I’ve got some sort of pretty resilient bacteria infection, and after seeing the doctor yesterday, I’m now on a collection of antibiotics and other medicines with the goal of giving the sickness the boot, once and for all. I usually don’t have a lot of good things to say about the medical system in the U.S., having observed it (and sometime used it) all around the world, but yesterday’s experience wasn’t too terrible. Now, just if drug pricing seemed more rational…
Well, that’s not really fair. Drug pricing in the U.S. is rational. Very rational. That doesn’t make it fair or affordable, but I should say that it makes sense. Simply put, Americans really don’t mind paying many times the amount the rest of the world pays for the same drug. We complain about it, threaten to do something about it, build layers of bureaucracy to try to make it more efficient, and use it as a talking point of what must be done to build a better society, but we really don’t care about it. Why? Because compared to most of the world, we’re rich. Drug prices, even stupidly unfair drug prices, hurt, but they don’t hurt enough for us to demand systemic change to the pharmaceutical industry.
I’m not talking about nationalizing the pharmaceutical industry. I’m a libertarian (little “l” – libertarianism is best realized as a philosophical outlook rather than a political party), and I would not nationalize any industry like that. Rather, I think that most folks haven’t given the pharmaceutical industry’s advances per their cost much thought lately, because they have been too busy yammering on about high drug prices. The facts are that, with very few exceptions, the pharmaceutical industry hasn’t cured very many illnesses in the past 50 years. What they have done very well, along with the medical supply industry, is provide decreasing percentages of improvements on existing drugs that treat mostly chronic maladies, allowing them to patent the marginally different chemical formula and create another wave of demand for what is essentially the same drug, only it help 2-3% more patients with a particular disease now.
Were this any other industry, I wouldn’t advocate a re-think of what we should expect from them. After all, aren’t they basically doing what the car industry has been doing for about a century now? Every year’s model is basically the same as the last, with slight improvements. Occasionally, you see a totally new model or a body style change on an existing model, but not very often, and the end result is basically the same: the ability to charge much more while your experience as a driver and the effect (getting from point A to B) doesn’t change very much. The problem with applying this model to the pharmaceutical industry is that people occasionally need drugs to stay alive, and the survival instinct will push them to pay more and more money for even the chance that they 2-3% improvement in the “new” drug will be more beneficial to them than the “old” drug, when actually they are pretty much the same.
This business model of low value for the consumer in matters of life and death also can be seen in hospitals and clinics, which struggle to purchase the very latest MRI machine, which can image only slightly better than the previous one but costs 4-5 time more. At the bottom of it all, hospitals, doctors, pharmacists, and everyone else in the health care industry knows that people will clamor for the very best equipment and chemicals, even if the treatment available from those medical tools is only very marginally better than the previous generation, which may have only been released a few years ago.
Eventually, I hope that we will wake up and demand true value from our health care industry. If a pill only gives a slight improvement over something that has fallen out of patent and is now available as a generic, just use the generic. Most people get the same medical problems, many of which have a treatment that hasn’t fundamentally changed for decades. I would gladly live with 1980 medicine if I could pay 1980 dollars to get it. As it is, the entire system only gets more and more complicated, and as more money flows into it, there are more and more cracks for money to seep out, into the pockets of middlemen, efficiency “experts”, and government bureaucracy. We should demand more for what we pay, and we should pass on the latest and greatest if its cost can’t justify its performance.
OK, if you’ve read through that entire rant, I’m sorry, and you deserve a lollipop. Or at least a picture.
I’ve been messing around with creating panographic pictures from freely available tools on the Internet, and here is the first one I have to show off:
I’m still working on producing a couple of 360-degree images, and I’ll post them here when they are ready.
Stay healthy out there, for all of our sake…