Daily Blague

Carl Elliott's "The Drug Pushers," in the current Atlantic, reminds me how important it is to disassociate our health care from free market ideology. The idea that people consume medical goods and services in the same way that they buy cars is imbecile. It doesn't make sense to anyone who has suffered a chronic illness or a serious crisis. The detached attentiveness required to make intelligent free-market choices plays no part in the psychology of an ailing and probably panicking human being.

Dr Elliott writes about drug reps, the salesmen who tout their medicines to doctors. There is almost always one of these people in the waiting room of my internist's group practice. Sleek and organized, they're usually dragging a small suitcase on wheels, like business travelers. They're certainly not sick, and if they look a little bit tense or stressed, they do so without the worry that creases the faces of patients and their companions. I know that my doctor sees the reps, because when he starts me on something new, he accompanies the prescription with a generous supply of samples. He has even, on occasion, had small shopping bags for carrying all the boxes, which typically contain only a few pills. I have to hope that he has chosen these drugs without considering anything but my health, and no sample drug has ever hurt me. But I don't like seeing the reps in the office. They wear their business like a cologne, and I don't want to think about business when I'm not feeling well.

Everything is not, in a word, business. Trying to make a business - a big business - out of everything is degrading the world we live in.

Heaven knows I've benefited from pharmaceutical research. But I wonder if the enrichment of stockholders is the only imaginable incentive to guarantee that such research is undertaken. Why can't universities develop and test drugs, receiving healthy grants into the bargain? These can then be licensed to mere manufacturers, whose only product costs would be ingredients and purity assurance. Why wouldn't that work just as well, if not better, than the current system. Bear in mind that conditions suffered by the poor and disadvantaged are said to go begging for treatments.