Peter Pitts
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The US healthcare system may be broken, as such sages as Michael Moore suggest, but it's not likely to be fixed as long as
our domestic debate remains stuck on the cost of prescription drugs. Meanwhile, obesity and diabetes are becoming national
epidemics. Talk about sicko.
Imagine American healthcare spending as a dollar bill divided into 100 pennies. How many pennies do you think represent spending
on prescription drugs? Sixty? Eighty? Wrong. The answer is 10.5. The other 89.5 represent everything else—from doctor visits
and hospitalization to administrative charges and insurance. (If this is news to industry professionals, imagine how enlightening
civilians might find it.)
Put another way, which is the bargain: a hospital stay at about $7,500 a day, or drugs that help keep you healthy and productive
at about $65 a prescription? Clearly, fewer cents make more sense.
Yet these and many other facts backing pharmaceuticals as a sound healthcare investment have been twisted to suit the agendas
of politicians, pundits, and other competing stakeholders. It goes relatively unreported that insurance companies continue
to increase their monthly premiums without really explaining why. The industry claims its costs are increasing because prescription
drug costs are busting their budgets. But prescription drugs account for only a small part of monthly insurance-premium hikes.
From 1998 to 2003, insurance companies increased premiums by an average of $104.62 per person. During that same period, drug
costs rose by $22.48.
Still, it's true that a majority of Americans with private health insurance are spending more for drugs—not only because they're
taking more but also because their insurance is paying less. And it's no surprise that with rising pharmacy co-pays—the only
healthcare costs that many of us actually see and feel—we tend to swallow the lie that increased healthcare costs are Big
Pharma's fault.
Where the Healthcare Dollar Goes: 2002
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Should we blame "Big Insurance"? Out-of-control out-of-pocket expenses cause many patients to stop using prescription drugs
for controllable chronic conditions. The unfortunate result is that visits to the ER have jumped by 17 percent and hospital
stays have risen 10 percent. And a new Integrated Benefits Institute study shows that when employers shift too much of their
healthcare costs to employees, the companies lose more than they save, through absenteeism and lost productivity.
Should we blame our skewed priorities? American healthcare often works miracles when people become very ill, but it needs
to do a better job with preventive care. Equally to blame is the fact that we spend a disproportionate amount of our healthcare
budget for end-of-life care.
But rather than tangle up the alreadyvolatile healthcare debate in ethical arguments over whose life is worth more, it would
be smarter to shift the focus to keeping people healthier longer. Earlier diagnosis and care are crucial to the future health
of both Americans and American healthcare—and pharma has a starring role here.
Why? Because prevention is our first line of defense. Now is the time to promote prevention, so that we have the funds to
invest in promising treatments for conditions like cancer and Parkinson's disease. We are on the cusp of a pharmacogenetic
revolution that will finally make personalized medicine a reality.
We cannot afford, in terms of dollars or lives, to continue the blame game. In order to deliver on the promise of affordable
and quality healthcare for all citizens, all the players in the healthcare debate must work together. At the end of the day,
we should unite against our common enemy—disease.
Peter Pitts is director of the Center for Medicine in the Public Interest and chief voice of
http://DrugWonks.com/. He can be reached at ppitts@cmpi.org
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