Our Representative Prefers Fraudulent Testing and Quack Remedies over Better Access to Health Care

Our representative tries to present himself as a moderate Republican. With this goal in mind, he recently participated in a 30-minute conversation with Democratic Rep. Jake Auchincloss of Massachusetts, moderated by Heather Caygle from Punchbowl News.

While the conversation touched on several issues, the main topic was congressional action on access to cancer screening and innovation in cancer detection. Ciscomani and Auchincloss agreed that more funding for cancer research is important, and our representative was happy to tell everyone that he had been voted the most bipartisan and the most able to reach across the aisle in his first term. But it didn’t take long to hear about the differences between the two representatives on this issue. While Auchincloss discussed expanding access to cancer screening, Ciscomani focused on promoting innovation. That’s when he mentioned testing through just one drop of blood.

You might have heard the phrase “One Drop of Blood” before.

This phrase was frequently used by Elisabeth Holmes, the founder of startup Theranos, which aimed to revolutionize diagnostics by testing very small volumes of patients’ blood. The company, thanks to a perfect pitch by the charismatic Holmes, became a darling in the eyes of venture capitalists and private investors. In 2013, the company targeted Arizona to roll out its Edison testing stations. Our state’s political class swooned. Arizona lawmakers took up and passed H.B. 2645, a bill drafted by Theranos staff, that would permit anyone to order a laboratory medical test without a doctor’s approval. The Arizona House voted 60-0 in favor of the bill. The Senate voted 26-2. Governor Ducey signed it on April 6, 2015.

Ducey worked with Walgreens Boots Alliance to install Theranos Wellness Centers in 40 Walgreens stores in the Phoenix area. The company’s ads promised faster testing at a lower price. Between 2013 and 2016, the company sold about 1.5 million blood tests to 175,000 Arizonans.

The scheme began to unravel even before the signature ink on H.B. 2645 dried. Surprised that the company didn’t publish any data certifying the validity of the test methods, investigators discovered that the testing procedure Theranos developed was, in fact, haphazard and prone to giving incorrect results. By 2016, the US Securities and Exchange Commission, the Center for Medicare and Medicaid Services, and the Arizona Attorney General were investigating Theranos. The company ceased all operations in 2018. Elizabeth Holmes was sentenced in 2022 to 11 years and 3 months of prison on several counts of conspiracy and fraud, including destruction of records during the company’s last days.

A consent decree with the Arizona Attorney General that Theranos entered into in 2020 and a class action suit against Walgreens Boots on behalf of defrauded Arizonans who paid for the tests out of their own pocket yielded an average payout of $60.92 per person.

One may ask why Arizona became the epicenter for the company’s operations and failure. The company was, after all, based in California, and it seemed like its home state would be a good proving ground. Arizona became a prime target because it was perceived as a business-friendly state, and it had a large population of residents without health insurance. Those residents became the target demographic for company tests.

This brings us to the differences between cancer testing and health care approaches between Representatives Auchincloss and Ciscomani, and between Democrats and Republicans in general. Auchincloss demonstrated how medical innovation can be funded by a government grant, commercialized by a company, and brought to doctors’ offices. He emphasized that test availability should expand as more people become insured. Ciscomani, in contrast, promoted innovation for innovation’s sake and did not address gaps in coverage in the general population.

Listening to Ciscomani, the miracle of testing by one drop of blood would be the Holy Grail. But medical test results are often meaningless without a wider context, such as a patient’s age, body composition, hours of sleep, diet, and long-term trends. That’s where access to regular medical care becomes paramount, and that’s what’s missing from Ciscomani’s and his party’s proposals. On the contrary, Ciscomani’s votes for The One Big Beautiful Bill Act will increase the uninsured population.

In practice, Ciscomani’s proposal, once implemented, could look like the Theranos fiasco: an unproven test purchased by someone who lost health insurance, with results that would not mean anything without the context of a general patient’s health. An unproven miracle therapy hawked on YouTube, for the low price of $99.99—and if you order within the next 10 minutes, you will get a 4-slice toaster for free! If something goes wrong, here is $60.92 to keep you from complaining. We think this is bonkers, but then again, we do not benefit from campaign donations from small bioscience companies (looking at you, Neuocrine Biosciences!) that members of Congress, like Representative Ciscomani, receive in return for voting for bills that benefit the corporate donors. Some of those companies might be offering innovative but unproven cancer-testing methods, but the conflict-of-interest concerns seem quaint these days.

Here is one question we can all ask our representative: Why does his cancer testing plan require so many of us to lose health insurance and medical care?

References:

Fisher, Howard, 2018. “Blood-testing company that used AZ law to expand here, charged by feds with fraud.” Arizona Daily Star, March 14. https://tucson.com/news/local/article_2e7470ba-9b98-5b7f-8e6b-6866eb5e26be.html

Flaherty, Joseph, 2018. “Author John Carreyrou Tells How Theranos Scammed Doug Ducey and Arizona.” Phoenix New Times, June 1. https://www.phoenixnewtimes.com/news/author-john-carreyrou-how-theranos-scammed-arizona-10477429/

Innes, Stephanie, 2021. “Author: Theranos conducted ‘giant, unauthorized medical experiment’ in Arizona.” Arizona Daily Star, August 30. https://tucson.com/news/local/article_aa6b953e-a1c3-5f0b-b15a-30b975fabf44.html

Reuter, Elise, 2023. “Walgreens to pay $44M to settle claims over fraudulent Theranos tests.” MedTechDive, September 8. https://www.medtechdive.com/news/walgreens-settle-class-action-lawsuit-theranos-tests/693065/