Thursday, October 29, 2015

Branded Healthcare

In my fifth decade parts of my body remind me that I’m no longer in my second or third decade. Somewhere along the way I became that groaner – the one who expels a long breath/sigh after getting up. After a particularly long period of sitting at the desk I’ll rise and it’s like those old commercials for “Snap, Crackle and Pop.” I’m not complaining – I’m blessed with generally good health and most don’t think I’m anywhere near my actual age, which is always good for the ego if nothing else. Along the way, however, there are various things that have needed attention and as a result I take a couple of pills that those who are far brighter than I in such matters indicate that I need. Whether its my cynicism, bad luck or just the way the system works, it seems that the pills I’m on are always the ones that don’t have generic counterparts. My prescriptions therefore are quite pricey. I’m not alone.

In September 2015 Martin Shkreli made significant news by raising the price of a drug he acquired some 5,000%. He’s a hedge fund investor who has a history of acquiring a drug products and increasing its price. In this particular case his company Turing Pharmaceuticals purchased a company whose drug had been selling for $13.50 a pill to AIDS and cancer patients and upped the price to $750. Consumer activists, health care professionals and a range of progressives as well as politicians from all stripes derided capitalizing on people’s health in such a crass way. Shkreli suggested he’d lower the price, but never clarified to what or how much. His attempts to meet with Bernie Sanders by making the maximum contribution failed when Sanders donated those funds to charity.

It’s capitalism. That’s how it works. Supply and demand determine cost. It’s not always pretty. It’s not always right. And it’s not always fair. But it’s what we claim to be proud of about America.

Turn-around being fair play, Shkreli was himself outraged a few weeks later when Imprimis Pharmaceuticals announced that they would be providing an alternative (non-branded/generic) version of the same pill he was selling at $750 for $1 each.  Capitalism strikes back and wins.

This incident reignites the chasm I have between my philosophical libertarian beliefs and the practical application of them. Situations like these are crazy making not because of the positioning, but because healthcare should not be based on ability to pay. It just seems wrong to me. Shouldn’t America have a system where when you’re sick you go to a facility and are treated? If you need an operation you get it? If it’s vanity driven(and not medically necessary) then pay retail and there’s a price list to choose from. Sure there will be some diseases that affect a minority of the population that can’t be covered because this isn’t Utopia…but that happens in a more defecto way under the current system already. Let’s create a system where all of the decisions and discussions are around symptoms, remedies and recuperation and not coverage, eligibility and reimbursement.

Such a system was in place in America once. It was before government regulations and insurance became the driving for of healthcare…reinforcing my philosophical belief system. We can’t go back to that time. We can build from it. We won’t because of the entrenched interests of insurance and politics. To sell it, it has to be branded…the ultimate irony in capitalist healthcare. Guess we should all pray for good health. 

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