obamacare and has attempted to deceive the Congress and US electorate on key policy points, does the NEJM need to go back and look at his articles? I bet they would have a second look at, say, a clinical trial that was published by an investigator later have found to have published fraudulent manuscripts.
I really like the Journal. It has been painful to see the Journal become so politicized during the ongoing debate surrounding Obamacare. The claim cited above that the Journal has not taken a position is belied by the articles that make it into its pages.
Continued in next post: Much, much worse