Big Pharma

Dr. Frances is highly critical of pharmaceutical companies in the video I embedded below.  I don't disagree, and I have heard many doctors echo similar sentiments, but I always wonder when I hear these complaints - what do you envision as the right system.  These companies run as businesses, and certain practices flow from that rather naturally.  If we don't like that, then what not-a-business model are we preferring?  He notes with some sourness that drug company reps are attractive people.  Well, yeah.  The companies that look for unattractive representatives don't do as well.  It's rather like Kermit's protest to Marvin Suggs, who is hitting the muppaphones with a mallet to make them sing:

Kermit:  Wait, wait!  You can't do this!  Those are live creatures!

Suggs:  But of course.  You can't make music hitting dead creatures.

Or similarly, the objection to the phallic nature of weapons in fairy tales and stories, even up to the present day.  The tribes which had weapons based on breasts didn't survive quite so well, I suspect.  Whether there is some primal connection in all this or not, the fact remains that swords, arrows, knives, spears - they work pretty well as weapons.

Are there no doctors who seek profit?  Does Dr. Frances think that the whole profession should be made to act in a more goodness-of-your-heart fashion?  Drug companies try to hide or downplay information that costs them money.  That's a bad thing. But you can read the ads for down-home medical devices, OTC medications, and ridiculous practices in many magazines, on websites, on TV - heck you can get whole catalogues of the stuff.  Does he want to forbid this?  Or does he want more restrictive rules for "real" drug companies, so that alternative medicines have an advantage over prescription meds? What's the plan that isn't worse than the disease, doctor?

And don't get me started on Europe.  Whenever I hear as a complaint that America is the only developed country that does X (in this case, allowing advertising), I am not one who automatically assumes that we must be wrong and the others right.  I think, given history, it is equally likely that we are more right than the others.  I'm tired of this Paris Envy in everything.  European pharmaceutical delivery also has enormous difficulties.  Everything does, because reality is tradeoffs.

There seems to be some lurking idea that pharmaceutical companies should be run as something holy, or a public service, or a public utility - that medical care itself should be something of a public utility like electricity. I will note with meaningful irony that one has to pay to get the electricity, phone, cable, or water hooked up and pay for it as you go.  So we must want medical care to be something even more free than that.