Like most everything that happens in health care today, our ideas about sickness are being shaped in the long shadows cast by the global drug giants. Yet the narrowing of the focus is making it harder for us to see the bigger picture about health and disease, sometimes at great cost to the individual, and the community. To use a simple example, if an improvement in human health was our primary aim, some of the billions currently invested in expensive drugs to lower the cholesterol of the worried well might be far more efficiently spent on enhanced campaigns to reduce smoking, increase physical activity, and improve diet.
(Selling Sickness: How the World’s Biggest Pharmaceutical Companies are Turning Us All Into Patients, by Ray Moynihan, Alan Cassels – Prologue, p xv)
There are two things I would change on my first day as dictator: 1) outlaw advertising to children; and 2) outlaw advertising of prescription drugs to the general public.
The first is a no-brainer. Advertisers, who are adults schooled in the art of psychological manipulation, have a decidedly unequal bargaining position over children. These poor schmucks, these kids, should be able to enjoy their childhoods. Advertising makes them dissatisfied with what they have. That’s its whole purpose, and why it works – it makes them unhappy.
Advertising to adults about drugs is no different. We grown-ups are supposedly better able to evaluate information and make wise choices, but with drugs, absent some medical training, we are children at the feet of the ad moguls.
The book I cited above is an exposé of the world of consumer drugs – overpriced remedies to manufactured conditions. The premise is that drug companies are more concerned with inventing diseases than curing them. The chapters of the book are each devoted to a particular malady – depression, high cholesterol, menopause, ADD and ADHD, high blood pressure, PDD (premenstrual dysphoric disorder), social anxiety, IBS (irritable bowel syndrome) and female sexual dysfunction. Each is either mythical or over-hyped.
The drug companies’ business model is to 1) invent (or (exaggerate the prevalence of) the disease; 2) conduct self-financed and self-directed clinical studies of drugs to treat the disease; 3) convince a large segment of the public that they have the disease; 4) market the remedy.
For any of this to be effective requires complicity of the regulatory agency, the FDA. Incredibly, in a blatant conflict of interest, that agency depends on drug companies for much of its funding. The regulator is employed by the regulatee.
Take just one ‘disease’ – high blood pressure. There’s no consensus that the measurement we use to delineate what constitutes “high” is terribly useful by itself. It is far better that people stop smoking, eat better, and are physically active. Non-smokers who eat well and exercise can endure higher blood pressure without risk. All of the billions that we devote to drugging the population to lower the numbers would be far better spent in education on how to avoid the need for the drug at all. Far more people take high blood pressure medicine than need it.
Dr.James McCormack does presentations for senior citizens, and asks them the following:
Would you take a drug every day for five years if it …?
A: Lowered your chance of having a heart attack by 33%?
B: Lowered your chance of having a heart attack from 3% down to 2%, a difference of 1%?
C: Saved one person in a hundred from having a heart attack but there is no way of knowing in advance who that one person will be?
That’s three ways of saying the same thing. People who attend McCormack’s seminars leave feeling relieved that they are far less at risk as they are led to believe.They become less susceptible to the drug company advertising, which hits hard on A while studiously avoiding C.
Other ‘diseases’, like ADD/ADHD, are controversial at best, over-treated and over-hyped. Female sexual dysfunction, for instance, is far more likely to be a product of stress in relationships than any physical disorder. Women who feel loved and who are comfortable in their relationships are far more likely to enjoy sex than those who aren’t. There ain’t no pill for that.
There are two problems here indicative of a dysfunctional society: 1) we allow advertisers unimpeded access to the market with their crap, and 2) that our drugs are supplied by drug companies whose primary motive is their bottom line. Pharmaceutical companies long ago realized that the most profitable drugs were those taken daily for years. It was only two logical steps further that they would invent diseases and advertise the cures.
The profit motive interferes with health care delivery, and advertising interferes with information and education. Two underpinnings of capitalism lead to dysfunction. I must be a damned socialist!
Piece of Mindful 
Right on!
LikeLike
Mark, speaking of dysfunction and completely OT (sorry!) to this topic, I note you have not revisited Ward Churchill. I see where the trial judge vacated the jury decision. http://www.insidehighered.com/news/2009/07/08/churchill
>>>>>>>>>>>>>>>>>>>
Ward Churchill Gets Nothing
July 8, 2009
The University of Colorado won just about everything it wanted, and Ward Churchill lost just about everything he wanted, in a ruling Tuesday by a state judge in Colorado.
Judge Larry J. Naves ruled that the University of Colorado Board of Regents had “quasi-judicial immunity” when it voted to fire Churchill from his tenured position teaching ethnic studies, after faculty panels found that he had committed multiple instances of research misconduct. Naves vacated an April ruling by a jury in the case that found that Churchill had been inappropriately fired. Based on that ruling, Naves could have ordered Churchill reinstated or ordered Colorado to pay him — issues that would have been moot given that Naves vacated the jury’s decision. But Naves went on and said that, even based on the jury’s findings, Churchill was not entitled to his job back, or to any money.
And Naves went out of his way to stress that he found the university’s findings of misconduct credible, and that the return of Churchill to the faculty would be damaging.
<<<<<<<<<<<<<<<<<<<
LikeLike
Well, as they say, if you don’t believe in someone’s right to say things you don’t like, you don’t believe in free speech. And honestly, there are a lot of people on the right wing who preach free speech, but when tested, as they were with Churchill, are true to form. They don’t believe in free speech.
This is no surprise to me.
LikeLike
So you like “free” speech but you don’t like “free” markets?
Ward Churchill essentially “advertises to children”. The modern college system funnels somewhat gullible 18 yr olds into his clutches so he can use psychological manipulation to sell his revisionist “drugs”.
Does Ward Churchill have a right to say things that are false?
LikeLike
Where you been? I’ve missed you.
“Free Markets” is kind of misnomer. If you said “unregulated” markets, which are a travesty for humankind, then you’d be right. I do not like them.
And yes, no teacher ever has the right to say things that are false, and you get to decide for us what’s true. Start with creationism.
LikeLike
Advertising would be less troublesome if the tax code capped the amount allowable as a business expense. It’s all about marketshare and monopoly, not competition and quality. Change the tax exemption and more people would compare outcomes and price, fewer would react to manufactured fear.
LikeLike