(Editor’s note: This is the first of a two-part column. The second column will run Friday, Sept. 23.)
Like all states, Tennessee has prostitution and drug laws. But does it make any sense whatsoever to go after penny ante streetwalkers and pot smokers, if millionaire kingpins are prostituting themselves to major drug companies, then laughing all the way to the bank?
As reported recently by the Times Free Press, 29 healthcare professionals in the Chattanooga area were listed as receiving anywhere from under $1,000 to well over $100,000 in pay and "perks" from pharmaceutical companies over the past two years. Closer to home, The Tennessean reported that several Nashville-area physicians received more than $100,000. (One local psychiatrist got a staggering $633,181.)
Mind you, I'm not saying that anyone in particular is doing anything wrong, and I have purposely not cited the names of Tennessee healthcare professionals because I don't know who, if anyone, may have stepped over certain ethical lines in the sand. But I think there is quite obviously a potentially huge problem that needs to be addressed.
Nationwide, according to the U.S. Centers for Medicare and Medicaid Services, prescription drug spending grew 480 percent between 1990 and 2008, from $40.3 billion to $234.1 billion. The money being paid to American doctors by pharmaceuticals looks suspiciously like "seed money" to me. Any industry that can invest a few thousand dollars here and there, then increase its revenues by $200 billion will be likely to do so. But when the products being sold are little-understood by consumers, and sometimes have catastrophic side effects, we as a society must hope (or demand) that doctors do not become "hookers," in both senses of the word.
Daniel Callahan, co-founder of the Hastings Center, a nonprofit research group that focuses on bioethics, points out that if doctors are "paid a lot of money it's in great part because they're probably expected to have a pretty great impact [on drug sales] ... It all begins to look very fishy after a while."
Beth Uselton, executive director of the Tennessee Health Care Campaign, has pointed out that while "the payments themselves are not illegal, the disclosure of such a widespread practice is disturbing for patients because it raises ethical concerns about conflict of interest around the treatments that we are prescribed by the doctors we trust."
And then there is the question of whether we can trust politicians to help protect us. When Tea Party types go into "Tarzan mode," saying in effect, "Business good, government bad," we have to consider what will happen if we end up with the smaller, dumbed-down federal government they so strenuously advocate.
But in any case, the money Americans spend directly on prescription drugs is only the tip of a gigantic iceberg. In my next column, I will discuss the human cost I have seen in my own family, after doctors prescribed powerful, mind-altering drugs for pain and anxiety. We are still trying to recover from the terrible side effects: family members who became addicted, who were unable to work and had to be supported for years, and who became so incapable of dealing with the daily stresses of life that they could only cope by taking more and more pills, until even the tiniest problems became insurmountable. Did those powerful little pills help, or did they do far more damage than good?