Among other things, I thought Peter Conrad’s book was a delightful introduction to how healthcare and medicine are becoming but another American consumer commodity. The factoids concerning the medicalization and practices of pharmaceutical companies appear disturbing and unethical. There is no question that duping the public through the marketing and distribution of drugs is a disturbing occurrence, particularly since health and trusted physicians is involved. But to me these issues merely reflect the American heritage of politics and business. Capitalism and meritocracy both have conflicting interests with the ethical treatment of patients. Universal healthcare contradicts on some level the basic notion relating hard work the allocation of resources among Americans. Most Americans would agree that everyone should have complete and equal access to medical care, but it does not translate so smoothly to our markets. The consumption and sale of pharmaceutical drugs however, fits seamlessly into profit making and capitalist venturing, as apparent by the success of “andropause” medication. Most physicians and studies agree that prescribing testosterone for this unrecognized disorder is questionable, and that progressive androgen deficiency is perfectly natural as one ages. But if there is a market for such products, it is perfectly patriotic for these pharmaceutical companies to advertise and sell them.
It is also disturbing to hear about the gifts and vacations allocated to physicians for prescribing expensive medication, however this is also a problem deeply rooted in our culture and politics. Apart from some silent veil expecting physicians to act devoid of monetary incentives, the current healthcare system has some very distinct routes for medical students to pursue a profit driven career. And after rigorous years in school and graduating with considerable debt, who is to blame physicians for opting for a career in dermatology, a free vacation or Montblanc pens?
In the end, these costs do come out of the pockets of the patients. And this is difficult to face, as on some level they are being manipulated and entering a market they do not fully comprehend. But this is the tragedy of the American consumer across the board. We are constantly being alienated from the true origins and implications of our purchases. When we are buying food for our family, toys for the kids, or pumping fuel into our vehicles. We are kept distanced from intelligent consumerism. This is a particularly complex issue in health, as the theory and intricacies involved in choosing which medicine to consume usually require years of training to fully understand. If we as a nation soldier up and opt for ethical and equal care for patients (which may resolve many healthcare cost issues) we need to decide where the buck stops. I personally believe the political and commercial sectors (i.e. government and drug companies) cannot be expected to make such decisions due to aforementioned American ideals. Medical institutions and education need to instill a sense of greater obligations in physicians, and have a pure emphasis on healing and quality of care. There needs to be a penalty for a system that pays doctors and hospitals set fees for providing services regardless of quality or efficiency, and a discouragement for prescribing profit-driven drugs (such as the propublica information).