It’s always dangerous for me to watch TV since I am especially susceptible to infectious earworms that repeat a musical chorus or catch-phrase long after the commercial has ended. (I thought “earworm” was a humorous term, but like everything else today, it has been studied by psychologists and medical professionals as involuntary music imagery-INMI.) Generally, I accept this as a bit of collateral damage caused by my basketball and Jeopardy! mania, but I became alarmed when I began humming the jingle for a prescription drug for diabetes, something I thankfully have no experience with.

I began noting TV ads for prescription drugs and soon became overwhelmed with promotions designed to fight rheumatoid arthritis, diabetes, asthma, heart problems, strokes, osteoporosis, eczema, and a variety of others. With minimal research, I found that drug companies currently spend about $4.5 billion yearly on TV ads for prescription drugs that generally have extremely high prices.

Drug companies defend high prescription drug prices and advertising expenses by pointing to the extensive research and development costs (R&D) associated with creating, testing, and approval of new drugs. A Forbes business writer supported them by comparing drug R&D investments with those for tech giants such as Amazon, Google, and Apple, finding the percentage for drug companies much higher as a percentage of revenues.

But this approach assumes that pharmaceutical companies are just another cog in the corporate machinery that chews up any and all consumers in pursuit of greater profits. In the U.S., Canada, and Europe, drug makers have always earned large profits, and continue to be the U.S. sector with the greatest profit margins: an average of 15-20% over a decade compared with 5-9% for the top earners in other industries (https://corporatewatch.org/five-ways-big-pharma-makes-so-much-money/).

The European Union, Canada, and United Kingdom all prohibit marketing prescription drugs to consumers. In those areas, I would be spared the pharmaceutical earworms, and the exorbitant drug prices that reflect ad costs. Prescription drug costs for consumers, including the government, in those industrialized areas are about half of what they are in the U.S.

The U.S. government pays out more (from our tax money) for prescription drugs and protects big pharmaceutical company profits (through patents, etc.) better than anywhere in the world. It’s no coincidence that the drug industry spends $4.5 billion lobbying politicians, more than twice the amount spent by the next largest industry (insurance).

Another spectacular misalignment between for-profit health care and the U.S. public is noted in a New Yorker article about the “hospice industry.” Hospice care originated in England in the 1960s as a response to the physical pain and social isolation of terminally ill patients in ICUs in hospitals. As it became clear that using pain relief instead of futile, costly, and painful life-extending treatments, and assisting social and family contact during a person’s last weeks or months was far superior to previous approaches, hospice programs became common in most hospitals.

But as seems inevitable under capitalism, the profit motive overwhelmed the compassionate care which spawned the movement. The federal government saw big Medicare savings by avoiding costly end-of-life hospitalizations, and authorized Medicare to pay the lower costs of hospice care under Ronald Reagan.

Soon, for-profit companies began offering hospice care: they accounted for 30% of programs by 2000, but 70% today, many owned by private equity companies. Why such a big increase? Medicare pays for each day a patient is in a program. A large company with thousands of patients per year can generate millions of dollars. But even more attractive was the fact that government payments were made essentially on an “honor system” with virtually no oversight.

Once this became widely known, the abuses came hard and fast. Many people were signed up for care whose medical condition was probably not terminal (6 months or less to live) and patients were often extended for multiple 6-month periods. After the government began to penalize programs with an excessive rate of extensions, large companies responded by pushing “salesmen” to sign-up new patients while cutting off services for those jeopardizing their profits, many of whom had become dependent on the program for medical and social help.

One lawyer described the ongoing scams (7 of the 10 largest hospice companies have been sued for fraud at least once) as a predictable result when there is “a capitalist payee [the for-profit hospice company] and a socialist payer [Medicare without oversight].” It’s clear that some basic American rights, such as health care and education, shouldn’t be subject to capitalism’s insatiable hunger for profits.

Allen Woods is a freelance writer, author of the Revolutionary-era historical fiction novel “The Sword and Scabbard,” and Greenfield resident. His column appears regularly on a Saturday. Comments are welcome here or at awoods2846@gmail.com.

]]>