#this is admittedly my first time with company sponsored health insurance so I am VERY confused

[weswardstars]

I fucking hate employer sponsored healthcare. not only am I going to have to stop seeing my current pcp at the lgbt clinic because he's not covered, bUT even though I'm looking at the FANCY insurance with the WIDEST RANGE and it covers 11,500 doctors within 15 MILES OF ME, including OVER 100 ENDOCRINOLOGIST SPECIALISTS —

absolutely 0/11,500 of these doctors cover gender affirming care 🙃

[exploringsocialinformatics]

Post #3: A Lovely Impossible Dream

I wrote this post based on the article “The Pill That Costs $9000 in US Sells for $70 in India,” which I chose because I just have a lot of feelings about access to healthcare, especially considering it’s such a hot topic in the US at the moment. I took the general idea of disparate access to medication between various countries and went on a bit of a globalist screed.

There should be a global, regulated, human rights-focused manufacturer of generic, necessary medications.

I should go ahead and say this is wildly speculative and probably (almost definitely—like, somewhere between 99.999% and 150%) impossible, but I truly believe we should dream as high as possible to at least get closer to a better world, so bear with me as I weave this pie in the sky dream of a global community of people not dying from easily preventable diseases.

The United States’ pharmaceutical industry is a nightmare. Based on the article from The Times of India, India’s is certainly better—if by “better,” we mean, “better for the people who need medication,” which would be the ideal focus (Nagarajan). But putting any price on life-saving medication that’s already cheap to manufacture is in and of itself a telling statement on the value we place on our global citizens, especially when the medication could be manufactured outside of a competitive industry and provided at a fraction of the cost.

Or there could be virtually no cost if it could be sponsored entirely by the governments of the world or through the same foreign aid given out via the United Nations—in fact, based just on the impact that the United States has already had on global health, it’s easy to imagine that supplying more cost effective medication would only make it easier for us to give as much if not more than we have in year prior. After all, as it was addressed in a Stanford Medical article, these donations rarely cost more than 1% of the US’s GDP (Bendavid). Imagine if that medication was already being produced via a global pharmaceutical manufacturer and they didn’t have to go through the complications of mixing public and private interests to go about distributing this aid.

Free medication for the whole world is admittedly something that probably wakes wealthy industry executives up in the night, sweating and terrified, and I’ll touch on how that could hold it back in moment, but as I said: pie in the sky.

In The Globalization of the Pharmaceutical Industry, J.L. Valverde addresses several aspects of global pharmaceutical policy that would need to be the focus if we were to better bring together the pharmaceutical industries from different nations for the greater good, including the involvement of international organizations such as the World Health Organization and The Global Fund—who, according to him, have “facilitated the immense improvement in access to HIV/AIDS treatment over the last 15 years” (22) among many other accomplishments.

Imagine if we could use existing organizations like the WHO to establish generic pharmaceutical manufacturing that is equitable to all who seek their help—or, at least, to use their focus on policy to create a new organization. Not only would this make a huge impact on health specifically but it would be a global method: we’re in this together. When we’re facing huge issues like climate change that will require multiple countries to work together (Zavis 2015) to literally save the world, working together to save our people—treating all people of all countries like our people regardless of where you live—is a significant, improbable, beautiful step in the right direction.

Are there significant issues with implementing a global policy like this? Absolutely—there will always be significant issues when you are attempting to disrupt a power as big as the pharmaceutical industry, and my lack of in-depth experience in both pharmaceutical policy and global economies is holding back a full investment in my own argument. The scope and depth of this argument are difficult to determine and certainly not something that could be covered in a blog post. If I’m speculating, though—and as I said, wildly—I can address the issues essentially as well as I can the greater possibilities.

The biggest issue that I would point to in terms of what would hold this idea, good or bad, back is the fact that the pharmaceutical industry in the US has consistently donated the most to campaigns for congressional seats than any other lobby (Evers-Hillstrom 2019), which affords a lot of power to a significant portion of the global industry to influence lawmakers. In terms of criticism, though, a central argument is that something that takes away that much power from the people who have developed those medications would be a violation of their rights. This article from The Globalist is from 2000 but it had the most concise description of this argument framed against the concept of a government manufacturer that I could find, saying, “Locally produced drugs would, of course, be much less expensive than those produced in the United States [referring to African countries manufacturing their own drugs]. But to U.S. trade authorities and drug companies, this represents a gross abuse of U.S. intellectual property rights” (“Medical Socialism”).

I don’t want to completely dismiss the idea of intellectual property rights, nor do I completely want to dismiss similar arguments like the idea that it would keep industry leaders (the people who own the patents that constrict smaller companies from competing but also the people who are consistently developing important medications) from continuing to innovate and explore new possibilities. While, based on the profits they make, I am skeptical something like someone else producing a limited array of generic medication (probably based on the WHO’s “Essential Medications List,” though it is admittedly long [2020]) would hold them back that much, there’s no denying that this would have an impact on the economy surrounding the pharmaceutical industry and the economy as a whole. And, again, I can’t successfully argue what that impact would be because this idea is untested but it’s a potential red flag against it.

An argument that’s a little more grounded in reality and certainly more achievable is to have government-manufactured generic medication on a national or even state/province level in countries where this is possible. There are at least two significant proposals that have come out of the United States in the last few months supporting this concept. Elizabeth Warren sponsored a bill in late 2019 that would create an Office of Drug Manufacturing under the Department of Health and Human Services, saying, “The solution here is not to replace markets, but to fix them. The Affordable Drug Manufacturing Act will introduce more competition into the prescription drug market, and bring down prices for consumers” (Warren 2019).

More recently, just last month in January of 2020, Governor Gavin Newsom of California has proposed similar legislation, described as, “part of a multi-prong effort that includes strengthening the state’s public option for health insurance and increasing drug pricing transparency” (Lin).

The concept of governments individually manufacturing their own generic medication to take place within the pharmaceutical marketplace is incredibly progressive and also infinitely more sellable than a global manufacturer—especially one giving out medication for free. The first can fit relatively easily within the pharmaceutical industry as we know it while the latter would. . .probably require a dramatic global transition of moral priorities, which is not something that’s likely to be achieved. Like I said, though, we may as well dream big. Coming from my own perspective, the very fact that we have pharmaceutical industries at all represents a degree of moral deficit. But if we start within the bigger framework that the health of the world as a whole—especially that of struggling, marginalized people who already lack access to proper healthcare—is the most important factor when thinking about healthcare and pharmaceutical production, maybe we’ll at least get nudged in the right direction even if my own wild starry-eyed globalist dream is out of reach.

 Resources

Bendavid, E. (2019, May 16). Foreign aid for public health bolsters America's 'soft power'. Retrieved from https://med.stanford.edu/news/all-news/2019/05/foreign-aid-for-public-health-bolsters-americas-soft-power.html

The Globalist. (2000, July 10). Medical Socialism. Retrieved from https://www.theglobalist.com/medical-socialism/

Lin, J., & Aguilera, E. (2020, January 11). Gov. Gavin Newsom to propose that California manufacture its own generic drugs. Retrieved from https://calmatters.org/health/2020/01/gavin-newsom-to-propose-california-manufacture-state-generic-drugs/

Nagarajan, R. (2016, February 7). The pill that costs $9,000 in US sells for $70 in India - Times of India. Retrieved from https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/The-pill-that-costs-9000-in-US-sells-for-70-in-India/articleshow/50887471.cms

Valverde, J. L. (2016). The Globalization of the Pharmaceutical Industry. Retrieved from https://www.ifpma.org/resource-centre/the-globalization-of-the-pharmaceutical-industry/

Warren, Elizabeth. (2019, December 20). Schakowsky, Warren Reintroduce Affordable Drug Manufacturing Act, Legislation to Radically Reduce Drug Prices through Public Manufacturing of Prescription Drugs. Retrieved from https://www.warren.senate.gov/newsroom/press-releases/schakowsky-warren-reintroduce-affordable-drug-manufacturing-act-legislation-to-radically-reduce-drug-prices-through-public-manufacturing-of-prescription-drugs

World Health Organization. (2020, February 3). WHO Model Lists of Essential Medicines. Retrieved from https://www.who.int/medicines/publications/essentialmedicines/en/

Zavis, A., Megerian, C., & Yardley, W. (2015, December 12). Nearly 200 nations join together to fight climate change in historic Paris agreement. Retrieved from https://www.latimes.com/world/europe/la-fg-climate-talks-20151212-story.html