The Bush Recession: Part 2

When confronted by the possibility of a long siege, people hoard things. As hurricanes approach the coast of Florida, grocery stores run out of bread, milk and other staples. Filling stations run out of gas. ATMs run out of cash. It’s natural human behavior.

Tomorrow I’ll be 61 years old. Like most people my age, I’m troubled by a number of typical age-related ailments, though none of them are life-threatening, thank goodness. I have to take several medications every day to control my symptoms. The problem is, I lost my medical insurance at the end of last month.

All of these medications are expensive. But they’re absurdly expensive if you don’t have medical insurance. Yes, I can pay for COBRA coverage, but if there’s one thing more absurdly expensive than my medications, it’s COBRA coverage. I have 62 days to elect whether to pay for COBRA insurance or not. I’m hoping it won’t be necessary, because I currently have no reliable source of income.

Once I realized I was going to lose my medical insurance, I went to my doctor and asked for a prescription for 90 days’ worth of my meds. But some weird law prevents me from purchasing a 90-day supply of these medications at my local pharmacy. Instead, the order has to be delivered by mail, from the approved mail-order fulfillment center. My doctor graciously offered to fax the information to the fulfillment center.

Weeks later, I still had not received the meds, so I called the fulfillment center. They told me that the form submitted by my doctor’s office was incorrect, and they had faxed back the correct form the same day. My doctor’s office claims they never received a return fax from the fulfillment center. Somebody’s lying, and in the meantime, my insurance coverage ended.

Today, I ran out of one of my medications. I can’t afford to buy it at normal retail prices.

In this country, medical patents expire in 17 or 20 years, depending on whether the patent was filed prior to 1995. When a pharmaceutical company invests R&D capital in a new medication, they have every right to enjoy patent protection to recover those costs and earn a handsome profit. Once the patent expires, any company can make the drug and prices drop as the companies are forced to compete in the marketplace. This mechanism serves as encouragement for those companies to invest their patent-protected pricing profit in further R&D on new medications, and the cycle continues. But there’s a problem.

Pharmaceutical companies invest 250% more on the marketing of new drugs than they spend developing them. Recovering these costs drives the costs of these drugs up even further. Worse, when a popular drug is reaching the end of its patent protection, pharmaceutical companies invest those precious R&D funds to create a variation on the formulation that differs by some insignificant amount. They then declare this to be a new drug and invest huge amounts of those R&D funds on marketing, intended to convince doctors to prescribe it in place of the older, perfectly suitable drug.

So instead of encouraging the development of new, effective drugs, the system encourages pharmaceutical companies to game the system, putting old drugs in new packages and charging ruinous prices for them. Why work on a new problem with no guarantee of success, when you can repackage an old solution and sell it as a new solution without competition?

There are a lot of things wrong with the American system of health care and medical insurance. Our new president has promised to look into it. I hope he looks at it pretty quickly. I don’t feel very well.