I have been working, admittedly on-and-off, on a blog piece dealing with drug prices and “complementary and alternative medicine” (CAM) expenditures. Only something strange happened. The more time I spent with it, the less I liked it.

Initially, it was a reaction to a Consumer Reports article on drug pricing. As I’ve pointed out before, only a small fraction of prescriptions account for about a third of all drug spending in the US. In contrast, people spend billions every year on CAM, in the form of nutraceuticals, herbals supplements, and payments to alternative practitioners. So, it was a good case. Regulate the CAM folks, and use the savings to help pay for expensive drugs. The idea sounds like a campaign speech.

But that’s not a good case. It’s self-serving. At one level, it’s “tax the bad guys that I don’t like and give the money to the good guys who do clinical trials, aka the pharmaceutical industry.” It’s also an exercise in logical behavior that could not be expected from government. Most importantly, it completely overlooks the fact that individuals are involved in all these transactions. People, most of them very ill, find out that a drug that might help with a little relief or a little more time is extremely costly. People, often misled or ill-informed, decide to buy an herbal compound or to see a CAM practitioner. Like those of us who can’t resist a quick pick lottery ticket at the gas station, they are buying a small and short-lived parcel of hope.

As I think back to State Street Junior High, 1956, “health and physical education, third period M-W-F, Mr. Chester Riffle,” meant those were the days I carried my gym bag with shorts, T-shirt, socks, jock and a towel. Health education meant learning that if you don’t dry between your toes after a shower in the locker room, then you will get “athlete’s foot.”

As an aside, medical school is not a place to learn about health. Medical school is where you go to learn to call “athlete’s foot” by its proper name, tinea pedis. Medical school is about disease, not health.

I’m glad that I didn’t subject you to a rant about drug costs and CAM. I appreciate your patience with this alternative. Maybe, just maybe, there’s a need for a book about health. What do you think?

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