Ben Smith’s latest on Jonathan Gruber’s disclosure problems makes a very salient point – while disclosure would be expected in cases of traditional media mentions of Gruber, in the case of the New England Journal of Medicine, they have a formal process for disclosure:
Gruber pointed out that he’d disclosed the contract in the New England Journal of Medicine’s formal disclosure process, but the disclosure does not appear in any number of other places: beside his quotations in newspapers and magazines supporting the plan, including a Ron Brownstein piece the White House pushed hard; under a recent Washington Post op-ed; and beside crucial statements, such as his dismissal of an insurance industry study, which was part of a successful administration fight to discredit the study [...]
“The [New England Journal of Medicine] asked me, so I disclosed it. Nobody else really asked,” Gruber told me a few minutes ago, adding that the journal article was “the most important” to disclose because it was an explicit defense of the plan.
Presumably NEJM had the same formal disclosure process back in July of this year. Back then, Gruber wrote this article. It actually appeared in the July 2, 2009 print edition, but was on the website by June 10, 2009.
At that time, Gruber was under a $95,000 federal contract to HHS the first of his two this year. The article discusses the employer deduction, and essentially what has led to the excise tax on “Cadillac” plans.
This is what’s so important about Gruber’s lack of disclosure. Virtually every discussion of the controversial “Cadillac tax” features Gruber as the main defender. John Kerry, who is credited with designing the tax on insurance companies, wrote just today at the Huffington Post about the Cadillac tax, and the only economist he cited was Jonathan Gruber. Bob Casey, on the floor of the Senate, talked about how savings in health reform, partially through this tax, would raise wages, using data from… Jonathan Gruber. Here’s the money quote.
That is Dr. Gruber at MIT, not my words, not the words or the analysis of some Senator or House Member on one side of the debate or the other.
Austin Frakt has a defense of the theory that premium prices affect wages (that always is “proven” in one direction, noting that the rising costs of premiums lead to cuts in wages, but the reverse, that lowering premiums for employers would lead to concomitant rises in wages, is often assumed) and he cites several peer-reviewed journals on the subject, including two from… Jonathan Gruber.
Gruber is at the center of virtually every discussion of this particular financing element of health reform, and yet he doesn’t disclose when writing about it that he’s being paid by the Administration? And he doesn’t mention it to the New England Journal of Medicine back in June, which has a strict disclosure policy?
This looks like a serious breach of professional ethics.
FDL News has contacted the NEJM for a comment, we’ll let you know if they respond.
UPDATE: One of the amusing sidelights to this is that we know much about Jonathan Gruber’s contracts with HHS because of the new website USASpending.gov, created so the public would get some transparency over the federal contracting process.
You know who co-sponsored that law?
Tom Coburn and then-Senator Barack Obama.
UPDATE II: Jennifer Zeis, a NEJM spokesperson, has emailed a response, but it’s incomplete:
Jon Gruber’s article was published Online First on June 10, 2009; this is noted under “Source Information” on the article’s page. So this article was published before the contract was awarded.
That’s true. But he was at the time already operating under a separate contract that was awarded on March 25 and didn’t end until July 25 (scroll down). I’ve asked NEJM to clarify that.
UPDATE III: Here are the NEJM’s guidelines for disclosure:
“Public trust in the peer-review process and the credibility of published articles depend in part on how well conflict of interest is handled during writing, peer review, and editorial decision making. Conflict of interest exists when an author (or the author’s institution), reviewer, or editor has financial or personal relationships that inappropriately influence (bias) his or her actions (such relationships are also known as dual commitments, competing interests, or competing loyalties). These relationships vary from negligible to great potential for influencing judgment. Not all relationships represent true conflict of interest. On the other hand, the potential for conflict of interest can exist regardless of whether an individual believes that the relationship affects his or her scientific judgment. Financial relationships (such as employment, consultancies, stock ownership, honoraria, and paid expert testimony) are the most easily identifiable conflicts of interest and the most likely to undermine the credibility of the journal, the authors, and of science itself. However, conflicts can occur for other reasons, such as personal relationships, academic competition, and intellectual passion.
All participants in the peer-review and publication process must disclose all relationships that could be viewed as potential conflicts of interest. Disclosure of such relationships is also important in connection with editorials and review articles, because it can be more
difficult to detect bias in these types of publications than in reports of original research. Editors may use information disclosed in conflict-of-interest and financial-interest statements as a basis for editorial decisions. Editors should publish this information if they believe it is important in judging the manuscript.