Health in the Heartland

Over the next several days this blog will be fleshed out regarding our observations of the experiences, concerns, and hopes of Americans in the heartland regarding our healthcare system. We will be speaking with dozens of citizens and sharing our perceptions with you.

The tour started in Suburban NY. We spoke with 40 men and women and all shared a common experience and belief -- the healthcare system in its current form is not working. The primary reason: costs are out of control. There is no single culprit. A lot of institutions share the blame . The greatest culprits in the eyes of these Americans were the drug companies and the government -- aka politicians. Doctors and hospitals also came under the gun but not nearly to the degree as Pharma and politicians.

Where are the costs? All over. The most visible culprit was drug companies. Consumers were enraged that U.S. Pharmaceutical companies sell their products in other countries at a fraction of the price that they do here -- they rightly wonder how this can be. If the health systems in other countries are able to negotiate favorable prices why can't the U.S. do the same? The answer for most was the politicians. Consumers know that Pharma is a huge lobby, employing hundreds-of-thousands, and are major contributors to all of the legislators -- in short they believe the politicians are in the pocket of the drug industry.

Consumers firmly believe that drug advertising drives costs up, though they are unsure of the mechanism. Some speculate that cost are high simply to pay for the advertising, others correctly identify the problem -- classic push-pull marketing. Push the new drugs out to docs with detailing, pull the inventory of new drugs through the system by fostering demand and perceived need with consumers -- the end result -- increase sales of the newest, and usually most expensive, drugs driving costs up and pumping profits into Pharma. Consumers object on all fronts. They object to the life-style advertising adopted by most drug marketers selling drugs like they were soft-drinks. They object to the vague symptoms featured in many -- who doesn't this drug apply to. They object to the end result - an over prescribed society. Mostly they object to the cost burden it places on society for the benefit of a few companies. Most would gladly support a regulation of drug advertising, possibly its prohibition. Why, they ask, are these companies spending money advertising products a consumer can not buy directly -- drug advice should come from physicians not a 30 second spot.

The next stops on the tour will take us through Texas and Iowa. Much more on the opinions from the heartland to follow.