A Theory of Health Care Spending
Tuesday, 09 March 2010
For a good while, I've had a half-baked and only half-joking theory that health care spending would not be so high if we were not constantly reminded of all the things that could be wrong with us.
I watch or listen to television news in short bursts of a few minutes each throughout the day. My general impression is that well over half – perhaps even three-quarters – of commercials are disease related. To see if that is anywhere near true, I grabbed a book yesterday morning and settled down to spend a random hour with television to make notes on the topics of the commercials.
That much time was not needed. I was shocked to find that in the period of one, three-minute commercial break, remedies for the following diseases and conditions were advertised:
High blood pressure
That's a lot of health problems to cram into three minutes and it is repeated all day on all channels except, possibly, MTV which undoubtedly highlights acne cures.
I don't remember so many health-related commercials when I was a kid. “The heartbreak of psoriasis” comes to mind, along with “Speedy Alkaseltzer” and Bayer aspirin, but certainly no prescription drugs back then. I still don't understand why that last is done; it must drive physicians nuts to have patients demanding drugs advertised on television that may or may not be relevant to the patients' ailments.
My theory is that it all adds up – that we are bombarded with so many pictures and words about what might be wrong with us that thousands of people who otherwise feel healthy, run to their doctor asking for prescription drugs they saw on television and/or start buying over-the-counter remedies. Certainly the advertising must have an effect similar to reading disease symptoms – too much of that and you believe you've contracted something terrible.
It's just a theory, but I wonder – and I wonder if there were less health-related advertising, how many fewer doctor visits, prescriptions and OTC drug purchases there would be.
At The Elder Storytelling Place today, Johna Ferguson: Living Abroad
All your postings are worth reading, and this one especially so. George Lakoff writes convincingly of how Republicans have "framed" so many issues by channeling the discussion with emotional language. I suspect you are exactly right about drug commercials: companies selling these products have framed our view of sickness and medicine by conditioning our thinking so that we see ourselves principally in terms of symptoms. Constant repetition reinforces the message, making the world sicker than hell.
Posted by: barry knister | Tuesday, 09 March 2010 at 04:21 AM
Yes, and pick up a magazine and leaf through sometime. I can never understand this concept of ads for prescription drugs--especially after they finish with all the possible side effects. An asthma drug that "may cause asthma related death"??? Who is going to ASK for that? Who is going to prescribe it?
Posted by: Olga | Tuesday, 09 March 2010 at 05:44 AM
Some messages may have unintended consequences. I quit smoking ten years ago after 50 years of excessive puffing. I often get a tremendous desire to light up when viewing TV ads supposedly designed to convince people to quit.
Posted by: Gabby Geezer | Tuesday, 09 March 2010 at 05:58 AM
We have counted the ads too and have wondered why they are allowed to advertise. I think the biggest problem with health care is too many people making too much money from it. I know many people who won't go to the doctor now because if he finds something wrong they now have a pre existing condition and are ineligible for insurance. Most of us are just hoping we make it to Medicare.
Posted by: zuleme | Tuesday, 09 March 2010 at 06:05 AM
This is an ancient marketing ploy: create the need, and fill it with what you're selling. (Think deodorant, mouthwash, teeth whiteners. The list of unnecessary consumables we buy is endless.)
The drug ads are a major reason for me to just not watch TV. I know I'm suggestible. The depression-drug ads are the worst IMO, because they are such very good ads. I suppose the ED ads are also good, although they don't resonate all that much with me, being female. But who wouldn't want to be able to enjoy sex again?
Posted by: mary jamison | Tuesday, 09 March 2010 at 06:20 AM
Direct-to-consumer advertising of prescription drugs is only permitted in the United States and New Zealand. The number of psychiatric drugs, many whom have to mention death as a possible side effect, outrages me. It is impossible to watch network TV without being bombarded with them. My English husband is outraged.
Posted by: Redstocking Grandma | Tuesday, 09 March 2010 at 06:46 AM
I think the reason we are subjected to drug company ads is that sometime in the late 80s or early 90s, the courts decided that that this was a "free speech" right of drug companies. Until then, direct to consumer drug ads were illegal. I just did a quick check -- looks like one of the deals the Administration made with the pharmaceutical industry was NOT to consider regulating this kind of advertising in the health care reform process.
In fact there were many categories of speech that were once illegal that we now see all the time. Most of us probably remember when lawyers were prevented by their own professional associations from advertising. It was called "ambulance chasing." No longer -- now thay have billboards.
It will be interesting to see how much more corporate political advertising we see now that the Supremes have decided that Exxon Mobil and AT&T are people for the purposes of election propaganda.
Posted by: janinsanfran | Tuesday, 09 March 2010 at 07:37 AM
They used to ban advertising for prescription drugs and they should again. It's up to our doctor to know what meds are best for us, not us to be impressed by some ad and ask for it. The ones for sexual dysfunction are especially tough for families with children!
Posted by: Rain | Tuesday, 09 March 2010 at 07:51 AM
I don't think you're being half-baked at all. Marketing has to be a significant part of Big Pharma's expenses, and you know who pays for that in the end. On a TV ad for an anti-depressant, the sales impact of the soft music, muted colors, sympathetic voices, and empathetic actors depicting sensitive people on their way to recovery easily outweighs any informational value the spot might have.
Posted by: Citizen K. | Tuesday, 09 March 2010 at 08:10 AM
Now you have me curious too. Saturdays....kid stuff. Early mornings here: mattresses, More furniture, Jeromes furniture, Toyota's...of all things right now, and you know, neither of us pay attention. We never turn things on during the day, but I should take a look at what they are feeding us in the hour we watch at night. We are obviously not good tv watchers here.
Posted by: Mage B | Tuesday, 09 March 2010 at 08:12 AM
Before I got rid of my television three years ago, I often thought that a visitor from another planet would think that all Americans were ill, drove fast cars, and only ate at McDonald's. Ridiculous.
Posted by: Lucy | Tuesday, 09 March 2010 at 08:19 AM
You have brought to my attention the very reason that almost every item in my shopping cart is labeled..
FOR THE FAST RELIEF OF..........
Posted by: Nancy | Tuesday, 09 March 2010 at 08:34 AM
I'm glad I gave up TV (except for coverage of major news events once or twice a month). I already know my tendencies toward hypochondria; I glom onto and worry about every new syndrome I hear of...and what a lot of THOSE there are, too. I think a tendency to worry about our bodies increases with age (it dawns on us that we may someday spot the symptom that signals our fate), so we're sitting ducks for advertisers.
Posted by: Nance | Tuesday, 09 March 2010 at 09:31 AM
Way back in wild & wooly sixties, B.F> Skinner wrote a book entitled "Beyond Freedom and Dignity" wherein he proposed that overpopulation combined with technology and a few other facets of 20th century civilization, made free speech assembly and the right to bear arms (like, strapping on a handgun to go to Starbucks) anachronistic. Most people thought Skinner was a nut case but? Hmmm!
Posted by: mythster | Tuesday, 09 March 2010 at 10:11 AM
We have computers and alternatives now. I don't see any reason to subjugate ourselves to the massive propaganda.
I live north enough to get what I call "Canable" and their advertising is so silly that you really couldn't take it seriously. For example: "My wife and I were compulsive gardeners...everyday garden, garden, garden...We couldn't stop! We are okay now we have discovered Viagra and now we only garden perhaps once a week". All this is stated completely straight faced. [don't take me word for word on that ad - It is just to give you an idea of what they are like!]
I'm always shocked when I see American TV - it is REALLY obtrusive what people suck up everyday as an OK message from advertisers and newscasters. Leave off it for a week or so and turn it on again and you'll see - better yet, do yourself a favor and leave network broadcasting off for good!
Thanks for tossing this subject out for discussion, Ronni.
Posted by: Cile | Tuesday, 09 March 2010 at 10:17 AM
You are so right on this one. I also think that some of the obesity issues are also caused by the endless food commercials. I often am awake in the middle of the night, don't feel like reading and will turn on the TV - only to be inundated by endless food commercials, with each item loving displayed in glistening close up.
It's a good think that I keep my fridge and pantry in a stripped down, no sugar, sweets or fatty goodies because I would be so tempted. At 2 AM , you can just imagine how much trouble that would cause.
Posted by: Nancy Ewart | Tuesday, 09 March 2010 at 10:41 AM
The medium is the massage, as MacLuhan put it.
I think television has gotten so bad that it is making us stupid. And we can't afford to be spaced out right now with what's coming down.
Posted by: Hattie | Tuesday, 09 March 2010 at 11:12 AM
I think you're onto something, Ronni!!! And don't ya just love the people who say the generics don't work?
I cancelled my cable a while ago and now I just get Netflix. It's nice not seeing those commercials. I think there are far too many commercials on the net for prescription drugs, too!
I am a bare bones type of gal who doesn't take any more medicine than I really need. Most of the women I know take lots of stuff but I ask questions before I agree to take anything.
Posted by: Kay Dennison | Tuesday, 09 March 2010 at 11:34 AM
My Mom, unfortunately a confirmed hypochondriac, worked at a drugstore for many years. She was the one in charge of ordering the drugs! Talk about the fox guarding the hen house ... she regularly acquired every symptom that matched every new drug that was presented to her by every drug salesman. Sighhh My poor, long-suffering father would just look at me and we would just shrug our shoulders and wait it out.
I have also become a minimalist regarding drugs and medical treatment ... probably due to this early influence, for which I am, sadly, eternally grateful. And, probably as a result, I am the healthiest and happiest in my group of friends and acquaintences.
Posted by: Miki Davis | Tuesday, 09 March 2010 at 12:18 PM
"Talk you your doctor about this drug” is the hook to get older and younger American TV viewers ,convinced they have a medical problem and the solution will be get to that doctor and get a prescription for - Viagra, Flomax, or whatever Big Parma product that the commercial wants us to buy. In the wake ,the US health care system is in ruins and needs to be reformed, Pharma's get richer and the population gets sicker.
Posted by: Cathy Cress MSW | Tuesday, 09 March 2010 at 12:24 PM
I wonder if this has something to do with our being less healthy than the Europeans. It is reported that we spend far more than they do on health care. Could this be one of the reasons?
Posted by: notdotdot | Tuesday, 09 March 2010 at 02:28 PM
It always infuriates me when I see the drug commercials knowing how much big pharma spends on them. Think of the inoculations for children this money could pay for.
I did what you did, Ronni. I made a list of the prescription drugs that are advertised in just one hour. It was shocking. And, as pointed out by Olga, it isn't just TV. It's radio, magazines and now the pharmaceutical advertising is invading blogs.
Two evil problems in the World are money and greed. This is just another example of what happens when money is the sole motivation.
Posted by: Darlene | Tuesday, 09 March 2010 at 02:47 PM
The ads are horrible, should be banned again. However, I also hate the constant "scientific" studies that contradict one another. And it makes me wonder if we eliminated the ad/studies whether affordable health care would be available. Too much "consumerism" and "commercialism" in medical care industry has literally run it into the ground financially.
Posted by: Cara | Tuesday, 09 March 2010 at 06:02 PM
This is very true.Homeopathic remedies are an option, and I use them first, and consult medical help if needed.
Posted by: Ron | Tuesday, 09 March 2010 at 06:43 PM
My comment to your post -- "my sentiments exactly!" TV is a disease in my opinion. -- barbara
Posted by: barbara | Tuesday, 09 March 2010 at 07:13 PM
But could the U.S. corporations and their supportive politicians tolerate the consequences of "fewer doctor visits, prescriptions and OTC drug purchases"? Lower gross naational product, less competition, and all that spurious stuff they all love to huff & puff about!
Your commenters seem to have the right ideas, but our elected reps are unable to act on what they hear from us.
Posted by: naomi dagen bloom | Wednesday, 10 March 2010 at 05:26 PM
Ronni, you're absolutely on target. Free speech be ****ed in the case of Rx drug advertising. Free speech doesn't apply to this at all in my view. We're talking about COMMERCIALS. Somehow, I'm sure that's not what the founding fathers intended to protect.
Personally, I think one of the darkest days in the history of our economic system is the day drug ads were inflicted on a susceptible public via their TV screens. I've learned to tune them out, and lately I'm simply turning off the TV. If I have a health problem, I'll make a doctor's appointment and I won't be asking him to prescribe a drug promoted on TV!
I support the less-is-more approach to medical care. Think how much further our healthcare dollars could go if high-priced, over-advertised drugs, medically UNnecessary tests and high-tech procedures could be eliminated or greatly reduced.
Wow, we might even be able to afford healthcare for working- and middle-class citizens at a price they could afford. What a concept!
Posted by: Elizabeth Rogers | Wednesday, 10 March 2010 at 09:00 PM