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Partnership or Mutually Assured Destruction?

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Can medical services and drug companies survive each other? Let take a look at two very strange bedfellows.

The drug companies represent rampant capitalism at its best and worst. Medical services are the epitome of the socialism at its best and worst. The two opposing concepts exist in tandem and are mutually dependent. Both are being criticized. The criticisms are almost stereotyped. The companies are accused of being manipulative and profit driven and the services profligate and mismanaged.

Services are badly run. The core phrases are “cost management” and “risk management”. The core sentiments are how to avoid being caught out: Caught out mishandling money or caught out legally. The guiding principle of helping and healing the patient does not appear. It’s obscurity enshrined in goals, benchmarks and constant measurements.

Medical management has refused to manage. It has failed to say what it can and cannot do. It has failed to prioritize its role and function. It has failed to look at the best and cheapest ways of achieving what it is supposed to do. As a result the public expect both everything and nothing.  Doctors have become the recipients of the latest managerial fad and demand. It's as if the doctor is there to satisfy the needs of the managerial class and not his patient.

Third party payment however puts a lot of money in the hands of the managers and who better to relieve them of this burden than the drug companies? The companies have convinced themselves that medication is the “only game in town”.  The Services went along, as that was the line of least resistance. A lot of pressure is exerted through self-serving” research” and its funding by the drug companies. This pressure points in one direction. Medication is best. Funding must be found.

This is very wrong.

Medicine is based on prevention, rehabilitation and cure. Drug companies are only selling the “Magic Bullet”, namely cures. Today’s medicine is being dragged along for the ride. Drug companies search for new ways of selling drugs. They create a sense of need. This is the capitalistic ethic. But it is swallowing up money needed for prevention and  rehabilitation.

Even more dangerous are the manipulations of the generic drug market. The generic market means that one patent beating drug company can sell a package of drugs and manipulate the market. This may eventually threaten research.

The machinations of the drug companies and medical services have had catastrophic affects. The basic unit, the doctor-patient relationship has been discarded.  The doctor is overburdened and dissatisfied, the patient alienated and confused. The result is a new alliance between them, which threatens politically the basic concepts of third party payment. Third party payment, which was conceived in politics, can be aborted politically.

Medical management must wean itself off the “market model”. It must provide a service structure that allows accountability in its core functions. Drug companies will have to realize that they must provide a service that is felt to be genuine even though it may “compete “ with their medications. This service must include cheaper, yet less attractive , to the drug companies, prevention & rehabilitation.

The ideal and maybe only answer is for the drug companies to enter the fields that are needed. This would mean offering managerial services, training, managing, prevention, and rehabilitation programs. They should do this not as a fob or gimmick but to enter the field to make money. That is their real “raison d’etre” and there is no shame in being true to this.

This is a profitable exercise because in many instances the three fields, prevention, rehabilitation and cure are not mutually exclusive.  In all probability the medical services could harness the managerial skills found in the drug companies. The services should be sold as economic packages.

An ideal solution would involve that both the services and the companies realizing that they have to either “hang together” or be “hung together”. Only by utilizing the positive aspects in both will they overcome the threat that has arisen from the synchronization of their weaknesses.

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  • Good article. I don’t think any of the posts here considering the problems of our health care system had come from anyone inside.

    I believe that one of the problems is as you note, the lack of focus on the patient, or the doctor/patient relationship.

    All too often the main concern of drug companies, insurance companies, HMOs and other health providers is the bottom line. The primary focus being on pleasing share holders rather than patients.

    The primary goal of any health care system should be the health and well being of citizens, not a high profit margin. How best to achieve the desired goal is an open question which, hoepfully will be addressed more thoroughly by the next federal administration.


  • Both the Drug Companies and The Providers are participants in sham markets. They are both Private Monopolies, endorsed, capitalized and defended by the USA government, at the taxpayers expense and at the expense of patients. They are welfare recipients of the worst sort.

    Unfortunately, the patients are thrown to the mercies of these openly manipulated market monopolies under the pretense of being “free to choose”, which they are not. Which competing company shall I buy my Lipitor from?

    Nevertheless, the “defend any and all corporations at any expense” types continue to defend a system which is far more expensive and bureaucratically cruel to supplicants than the worst imaginable type of publicly administered program.

    I suspect it is far too late to make any suitable change or adjustment. We are doomed.

  • Bliffle,

    I don’t know that we are “doomed.” However, the future of health care in this country is tenuous at best. It can trudge onward as it is, leaving a trail of broken lives behind while the HMOS, insurance and drug companies celebrate record earnings and pat each other on the back at share holder meetings, lifting high their champagne glasses in homage to their largess. I see these people as the true robber barons of our age.

    However, if there is to be any significant change, the D.C. pols will have to be strong enough to overcome the powerful health care lobbies which have, and will continue, to wine and dine them, fill their campaign coffers and otherwise twist their arms, perhaps with promises of lucrative post-political jobs, to maintain the status quo, or at least to minimize the financial impact of whatever changes may be instituted.

    Crap. Now that I think about it, you’re right. We’re doomed!


  • rc

    not sure that we are “doomed”, but otherwise agree with biffle’s comments. health care is a series of interlocking cartels regulated, licensed and about 50pc funded by government.

    further, while true that the pharm industry is profit oriented (indeed the most profitable industry in the country) it is difficult and imprecise to state that it is “capitalistic”. its entire product line is government protected and enforced intellectual property.

    few, if any, of the pharma companies could exist without these monopolies. suggesting that these companies could effectively manage a health care delivery system, unless it were monopolistic, i believe is misguided. but then again health care delivery is pretty much monopolistic.

    the solution is to establish competition in all phases and portions of health care. unfortunately with pharma, insurance, hospital and physician ‘support’ of politicos the likelihood of that happening is essentially zero.

  • The only plausible scenario is that the people who really control the government, thru their lobbyists, the major US businesses and corporations, decide that it’s worth their while to reduce employee overhead costs by foisting healthcare on the taxpayers. You’ll hear them reciting chants about how they have to reduce employee costs to be competitive in international markets. In fact, you hear some of that now, i.e., the GM vs. Union negotiations that are on now.

    If companies can foist some healthcare costs onto the taxpayers then, presumably, they can sell cars cheaper and sell more. That’s the theory, but it probably isn’t valid right now because, from what I’ve read, people buy a vehicle based on brand, not price. Whether it is old-fashioned brand loyalty or the perception of superior vehicle, people pick a brand and then go to a few dealers of that brand to get the best price. But they are not sensitive to relative prices among brands.

    Anyway, GM is likely to go bankrupt anyhow, what with the kingsize bonuses to execs and unwarranted dividends to shareholders. The execs and shareholders are eating GMs seedcorn. Looks like death throes to me.

    We’re doomed.

  • Bliffle,

    It’s true. It’s a bitch. We’re all going to die!


  • Clavos


    On one thread tonight we have people talking about “End Times,” and on this one, we have others saying we’re doomed.

    Awright, which SOB spiked the Kool Aid???

    Sheesh, people, it’s not even Wednesday yet (well, for Stan it is); how’re we gonna get through the week?


    i had to stop reading above when it stated that the drug companies are looking for magic bullet cures.No they are not. Drug companies want to sell you drugs that you must continue to take for as long as possible to keep them on their cash rolls. healthy humans are drug companies worst enemy. Hello folks, why do you think it is called “The Health Care Industry”? Because we are all just sheep heading to slaughter with as much money pulled out of our pockets and given to shareholders as possible. Nobody is working on curing Aids, because the majority of people who have it are in countries that can’t afford to pay for medication once it is fully developed and the drug companies can’t get a high return on investment (if any) from people with not to mention have no money, but often times, don’t even have clean drinking water.