February 14, 2008
With all the talk about health care costs swirling around this election year, Stan Finkelstein and Peter Temin's Reasonable Rx: Solving the Drug Price Crisis is a very timely book. To prove that it can bring some of the various factions on this issue together, they have blurbs on the back from a Nobel Laureate in Economics, a former senior official in the FDA, a US Congressman, and a retired president of a pharmaceutical research group. Although they did write the book for laypeople, you really have to be interested in the topic to wade through the first 150 pages, and you'd have be a real policy wonk to read the appendix after that, which lays out their plan in detail after already giving you a general outline in the last chapter.
Is it any wonder that there's such a huge outcry about prescription drugs, particularly their high cost? Consider this: If your only source of information was commercial television, no one could fault you for thinking that GERD was a public health crisis in the United States on the scale of AIDS in Africa. In the time it takes you to read this paragraph, you can reasonably assume that American TV watchers saw dozens of advertisements encouraging them to check with their doctors to make sure they don't need to treat GERD with the Purple Pill. What's GERD? It's the acronym for gastrointestinal esophageal reflex disease, commonly known as acid reflux disease--a condition in which the stomach releases an acid back into the esophagus. Until the 1980's, physicians rarely used the term, and when they did mention GERD it was probably to describe a complication of a rare pancreatic disorder. But that was before drugs like Zantac and Nexium came onto the market.I haven't reached all the way into the heart of this book yet, but so far it has been very balanced, in-depth, and informative. And, for someone who's not a health-care policy wonk, it's even been rather entertaining. Ambrose Bierce, the great American author of An Occurrence at Owl Creek, is quoted at the beginning of Chapter 5--How Not to Lower Drug Prices--saying "Insurance: An ingenious modern game of chance in which the player is permitted to enjoy the comfortable conviction that he is beating the man who keeps the table." Entertaining indeed.