Sickening
This book probably wins the “most depressing book you are going to read this year” award. It goes into how badly the American pharmaceutical market is broken, why it is not going to get fixed in your or my lifespan, and why well meaning doctors, cannot but help perpetuate the systemic wrongs that is our health care system.
The gist of it is that the pharmaceutical market has completed the regulatory capture dream that is the fantasy of all wanna-be monopolists. They control the political arm, the research arm, the marketing arm, and reap all the rewards for having completed that seldom-but-going-to-happen-more dream of complete regulatory capture.
For one, Congress cannot price negotiate the price of medicine. So the biggest payer, the government has to pay full freight for medication that costs just 1/10 or less that other governments has to pay. This is through the lobbying effort of the pharma industry, through donations and other influences, making sure they torpedo any meaningful change to their business.
Second, the deregulation that began in the 1980s from Ronald Regan has weakened the FDA so much so that even drugs with no efficacy gets approved, witness the recent approval of the Alzheimers drug Aduhelm. The FDA head even suggested that the fix to the uproar should be less regulation.
Third, big pharma has also captured the research and publishing arm of medical journals. It is from these medical journals that your doctors prescribe drugs. However, because big pharma funds the studies and also restricts the full data from peer reviewers, no one can really look at any one study and decide if the efficacy is as the articles states, or if big pharma has doctored the studies and data to show what it wants to show. Pfizer, of covid19 vaccine fame, even states that the purpose of research is to help MARKET the drugs they make.
Fourth, the recycling of drugs from generics into new patentable formulas and their marketing of this drug to doctors to prescribe. The case study here is insulin, and how we went from cheap animal based insulin to expensive human analogs that are 10x the price of the cheap insulins but have 0 additional benefits. Doctors don’t know any better, and thus prescribe the expensive drugs because they also don’t know how much more it costs.
All this combine to make the american health care market one of the most f’ed up in the world. Our employer based health care, our lack of ability on congress to let itself negotiate the best prices it could for medicine, the regulatory capture of our politicians and the research journals, all lead to Americans paying the highest prices for medicine for only the worst outcome.
Worst yet, to change any of this would require herculean effort on the parts of health consumers, health care providers AND politicians.
This book is named Sickening, mostly because after learning all this, you WILL be sickened. You realize that the American health care system is broken, and you are better off going to another country where things are not as messed up.
4*, highly recommended to learn how messed up the whole health care system is, and what you can do to plan to get out from it (hint, go to another country where its not so broken and insane and impossible to fix).