Stephen Cha attacks the pharmaceutical industry’s practice of showering gifts on physicians.

Food, trinkets, pens and coffee mugs were being handed out to the whole office staff, about 20 people including med students and doctors — all courtesy of Merck & Co. And to the physician who was the number one prescriber of Vioxx in the entire region that year, a marketing rep of the company awarded a pair of Philadelphia Eagles season tickets.

My guess is that this gift-giving would probably fall to zero if all drugs could be sold over-the-counter. But somehow, I suspect that the last thing that doctor Cha or his colleagues will suggest is that removing the physician’s gatekeeper role is the way to eliminate the source of corruption here.

Speaking of how government corrupts health care, the Washington Post also has this story on Medicare.

In Medicare’s upside-down reimbursement system, hospitals and doctors who order unnecessary tests, provide poor care or even injure patients often receive higher payments than those who provide efficient, high-quality medicine.

The article says that Medicare’s much-vaunted low overhead is actually a bug, not a feature.

Its oversight system is fragmented, underfunded and marred by conflicts of interest, records and interviews show. For every $1,000 that it pays to hospitals and doctors, it invests just $1 or $2 to oversee and improve patient care.

“The amount we spend on quality is a pittance,” said Kenneth W. Kizer, a physician and president of the National Quality Forum, a nonprofit that works with Medicare officials to develop standards of care.

I talked about the challenge of rewarding health care suppliers on the basis of quality in this essay.

UPDATE: See also this New York Times series on Medicaid fraud and abuse.