Did You Ever See An Ant And Then Get Itchy?

The Associated Press – June 18, 2009:

“The (Oil) industry spent $44.5 million lobbying Congress and federal
agencies in the first three months of this year, on pace to shatter
last year’s record. Only the drug industry spent more.”

If you don’t mind, read that quote one more time and seriously think
about it for 30 seconds. Think about how that might be shaping your
care, the costs of healthcare, the inefficiencies, the reason why it is
on pace to bankrupt our government and many of us individuals.

Some of you might think I am overly sensitive to healthcare because you
haven’t had to deal with it. I haven’t been to the doctor in over 5
years, actually, I guess I was in college when I last went to the doc
for a regular visit. My wife and kids have gone for pregnancy and
routine visits and let me tell you, there’s something horribly wrong
with the big picture, it is slowly becoming par with a trip to the DMV.

My goal with this entry is to outline a couple major remedies to the
situation. They may be an over simplification of the problems we’re
facing, but I can honestly say that there is no doubt that they would
improve the system.

Before I pontificate on major issues that need to be addressed, I would
like to say that any doctor or nurse that I have ever met or been
associated with has been an incredibly good person who truly cares
about the patients they help.

With that being said, here are my proposed solutions:

1. You the patient must stop seeking remedy for symptoms and start
addressing the cause. There are many disease states where the symptoms
are related to unhealthy habits such as inactivity, smoking, and poor
eating decisions. In fact, I would venture to say that some of the
largest markets out there are interlinked with some of these poor
decisions, such as diabetes, cancer, heart and cardiovascular issues,
acid reflux, and sleep apnea to name a few. I worked on a small
prescription drug to treat acid reflux, it made $10 Billion in one
year. The drug represented 10% of the prescription drug market, now
imagine the over the counter marker with Prilosec OTC, then ad in
physician visits, specialist visits, you’re now over a $100 Billion for
one disease state that can be minimized and in some cases eliminated
through a more healthy lifestyle. Okay, maybe we can’t expect people to
live like saints, but then tax the contributors to that impact the
cause. Tax McDonald’s, tax cable TV, tax Ben & Jerry’s, and then you’ll
start paying for the health costs associated with them. We already tax
cigarettes and alcohol disproportionately, why not make the leap to
culprits who are contributing equally.

2. Stop Direct To Consumer advertising of medical products. There is a
placebo effect, we all know that a placebo is capable of making people
feel relief or in some cases, adverse events. Did you ever see an ant
and then get itchy? That’s what direct to consumer ads are doing,
making people feel symptoms that they didn’t know they had. There’s a
reason why pharma companies are doing it more and more.

3. Stop several companies from manufacturing the same product and
selling them all at the same rate. If you want to release a product
that has the same active ingredient and a similar mechanism of action
to an existing product, you can still enter the market, but you can
only do it at 50% costs of the current offering. Almost every drug
available has 3 or 4 “me too” products in the same class. These
products offer no true differentiation, just marketing niches that
require 1,000’s of drug reps to carve out the micro differences.

4. The payment should be based on the disease or problem, not the
medication and procedures. Many physicians, specialists, and
pharmacists know they can get paid more by doing additional procedures,
additional tests, and in some cases, by prescribing one drug over
another. Some pharmacists even get kickbacks for dispensing one drug
over another. Major managed care organizations negotiate with all the
pharmaceutical companies to see who can give them the best deal out of
all the “me too” products, not so they can keep prices down, but so
they can keep a higher profit margin on what is dispensed to their
patient. If doctors and pharmacists were compensated on the disease
state, they would stop trying to maximize profit on each patient and
focus on fixing the problem more efficiently to move onto the next
patient who brings on a new disease state representing new revenue.
Imagine being billed for pregnancy, rather than the dozen bills for
ultrasounds, medications, physician visits, hospital room, etc.

5. Consolidate medical records. This is one thing that’s being done and
I really do think it would be very helpful. Imagine not having to get a
tetanus shot every time you went to the doctor because it was already
available on a global system. If you went to the ER, you wouldn’t need
a battery of tests, you might be able to eliminate a few with a
complete set of records. This will help and I can’t wait until it is a
reality.

So, the question comes up. Am I crazy for saying this about an industry
I work in? Probably. But I am fascinated by this industry and think it
has the potential to be the greatest industry to work in, but we need
to take a look at ourselves and really ask if we’re doing what is
right. Are we advancing medicine, are we helping patients and
physicians, or are we trying to maximize profit? I am committed to
doing the best I can, to provide marketing materials that help patients
and physicians. I just think the industry as a whole could do a better
job.

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