So I was on a coast-to-coast flight {deep vein thrombosis?}, feeling a crick in my neck {fibromyalgia?} and a bit of the blues that sometimes set in around Colorado heading west {depression?} thinking about loosening the seat belt {irritable bowel?}, watching a CNN roundtable discussion of the health-care crisis. Polarities abounded: We should spend more on prevention, we should hold people to account for their lifestyles and focus on cure, we have to ration, but won't that mean only wealthy people can afford care? Is an angiogram a great tool or a billing bonanza, and how about those stents?
And then Michigan governor Jennifer Granholm addressed a question to the pharmaceuticals executive who was defending high prescription costs, even though some of them cost half as much in Canada. He pointed out that generics are reasonably priced, which should provide comfort to anyone suffering from a disease whose treatment's patent has already expired. He talked about the cost of research and development, a reasonable enough topic, but the governor pressed him on a slightly less logical line item: Direct-to-consumer advertisements for prescription drugs.
Anyone who has ever seen the network evening news has seen these ads; aside from deep vein thrombosis, every medical condition that flitted through my brain on that airplane ride was planted there by a television commercial. Actors who personify the demographic of a particular ailment are avoiding the unemployment lines convincing us, in an unintended riff on "Amazing Grace," that they once were lost but now they're found, thanks to a remedy they should ask their doctor about as soon possible. If an alien landed in your media room during the news, he/she/it would think that we are a very unhealthy species indeed.
Governor Granholm wondered: If pharmaceutical companies cut consumer advertising, which hit the airwaves big-time when the FDA relaxed its advertising restrictions in 1997, would prices come down to a level where more of those consumers might actually be able to afford their drugs? If drug companies weren't spending - here it comes, and these are 2005 figures -- $4.1 billion for direct-to-customer ads, part of a $29.9 billion marketing budget - would their product perhaps cost a wee bit less? Stories abound of older people who practice their own sad form of medical rationing, taking less medication or taking it less often because they cannot afford the proper dose. The governor wondered: As long as doctors know what medications are out there, which is the way drug advertising used to work, why spend so much money building brands with civilians?
I don't recall who at the table piped up with an answer, but here is part of it: A viewer might see a commercial for an anti-depression medication, recognize her own symptoms, and get help she might not otherwise have thought to seek. A commercial - not the crushing symptoms it describes, but the HD image and the background score and the happy, relieved loved ones surrounding the newly-happy patient - can make the difference in someone's life.
Which raises a new question: How dumb do they think we are? If we're suffering as badly as the people on screen, aren't we perhaps going to mention it to a friend or loved one, or, holy intake form, to a doctor? Isn't someone going to notice that we're off our feed? Do we need to see something on television to know that what we're feeling is real? And is it reassuring or somehow terrifying to think that a doctor would prescribe based on a patient's suggestion? Call me a cock-eyed optimist; I'd like to think that someone who suffers, chronically, might do something about it on his or her own. On the other hand, people who are in such denial that they ignore these kinds of symptoms probably aren't going to change their minds because of a sixty-second spot.
Let's not even address the likelihood of mis-self-diagnosis - and if you doubt that possibility, go up onto one of the medical sites, type in a set of symptoms, and see how many possibilities you get.
But back to the economics of branding: How much likelier might we be to ask for medical help if we thought we could actually afford the offered solution?
So kudos to Governor Granholm for her plain-wrap, straight-out question, to which she did not get an equally straightforward answer. May she keep asking. And as certain groups send out emails exhorting people to "join the mob" protesting President Obama's health-care plans, may we find a dignity similar to hers, in which we ask these kinds of pertinent questions with a reasonable and reasoned voice.
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