The Selling of the No No, Prescription
Drugs and Health Insurance: Mad Men in White Coats

By

Leonard Zwelling

         The best part about HBO is the lack of commercials during
broadcast dramas. Of course most of the content is great just as it is on
Showtime, Cinemax (aka SkinaMax) and the other pay cable networks. Heck,
Netflix isn’t even a network and House of Cards was terrific. It’s the closest
depiction of what I saw in DC by far. Pay TV may produce the the best filmed
drama available today. And the lack of commercials only makes it that much
better.

         Commercials have been the bane of the TV watcher since TV
began (and I was there for Howdy Dowdy on my parent’s Dumont console
black-and-white TV). Nonetheless, they surely have influenced our culture and
our thinking from Dinah Shore singing about Chevrolets to Where’s the Beef to
Ring Around the Collar to Hump Day. One accepted fact of most commercials was
that what was being sold, viewers could go out and buy.  No intermediary needed.

         Then how do you explain commercials for Viagra, Xaralto and
Crestor? Unless you happen to be a physician willing to have a fool for a
patient, you can’t buy this stuff on your own. Why do the drug companies
bother?

         Because it works.

         By marketing prescription drugs to potential patients, many of
whom are healthy so have to be convinced they have a disease like ED or low T
or High C, the face of medicine has shifted from looking like that of Marcus
Welby to resembling a device that painlessly removes hair from men’s chests
called No No. (If you don’t know No No, ask your kids). Dr. Kildare has become Don
Draper. If you have a disease there must be a pill to fix you and that means a
trip to your doctor to demand it. And if your doctor is competent and realizes
that you don’t need the pill, he or she may well give it to you anyway knowing
that if he or she doesn’t cave in to the demand being driven by television marketing,
you’ll just seek the drug from his or her competitor down the block.

         Now we have the latest in marketing–health insurance. With
the Affordable Care Act’s promise of insurance for all, the American carriers
are falling over themselves trying to acquire this new business. (AARP figured
this out years ago, for what you thought was a lobbying group for old people
like me is really just a large insurance vendor for the Medicare Advantage
set). After all, it was the potential for this new business that got Karen
Ignani’s AHIP (America’s Health Insurance Plans), the lobbying group for the
insurers, on board with the ACA. Well, at least in theory you can buy this
without help from your doctor although you may need consultation from your
local IT expert to make the web site work for you.

         This is starting to get weird.  They advertise drugs we can’t buy to drive up
the demand and force doctors to compromise their ethics to preserve what little
is left of private practice. Then there are ads for insurance that you may even
want and might get to buy if the front and back ends of healthcare.gov work in
your state.

         What are we doing?

         It used to be that when we wanted to watch graphic
corruption, we would have to resort to HBO’s The Sopranos. Now all we have to
do is watch the NBC Nightly News or The Good Wife and wait for the next
commercial. And if you think you will skip the commercial break to use the
restroom, I sure hope you have forced your doctor to prescribe the latest drug
for incontinence.

         Is this a great country, or what?

Leonard Zwelling