Sunday, October 24, 2004
Got to Keep 'em Superficial
As we head into the presidential election, and despite the level of interest we have seen in this election by groups that traditionally do not participate in elections, we know there is one consistency from previous elections. The treatment of the superficial over the substantive. There have been a number of stories on Kerry's comments regarding the Cheney's lesbian daughter, about Teresa's comment that she did not know that Laura Bush held a job before becoming First Lady, but very little on the substantive issues that make a difference in our lives. For those, we have to turn to political ads, which we know have no interest in making sure that American are informed on the true nature of the interest.
Take for issue health care. Here is an issue that has been on the top of American's minds since the late 1980s and early 1990s, and to date there has been nothing done to fix it. John Kerry, which seeks to tweak the health care system we have has been tied by the Bush camp as calling for a crazy government run system that makes "Hillary-care" look like a walk in a park.
In 1993, "Hillary-care" was what the Republicans, and in particular the health insurance companies, worked to kill any change in our miserable health care system in America. In one famed example, the Health Insurance Association of America (HIAA) took out ad buys in which it showed a fictitious couple talking about the "big government" plan by the Democrats. The ads, targeted only in markets where key politicians are media existed, had the effect of elevating the HIAA from a minor player to the major player onn health care reform. HIAA won, and America lost.
We have a similar situation today. The story that has dominated the news cycle the last couple of weeks has been a lack of flu shots to protect most Americans in the upcoming flu season. John Kerry blames the President for outsourcing the flu vaccine to the Brits, and Bush blames Kerry for trial lawyers driving up the cost of health care (?).
The real reason that the flu vaccine is not available has a great deal to do with the power of the drug lobby in the United States. In an article in the "New York Times," Bartlett and Steele, which have a great book on the power of big drugs in the US, argue that the absence of a flu vaccine is because there is no money in making one, unlike one to treat erectile dysfunction. If you have trouble "gaining wood," there are three different drugs to help you out (in fact, the term "erectile dysfunction" was used over "impotence" when pitchmen like Bob Dole and Mike Ditka did not want a term like "impotence" to clash with their leadership image).
All of this has come from changes in FDA regulations in 1997 that allowed drug companies to no longer go through doctors in an effort to push products, but rather to appeal directly to the American public through television ads. The result? The most expensive prescription drug prices than anyone in the rest of the world pays.
But this is not what we are being told by our elected leaders.They tell us that drugs cost so high in the US because companies are consistently spending sizeable sums in research and development to give us the best drugs for the future to fight any disease imaginable. But this is false. As Marcia Angell has argued, R&D is a small part of the budget of big drug companies--right around 14%--while marketing and administration absorbs nearly 40%. Further, the introduction of these new drugs that are supposed to be helping us fight the diseases of the future have nearly dried up. What have they been replaced with? The erectile dysfunction drugs or those that are to help with high cholestoral levels.
Bartlett and Steele argue for a centralized system like the Federal Reserve System whose members would be free from politics and would coordinate our health care system, identifying those drugs that work and funneling "research money to where it will do the most good rather than to those areas with the largest and most vocal constituency, thereby treating the victims of various diseases and conditions more equitably."
Thousands of people may die this year because there is no vaccination available to treat those who get the flu. To their survivors, someone has to tell them that their loved one died because "there is no money in a flu vaccination."
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Take for issue health care. Here is an issue that has been on the top of American's minds since the late 1980s and early 1990s, and to date there has been nothing done to fix it. John Kerry, which seeks to tweak the health care system we have has been tied by the Bush camp as calling for a crazy government run system that makes "Hillary-care" look like a walk in a park.
In 1993, "Hillary-care" was what the Republicans, and in particular the health insurance companies, worked to kill any change in our miserable health care system in America. In one famed example, the Health Insurance Association of America (HIAA) took out ad buys in which it showed a fictitious couple talking about the "big government" plan by the Democrats. The ads, targeted only in markets where key politicians are media existed, had the effect of elevating the HIAA from a minor player to the major player onn health care reform. HIAA won, and America lost.
We have a similar situation today. The story that has dominated the news cycle the last couple of weeks has been a lack of flu shots to protect most Americans in the upcoming flu season. John Kerry blames the President for outsourcing the flu vaccine to the Brits, and Bush blames Kerry for trial lawyers driving up the cost of health care (?).
The real reason that the flu vaccine is not available has a great deal to do with the power of the drug lobby in the United States. In an article in the "New York Times," Bartlett and Steele, which have a great book on the power of big drugs in the US, argue that the absence of a flu vaccine is because there is no money in making one, unlike one to treat erectile dysfunction. If you have trouble "gaining wood," there are three different drugs to help you out (in fact, the term "erectile dysfunction" was used over "impotence" when pitchmen like Bob Dole and Mike Ditka did not want a term like "impotence" to clash with their leadership image).
All of this has come from changes in FDA regulations in 1997 that allowed drug companies to no longer go through doctors in an effort to push products, but rather to appeal directly to the American public through television ads. The result? The most expensive prescription drug prices than anyone in the rest of the world pays.
But this is not what we are being told by our elected leaders.They tell us that drugs cost so high in the US because companies are consistently spending sizeable sums in research and development to give us the best drugs for the future to fight any disease imaginable. But this is false. As Marcia Angell has argued, R&D is a small part of the budget of big drug companies--right around 14%--while marketing and administration absorbs nearly 40%. Further, the introduction of these new drugs that are supposed to be helping us fight the diseases of the future have nearly dried up. What have they been replaced with? The erectile dysfunction drugs or those that are to help with high cholestoral levels.
Bartlett and Steele argue for a centralized system like the Federal Reserve System whose members would be free from politics and would coordinate our health care system, identifying those drugs that work and funneling "research money to where it will do the most good rather than to those areas with the largest and most vocal constituency, thereby treating the victims of various diseases and conditions more equitably."
Thousands of people may die this year because there is no vaccination available to treat those who get the flu. To their survivors, someone has to tell them that their loved one died because "there is no money in a flu vaccination."
