Road Stop -- Stafford Texas

We finished our first night in Stafford,TX, one more to go. The surprising thing is how similar the CT groups were to what we heard last night. As in CT the biggest issue to most was cost. This is not simply the cost of their co-pays or insurance contribution but the belief that costs are totally out of control. Some new experiences came to light last night -- medical tests gone wild. Many reported being referred for elaborate blood work-ups, CAT-scans and the like for seemingly mild maladies. One guy recounted his journey through 3 specialists 2 scans and a final bill of $8,000 and, in the end he was fine.

The contributors to runaway cost once again were identified as hospitals, pharma, and physicians, The perception was once they get hold of you the industry often tries to run up the cost.

Personal experience with their PCP's was varied. One or two had physicians that were very attentive, asked questions, listened, and explained the treatment options. The norm how ever was the 15-minute visit, a glance at the chart, a couple of questions, maybe a prescription and the patient was on their way.

The discussion of evidence based medicine bore mixed results. Most agree that they do not necessarily want the newest drug, but one that is proven effective and safe. There was a belief that doctors prescribed the latest drug being pushed by the drug industry. Some believe that the newest drugs are the best – why else would they be introduced – others thought that often the newest drugs are not well understood by practitioners and may have problems that are yet to be uncovered.

Respondents felt that Pharmaceutical companies push drugs with advertising to foster demand – "we see it advertised then we ask doctor and they sell more ... some doctors inclined to prescribe a drug simply because you asked for it." "Doctor gave me diabetes med I saw advertised – made my head spin – went back to old medicine." Advertising was also seen to increases which can be good and bad. Some respondents wondered how they would even know of new drugs if it wasn't for advertising. The bad thing "pushes drugs for the companies pushes drugs we don’t need."

More to come from Texas.

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.