Well it’s a bit more confusing for childhood obesity. Those percentiles are based on a hybrid of figures mainly from the seventies and eighties and are now fixed. So when we currently say a child is overweight or obese, we say that it means in the top 15 or 5% respectively, but 30% of kids are in that top 15%!
I can follow it. Your objection is that the cost of people’s unnecessary pills is spread out across everyone in the health plan, forcing everybody to pay higher rates. But this could be true for other resources, like wasting water. If you have someone in your apartment building who takes ten showers a day, while everyone else takes one, he is using up more water, and if everyone in the building has to pay an equal share of the water bill (which has been the case in all the buildings I’ve been in) he is raising the cost for everyone. Likewise, SUVs burn gas at a much faster rate than economy cars. When more people use SUVs to get everywhere, the gas gets burned up faster, so there’s less of it, thereby raising the gas prices (that’s not a totally accurate analogy though since there are other factors involved in gas prices). I think Oy! was saying that you were selectively attacking pill-poppers and not considering other ways that people foist higher prices on other people. Which is kind of a non-sequitur, but the general principle IS the same.
Personally, I think we should all try to strive for economy in everything and not make any unnecessary purchases, but that’s just me.
You’re talking about two different things–IBS and IBD. Inflammatory bowel disease (IBD) refers to ulcerative colitis and Crohn’s disease, both of which are specific pathologic entities and both of which are serious and frequently debilitating conditions that often require surgery.
Irritable bowel syndrome (IBS) refers to symptoms of abdominal pain, constipation, and/or diarrhea in the absence of a specific organic cause, often in response to stressors. Unlike UC and Crohn’s, which have findings that can positively make the diagnosis, it is a “diagnosis of exclusion”, meaning that it’s the diagnosis you’re left with when you don’t find anything else to explain the symptoms. It can be very troubling, but it isn’t as serious or as morbid as IBD.
Patients often conflate the two; I probably see half a dozen new patients a year who claim a history of UC or Crohn’s disease, when their records show IBS. (Usually she’s gotten hold of some info on IBD, thinking it’s her condition, and she has used some sort of checklist to determine which one she has.)
You get it, davenport, except that it’s not just a single apartment building. Potable water is a scarce resource. The more anyone uses, the more the price goes up. Granted, by very little, but then John Doe’s blood pressure medicine doesn’t raise the price by much either.
I don’t think it was a non sequitur. The question remains as to why someone who takes drugs rather than modifying life style to treat a medical problem is more worthy of scorn/disgust than other folks who “over-use” resources - which includes any member of a western society, really. On the first page of this thread, there were some who expressed real *disgust * at those who use meds rather than lifestyle change to help problems that the poster considered entirely controllable by lifestyle (not necessarily true, but I’ll assume it is for the sake of the argument). I’m still trying to understand WHY some people feel that way (and it’s not uncommon). I was hoping someone would be willing to do enough self-examination to tell me, but apparently that was asking too much.
You yourself used the term pill-popper. Why is the taking of medicine so despised?
Well, personally I look at the improper use of these resources all the same. It’s all wasteful and indicative of Western excesses, and it should all be derided. I almost disowned my own father when he talked about buying an SUV, it was a major major issue for awhile. So no, I don’t give pill-poppers any special attention, if I do on the board that’s just coincidence, but in real life I’m an all-around wet blanket. But since this thread is not about SUV drivers, I didn’t go off on them.
But as for why I “call out” perceived medical misuses? Look at the figures, look at the facts. Think globally. People are dying of an easily treatable illness (malaria) by the thousands, with no cure in sight. Meanwhile, Americans take pills for trumped-up conditions that can be fixed with diet and exercise. And while you can objectively say that the money spent on an unneeded pill in America wouldn’t necessarily go towards a shot of quinine in India, to me it FEELS as if you are taking away someone else’s cure with your (general you) selfishness. And I also care because all this R&D into piddling conditions takes away resources that should be going to fight true epidemics. Do you know that the amount of money being put into AIDS research has plateaued over the last decade? Now that it’s a disease that fewer Westerners get, it’s fallen off the radar, and all the companies are looking at the next drug we richies might buy, which happens to be some kind of foot fungus pill.
But you’re right in that pill-popping is but one symptom of an entire syndrome of Western wastefulness and greed. It’s no worse than driving SUVs when you don’t have to, or buying things you don’t need (I am guilty of this myself, I am as guilty of being a Westerner as anyone), or wasting energy, or any of it. It’s just that this thread is about one aspect of the syndrome.
Since this is GQ, let’s see some cites that we ARE taking resources away from fighting say, malaria?
According to Wikipedia, in 1994 the US gave $500 million in malaria aid. Contrast this with the $15.7 BILLION just to market prescription drugs, many of which are for conditions far less disastrous, and far less treatable, than malaria. All ads which are directed at rich Westerners. I mean, that’s JUST the cost for advertising. That doesn’t count the billions poured into R&D for unnecessary meds (I just spent a half hour trying to find out how much it cost to develop Lamisil and could not come up with a specific figure, however, I’ll bet all the tea in China that it’s higher that 500mil). Astounding, especially when you consider that in many ways it is advertising that’s to blame for the overmedication of our society. A good doctor knows his drugs and can match a patient’s symptoms to a specific drug. Do we need the advertising? Does it do anything other than convince hypochondriacs that they have the disease listed in the ad? I’m not going to debate the existence of depression or RLS because I know they exist, however, all these ads do is convince people they’re sick and they need multinational corporations to save them. And it’s a lot easier to convince someone they’ve got an invisible disease than that they’ve got cancer, which is detectable on objective tests. Which is why you don’t see ads for cancer meds.
Here is an article calling malaria “the white elephant of global health” because it is such an easy disease to cure yet is still a total pandemic. Dying from malaria is a lot like dying from the flu. It is easily preventable and easily treatable, and its sufferers can go back to 100% productivity and quality of life once cured, unlike diseases like TB which tend to be chronic. The only issue involved is money.
I think you’re comparing two different things. The amount spent by a drug company to develop and market a product is private enterprise, and is done in the hope of making a profit later. A fair amount of such development effort goes for naught but for showing that a particular thing doesn’t work. I don’t know the real percentage, but it’s far from 100% of all drugs tested that ever come to market. Drug companies, like all other private enterprise, may create useful or even life-saving products, but unless they make a profit, they will cease to exist.
You are comparing this to U.S. aid, which is our tax money given away, presumably for good reason, to promote something that is (we hope) for the good of ourselves and others.
Of course more is spent on research, development and marketing by the private pharmaceutical companies. Why not also compare how much is spent developing and promoting, say, cars? Or toys? Or any other consumer product? If such things were scaled back, there is no reason to think that the money could otherwise be spent on more humane projects. In fact, if the various private enterprises don’t make profits, they will pay less in taxes, and the government will have less money available to spend on malaria or whatever other more worthwhile cause you had in mind.
But should medicine be treated like just another consumer product? I say not. I don’t think it’s right to pour millions of dollars into antifungal remedies (and you’re right, I should have posted that instead of the advertising bit, but I couldn’t put my finger on a solid number) when millions of people are dying of curable diseases. I don’t know what’s to be done about it, but I sure can shake my fist and yell.
Seriously, is there any good reason why drugs should be advertised on television? From what I can see, all it does is foment hypochondria and make millions for the pharmaceutical companies from people who’ll say “I saw an ad for Paxil, I don’t know what it does, but me wantee!” (and yes, some doctors WILL give it to them). Leave the doctoring to the doctors. That’s at least one thing we can do to stop the misuse of medicine, ban these ads.
Again, how would forbidding development of remedies for non-lethal ailments result in more funding for other diseases? Perhaps we should also ban the development and advertisement of, say, Barbie dolls. Now there’s a useless item; maybe even harmful, since it promotes an unhealthy self image for little girls. How much better to use all those resources to fight malaria!
Why should the government interfere with what a private industry does? Isn’t that socialism, or worse, communism? How would that work? Ban all advertising for anything medical? So if I, MLS Pharms, Inc., develop a better pimple cream or psoriasis remedy, may I not advertise this to let people know that mine not only works faster, but smells better? How about toothpaste? Or is some government bureaucrat going to decide how much I must spend on malaria and polio? Maybe I don’t know nuthin’ bout malaria and polio, but I have good researchers who know skin remedies. Why should I not do what I do best?
I’ll tell you, Davenport. I agree with you on the advertising of medicine (which was not legal for the first half or more of my life), and I hate to see billions spent developing heroic measures to save a few or to treat a minor (or at least non life-threatening condition) when so small a fraction of that would go so far in eradicating life-threatening diseases in poor countries. I think that there should be National Health in the US, and I deplore the trends within big Pharma.
But, my heavens, your self-righteousness is enough to alienate even the most fervent supporters of your position. I’m delighted for your sake that you are so perfect, and that you manage to guide your actions by your principles at all times. Most of us aren’t and don’t. And there’s nothing noble in suffering. If you suffer through a condition, while I spend a couple of bucks to buy something that will make me feel better, that actually doesn’t make you a superior human being. If you change your lifestyle to deal with a condition that would be treatable by meds, that means that to you not taking the meds was more important than maintaining your lifestyle. Not everyone has your priorities or your apparent self-discipline.
If you really want to effect change, alienating the people whom you wish to convince is probably not the best way to go about it.
I never said I was perfect. I’m a terrible, wasteful, egocentric, semi-sociopathic Westerner just like everybody else. I’ve just got more than the usual amount of self-hatred about it. I hate myself for not being able to live up to my principles, which are partially outlined here. Self-righteousness is not my modus operandi, guilt is. And that goes for everything: medicine, energy, resources in general. I’m really no fun at all! (nonexistent “sarcastic” emoticon implying that I’m kidding, though in actuality I am not)
I’d say the same thing, except I would be serious. But seriously, I am not singling out medicine here. There are probably plenty of things we could all do to make the world a better place: I could only eat rice and beans for the rest of my life to save resources, I could only leave my house to go to work to save gas, I could wear one outfit and handwash it to save money on clothing. (Actually, those are all things I have considered doing.) But I didn’t mean to sound self-righteous even though I can see how I’m being taken that way. I just have a bug up my ass about resources in general and the use thereof.
davenportavenger, just out of curiousity, did your mom try to make you eat all your veggies with the admonition that there are children starving in Africa?
Just like then, your leaving the food on your plate (or buying toenail fungus products) or not, doesn’t effect those starving kids one way or the other.
Pharma is not in the good works business; they are trying to make a buck and they are looking for blockbuster lifestyle drugs to develop and promote to do it with. Doing good for the world needs other venues. Gates’ foundation for example, comes to mind. Donate to good causes.
If the ad had listed only that one symptom, I would agree that the marketing drive had been “centered around” problems with decreased ability to concentrate. Such was not the case. A decrease in the ability to concentrate can, in and of itself, be severe enough to require the attention of a physician. On the other hand, by itself, such a symptom would not merit a diagnosis of depression.
The mischaracterization of the medications used to treat depression as “happy pills” arises from a common misconception. For example if a person is not clinically depressed, SSRIs will not make that person “happier.” If the patient is clinically depressed, the SSRIs may allow her or him to return to feeling normal.
Sorry, davenport, I didn’t mean to make you feel worse. But really, martyrdom is not the answer. It has zero effect, and serves no purpose but to make someone miserable but smug about it.
Dseid was right - find charities that are doing truly worth-while work (such as helping areas to get clean water) and donate. Even volunteer - the Peace Corps certainly does much of the kind of thing you want to see. But wasting your life on futile gestures such as
serves nothing except a misdirected conscience. While I’ve been a staunch left-winger for pretty much all of my fifty years, I’ve come to realize that working against commonly shared motivations such as the desire to make money or the desire to use (in various ways) more resources that one’s “proper share”, in short working against the tide, *cannot * work. You will never win over more than a fringe group of fanatics. No matter how worthy the object, you will never see a large-scale movement that says “Let’s give up the vast majority of things we enjoy so that more people in third world nations can live longer and have a slightly better life.” So your self-flagellation serves only to make you unhappy - no third worlder would thank you for it, or emulate it in your place.
You have to think of ways to make it a win-win situation for everyone. Much of our resource problems are due to waste or inefficiency; coming up with ways of making it more cost effective to either conserve or produce the resource will help more than sacrificing your small pleasures in day-to-day life. In other situations (oil comes to mind), we’re simply going to have to suck it up and learn to pay more for the resource from other sources. For example, there’s plenty of energy available. It’s just not as cheap as oil is now.
The earth is not about to “run out” of anything. It can support the current population with respect to food, even if it doesn’t do so at the moment - the reasons for starvation are numerous, but do NOT include “we simply can’t grow enough to feed these people.” It’s true that all of western society is likely to have to make some hard changes in the coming century, because what WILL run out is the CHEAP resources we’ve had access to. How well we adjust and adapt to those changes will likely determine how successful we are as a nation and culture in the future.
In the meantime, seriously, get over yourself. Your contribution as either consumer or producer is simply not very significant on the whole, and there are better ways of spending your guilt.