Art & Understanding

White Man’s Medicine

What’s wrong with the business of healthcare?
by Patricia Nell Warren

Left Field July 2003

After years of searching for my native American relatives, I connected with a cousin who is a healer schooled in the old ways. As we talked about the differences between those ancient traditions and modern healthcare, he said: "In the old days, the People made sure that medicine stayed good. No payment changed hands. You gave the healer a nice blanket and some tobacco, and that was it. Yes, today, white man’s medicine is often Bad Medicine. Greed for money sucks all the integrity out of it."

My cousin said these words in 1980. Today he might frown at the price-gouging that is so rampant in White Man’s Medicine. We pay through the nose for everything–insurance, hospital costs, prescription drugs, over-the-counter drugs. Soaring costs are putting routine medical care out of reach of more and more Americans. While it’s not realistic to hope that the U.S. could revert to that altruistic tribal socialized medicine, I’m worried at the growing greed and corruption–at its effect on our country’s well-being.

First, the drug-pricing scandal. Hurray for Glaxo that they’re reducing AIDS drug prices for developing nations. But here at home we’re often held hostage at the cash register. Congress needs to investigate drug pricing, and establish what’s "fair."

Roche is the latest glaring example. Their new AIDS drug, Fuzeon, debuts in the U.S. at around $20,000 annually–three times the price of other AIDS drugs. Roche’s excuse: a lot of ingredients, a complicated manufacturing process, allegedly high development costs. Yet Roche didn’t pay the $600 million development tab by themselves–government and private foundations gave significant help. According to Consumer Project on Technology, the Swiss firm got seventeen grants from NIH alone. By the end of 2005, Roche and its U.S. partner Trimeris expect 39,000 Fuzeon users. $20,000 times 39,000 equals $780 million–a tidy annual revenue from one product. But there’s more. Fuzeon is used with other antiretrovirals which can cost from $14,000 to $34,000 a year. Combined with Fuzeon costs and costs of managing side effects, this could spike a patient’s bill to between $61,500 and $80,000 a year. Says Michael Montgomery, AIDS chief at the California Department of Health Services: "We just don’t know if we’ll have the money to pay for it." Some fear that Fuzeon will bankrupt ADAP.

On to other scandals. Like the way our tax dollars get slathered into private-sector drug development. Long-suffering consumers are subsidizing a substantial portion of the drug R&D, yet we don’t get any consideration at the cash register. Our hard-earned bucks flow not only to U.S. corporations but foreign corporations as well. Worse–Washington often signs away future share of profits, as with its share of Fuzeon’s billions. It did the same with AZT, a gold mine for twenty years and still in international use. And NIH just did it again with an HIV microbicide, handing $10 million in grants and exclusive rights to Biosyn, Inc., on a silver platter. No wonder our government is broke!

Another scandal: Overcharging is now routine. In a recent settlement, Bayer and GlaxoSmithKline agreed to pay nearly $350 million for having overcharged Medicaid. As a result of the largest healthcare fraud in U.S. history, TAP Pharmaceutical Products had to pay $875 million in federal fines for defrauding Medicare and Medicaid, helping doctors bill the government for free drug samples. In a more recent case, five corporations were caught overcharging ADAP and other providers who buy discount drugs for indigent patients. Hospital chains often overcharge too. The country’s biggest pension fund–California Public Employees’ Retirement System (CALPERS)–faces a possible federal probe because five of its Sutter hospitals allegedly overcharged Medicare patients by as much as fifty-three percent.

A recent AOL survey showed that most Americans who took the poll are more worried about the economy than about terrorism. It’s a hint that American patience with high health prices might someday snap. But right now many of us are too politically apathetic, too frightened for our health and that of our loved ones, to do more than grumble. So we put our tails between our legs, and we pay up. Big corporations and big government and big institutions know this fear of ours, and they trade on it. And that, friends, is what my healer cousin means by Bad Medicine.