“He was an orthopedic surgeon. They want to orth surg.” That was the funniest line in an NPR interview with journalist T. R. Reid, who took his old, non life-threatening shoulder injury around the globe to compare five of the most developed health care systems.
His report fills in the facts and history, and explains how other nations manage to give more for less. For instance, did you know that we’re subsidizing the Swiss?
It was interesting to learn in the report that some of Switzerland’s drug companies make one-third of their profits in the U.S. market. Are we subsidizing these other nations’ prescription drugs, and what would happen if America clamps down on prices?
Yes, we subsidize the whole world. Americans pay more for pills than people in any other country. Sometimes, the same tablet made in the same factory costs $1 in the U.S. and 20 cents in Britain. If we could negotiate lower prices in the U.S., the drug companies would then try to raise prices overseas to make up for the lost revenues.
The pharmaceutical industry spends billions on research. Drug companies say they would have to reduce R&D if Americans paid less for their drugs, but the companies spend more on marketing than they do on research. In Switzerland, when the government started negotiating lower prices for drugs, the companies cut their marketing budgets and maintained the level of R&D.
Marketing. Let me elaborate on that. When your TV show is interrupted and the volume goes up for a commercial about some stranger’s hemorrhoids–‘ask your doctor’, Grandma is paying for it. Oh yes she is. Ask her how much her pills cost, and your hair might just fall out. Rogaine is over the counter now.
And folks, if they had a pill that cured cancer better than what we have now, do you think they would have to advertise it on TV? You think people wouldn’t be beating down the pharmacy door to get it?
Our system doesn’t reward letting things get better on their own, or old-fashioned, low tech cures. It rewards intervention. Reid got similar advice on his shoulder from doctors in five countries (I find that very reassuring) with the majority saying he didn’t need surgery. In the US a good surgeon will tell you that, but they lose a chance to make bucks every time they do.
The need to make a profit competes with the mandate to serve the patient. How often does profit win? Ask your doctor. I know that mine is unhappy with the general state of things.
We can argue about how to set the sails on the ship of state. But there are holes in the hull. It’s nice and dry on the top decks, but if we don’t all agree to get down where it’s dirty and start bailing, work together, and make some sacrifices–it won’t matter what color we paint the mast–we’re going down.