EP260: The Latest Shkreli Awards for the Worst Examples of Profiteering and Dysfunction in the Health Care Industry, With Shannon Brownlee and Vikas Saini, MD, of the Lown Institute

In this episode, Stacey Richter talks with Shannon Brownlee, senior VP, and Vikas Saini, MD, president and CEO, of the Lown Institute, about the latest Shkreli Awards for the worst examples of profiteering and dysfunction in the health care industry.

WHAT YOU'LL LEARN

✅ What the Shkreli Awards are and what they're meant to spotlight

✅ How the decline in public trust correlates with hospital rankings on the Shkreli list

✅ Why converting nonprofits to for-profits isn't a fix for the underlying incentive problems

✅ Where private equity shows up in stories of profiteering and dysfunction

✅ Why "fraud is just a fact of life" but the bigger problem is bad behavior that's perfectly legal

WHY THIS MATTERS

Shannon Brownlee and Vikas Saini walk through the Lown Institute's annual Shkreli Awards, a top 10 list naming the worst examples of health care profiteering and dysfunction, named for the infamous "pharma bro." Beyond the individual stories — fraud schemes, corporate pressure on clinicians who raise safety concerns, opioid marketing malfeasance — the conversation returns to a consistent theme: the biggest problem in health care isn't just outright fraud, it's bad behavior that's perfectly legal and normalized. Brownlee and Saini argue real transparency around hospital behavior is what's needed to start shifting incentives.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction.

03:21 What the Shkreli Awards are.

05:17 What the Shkreli Awards are meant to do by spotlighting these areas of health care.

07:24 The categories that the Shkreli Awards winners fall into.

08:56 Balancing the business side with the mission side of health care organizations.

09:33 The correlation between the decline in trust and hospital rankings on the Shkreli Awards list.

12:30 The constraints of the current system and how these affect the behavior of nonprofit hospitals.

13:27 Why making nonprofits for-profit isn't the answer.

16:43 Where private equity plays into profiteering and dysfunction in health care.

19:54 The opioid "kingpins" and the oncology organization that made the Shkreli list.

21:43 "Fraud is fraud; that's just illegal."

26:27 "Fraud is just … a fact of life … the biggest problem [is] bad behavior that's perfectly legal and everybody thinks is okay."

27:10 Shannon and Dr. Saini's advice for organizations looking to avoid getting on the Shkreli list.

27:25 "We need real transparency around hospital behavior."

29:24 "You can't legislate the heart."

29:31 You can see the list at lowninstitute.org/shkreli-2019.

29:46 What the Lown Institute is and what they do.