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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Financial Ties. Show all posts
Showing posts with label Financial Ties. Show all posts

Tuesday, February 7, 2023

UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings.

By D. Armstron, R. Rucker, & M. Miller
ProPublica.org
Originally published 2 FEB 23

Here is an excerpt:

Insurers have wide discretion in crafting what is covered by their policies, beyond some basic services mandated by federal and state law. They often deny claims for services that they deem not “medically necessary.”

When United refused to pay for McNaughton's treatment for that reason, his family did something unusual. They fought back with a lawsuit, which uncovered a trove of materials, including internal emails and tape-recorded exchanges among company employees. Those records offer an extraordinary behind-the-scenes look at how one of America's leading health care insurers relentlessly fought to reduce spending on care, even as its profits rose to record levels.

As United reviewed McNaughton’s treatment, he and his family were often in the dark about what was happening or their rights. Meanwhile, United employees misrepresented critical findings and ignored warnings from doctors about the risks of altering McNaughton’s drug plan.

At one point, court records show, United inaccurately reported to Penn State and the family that McNaughton’s doctor had agreed to lower the doses of his medication. Another time, a doctor paid by United concluded that denying payments for McNaughton’s treatment could put his health at risk, but the company buried his report and did not consider its findings. The insurer did, however, consider a report submitted by a company doctor who rubber-stamped the recommendation of a United nurse to reject paying for the treatment.

United declined to answer specific questions about the case, even after McNaughton signed a release provided by the insurer to allow it to discuss details of his interactions with the company. United noted that it ultimately paid for all of McNaughton’s treatments. In a written response, United spokesperson Maria Gordon Shydlo wrote that the company’s guiding concern was McNaughton’s well-being.

“Mr. McNaughton’s treatment involves medication dosages that far exceed FDA guidelines,” the statement said. “In cases like this, we review treatment plans based on current clinical guidelines to help ensure patient safety.”

But the records reviewed by ProPublica show that United had another, equally urgent goal in dealing with McNaughton. In emails, officials calculated what McNaughton was costing them to keep his crippling disease at bay and how much they would save if they forced him to undergo a cheaper treatment that had already failed him. As the family pressed the company to back down, first through Penn State and then through a lawsuit, the United officials handling the case bristled.

Thursday, December 23, 2021

New York’s Met museum to remove Sackler name from exhibits

Sarah Cascone
artnet.com
Originally posted 9 DEC 21

The Metropolitan Museum of Art in New York has dropped the Sackler name from its building. The move is perhaps the museum world’s most prominent cutting of ties with the disgraced family since their company Purdue Pharma’s guilty plea to criminal charges connected to marketing of addictive painkiller OxyContin in 2020.

The decision, which came after more than a yearlong review by the museum, was reportedly mutual and made “in order to allow the Met to further its core mission,” according to a joint statement issued by the Sackler family and the institution.

“Our families have always strongly supported the Met, and we believe this to be in the best interest of the museum and the important mission that it serves,” the descendants of Mortimer Sackler and Raymond Sackler said in a statement. “The earliest of these gifts were made almost 50 years ago, and now we are passing the torch to others who might wish to step forward to support the museum.”

Institutions have faced increasing pressure to sever relations with the Sacklers in recent years as part of a growing push to hold institutions and other cultural groups accountable over where their money is coming from. (Other donors that have come under fire include arms dealers and oil companies.)

Seven spaces at the Fifth Avenue flagship bore the Sackler name. The biggest was the Sackler Wing, which opened in 1978, and includes the Sackler Gallery for Egyptian Art, the Temple of Dendur in the Sackler Wing, and the 1987 addition of the Sackler Wing Galleries.

The day of the announcement, Patrick Radden Keefe, the author of Empire of Pain: The Secret History of the Sackler Dynasty, visited the museum to find that the family’s name had already been removed.

Thursday, January 14, 2021

Memorial Sloan Kettering Gave Top Doctor $1.5 Million After He Was Forced to Resign Over Conflicts of Interest

Katie Thomas & Charles Ornstein
ProPublica
Originally published 22 Dec 20

Here is an excerpt:

After months of review, Memorial Sloan Kettering overhauled its conflict-of-interest policy, barring its top executives from serving on corporate boards of drug and health care companies and placing limits on how executives and top researchers could profit from work developed at the institution.

Like other major hospitals, Memorial Sloan Kettering’s finances have taken a hit during the coronavirus pandemic. For the first three quarters of 2020, the hospital reported an operating loss of $453 million compared with an operating profit of nearly $77 million in the first nine months of 2019. The hospital saw a decline in surgical procedures and clinic visits, as well as clinical trials and other research. The hospital did receive $100 million in relief funds as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act.

Baselga wasn’t the only former official to receive severance from Memorial Sloan Kettering in 2019. It also paid more than $250,000 in severance to Avice Meehan, the hospital’s former chief communications officer, according to its IRS filing. Meehan declined to comment.

Laurie Styron, the executive director of CharityWatch, an independent watchdog group, said that hospitals often compensate their staff generously because they must attract highly trained and educated doctors who would be well-paid elsewhere. Still, she said, the multimillion-dollar sums can surprise donors, who typically give money to support research or patient care.

Friday, April 17, 2020

Trump's Claims Are Dangerous: COVID-19 & Hydroxychloroquine

Andre Picard
Globe and Mail
Originally published 9 April 20

Here is an excerpt:

The principal argument the President has used in support of hydroxychloroquine is the rhetorical statement: “What do we have to lose?” (He repeated that phrase five times at his Saturday media briefing.) “I’m not a doctor but I have common sense,” Mr. Trump added.

“Common sense” is not evidence. And “what have we got to lose?” is certainly no way to practise medicine – or policy-making for that matter.

Physicians in China started using hydroxychloroquine to treat COVID-19 patients early in the pandemic. There was certainly some logic to this move. The drug has antiviral properties and showed some promise in vitro but that doesn’t mean it will work in vivo.

It remains a desperation drug, something to try when the rest of the very limited armamentarium has been exhausted.

The evidence of benefit in patients is mostly anecdotal, based on highly publicized but scientifically weak studies. Controversial microbiologist Didier Raoult has made wild claims about the effectiveness of hydroxychloroquine but his study, published in the International Journal of Antimicrobial Agents, is little more than anecdotal.

Similarly, Vladimir Zelenko, a small-town doctor in New York State, has gained internet fame promoting a cocktail of three drugs – hydroxychloroquine, the antibiotic azithromycin and zinc sulphate. There is no real evidence for claims that he has cured hundreds of cases of COVID-19, but that hasn’t stopped Mr. Trump from promoting the regimen.

There needs to be proper studies done, with control groups – meaning one group gets the drug(s) and the other does not, and the outcomes are compared. Like it or not, that takes time.

Impatience is not an excuse to make unsubstantiated claims.

The info is here.

Wednesday, January 8, 2020

Many Public Universities Refuse to Reveal Professors’ Conflicts of Interest

Annie Waldman and David Armstrong
Chronicle of Higher Ed and
ProPublica
Originally posted 6 Dec 19

Here is an excerpt:

All too often, what’s publicly known about faculty members’ outside activities, even those that could influence their teaching, research, or public-policy views, depends on where they teach. Academic conflicts of interest elude scrutiny because transparency varies from one university and one state to the next. ProPublica discovered those inconsistencies over the past year as we sought faculty outside-income forms from at least one public university in all 50 states.

About 20 state universities complied with our requests. The rest didn't, often citing exemptions from public-information laws for personnel records, or offering to provide the documents only if ProPublica first paid thousands of dollars. And even among those that released at least some records, there’s a wide range in what types of information are collected and disclosed, and whether faculty members actually fill out the forms as required. Then there's the universe of private universities that aren't subject to public-records laws and don't disclose professors’ potential conflicts at all. While researchers are supposed to acknowledge industry ties in scientific journals, those caveats generally don’t list compensation amounts.

We've accumulated by far the largest collection of university faculty and staff conflict-of-interest reports available anywhere, with more than 29,000 disclosures from state schools, which you can see in our new Dollars for Profs database. But there are tens of thousands that we haven't been able to get from other public universities, and countless more from private universities.

Sheldon Krimsky, a bioethics expert and professor of urban and environmental planning and policy at Tufts University, said that the fractured disclosure landscape deprives the public of key information for understanding potential bias in research. “Financial conflicts of interest influence outcomes,” he said. “Even if the researchers are honorable people, they don’t know how the interests affect their own research. Even honorable people can’t figure out why they have a predilection toward certain views. It’s because they internalize the values of people from whom they are getting funding, even if it’s not on the surface."

The info is here.

Wednesday, November 20, 2019

The ‘cancer growing in cancer medicine’: pharma money paid to doctors

Money and medicineVinay Prasad
statnews.com
Originally posted October 30, 2019

Here is an excerpt:

The fundamental problem is that, as a profession, cancer physicians are not interested in addressing conflict of interest. Too many people in prominent positions benefit from the current lax policies. Disclosure is not the solution —ending these payments is.

I want to be clear: I’m all for doctors interacting with and working with the pharmaceutical and device industries. I have lectured at major pharmaceutical companies, but without accepting money, travel expenses, or meals. Researchers should be free to work with pharmaceutical companies on trials, but there is no legitimate reason why a well-paid physician needs to take personal payments, gifts, meals, or travel expenses from the pharmaceutical industry. That practice must end.

Conflict of interest is the cancer growing in cancer medicine. It poisons the field. It leads us to celebrate marginal drugs as if they were game-changers. It leads experts to ignore or downplay flaws and deficits in cancer clinical trials. It keeps doctors silent about the crushing price of cancer medicines. It is rampant in guidelines that lead to off-label prescribing and that mandate payment. It is surely a calculated maneuver by the industry to increase their profits.

The info is here.

Thursday, March 28, 2019

Behind the Scenes, Health Insurers Use Cash and Gifts to Sway Which Benefits Employers Choose

Marshall Allen
Propublica.org
Originally posted February 20, 2019

Here is an excerpt:

These industry payments can’t help but influence which plans brokers highlight for employers, said Eric Campbell, director of research at the University of Colorado Center for Bioethics and Humanities.

“It’s a classic conflict of interest,” Campbell said.

There’s “a large body of virtually irrefutable evidence,” Campbell said, that shows drug company payments to doctors influence the way they prescribe. “Denying this effect is like denying that gravity exists.” And there’s no reason, he said, to think brokers are any different.

Critics say the setup is akin to a single real estate agent representing both the buyer and seller in a home sale. A buyer would not expect the seller’s agent to negotiate the lowest price or highlight all the clauses and fine print that add unnecessary costs.

“If you want to draw a straight conclusion: It has been in the best interest of a broker, from a financial point of view, to keep that premium moving up,” said Jeffrey Hogan, a regional manager in Connecticut for a national insurance brokerage and one of a band of outliers in the industry pushing for changes in the way brokers are paid.

The info is here.

Tuesday, March 5, 2019

Former Ethics Chief Blasts Groups for Holding Events at Trump Hotel

Charles Clark
www.govexec.com
Originally posted March 4, 2019

Here is an excerpt:

“How many members of Congress, who have a constitutional duty to conduct meaningful oversight of the executive, giddily participate in events at the Trump International Hotel, a taxpayer owned landmark where Trump is his own landlord and the emoluments flow like the $35 martinis?” Shaub wrote.

The criticism of Kuwait was prompted by a letter tweeted earlier by Rep. Ted Lieu, D-Calif. Kuwait's ambassador to Washington, Salem Abdullah Al-Jaber Al-Sabah, had invited Lieu to the February celebration of Kuwait’s 58th National Day and 28th Liberation Day.

Lieu wrote the ambassador on Feb. 11 saying that while he looked forward to a continuing productive partnership, “Regrettably, the event will take place at the Trump International Hotel, which is owned by the President of the United States. I must therefore decline your invitation, as the Emoluments Clause of the U.S. Constitution (Article 1, Section 9, Paragraph 8) stipulates that no federal officeholders shall receive gifts or payments from foreign state or rulers without the consent of Congress.”

Lieu then warned the embassy that the issue raises “serious ethical and legal questions,” and that continuing to hold events “could amount to a violation of the U.S. Constitution.”

The info is here.

Sunday, December 16, 2018

Institutional Conflicts of Interest and Public Trust

Francisco G. Cigarroa, Bettie Sue Masters, Dan Sharphorn
JAMA. Published online November 14, 2018.
doi:10.1001/jama.2018.18482

Here is an excerpt:

It is no longer enough for institutions conducting research to only have conflict of interest policies for individual researchers, they also must directly address the growing concern about institutional conflicts of interest. Every research institution and university deserving of the public’s trust needs to have well-defined institutional conflict of interest policies. A process must be established that will ensure research is untainted by any personal financial interests of the researcher, and that no financial interests exist for the institution or the institution’s key decision makers that could cloud otherwise open and honest decisions regarding the institution’s research mission.

Education and culture are fundamental to the successful implementation of any policy. It is incumbent upon institutional decision makers and all employees involved in research to be knowledgeable about individual and institutional conflict of interest policies. It may not always be obvious to researchers that they have a perceived or real conflict of interest or bias. Therefore, it is important to establish a culture of transparency and disclosure of any outside interests that could potentially influence research and include individuals at the highest level of the institution. Policies should be clear and easy to implement and permit pathways to provide disclosure with adequate explanation, as well as information regarding how potential or real conflicts of interest are managed or eliminated. This will require the establishment of interactive databases aimed at mitigating, to the extent possible, both individual and institutional conflicts of interest.

Policies alone are not sufficient to protect an institution from conflicts of interest. Institutional compliance toward these policies and dedication toward establishing processes by which to identify, resolve, or eliminate institutional conflicts of interest are necessary. Institutions and their respective boards of trustees should be prepared to address sensitive situations when a supervisor, executive leader, or trustee is identified as contributing to an institutional conflict of interest and be prepared to direct specific actions to resolve such conflict. In this regard, it would be prudent for governance to establish an institutional conflicts of interest committee with sufficient authority to manage or eliminate perceived or real conflicts of interest affecting the institution.

Tuesday, October 9, 2018

Top Cancer Researcher Fails to Disclose Corporate Financial Ties in Major Research Journals

Charles Ornstein and Katie Thomas
The New York Times
Originally published September 8, 2018

One of the world’s top breast cancer doctors failed to disclose millions of dollars in payments from drug and health care companies in recent years, omitting his financial ties from dozens of research articles in prestigious publications like The New England Journal of Medicine and The Lancet.

The researcher, Dr. José Baselga, a towering figure in the cancer world, is the chief medical officer at Memorial Sloan Kettering Cancer Center in New York. He has held board memberships or advisory roles with Roche and Bristol-Myers Squibb, among other corporations, has had a stake in start-ups testing cancer therapies, and played a key role in the development of breakthrough drugs that have revolutionized treatments for breast cancer.

According to an analysis by The New York Times and ProPublica, Dr. Baselga did not follow financial disclosure rules set by the American Association for Cancer Research when he was president of the group. He also left out payments he received from companies connected to cancer research in his articles published in the group’s journal, Cancer Discovery. At the same time, he has been one of the journal’s two editors in chief.

The info is here.

Tuesday, September 4, 2018

Financial Ties That Bind: Studies Often Fall Short On Conflict-Of-Interest Disclosures

Rachel Bluth
Kaiser Health News
Originally published August 15, 2018

Papers in medical journals go through rigorous peer review and meticulous data analysis.

Yet many of these articles are missing a key piece of information: the financial ties of the authors.

Nearly two-thirds of the 100 physicians who rake in the most money from 10 device manufacturers failed to disclose a conflict of interest in their academic writing in 2016, according to a study published Wednesday in JAMA Surgery.

The omission can have real-life impact for patients when their doctors rely on such research to make medical decisions, potentially without knowing the authors’ potential conflicts of interest.

“The issue is anytime there’s a new technology, people get really excited about it,” said lead researcher Dr. Mehraneh Jafari. “Whoever is reading the data on it needs to have the most information.”

The article is here.

Thursday, March 29, 2018

Authors of premier medical textbook didn’t disclose $11 million in industry payments

Adam Marcus and Ivan Oransky
www.statnews.com
Originally published March 6, 2018

Here is an excerpt:

“These findings indicate that full transparency of [author conflicts] should become a standard practice among the authors of biomedical educational materials,” according to the authors, whose study appears in the journal AJOB Empirical Bioethics.

McGraw-Hill, which publishes Harrison’s, did not respond to STAT’s requests for comment.

Financial disclosures have become de rigueur in scientific journals, where many of Harrison’s authors also publish and are subject to guidelines for such disclosures. Textbooks, however, have typically not required disclosures — and that means they’ve fallen even more behind standard practices.

The researchers, led by Brian Piper, a neuroscientist at the Geisinger Commonwealth School of Medicine in Scranton, Pa., acknowledge that simply looking at patent awards and fees from biomedical companies doesn’t prove the existence of biased work. But they note that medical textbooks are enormously influential due to their perceived authority and the wide readership they receive.

The article is here.

Sunday, July 16, 2017

Masked Marketing: Pharmaceutical Company Funding of ADHD Patient Advocacy Groups

Marnie Klein
Hastings Center
Originally posted June 29, 2017

In 1971, the United Nations passed a resolution prohibiting its member nations from advertising psychotropic drugs to the general public. More than 40 years later, this resolution has done little to halt pharmaceutical companies from marketing stimulants as treatments for attention deficit-hyperactivity disorder. The means by which, and the ethical dilemmas involved when, pharmaceutical companies market their products was discussed earlier this month at the annual PharmedOut conference, which investigated how industry influences medical discourse.

Alan Schwarz, the author of ADHD Nation, exposed how drug companies have, often covertly, sponsored educational resources and patient advocacy groups. These groups face a difficult conflict of interest: by accepting drug company funding, they can increase their reach to those looking for resources; however, their neutrality is compromised, particularly when they fail to disclose the funding source. The New England Journal of Medicine reports that pharmaceutical industry-sponsored advocacy groups may be likely to support drugs, as well as policy proposals, that cater to their sponsors’ financial interests.

One such pharmaceutical company is Shire. One of the British company’s highest-grossing products is Adderall, a stimulant used in treating ADHD that has earned the company billions in sales to date. Shire sponsors ADHD patient-advocacy groups, like Children and Adults with ADHD (CHADD).

The article is here.

Friday, July 7, 2017

Federal ethics chief resigns after clashes with Trump

Lauren Rosenblatt
The Los Angeles Times
Originally posted July 6, 2017

Walter Shaub Jr., director of the U.S. Office of Government Ethics, announced Thursday he would resign, following a rocky relationship with President Trump and repeated confrontations with the administration.

Shaub, appointed by President Obama in 2013, had unsuccessfully pressed Trump to divest his business interests to avoid potential conflicts of interest, something Trump refused to do.

The ethics watchdog also engaged in a public battle with the White House over his demands for more information about former lobbyists and other appointees who had been granted waivers from ethics rules. After initially balking, the White House eventually released the requested information about the waivers.

Shaub called for a harsher punishment for presidential advisor Kellyanne Conway after she flouted ethics rules by publicly endorsing Ivanka Trump’s clothing line during a television appearance.

The article is here.

Saturday, July 1, 2017

Trump's politicking raises ethics red flags

Julie Bykowicz
The Associated Press
Originally posted on June 27, 2017

Here is an excerpt:

The historically early campaigning comes with clear fundraising benefits, but it has raised red flags. Among them: Government employees have inappropriately crossed over into campaign activities, tax dollars may be subsidizing some aspects of campaign events, and as a constant candidate, the president risks alienating Americans who did not vote for him.

Larry Noble, former general counsel to the Federal Election Commission, said the early campaigning creates plenty of "potential tripwires," adding: "They're going to have to proceed very carefully to avoid violations."

The White House ensures that political entities pay for campaign events, and White House lawyers provide advice to employees to make sure they do not run afoul of rules preventing overtly political activities on government time, spokeswoman Lindsay Walter said Tuesday.

The Trump team has decided that any risks are worth it.

The article is here.

Thursday, June 8, 2017

Shining Light on Conflicts of Interest

Craig Klugman
The American Journal of Bioethics 
Volume 17, 2017 - Issue 6

Chimonas, DeVito and Rothman (2017) offer a descriptive target article that examines physicians' knowledge of and reaction to the Sunshine Act's Open Payments Database. This program is a federal computer repository of all payments and goods with a worth over $10 made from pharmaceutical companies and device manufacturers to physicians. Created under the 2010 Affordable Care Act, the goal of this database is to make the relationships between physicians and the medical drug/device industry more transparent. Such transparency is often touted as a solution to financial conflicts of interest (COI). A COI occurs when a person owes featly to more than one party. For example, physicians have fiduciary duties toward patients. At the same time, when physicians receive gifts or benefits from a pharmaceutical company, they are more likely to prescribe that company's products (Spurling et al. 2010). The gift creates a sense of a moral obligation toward the company. These two interests can be (but may not be) in conflict. Such arrangements can undermine a patient's trust with his/her physician, and more broadly, the public's trust of medicine.

(cut)

The idea is that if people are told about the conflict, then they can judge for themselves whether the provider is compromised and whether they wish to receive care from this person. The database exists with this intent—that transparency alone is enough. What is a patient to do with this information? Should patients avoid physicians who have conflicts? The decision is left in the patient's hands. Back in 2014, the Pharmaceutical Research and Manufacturers of America lobbying group expressed concern that the public would not understand the context of any payments or gifts to physicians (Castellani 2014).

The article is here.

Saturday, June 3, 2017

Trump Exempts Entire Senior Staff From White House Ethics Rules

Lachlan Markay
The Daily Beast
Originally published May 31, 2017

Here is an excerpt:

Andrew Olmem, another White House economist and a former lobbyist for a host of large financial services and insurance firms, will be free to work with former clients on specific issues affecting bank capital requirements, financial regulation of insurers, and the Puerto Rican debt crisis, all issues on which he has recently lobbied.

Those officials have been given freer rein to advance their former clients’ financial interests, but ethics rules have also been waived for every other “commissioned officer”—staffers who report directly to the president—in the White House who has worked for a political group in the past two years.

That will allow a number of White House staffers to collaborate with pro-Trump advocacy operations. The West Wing is stacked with officials who have made significant sums working, consulting for, or representing high-profile political organizations, including networks of groups financed by the Trump-backing Mercer family and the libertarian Koch family.

Conway herself consulted for more than 50 political, policy, and advocacy organizations last year, according to a White House financial disclosure statement.

The article is here.

Monday, May 22, 2017

Half of US physicians receive industry payments

Michael McCarthy
BMJ 2017; 357

Nearly half of US physicians receive payments from the drug, medical device, and related medical industries, and surgeons and male physicians are more likely to do so, a US study has found.

The study leader, Jona A Hattangadi-Gluth, of the University of California, San Diego, based in La Jolla, said that most payments were relatively small but that many specialists receive more than $10 000 (£7750; $9160) a year from industry, including 11% of orthopedic surgeons, 12% of neurologists, and 13% of neurosurgeons.

She said, “The data suggest that these payments are much more pervasive than we thought and [that] there is much more money going directly to physicians than maybe people recognized.”

The researchers analyzed data from 2015 collected from Open Payments, a program created by the 2010 Affordable Care Act that requires biomedical manufacturers and group purchasing organizations to report all general payments, ownership interests, and research payments paid to allopathic and osteopathic physicians in the US.

The article is here.

Friday, May 19, 2017

Conflict of Interest: Why Does It Matter?

Harvey V. Fineberg
JAMA. 2017;317(17):1717-1718.

Preservation of trust is the essential purpose of policies about conflict of interest. Physicians have many important roles including caring for individual patients, protecting the public’s health, engaging in research, reporting scientific and clinical discoveries, crafting professional guidelines, and advising policy makers and regulatory bodies. Success in all these functions depends on others—laypersons, professional peers, and policy leaders—believing and acting on the word of physicians. Therefore, the confidence of others in physician judgment is of paramount importance. When trust in physician judgment is impaired, the role of physicians is diminished.

Physicians should make informed, disinterested judgments. To be disinterested means being free of personal advantage. The type of advantage that is typically of concern in most situations involving physicians is financial. When referring to conflict of interest, the term generally means a financial interest that relates to the issue at hand. More specifically, a conflict of interest can be discerned by using a reasonable person standard; ie, a conflict of interest exists when a reasonable person would interpret the financial circumstances pertaining to a situation as potentially sufficient to influence the judgment of the physician in question.

The article is here.

Saturday, April 22, 2017

As Trump Inquiries Flood Ethics Office, Director Looks To House For Action

By Marilyn Geewax and Peter Overby
npr.org
Originally published April 17, 2017

Office of Government Ethics Director Walter Shaub Jr. is calling on the chairman of House Oversight Committee to become more engaged in overseeing ethics questions in the Trump administration.

In an interview with NPR on Monday, Shaub said public inquiries and complaints involving Trump administration conflicts of interest and ethics have been inundating his tiny agency, which has only advisory power.

"We've even had a couple days where the volume was so huge it filled up the voicemail box, and we couldn't clear the calls as fast as they were coming in," Shaub said. His office is scrambling to keep pace with the workload.

But while citizens, journalists and Democratic lawmakers are pushing for investigations, Shaub suggested a similar level of energy is not coming from the House Oversight Committee, which has the power to investigate ethics questions, particularly those being raised now about reported secret ethics waivers for former lobbyists serving in the Trump administration.

The article is here.