Now that George W. Bush is back in the news with his attacks on Trumpist insurrectionists, it might be worth reviving one of the great lines of his presidency. After the September 11 attack, when Bush decided to go after not just the terrorists who planned the hijackings, but all sorts of people around the world he didn’t like, he lumped them together as “evildoers.” That may not be the most eloquent phrase, but it works well as a description of the modern pharmaceutical industry.
Some may find this description of the pharmaceutical industry abhorrent; after all, they develop life-saving drugs and vaccines, most recently the vaccines against the coronavirus, which have saved millions of lives. But the industry’s story line gives us a very incomplete picture of what it does and how.
Probably the best way to think about the pharmaceutical industry is to imagine an incredibly corrupt fire department. Most of the money that the fire department gets to buy new trucks and other equipment goes right into the pockets of the department’s commissioner and his closest friends. The department may still do its job in the sense that they rush to fires and rescue people trapped by flames, but it costs way more than it should.
The fire department may even occasionally start fires itself so that they can be heroes in putting it out and rescuing potential victims. If that sounds like an over-the-top accusation against the pharmaceutical industry, then you didn’t pay attention to the opioid scandal. Several major drug companies have paid out billions of dollars in settlements over the accusation that they deliberately misled doctors about the addictiveness of the new generation of opioids.
Note that the accusation was not that the industry failed to recognize how addictive their drugs were. The accusation was that they knew they were highly addictive, but lied to doctors so that they could sell more prescriptions. This is not very different from deliberately starting fires to drum up business.
Now, suppose that the there was growing political pressure to cut back the fire department’s budget and clean up its practices. Naturally, it’s not going to just sit back and let someone take away the trough. Our corrupt fire department will do everything in its power to continue the practices that are allowing its top officials to get rich.
In the case of the corrupt fire department, we can anticipate big public relations campaigns where they highlight the fires they have extinguished and the lives they have saved. We can expect to see pictures of adorable children who were saved from burning blazes by the fire department. This, of course, has nothing to do with the effort to eliminate corruption, but it makes great material for advertisements on the major news shows. And, who knows, maybe these expensive ads will even influence their reporting on the fire department’s corruption.
This corresponds to the pharmaceutical industry’s campaign to beat back congressional efforts to lower prescription drug prices and weaken the protection the industry now enjoys with government-granted patent monopolies. Just as the corrupt fire department actually does save kids’ lives, the pharmaceutical industry does produce drugs and vaccines that are hugely important for people’s lives and health.
But that is not the issue. The question is whether there are better ways to get these drugs and vaccines. There is good reason for thinking there is.