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AARP and prescription drugs

I received three petitions from the American Association of Retired Persons (AARP) on prescription drugs. The petitions are written to my congresspersons (two senators, one representative), and they read:

In case you can't read it, it urges these representatives:

...Additional legislation should be passed that will ...legalize the importation of safe prescription drugs from Canada and other countries...empower the federal government, if necessary, to negotiate lower drug prices on behalf of Medicare beneficiaries...reform the way the pharmaceutical industry does business...as well as other actions that will lower prescription drug costs.

Frankly, this doesn't do much for me. I therefore wrote a memo to the AARP which I will mail to them with the unsigned petitions tomorrow:

DATE: March 13, 2008


FROM: Judith Lautner, AARP member

SUBJECT: Petitions on prescriptions

I am not signing these petitions because they do not get at the heart of the matter. I am concerned that groups like AARP, however well-meaning, are barking up the wrong trees.

Yes, there is a health care crisis. The answer, though, is to dig deeper. Find out the roots of the problem. It may surprise you. In a nutshell, a major part of the increase in health care costs comes from prescriptions and procedures that are not only expensive but often unnecessary. We shouldn't start with the assumption that all of the prescriptions elderly people take are critical or necessary for their health or that they are even the best prescriptions for the situation. Often an older drug or none at all is preferable, is actually more effective.

I urge you to purchase a copy of Overdosed America: The Failed Promise of American Medicine, by John Abramson, M.D. My review of this book:

You may have suspected it. In spite of the incredible expense poured into our health care system we aren't any healthier. Here, then, is the proof confirming your suspicions and the why.

Near the end of the book Abramson, a long-time family doctor who has an extensive background in statistics, epidemiology, and health policy, puts it simply: the bad news is that many of our celebrated advances in medicine, including new drugs, medical procedures, and sophisticated equipment, do not perform as well as older treatments and cost a great deal more. The good news is the same! If we knew what really works, based on unbiased well-designed studies, we would not need to use expensive treatments, equipment, or drugs nearly as often as we do, and we'd be better for it. In other words, our health care costs would drop and our health would improve.

Our health care system has gone so far astray that in comparisons with other developed countries the U.S. pays twice as much for abysmal results. And it really is not an accident. And it isn't because we eat too much fried food (although, of course, we do have to take responsibility for choices within our power). Read this book and find out for yourself. It's easy to read, clearly written, easy to understand. And so important. I would like every one of our political leaders to have a copy.

Another book that helps clarify another aspect of the current situation and explains some of the cost escalation is The Secret History of the War on Cancer, by Devra Davis. My review:

The book I and likely many others have been waiting for. The book that asks why the focus on cancer has so much been on cure and so little on prevention. The book that asks why we know so little about the environmental basis for cancers.

Davis, an epidemiologist, actually thought of this book many years ago, but was persuaded to set the idea aside or risk her own career. Now that she is established and at less risk she has laid it all out for us: it is no accident that we don't know much about the environmental causes of cancer.

Yet it wasn't always so. Davis points out that in the early part of this century, into the 1930s, a great deal was already known about how substances like asbestos and professions like coal mining are directly linked to cancer. Even more astonishing, companies that made or mined cancer-causing agents freely admitted the connection. And much of what we believe is new information about many chemicals was known then. So why were we in the dark for so long?

The scene has changed. Hiding behind "trade secrets", companies routinely deny any knowledge of the harm their products do, even when their own investigators have proven otherwise. Most significantly, the industries responsible for so much cancer - through their pollution of the air, the water, our food, our land - have learned an effective way to delay any real action: they sow the seeds of doubt. We saw it in the tobacco companies. We see it now in the global warming deniers. They give the impression that they are all over this, that they want the answers as much as we do - to prove it, they fund "further studies". But of course nothing can be done until those studies are complete.

And they have it easy. In this world, nobody is safe from man-made contamination of the environment. It is impossible to determine without a doubt exactly which product or exposure caused cancer in a particular person. Worse, courts have tightened the burden of proof requirements so that a plaintiff has to show overwhelming evidence of causation by a particular agent. It's easy for the accused to point out that we live in a chemical soup so who can honestly claim this or that exposure was the one that caused the cancer?

Davis lays out the case against the corporations and the colluding government agencies with compelling evidence. She further calls for an end to "further study". We know enough, she said. The time to act is long overdue. I can only hope enough people with power hear her.

Let's stop pussyfooting around. Let's take the power of AARP where it can do the most good: into the heart of the pharmaceutical corporations and their lobbyists, and the government agencies that assist them in gouging the American public. The cost of American medicine is not related to improved health (see Abramson's book) but instead to profits for corporations. One fine first step is to get rid of drug advertising. I am sure you can come up with many more – and if you are looking for someone to sit on a panel of interested citizens, I'm up for it.



Judith Lautner
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