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Highlights of the interesting and the important from the world of health care:

The myth of tort reform: Dr. Jeffrey Parks, who blogs under the name Buckeye Surgeon, comes out with guns blazing against the American Medical Association in this blog post. An editorial penned by AMA President James Rohack at KevinMD.com has rankled Parks due to Rohack’s silence on tort reform in a list of improvements the AMA would like to see in the Senate health-reform bill. Parks writes:

It’s truly an amazingly contemptuous act of arrogance to write up something like this without even acknowledging the one aspect of reform that doctors universally would like to see enacted. Any shred of credibility the AMA had as the “voice of American physicians” is now officially gone.

While there’s no doubt that Parks is absolutely correct that tort reform is a hugely important issue from the perspective of doctors, how important it should be to the rest of us is a very open question. Malpractice premiums have dropped four consecutive years, while health costs continue to skyrocket, suggesting that medical tort reform would do little for the average American, at least when it comes to saving money on runaway health expenses. A 2004 Congressional Budget Office report said malpractice suits contribute less than 2 percent to the nations’ health expenses. Indeed, it’s time we realized that, when it comes to health costs, the tort reform argument is a red herring. Take it away, Tom Baker:

Tom Baker, a law professor at the University of Pennsylvania and author of The Medical Malpractice Myth, theorized that having “a common enemy” – trial lawyers – keeps insurance and pharmaceutical companies – the real culprits behind rising costs, he said – from fighting among themselves.

Top 10 Medical Advances of the decade: ABC News and MedPage Today have published their list of the decade’s top medical advances, created with input from various medical professionals. Mapping the human genome comes in at the top spot. Take a look at their list and see if you agree.

Obama breaks campaign promise on drug reimportation: The blogosphere is alive with the sound of liberal discontent, and rightfully so. After promising during his presidential campaign to allow Americans to import cheaper medicine from foreign countries, Barack Obama has bowed to his pharma masters. The always-insightful superstar journalist Matt Taibbi explains Obama’s bait and switch.

There’s no legitimate reason to bar re-importation, except one: to preserve a subsidy for the pharmaceutical industry and, by extension, preserve the flow of campaign contributions to the Democratic Party. That is why President Obama is now opposing the sensible measures he endorsed as a candidate. He is pursuing this year’s expedient goal of getting a campaign war chest now that he’s already achieved last year’s expedient goal of getting elected.

Death of a (pharma) salesman: With the unemployment rate at 10 percent, it’s hard times all around in the good ol’ U.S. of A. But recent years have been particularly tough on pharma reps, as the number of reps employed at the top 40 U.S. drug companies fell to 82,000 in third quarter of this year from 102,000 in 2005, Reuters reports. (See pharma rep employment numbers here, in convenient graphic form.) One poor guy, 27-year-old Andy Smith, was laid off three times by different companies in 11 months. And the downturn in reps’ employment isn’t all about cost cutting.

Pharma companies have realized that primary care doctors are increasingly less influential when it comes to decisions about what to prescribe. So who’s got the power? We shouldn’t even have to ask — it’s the insurance companies that draw up the formularies, which indicate which drugs are covered by which health plans. So while some politicians drone on with scare tactics about “a government bureaucrat coming between you and your doctor,” anyone who’s been paying attention knows that every physician-patient interaction already is disrupted by a bureaucrat — it’s just one from an insurance company instead of the government.