This blog wasn’t started with the intention of discussing problems with health care or health care reform, but it is such a crucial issue, and I hear from people almost daily about how it is affecting their lives, that I feel compelled to write about it.
I recently watched two Bill Moyers webisodes, one on the insurance companies, and one on the pharmaceutical companies. They’re around 20-30 minutes each and well worth watching.
Bottom line: Insurance and pharmaceutical companies are businesses just like any other American capitalistic business. That means their first, most important, and only goal is maximizing their bottom line. If they don’t, Wall Street punishes them and their stocks plummet in value. In that regard they are no different from Wal-Mart or Apple computers. The difference is that when other companies maximize their profits, they lay off people, or deliver a cheaper, inferior product. When the insurance and pharmaceutical companies cut costs and increase profits they drop coverage, raise policy rates, deny care, and increase the cost of medications. This, indirectly, results in the suffering and death or real, live people. Should these industries play by the same rules as other non-healthcare businesses?
But it goes beyond that. Removing people from policies or increasing rates are legal and legitimate (at least sometimes). But as this story illustrates, insurance companies are more than willing to use quasi-legal and ethically scum-bag behavior to further their bottom lines. And recission, where the insurance companies look for any excuse (no matter how trivial) they can find to deny care, is equally vile behavior. And it gets worse. Both industries routinely buy off politicians (the pharmaceutical industry has two lobbyists for every member of Congress) to prevent legislation that would bring these practices under control… and reduce their profits. And more…
The pharmaceutical companies:
- Engage in deceptive direct to consumer advertising that down plays side effects and shows images of people frolicking through fields and beaches and other idyllic scenes (if you take their drug). These ads also serve to medicalize normal life events. Where before it was a result of aging or other normal circumstances, it’s now an actual disease, which of course requires treatment with a drug.
- Turn the scientific literature into little more than propaganda. Perhaps their worst offense. Many of us believe in scientific studies, that it helps us understand the truth. Sadly this is not the case. It’s been clearly shown that they…
- Rig scientific trials. Design the studies for scientists so the outcome they desire is guaranteed.
- Ghost write trials (this is most often done by an ad agency, not a scientist) so that the studies say what they want them to say. This has gone as far as completely making up the data used in studies.
- Repress studies that disagree with the point that they are trying to make. Studies are rejected by journals (can’t get published). Studies fail to get any attention in the media. Scientists are told they won’t receive any funding for future studies, or that they will lose their jobs, if they study the “wrong” thing or have “wrong” conclusions.
- Create inaccurate media frenzy. Which studies make the headlines? Most often, those with pharmaceutical sponsors. Pharmaceutical companies buy a lot of advertising in media. Publishing an article with the “wrong” conclusion can cost TV stations, radio, and newspapers major advertising revenue, so it often doesn’t get published. What does get published is too often ghost-written by ad agencies, not reporters.
- Buy experts. Try to find an expert in a field and chances are almost certain they have been “bought” by a pharmaceutical company. Whether it’s research money, gifts, vacations, or just plain money, many “experts” make a great deal of their livelihood by sticking to the corporate line and being generously rewarded.
- Buy doctors. Like the experts most doctors are relentlessly chased by drug reps who are beautiful (many come from the ranks of cheerleaders and models), young, and friendly, who flatter and pay attention. Who provide gifts (from pens and notepads, to free dinners, free events, free vacations), and samples. The reps use computer programs to monitor the prescribing habits of doctors. Doctors who prescribe more of their drugs receive greater rewards, doctors who prescribe less get more pressure. Most doctors genuinely believe that their decisions are their own, but studies have shown this is far from the truth. These salesmen and women profoundly impact the medical decisions that doctors are making.
Both industries have taken strong notice of the tactics used by the tobacco companies, and use them to aggressively maximize their bottom lines, even as they cause death and suffering.
If we’re honest, we have to say that these two industries are probably no worse than others. We’ve seen the lows that the financial industry went to, in terms of short-term profit, creating trillions in debt and plunging the world into a recession. The capitalist system, as it applies to health, is filled with incentives to make money and disincentives to provide good care. Should we expect any better from the pharmaceutical or insurance companies?
Watch Bill Moyers interview with Wendell Potter on insurance companies here.
Watch Bill Moyers interview with Melody Petersen on pharmaceutical companies here.
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