American Health Care : A Sucker Born Every Minute

‘The insurance industry and PhARMA are well aware of the TV watcher’s predilection to accept, without question, their lies, distortions, and innuendoes about the nature of and need for single payer, universal health care.’

By Dr. Stephen R. Keister / The Rag Blog / December 27, 2008

P.T. Barnum’s famous statement plays well today, “There is a sucker born every minute.” In some yet undetermined way Barnum must have anticipated the age of television and the fact that for some obscure reason the average American feels that what he sees on television must be true. Therein we who favor single payer, universal health care face one of our two greatest problems. The insurance industry and PhARMA are well aware of the TV watcher’s predilection to accept, without question, their lies, distortions, and innuendoes about the nature of and need for single payer, universal health care and by deceit invade the psyche of the boob glued to the tube and convince him that his best interest is served only by a greedy, capitalistic group of corporations, thus, depriving him of his right to health care for him and his family.

The United States is one of two industrialized nations that permit advertising of prescription medication on TV. I recently noted that the various drug companies, in one year, spent half a billion dollars on sleep problems, and the medicines to correct them. Watching TV for an evening one can only imagine the cost to the pharmaceutical industry, as every other ad seems to espouse a different prescription nostrum for ailments real or imagined. One can only surmise the overall cost that, in the long run, will be passed on to the patient at the drug store. What is the purpose? One assumes that the pharmaceutical companies anticipate that the TV watchers will harass their family doctors into giving them “what I saw advertised on TV.” Of course any thoughtful physician will discuss the pros and cons of the request, and then make it very clear that he determines from scientific knowledge what medications he will prescribe, and not be guided by rank commercialism. If he does not do so it is time to suggest a change in physicians.

Excessive pharmaceutical prices are largely indigenous to the United States. On Nov. 21, 2008, in an article posted on TruthOut, an American expatriate in Paris, Steve Weissman, notes his initial experience with the French medical system. He writes.

The system here is surprisingly nonbureaucratic, at least for the patient.. My wife Anna and I picked our own general practitioners, specialists, and hospital care, with no insurance company restricting us to their list of doctors or hospitals. In fact, we found only two restrictions. The GPs could turn us down if they already had too many patients and they had to be within our geographical area so they would not have to travel too far when making a house call. Thus, under socialized medicine here in France, doctors still make house calls, even here in the boondocks where we live.

For each visit to the GP, we write a check for 22 euros. The system then reimburses us for 70% with a direct deposit to our bank account. For some particularly debilitating conditions the government pays the full 100%. To pay whatever the government doesn’t many people have private top-up insurance, which is very reasonably priced. At the pharmacy, we don’t pay at all. We simply present our health care cards; the government and top-up insurance then pay the pharmacist directly.

How good is the French medical care? Surveys by the W.H.O. rate the French system the best in the world, and far better than average health care in the United States.”

Again, please note that French TV does not carry pharmaceutical ads. But then the French physician seemingly does not need to be directed by corporate advertising and appears to be much better off for the lack of it. But our TV watchers should be cautioned that the profit making, politician-prostituting drug companies are not serving the viewers’ best interest but, amazingly will be believed by most Americans.

I practiced internal medicine and rheumatology for 40 years, retiring in 1990. Rousseau noted in his writings that we should each experience every situation presented to us as a life experience. In 1989 I received an invitation from a pharmaceutical company to attend a three day seminar at a luxury hotel in Phoenix, air-fare paid, with a “companion of my choice.” For 39 years I had never replied to such an invitation, but decided that it was my last chance for such an experience. Hence, I showed the invitation to my wife, and the “companion issue” was quickly answered. We flew from Erie, Pa. to Phoenix, were provided with a $500 a day room, meals, picnics, entertainment, and were required for three days to attend a three hour morning seminar. There were 200 physicians and “companions” in attendance, all with expenses paid. (At the first dinner I noted to my wife that a great number of physicians had brought their daughters, and she noted that I was extremely naïve.) In any event, after 24 hours I was educated about and ashamed by what was being done by the pharmaceutical companies in offering baksheesh to the medical profession. I gained an insight into the high price of drugs to the consumer.

There are many reasons for the high price of prescriptions in this country. Do not blame the pharmacist. There has been collusion between the Bush administration and big PhARMA, as well as the insurance industry. The Medicare Part D “prescription plan” is the outstanding example. This insult to the intelligence of the American public was passed by a whip-sawed congress in the middle of the night by 2-3 votes. The congressional sponsors, by and large, have been employed by the pharmaceutical industry since the bill’s passage. In return a grossly imperfect “prescription plan” with payments in the billions out of the Medicare Fund being made to the pharmaceutical and insurance industries for “administering” the plan, and with minimal control of the payment schemes presented to the subscribers. The bill specified prohibiting prescriptions from abroad, deemed price control on drugs as with the VA system out of bounds, and specified that there be no negotiations by Medicare on drug prices with the carriers. One prominent insurance company, which is also in the hospital business, has surreptitiously used the prescription drug plan as a vehicle for pedaling its HMO

We who are rational, discerning human beings must try our utmost to influence the Obama administration to (1) revise the Medicare part D prescription bill in the interest of the consumer rather than the corporations; (2) legislate against advertising of prescription drugs; and (3) establish hard and fast restrictions on the financial interaction between the pharmaceutical industry and the medical professions, including the ghost writing of professional papers for academic researchers by the pharmaceutical industry.

I have addressed one part of the problem regarding health care for all, but there is another chapter dealing with the distortions by the insurance companies and HMO’s which we will address at a later time. It is only the citizens of this nation, acting collectively, who can bring about change. We must make our voices heard by our elected representatives. And we should check out the contributions those representatives have received from the drug and insurance industries on any of several available web sites like OpenSecrets.org.

The Rag Blog