"American adverts make me feel like I’m in some post-apocalyptic world"
March 8, 2021 3:20 PM   Subscribe

 
You’re welcome, NHS.
posted by Huffy Puffy at 3:20 PM on March 8, 2021 [8 favorites]


Over the last week or two I've been seeing the same ad over and over for a drug where one of the side effects is "unusual urges," and like, you can't just say that and not give me more details
posted by theodolite at 3:26 PM on March 8, 2021 [147 favorites]


If American adverts are the first thing to tip you over into the post-apocalyptic world ... I guess the kind thing to say is you live a very sheltered life.
posted by rikschell at 3:26 PM on March 8, 2021 [18 favorites]


Part of what put me off living in the U.S. and made me come home to Chile was the ads: medicine scams, car loan scams, rinse, repeat.
posted by signal at 3:29 PM on March 8, 2021 [21 favorites]


Americans, just stop and consider the situation.

A drug that is meant to be administered by a Medical Doctor after a professional diagnosis is something that is an extremely technical professional decision. It is a decision made through review of research, study of interactions, and so on.

People gripe about "doctor google" but this right here is utterly absurd: people are meant to go into the doctor's office and say "thanks for the scrip, doc, but I saw an ad while I was up late one night that showed people walking their dog on the beach and it said Znorptraptophynobarbitucrack could make me happy and only caused mild internal hœmorrhaging. I want that!"

Just stop to think of what world in which that would be an even remotely sensible policy to allow such a thing.
posted by rum-soaked space hobo at 3:30 PM on March 8, 2021 [77 favorites]


I've sometimes wondered whether advertising is solely responsible for the fact that Americans spend twice as much on healthcare as anybody else.

I'm sure it's not, but I wonder.
posted by clawsoon at 3:32 PM on March 8, 2021 [7 favorites]


Just stop to think of what world in which that would be an even remotely sensible policy to allow such a thing.

Why do you hate freedom?
posted by Dr. Twist at 3:32 PM on March 8, 2021 [51 favorites]


Americans, just stop and consider the situation.

Why do you assume we haven't done this?
posted by cooker girl at 3:37 PM on March 8, 2021 [49 favorites]


Oh, I'm fully aware of how awful it is, believe me. I'm not saying it's not a sick nightmare. But on the list of things that make the USA a hellscape (hell, even measured against the list of things that make the UK a hellscape) I'm not sure pharmaceutical ads even crack the top ten.
posted by rikschell at 3:37 PM on March 8, 2021 [21 favorites]


The ads themselves, no, but the root cause behind the ads is definitely on the top ten, if not the number one thing wrong with America. It has corrupted the medical industry and turned public sentiment against any system other than one designed to leech as much money as possible out of sick, vulnerable people.


(the root cause is Capitalism)
posted by Mr.Encyclopedia at 3:46 PM on March 8, 2021 [47 favorites]


I remember seeing an ad for Adderall a year ago or so. Like who in then marketing department was like need to boost Adderall sales.
posted by geoff. at 3:46 PM on March 8, 2021 [6 favorites]


Same in Canada: "WTF is thi... Oh, it's an American channel."
posted by klanawa at 3:47 PM on March 8, 2021 [25 favorites]


II've sometimes wondered whether advertising is solely responsible for the fact that Americans spend twice as much on healthcare as anybody else.

I'm sure it's not, but I wonder.


The percentage of healthcare money spent on pharmaceuticals by Americans is quite small (about 10%). So not even close.

(FWIW I'm a shill for the pharmaceutical industry, at least the research side of it, and it's why I have a home. I also hate TV ads though, am embarrassed by them and think they should be banned.)

(Another point, while I'm here: Ads give a very skewed perception of what we research. You generally don't do TV ads for cancer or HIV or something like that, as those serious diseases already have people seeking treatment and you target doctors, or at least specialist publications that reach patients trying to manage their disease. What's left over for TV is things you want to convince people they should see a doctor about, like restless leg syndrome, erectile disfunction, heartburn, etc.)
posted by mark k at 3:48 PM on March 8, 2021 [14 favorites]


The target audience in America was older folks it seems.
posted by Brian B. at 3:49 PM on March 8, 2021 [3 favorites]


I'm not at all assured that Canadians have anything to feel great about. We created a great universal healthcare system that we seem intent on losing, and last time I tuned into a hockey game we're seeing a greater frequency of pharma ads. Are we happy to be US-lite in all things? Like, the healthcare situation is getting worse at a slower rate?
posted by elkevelvet at 3:52 PM on March 8, 2021 [2 favorites]


Just stop to think of what world in which that would be an even remotely sensible policy to allow such a thing.

Which policy do you refer to?

Why do you hate freedom?

While there are exceptions, they are relatively few. Advertising for a legitimate drug would probably fall under First Amendment protection. The burden of regulating these ads falls on the TV stations.
posted by 2N2222 at 3:52 PM on March 8, 2021


So I work in a healthcare-adjacent job, and even though my company only makes software and I barely ever interact with clients, every year I have to click my way through some mandatory "ethics" (actually regulatory compliance) training courses that are intended for pharmaceutical and medical device sales people. The basic format is that you watch a badly-acted movie of a hypothetical pharma-rep sales situation, and then you have to pick what you think the correct thing to do is. I repeatedly failed these tests because I would pick an option like "no, you shouldn't fly doctors to Hawaii on sales junkets" when the correct answer is actually "get that doctor on that plane but make sure you come up with a valid-sounding reason for them to go." It was basically a tutorial in how to skirt as closely to the line of legality as possible.
posted by theodolite at 3:52 PM on March 8, 2021 [43 favorites]


Mark k that number is for prescription pharmaceuticals not for pharmaceuticals in total. Also I've seen lots of ads for anticancer agents.
posted by dances_with_sneetches at 3:57 PM on March 8, 2021 [4 favorites]


mark k: The percentage of healthcare money spent on pharmaceuticals by Americans is quite small (about 10%). So not even close.

It's not just pharmaceutical advertising, though, is it? I swear I remember ads for clinics and doctors and health insurers and even hospitals(??) in my brief exposures to American television. Surely all of that has some effect on how much Americans spend on healthcare?
posted by clawsoon at 4:05 PM on March 8, 2021 [1 favorite]


We created a great universal healthcare system that we seem intent on losing...

True, and in fact we stopped short of creating a great system due to the resistance of... doctors and dentists.
posted by klanawa at 4:14 PM on March 8, 2021 [4 favorites]


You generally don't do TV ads for cancer or HIV or something like that

Two in current rotation:

Cancer
HIV
posted by gimonca at 4:15 PM on March 8, 2021 [3 favorites]


Canadians aren’t any different from most people the world over these days in that they’ll vote for anyone who promises to knock a buck off their taxes and be glad of their good fortune even after they subsequently have to pay back that dollar and four more to the private sector.
posted by The Card Cheat at 4:21 PM on March 8, 2021 [14 favorites]


These ads have never made sense to Americans either:

(a) Isn't it your doctor's decision, not yours?
(b) The side effects are always some crazy list of horrible shit that sounds far worse than your original medical problem you might take the drug for.
(c) That crazy list of horrible shit has never ever, not once, sold me on any of these drugs.
posted by jenfullmoon at 4:21 PM on March 8, 2021 [21 favorites]


It's important to understand that the reason the UK doesn't have pharmaceutical ads is because the UK specifically bans pharmaceutical ads. It's not a side-effect of having socialized healthcare.
posted by kickingtheground at 4:34 PM on March 8, 2021 [64 favorites]


I do remember a time before tv drug ads in the US. There was an FDA regulatory change in 1997.

There was a period at the end of the 1990s that saw the swift rise of a) television pharmaceutical ads; b) SUVs; and c) reality television. You could basically feel the timeline darkening.
posted by yarrow at 4:41 PM on March 8, 2021 [93 favorites]


I've seen lots of videos of the interview but no ads. Where are they seeing them? Youtube?
posted by picklenickle at 4:41 PM on March 8, 2021 [1 favorite]


(a) Isn't it your doctor's decision, not yours?


I no longer watch TV with commercials, but I remember that they were weird. I don't really agree with the choice of medication lying solely with the doctor. As a patient, I like being informed of treatment options that are available to me. My doctors have always encouraged this. I had a longstanding (minor) medical issue that wasn't really being addressed. I did my own research, found a drug that seemed like it would help, and asked my doctor about it. She prescribed it to me, and it completely fixed my problem. I've been taking it for years now.

More recently, my husband had a problem with his ear. The doc couldn't see anything unusual in there, so he got his own otoscope, took pictures that seemed to him very clear what was going on. He messaged his doctor what he thinks is going on, and offered to send the data. She welcomed it.

So there are a lot of reasons to not like the commercials, but keeping the patient out of the decision making doesn't seem like a good one to me.
posted by pizzazz at 4:42 PM on March 8, 2021 [21 favorites]


Many years ago, I had a job doing data entry and stuffing envelopes for a company whose big client was a drug company. The envelopes were mostly promotions to doctors, invites to "informational" presentations at restaurants, etc.

I guess we were having doctors send us stuff too? Because the point of the story is, one guy sent us the most eloquent denunciation of drug marketing. Talking about patients coming into his office and DEMANDING a prescription they saw on TV, that had nothing to do with any of their health issues, or patients tormented by anxiety that a condition they had just learned about in an ad was killing them. It went on for 2 or 3 handwritten pages. I should have Xeroxed it and kept it. I wish he knew that someone had read it, anyone at all.

I thought the high point of this was the one where they didn't even tell you what it was for. The Purple Pill! Ask your doctor. Whaaaat? Purple? I gotta try that!
posted by thelonius at 4:44 PM on March 8, 2021 [7 favorites]


These ads have never made sense to Americans either

Indeed, they hold no sway over me, though presumably the drug companies are betting otherwise. The ads that I find really perplexing are the ones that don't even explain what the pharmaceuticals are for.

I do find it extremely interesting who the individual ads seem to target, though, and make a bit of a game out of it. The latest one for a drug whose name I can't remember right now (I think its for rheumatoid arthritis) seems to be pitched to lesbians (???). Like rheumatoid arthritis is some kind of lifestyle hazard of lesbianism or something.

But yeah, post apocalyptic? No.

But what do I know? I live in a country without a monarchy.
posted by 2N2222 at 4:45 PM on March 8, 2021 [5 favorites]


There was a period at the end of the 1990s that saw the swift rise of a) television pharmaceutical ads; b) SUVs; and c) reality television. You could basically feel the timeline darkening.

also funk/metal bands
posted by thelonius at 4:46 PM on March 8, 2021 [15 favorites]


The ads that I find really perplexing are the ones that don't even explain what the pharmaceuticals are for.

Years ago there was an ad for a drug which featured a nurse in a maternity ward as the narrator; lots of shots of her running hither and yon, tending to babies. For a full week I was assuming it was a fertility treatment until I saw the print version somewhere and learned it was for migraine.

And then there's Cialis, about which practically NO ONE knows it's for erectile dysfunction becuase everyone assumes it's about bathtubs.
posted by EmpressCallipygos at 4:55 PM on March 8, 2021 [8 favorites]


I’m convinced the ads aren’t really meant for doctors OR patients. They’re to stuff money into media companies’ pockets to buy favorable coverage of our reprehensible healthcare system.
posted by sjswitzer at 4:56 PM on March 8, 2021 [18 favorites]


Whoa, American, did you realize that your pharmaceutical ads / electoral college / racist cops / healthcare system / tax system / public transportation system / prison system / etc. are completely fucked up?

Yes, I did! Sorry for not fixing it personally!
posted by paper chromatographologist at 5:21 PM on March 8, 2021 [89 favorites]


people are meant to go into the doctor's office and say "thanks for the scrip, doc, but I saw an ad while I was up late one night

I'm seeing this new specialist about trial-and-erroring my way to the best medication for my health issues, and they asked me if I'd heard of anything I'd like to try. Which, given that I'll probably have to try 3 or more is maybe not an entirely outlandish question, but I'm like, isn't that your job? The fact that something has name recognition probably isn't correlated to its chances of helping my specific body?
posted by Nonsteroidal Anti-Inflammatory Drug at 5:23 PM on March 8, 2021 [7 favorites]


It's important to understand that the reason the UK doesn't have pharmaceutical ads is because the UK specifically bans pharmaceutical ads. It's not a side-effect of having socialized healthcare.


The UK is saturated with OTC (over the counter, non-prescription drug) ads. What's banned is prescription drug ads!
posted by lalochezia at 5:25 PM on March 8, 2021 [10 favorites]


I remember the one of the first consumer ads, in the mid 90s. I’m pretty sure it was for Allegra(nope, Claritin) and it didn’t even say what it was for...and then the floodgates opened.
posted by rockindata at 5:26 PM on March 8, 2021 [6 favorites]


Americans, just stop and consider the situation.

We have. We do. It hurts. If I could make it stop, I would. *cries in American*
posted by treepour at 5:44 PM on March 8, 2021 [15 favorites]


Like who in then marketing department was like need to boost Adderall sales.

In 2014-2015, a friend of mine spent 6 full work months on a giant "audience awareness" campaign for a media property, with a specific focus on selling toys for this property during an event that would take place the first week of May. It even culminated with him flying out to Chicago personally supervise a midnight launch event at a flagship of a multinational department store.

What was this obscure property that required tens of thousands of person hours of work by my buddy and his team to let the public know what was coming, and to get them hyped? Just a little thing he liked to call: Star Wars: The Force Awakens. And the little event they were throwing was the merch launch on May 4th (May the Force Be WIth You Day).

The store he was at (Macy's) sold out within 10 mins of opening. Was this because of the weeks and months of late nights, including weekends and holidays from dozens of people? Fuck no. Everyone could have taken the 6 months off and the store would have sold out by maybe a minute or two later.

It was useless and stupid. But Disney didn't pay all that money for Maker Studios (although they probably wish they did, lol) to just let a new movie come out and not put like $100m of digital marketing behind it.
posted by sideshow at 5:44 PM on March 8, 2021 [3 favorites]


I wonder to what degree direct-to-consumer ads are profitable because a lot of people in the US are underinsured and don't have a trusted/longstanding relationship with a general practitioner, they just show up with a problem and see a doctor they've never met before for the few minutes they can spare.
posted by Emily's Fist at 5:46 PM on March 8, 2021 [20 favorites]


I legitimately can't tell if that Claritin advert is real or vaguely trippy satire.
posted by ToddBurson at 5:48 PM on March 8, 2021 [1 favorite]


> people in the US are underinsured and don't have a trusted/longstanding relationship with a general practitioner

Seen.
posted by glonous keming at 5:51 PM on March 8, 2021 [5 favorites]


I wonder to what degree direct-to-consumer ads are profitable because a lot of people in the US are underinsured and don't have a trusted/longstanding relationship with a general practitioner.

Yeah I was just thinking about this regarding that HIV drug ad or other treatments for chronic illnesses. In a better system you’d be able to discuss the state of the art treatments with a professional regularly. But instead, well, it’s mostly on you but you can ask about the stuff you’ve seen on TV!
posted by atoxyl at 5:51 PM on March 8, 2021 [4 favorites]


When the Claritin starts coming on...
posted by Windopaene at 5:53 PM on March 8, 2021


Of course there are some cases - like when the PDE inhibitor ED drugs first came out - where you can see, if the pharma companies are allowed to advertise to consumers, damn right they’re going to advertise to consumers.
posted by atoxyl at 5:55 PM on March 8, 2021


Whoa, American, did you realize that your pharmaceutical ads / electoral college / racist cops / healthcare system / tax system / public transportation system / prison system / etc. are completely fucked up?

Yes, I did! Sorry for not fixing it personally!


and now you know what it feels like to be a Floridian.
posted by Don Pepino at 5:57 PM on March 8, 2021 [23 favorites]


One way my spouse and I relax is by watching old US TV ads. They're easy to find on YouTube and they are a little glimpse of history - what did we buy and how did folks try to persuade us to buy it? what memories of our childhoods get unlocked? etc.

And every once in a while there's a little fossil record of a particular change. Like the ad that shows a person, walking through a doctor's office, telling you: there's a new treatment available for allergies, so if you suffer from allergies, go talk with your doctor and ask about it. (But the person never mentions the name of that treatment, because that's not allowed yet.) Or the ad that tells you about this new over-the-counter formulation for colds that has this new ingredient: pseudoephedrine. Or the ad for a VCR, airing (evidently) sometime before the Supreme Court ruled in Sony v. Betamax, with a bit of text at the bottom of the screen saying that a court had held that home taping of copyrighted material was infringement.
posted by brainwane at 5:57 PM on March 8, 2021 [8 favorites]


I wonder to what degree direct-to-consumer ads are profitable

If you knew the answer to this question you'd know more about advertising than anyone else on earth.
posted by Mr.Encyclopedia at 6:04 PM on March 8, 2021 [13 favorites]




I'm generally skeptical of reductionist explanations of national differences based on what's exceptionally striking or culture-shock-y to outsiders. Two specifics worth bringing up: the U.S. is one of two countries with legalized prescription ads, the other being New Zealand. Yet the Kiwis aren't drowning in excessive health care costs or especially high public mistrust of doctors or whatever AFAIK.

The other more salient point I think, as an American fan of cricket, the U.K. video streams are absolutely plastered with ads for online gambling. I swear at least half the ads are for cheesy and exploitative sports gaming, and always with the tiniest possible mandated lip service toward the possibility of gambling addiction maybe being a problem. It comes across as quite insidious and it would be a fun exercise to, say, put together an essay linking it to brexit or something.
posted by traveler_ at 6:26 PM on March 8, 2021 [22 favorites]


My understanding has always been, though I have no source to hand for this, that the reason so many ads are like "Ask Your Doctor about XYZ!" is that ads either have to mention BOTH what the drug does and its side effects or neither. So if they opt not to list side effects they just say "ask your doctor" instead. Is this some crazy thing I made up in my head?

I for sure remember ads that tried to cram all the side effects into a second of ad time, read superfast by an auctioneer on coke, but maybe that's not a thing anymore? I haven't watched OTA television in months.
posted by axiom at 6:28 PM on March 8, 2021 [2 favorites]


but without drug ads we’d have to look up what the perineum is and that would taint my search history permanently
posted by Huffy Puffy at 6:31 PM on March 8, 2021 [36 favorites]


Mark k that number is for prescription pharmaceuticals not for pharmaceuticals in total.

Non-prescription (OTC) sales are under $200 billion, so they'd add a few percent but not fundamentally change the point; over 85% of medical spending is non-drug related.

Also I've seen lots of ads for anticancer agents.

My age and cord-cutting habits may be catching up with me. It does seem in the last few years more anticancer drugs are on TV (described here for example.)

I did find this top 10 list, and a more accurate picture is: rheumatoid arthritis, diabetes and stroke prevention. It's still not a great picture of what we research but it's different than I said, and not nearly as off-base as I implied. I need to update my mental image of the standard ad.

I swear I remember ads for clinics and doctors and health insurers and even hospitals(??) in my brief exposures to American television

Yeah, these are all things and health insurer advertising is huge.

I wonder to what degree direct-to-consumer ads are profitable because a lot of people in the US are underinsured and don't have a trusted/longstanding relationship with a general practitioner, they just show up with a problem and see a doctor they've never met before for the few minutes they can spare.

One of the less creepy reasons to advertise is to make people aware that something is a symptom for a treatable illness. I've seen some numbers for certain fairly diseases where well over half the people who have it are either not diagnosed, or not in treatment. This is certainly related to our messed up health care system, and of course having pharma company do this corrupts what might be a useful public health service by tying education (good) to getting people to spend money on a specific very expensive drug (bad).
posted by mark k at 6:34 PM on March 8, 2021 [3 favorites]


Ayesha Siddiqi, who created the thread, has just published a transcript of a couple of interviews she gave regarding her motivations etc.
posted by maupuia at 6:36 PM on March 8, 2021 [5 favorites]


The percentage of healthcare money spent on pharmaceuticals by Americans is quite small (about 10%). So not even close.

That amounts to over $1,000 per person per year. That's $4,000 a year for a family of four. That's hardly trivial.

People may not see that huge number because it is hidden in their insurance premiums, but it is most certainly there.
posted by JackFlash at 6:36 PM on March 8, 2021 [1 favorite]


A drug that is meant to be administered by a Medical Doctor after a professional diagnosis is something that is an extremely technical professional decision. It is a decision made through review of research, study of interactions, and so on.

While I agree this is how it should be, and speaking as one with long-term depression, my experience has been more like throwing stuff at the wall and seeing what sticks...
MD) Here, try drug-1
Me) It made me suicidal.
MD) OK. Try drug-2.
Me) Nasty headaches and anger.
MD) No problem! Here’s drug-3.
And on and on.
posted by Thorzdad at 6:38 PM on March 8, 2021 [13 favorites]


Your doctor went to medical school for seven years. You watched a 30 second TV commercial. Who the fuck do you think you are telling your doctor what pills you need? This is exactly backwards! What are you doing?
posted by adept256 at 6:51 PM on March 8, 2021 [2 favorites]


If your doctor spent seven years in medical school, you need a new doctor. Most people make it through in four.
posted by mr_roboto at 7:01 PM on March 8, 2021 [2 favorites]


Also, doctors are often either overworked or not that sharp.
posted by mr_roboto at 7:03 PM on March 8, 2021 [2 favorites]


Try asking a doctor if they know any dumb doctors...
posted by mr_roboto at 7:04 PM on March 8, 2021 [12 favorites]


"Kill Your Television" - 1979

"Ask Your Doctor" - 2021
posted by Insert Clever Name Here at 7:11 PM on March 8, 2021 [5 favorites]


It’s only fair that Brits would have a WTF USA?? reaction to ads that played during our WTF UK?? tv show.
posted by Atom Eyes at 7:25 PM on March 8, 2021 [36 favorites]


And...we all know how expensive ad time is, especially during must-see tv...and they still try to convince that the high price of meds is because of R&D. Bullshit.
posted by OHenryPacey at 7:25 PM on March 8, 2021 [4 favorites]


Without pharmaceutical advertising, we wouldn’t have the song of the summer 2019, the undeniable banger ”Things Are Gettin’ Clearer”. Thanks Skyrizi!
posted by chrchr at 7:32 PM on March 8, 2021 [2 favorites]


I distinctly remember the first time I saw an ad for a prescription drug. It didn’t have any of the ‘ask your doctor’ stuff in it. I thought “wow, who are they pitching this to?? they must think a lot of doctors are watching this particular show...”
So very naive.
posted by dbmcd at 7:33 PM on March 8, 2021


My mother lives in New Brunswick and watches American TV. Today she told me she needs to find a new doctor because her current one won't prescribe the medicine she sees on TV that will help her lose weight.
posted by dobbs at 7:55 PM on March 8, 2021 [2 favorites]


Yes, if the ad just features the drug name and ask your doctor then that’s all that’s required. If the ad says the drug treats a disease then all the side effects must be listed, in some manner. Those were the rules set up when prescription drug ads were legalized. My mother worked for a doctor so I got see editions of the Physician’s Desk Reference (PDR) before it was sold in bookstores and probably Costco. The PDR had lengthy descriptions on all or most prescription drugs including indications (why take it), contraindications (why you shouldn’t take it), side effects, and dosages. There were also color pages with pictures of all the pills, just in case a strange person on the street handed you a pill and said “good times!” That way you could find out if it was true. The irony about this reference book is that all the entries for drugs are actually highly technical advertisements that may or may not have all the relevant information. “Leave out the horns appearing on the forehead if the patient is also taking statin drugs. It only happens maybe 0.73% of the time.”
posted by njohnson23 at 7:57 PM on March 8, 2021 [3 favorites]


but without drug ads we’d have to look up what the perineum is and that would taint my search history permanently

I know exactly the ad you’re talking about. I almost fell off my chair.
posted by sjswitzer at 8:14 PM on March 8, 2021 [1 favorite]


Thorzdad, that totally squares with my experience, especially if you throw in a few rounds of [recite timeline of previous drugs, dosages, effects, and side-effects to new doctor]. It's the worst. Psychiatric drugs are so poorly understood and hit-or-miss, even though psychiatry is kind of unique among medical fields in being almost solely focused on prescribing.

I have a hard time believing that people are, like, jumping up off their couch and demanding Ozempic, but maybe that is happening if the ad buy is worth it? I guess I have been in situations where prescribing was more of a back and forth than a command coming down from on high, like, "Hello, new general practitioner! I am having a flare-up of unusual condition x, which has previously been treated with y," and then the doctor replies with, "Hmm, how about we try z?" It isn't exactly ordering off of a menu, but it does involve providing input.

I'm also not sure how to reconcile the fact that I want to nuke prescription commercials from space, but wouldn't be quite as grossed out by a banner ad served alongside a relevant article, and am totally on board with subway PSAs about PrEP.
posted by evidenceofabsence at 8:17 PM on March 8, 2021


honestly every time I visit family in the US I am thunderstruck by the fact that every TV commercial is for a prescription drug, a political candidate, or a personal injury lawyer, with the occasional commercial squeezed in for anything else
posted by DoctorFedora at 8:20 PM on March 8, 2021


The US has all the ads for prescription rugs, but the UK public service ads are nightmare fuel—I remember watching one about wearing your seatbelt, where somebody gets into a car accident and slams into the back of their mom's skull, killing her instantly. The end, no moral!

Beat the GI Joe ads about not walking on thin ice into a cocked hat, that's for sure.
posted by fifteen schnitzengruben is my limit at 8:21 PM on March 8, 2021 [4 favorites]


ads for prescription rugs

Fallen arches, fasciitis, osteoarthritis? Ask your doctor about...
posted by paper chromatographologist at 8:26 PM on March 8, 2021 [6 favorites]


ads for prescription rugs

Fallen arches, fasciitis, osteoarthritis? Ask your doctor about...


...difficulty having a shag?

the UK public service ads are nightmare fuel

The Canadian ads that the Workers Safety Insurance Board (WSIB) did about 10 years ago were fucking horrifying [content warning: simulated sudden and traumatic workplace accidents].
posted by mandolin conspiracy at 8:31 PM on March 8, 2021 [7 favorites]


Metafilter: could make me happy and only caused mild internal hœmorrhaging.
posted by turbid dahlia at 8:56 PM on March 8, 2021 [4 favorites]


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Westphalia.

posted by clavdivs at 9:01 PM on March 8, 2021 [7 favorites]


I've sometimes wondered whether advertising is solely responsible for the fact that Americans spend twice as much on healthcare as anybody else.

It's been my consistent experience that products from obscure manufacturers I've never heard of almost always work every bit as well as their heavily advertised competitors while costing less than half as much.

Advertising is essentially privatized taxation, and it's imposed at ruinous rates.
posted by flabdablet at 9:18 PM on March 8, 2021 [6 favorites]


I got rid of cable and regular tv some ungodly long time ago and (15 -20 years), and didn't see any of this. Then recently, I got Hulu, the cheap one, seemed like a good deal, until I realized there were commercials,. Not so may medical ones they were really trying to focus on ads I want to see. The ads I want to see are NONE OF THEM. So I stopped watching Hulu. Than xfinity offered me a free set top box that had the new nbc premium channel for free (yes, you see where this is going). OMG! The medical ads! That shit was unbelievable. I couldn't do it. It takes up space unused in my living room. Someday all return it.
Whenever I visit my Mom, she would have TV on (so much better than my sister though who had Fox on all the damned time) I hated the commercials, but the shows were nearly as bad, in that they were mindless pablum, and I'm somewhat OK with mindless pablum. She complained to my sisters that I would hide in the bedroom and not talk to her on visits. I would love to talk to her. Not her and the TV. Fuck me I hate this country sometimes.
posted by evilDoug at 9:24 PM on March 8, 2021 [5 favorites]


One thing that kind of blew my mind when I learned about it is that when the U.S. banned cigarette advertising on TV and radio in 1970, tobacco company profits went up. (See for example a mention in this paper, in the third paragraph of the introduction.) Because it turned out that any tobacco company spending large amounts of money on advertising would gain a competitive advantage, forcing all of them to do so, but when all of them did the net effect was just that more of their revenue went to ad agencies instead of to profits. The advertising ban effectively relieved the tobacco companies of a prisoner's dilemma they were trapped in by making defection illegal. (Though apparently within a few years, marketing executives found ways to more effectively exploit print and other advertising media remaining to them, and the companies were back to spending a larger fraction of their revenue on advertising again.)

My understanding is that there are economic models explaining why this might happen in some cases and not in others, essentially related to whether advertising for a particular type of product can increase demand for the product or can only influence consumer choice between the brands available, so this wouldn't necessarily happen in every case. But I think it's still remarkable that in many cases, banning advertising for a particular industry may actually benefit that industry, and for most pharmaceuticals this may well be true. Even for drugs like Viagra that clearly benefited from increased consumer demand from its advertising blitz in the '90s and '00s, arguably the biggest benefit came not from the brand awareness of, say, Viagra versus Cialis, but from the normalization and medicalization of erectile dysfunction as a treatable physiological problem by having Bob Dole and other Very Serious Men as spokespersons directly trying to destigmatize it and make men more comfortable discussing it with their doctors. When it comes to the large and ever-increasing array of very similar drugs treating, say, depression, or allergies, or other profitable chronic diseases, do pharmaceutical companies actually benefit from being able to advertise their products directly to consumers? Probably not, but because it's permitted, they have to do it to remain competitive.

To a great extent, advertising is parasitism on the economy. It's often bad for consumers, and often bad for the companies buying the ads as well. It does end up patronizing the production of popular art in the form of television and movies, but also creates perverse incentives that often worsen the quality of that art (e.g., product placement, "vertical integration"). I personally hate being advertised to: commercials almost always operate by trying to convince you that your life will improve by buying something you don't need, or by appealing to and reinforcing our most base cultural biases and dark values, or by achieving brand recognition with heavy mindless repetition and un-funny skits that hollowly imitate the superficial forms of genuine artistic expression. In the rare cases that a marketing team manages to produce an ad that sells a product while managing genuine humor or, even more rarely, honest human sentiment, the effect is quickly destroyed by excessive repetition and by turning the ad into a "campaign" that is stripped of any innovation or point-of-view by whatever B-team marketing executives that got promoted above their abilities by the similarly-mediocre senior executives they suck up to while playing golf.
posted by biogeo at 10:31 PM on March 8, 2021 [20 favorites]




but without drug ads we’d have to look up what the perineum is and that would taint my search history permanently

I grundlestand what you did there
posted by taquito sunrise at 11:16 PM on March 8, 2021 [4 favorites]


psychiatry is kind of unique among medical fields in being almost solely focused on prescribing

Because that's what insurance companies are focused on paying for.
posted by villard at 11:54 PM on March 8, 2021 [1 favorite]


I grew up with doctor parents in the UK and was exposed to so much pharmaceutical advertising in the form of branded pens, notepads, computer mice, mugs, and other random crap.

I was annoyed the first time I had to buy a pen in a shop when I left home.
posted by knapah at 12:43 AM on March 9, 2021 [5 favorites]


Yeah as someone noted up thread, I think us Brits really can't get too high and mighty about pharmaceutical advertising when we are inundated with gross gambling ads. Gambling companies weren't actually allowed to advertise on television until the previous Labour government decided to change this. One of those decisions that just made the world a little worse for everyone except those who work for gambling companies.
posted by Cannon Fodder at 1:45 AM on March 9, 2021 [3 favorites]


one of the side effects is "unusual urges,"

Irrational urge to marry into the British Royal Family?
posted by Phanx at 1:46 AM on March 9, 2021 [2 favorites]


John Wanamaker: "Half the money I spend on advertising is wasted; the trouble is, I don't know which half"

American pharmaceuticals: "Well we spent $$$$$$$$ on advertising and people are still getting ill, so I guess some of it must be working."
posted by Lanark at 2:12 AM on March 9, 2021


it turned out that any tobacco company spending large amounts of money on advertising would gain a competitive advantage, forcing all of them to do so, but when all of them did the net effect was just that more of their revenue went to ad agencies instead of to profits.

This pattern generalizes.

"Half the money I spend on advertising is wasted; the trouble is, I don't know which half"

¿Por qué no los dos?

Modern marketing is the scientifically refined art of telling compelling lies for money, and the original lie - the one that gets the advertiser's foot in the door - is "My services are necessary for the health of your business".

It's a privatized consumption tax and a protection shakedown.
posted by flabdablet at 2:17 AM on March 9, 2021 [2 favorites]


My mother used to consult for a big pharmaceutical company, doing statistics for their R&D division. Sometime around 2005, they determined that the return on money invested in marketing was far greater than the return on money invested in R&D. They reallocated their spending accordingly, her work offers dried up, and she decided to retire.
posted by fuzz at 2:18 AM on March 9, 2021 [7 favorites]


biogeo, thank you very much for information that I didn't already have. A mere + isn't a sufficient expression of gratitude.

I was going to post my opinion that the most successful advertising is probably the advertising that ad agencies do to clients.

As for the mess that is the American medical system, the start has nothing to do with advertising. During WW2, there were restrictions on wages so that the companies weren't competing too hard with the military. Companies would give various non-wage perks to employees, and one of those was medical insurance. So health insurance got to be a default part of wages, even after the war.
posted by Nancy Lebovitz at 2:50 AM on March 9, 2021 [2 favorites]


The PDR had lengthy descriptions on all or most prescription drugs including indications (why take it), contraindications (why you shouldn’t take it), side effects, and dosages. There were also color pages with pictures of all the pills, just in case a strange person on the street handed you a pill and said “good times!”

I remember 60s/70s counterculture writers - Lester Bangs I think is my specific example - talking about owning a copy for this purpose.
posted by atoxyl at 3:07 AM on March 9, 2021 [1 favorite]


The ads for biologic drugs for auto-immune diseases are handy because I can tell my mom, "I've stopped taking the drug Phil Mickelsen advertises. Now I'm taking the one Cyndi Lauper takes."
posted by hydropsyche at 3:44 AM on March 9, 2021 [7 favorites]


I see someone has already brought up the gambling adverts in the U.K. I think it’s an apt comparison. The first time I saw them I thought they were bonkers and it’s probably a similar reaction to Brits seeing the pharmaceutical ads.

Even weirder as an American though, is the lack of ads during a sporting game Like, watching an entire 90 minute football (soccer) game with no ads. But the time before a game is chock full of gambling ads with live up to the minute odds.

In contrast you have football (American) whose gameplay seems specifically structured to show as many ads as possible. It’s kinda weird watching an American football game in Britain because they have to fill SO many gaps with minute by minute commentary where the ads would be.
posted by like_neon at 3:44 AM on March 9, 2021 [6 favorites]


like_neon: In contrast you have football (American) whose gameplay seems specifically structured to show as many ads as possible.

Total ball-in-play time for a typical NFL game is 10-15 minutes in a 3-hour broadcast. It's the perfect vehicle for advertisers.
posted by clawsoon at 3:50 AM on March 9, 2021 [4 favorites]


Oh, I'm fully aware of how awful it is, believe me. I'm not saying it's not a sick nightmare. But on the list of things that make the USA a hellscape (hell, even measured against the list of things that make the UK a hellscape) I'm not sure pharmaceutical ads even crack the top ten.

Drug ads in mass media are orders of magnitude down the list compared to other forms of drug marketing. The amount of swag they give away is pretty horrifying as well, but pales in comparison to the cynical use of women's bodies or the literal kickbacks for reaching "targets" for the number of prescriptions written.
posted by wierdo at 4:22 AM on March 9, 2021 [1 favorite]


Try asking a doctor if they know any dumb doctors...
What do you call the guy who finished last in his class at med school?

Doctor.
posted by cheshyre at 5:02 AM on March 9, 2021 [5 favorites]


Is it also fair to say that advertising and the arms-race of political infotainment over the last approximately 30 years in America is what has driven us to the looming civil-war scenario we find ourselves in? By that I mean, has the over-sensationalization and radicalization of political op-ed content on our cable TVs largely been a result of those channels' desperate attempts to farm more eyeballs-per-minute from the at-home viewership, because that way they can sell more adverts at better rates?
posted by glonous keming at 5:07 AM on March 9, 2021


Anti-Depressants Are So Not A Big Deal by Rachel Bloom & Adam Schlessinger
posted by cheshyre at 5:08 AM on March 9, 2021


The prescription drug ads of the sort we see in the US today weren't allowed until ~1997. But the FIRST ad was in 1983.

Guess who the pharma was? I don't remember this commercial at all from my teen years, but the first time I saw it, some years ago, I thought, This man is a John Cleese clone. I did notice that these sorts of ads weren't on television when I was in the UK.
posted by droplet at 5:13 AM on March 9, 2021


The thing about prescription drug ads that seems to go unmentioned is that these are largely for new and new-ish brand-name meds that are still under patent protection and, so, have no generic equivalent available yet in the US.*

Now, unless you have really good health insurance, practically none of these drugs are going to be on your insurer's preferred-medication formulary. Thus, none of them fall under your standard prescription co-pay amount. Instead, you're going to have to pay an exorbitant (still negotiated) out-of-pocket price for these meds, and only after your insurer provides prior-authorization to do so. If your insurer doesn't authorize the med (i.e. they decline to cover it at all), you're going to have to pay the full retail cost of the med, which can be eye-wateringly steep in the US.

These ads are better seen as a pretty cynical attempt by the drug companies to get people paying the full cost of these things.

As an aside, this seems to be an opening enterprises such as GoodRX are attempting to fill. You can score some pretty good discounts on even new medications via these services. The sticking point with using GoodRX and their ilk is that, if you go that route, what you pay does not go toward your health insurance deductible, whereas what you pay after going down the above-mentioned prior-authorization dance with your insurer does apply to your deductible.

This ends today's installment of "Just How Fucked is US Healthcare?" Our international audience members can now safely lift your jaws up from the floor.

* Yes, there are name-brands who still advertise after the patent ends.
posted by Thorzdad at 6:16 AM on March 9, 2021 [4 favorites]


How did UK viewers even see the American ads? Were they streaming from a US service or something? I can't imagine it would be okay for a UK broadcaster to rebroadcast American ads that weren't legal in the UK.
posted by Ampersand692 at 6:38 AM on March 9, 2021 [1 favorite]


I think most UK viewers who saw it the night it aired, saw it via VPN or some dodgy stream. It was broadcast in the UK last night on itv.
posted by like_neon at 6:49 AM on March 9, 2021


I just checked some popular torrent sites, and the first availability is not too long after it aired. There are SO many ways to view region locked content these days..
posted by DreamerFi at 6:52 AM on March 9, 2021 [1 favorite]


I've sometimes wondered whether advertising is solely responsible for the fact that Americans spend twice as much on healthcare as anybody else.

Well you see, we gotta spend the money on the ads, because otherwise we won't have people asking their doctors for drugs to treat conditions they don't have, and then how are we going to afford the small army of claims adjustors we need to deny people access to healthcare (which is really expensive so we don't want to pay for it, mostly because we have to subsidize the TV ads and the small army of claims adjustors)?

exits pursued by a bear
posted by Mayor West at 7:20 AM on March 9, 2021 [1 favorite]


Just stop to think of what world in which that would be an even remotely sensible policy to allow such a thing.

It is generally insane, granted. But there's another aspect: while I was still seeing my GP for regular diabetes checkups, I was keeping more up to date with developments in diabetes treatment than she was. And so I was able to ask one day, "what about this Byetta stuff?" and she said "I will have to look into that."

She did eventually refer me to a specialist so that's not so much of an issue anymore. Now, the main problem is that which drugs I take is an antagonistic negotiation between my doctor's office and my insurance company.
posted by Foosnark at 7:26 AM on March 9, 2021


I remember the one of the first consumer ads, in the mid 90s. I’m pretty sure it was for Allegra(nope, Claritin) and it didn’t even say what it was for...

I actually remember something a bit earlier for "Cardizem CD" which was similarly vague; the entire ad was just a conversation between a guy picking up his prescription for something else, and the pharmacist. I think she was telling him that Cardizem CD may treat his symptoms better and he should talk to his doctor about it. I definitely remember a moment when he raised his eyebrows at her and said "Can you give me Cardizem?" and she gave him an apologetic smile and said "Only your doctor can prescribe you Cardizem."

I remember being fascinated by it because the whole ad - the script and the acting - was just so stilted, and they never told you what the hell Cardizem was. It was also the first time I'd seen a medication that wasn't OTC advertised anywhere.
posted by EmpressCallipygos at 7:32 AM on March 9, 2021 [2 favorites]


I could easily be convinced that these cannabis ads aren't parodies. They aren't, right?

I don't expect weed to be legalised in the UK during my lifetime, but will happily look to the States for former "street" drugs to get surreal Superbowl advert treatments while I wait.
posted by Ten Cold Hot Dogs at 8:12 AM on March 9, 2021 [1 favorite]


I think we're getting close, guys. According to my calculations, if we get just... 13 more outsider perspectives to remind us of the hell scape we live in and are subjected to every day, things can finally change.
posted by FirstMateKate at 8:26 AM on March 9, 2021 [8 favorites]


I've sometimes wondered whether advertising is solely responsible for the fact that Americans spend twice as much on healthcare as anybody else.

I'm sure it's not, but I wonder.
The reason health insurance is so expensive in the US is private insurance.

Our biggest idiots wave the flag and say “woo capitalism” without understanding why markets work (when they work) and what problems they can and can’t solve. Because, see, when I just implied that some problems aren’t well addressed by markets, you might not have realized, but that was full-bore communism and I was apparently calling for the overthrow of western civilization. It’s a major act of heresy to even suggest such a thing.

Market competition is meant to result in superior service for lower prices, but the incentives for a private insurance provider run exactly counter to that. Insurers thrive when they deliver fewer services and retain more profit.

Advertising is part of the reason for the added expense. Medicare, our national health service for the elderly and disabled, doesn’t need to advertise, just as the UK NHS doesn’t need to. The private insurers most of us are stuck with do, and that’s an overhead cost we pay for.

But that’s only the start. Then there’s administrative cost, which reads like a ham-fisted science fiction satire: MBAs at the insurers want to cut expenses by “optimizing” healthcare and eliminating “waste,” and that means creating an adversarial relationship with healthcare providers, always insisting that they’re providing too many services, spending too much time with each patient, and charging too much to do it. Healthcare practices ought to run like automated assembly lines, because this maximizes the insurer’s profit. I don’t know if it’s the case now, but in the 1990s and 2000s we were actually losing doctors because the insurers were cutting so close to the bone that the cost of medical school couldn’t be offset by working as a doctor, and the doctors were in a perpetual death march to see ever more patients. This creates the extremely profitable “give em a pill and send em home” brand of doctoring, and results in doctors who can exhaustedly say “yeah, whatever” when a patient asks if Cebulogragriftin is right for him. Accepting insurance meant doctors were treated like employees of faceless taskmasters at those insurance companies, but few had the luxury of building a practice without accepting insurance.

Providers’ response was reasonable from their point of view as people who need to eat: First, break down every encounter with healthcare into as many separate itemized procedures as possible, to justify expenses in a highly granular way, but also to make invoices so convoluted it’s hard to parse them. So on a visit to your GP, sticking a tongue depressor in your mouth and having you say “aah” is a distinct medical line item. Second, invent wildly inflated “list prices” for each of those line items, trusting that every other healthcare provider must do the same because they too need to eat, and also knowing that the insurer treats the “list price” as an opening bid in a lopsided negotiation in which they’re going to unilaterally offer 25 cents on the dollar anyway. So the “list price” for administering the wooden-tongue-depressor examination is $20, the insurer offers $5, and you’ve still paid $5 for a wooden stick you could get off Amazon at under $10 for a box of 500 and three seconds of your doctor’s time.

The insurers’ response to incomprehensible medical billing was to establish a system of codes for every conceivable expense and to require that healthcare professionals use only those codes if they expect to be paid. This led to an entire ancillary industry built around expertise in working the coding system. Not only is the insurance company paying extra administrative costs, but your doctor must also employ people who know how to operate the medical billing system. Cue the market evangelists cheering that we’ve “created jobs,” but we’re paying for those jobs through our insurance premiums, and remember the point of all this was to reduce unnecessary expenses. All those “created jobs” amount to one giant example of broken window fallacy in that they are resources spent to patch over a broken system.

Coding errors and automated rejection are also rampant. It’s hard to find an insured American adult who wouldn’t have had the experience of having a procedure or medication prescribed by their doctor, having the insurance company reject it instantly, and the doctor has to either fight to justify the treatment or come up with an alternative treatment plan the insurer will accept. By “the insurer,” note, we are emphatically not referring to anyone with a medical degree.

The premiums we pay, in turn, are very often paid at least in part by our employers, and just counted as a cost of doing business, so the premiums can rise without a major customer revolt. They depress our wages and eat into our employers’ profits and we mostly don’t see it, except to the extent our employers have started introducing cost-sharing schemes that have employees pay a percentage of the premium cost, which creates an incentive to take a cheaper plan (or no plan at all), saving our employers money on benefits at the cost that some people end up developing medical conditions they didn’t anticipate when evaluating insurance options and get left in the lurch.

Even with insurance, for even the simplest surgical procedure you can expect bills to continue arriving literally for years after as the providers find and bill for things insurance didn’t cover.

This leads to the phenomenon of people, even insured, waiting out illnesses until it drives them to the Emergency Room, the department that by design delivers the least care for the most money. Those who are uninsured pay, you guessed it, the full “list price,” and if they can’t pay the bill it just wrecks them financially. The hospital, itself a for-profit entity, doesn’t get paid, so they toss the bill off into a for-profit collection agency that will hound the patient to death (if he hasn’t died already) and finally accept a settlement of pennies on the dollar, of which they take a cut.

The overwhelming majority of US bankruptcies result from medical debt.

Meanwhile, the hospital builds anticipated losses into its “list prices,” but gets to claim the losses against its taxes and gets federal and state payments, out of taxpayer money, for the delinquencies. For all our effort to avoid the dread nightmare of taxpayer-funded healthcare, we’ve gotten ourselves a completely under-the-table system of taxpayer-funded healthcare, at the cost of financial ruin for the people who receive it, surely appropriate punishment for the crime of becoming ill while knowingly being unprofitable.

And for all this “optimization,” administrative overhead costs 30% of the premiums of private insurers, where it costs 3% of the tax revenue that funds Medicare.

American healthcare is so expensive because it is not designed to treat patients. It is designed to extract as much money as possible from a demand-inelastic public need and permit as many people as possible to get their beaks wet. It increases fractionally every time one of the players involved comes up with a new way to try to increase their share of the take at other players’ expense.

But, woo, free market! Thank god we aren’t enduring the dystopian nightmare of national healthcare.
posted by gelfin at 9:00 AM on March 9, 2021 [30 favorites]


So I watch tv and see medical ads occasionally, but the one that angers me is the soft cover of Supergrass' Alright which means I'm getting close to being in the target demographic range for medical advertising.

Though I find it heartening that Supergrass possibly turned down use of the actual song.
posted by The_Vegetables at 9:38 AM on March 9, 2021 [2 favorites]


gelfin: Market competition is meant to result in superior service for lower prices

I know that's the theory, but what I've seen most often in practise is that market competition produces many options. It's not the best service for the lowest price. It's not the price of the iPhone continually going down; it's dozens of better or shittier Android models. It's not the Model T priced to perfection, it's a Chevy and a Cadillac and a Pontiac and a Buick and an Oldsmobile.
posted by clawsoon at 9:42 AM on March 9, 2021 [1 favorite]


Considering that we get to see the doctor for maybe ten minutes tops, when we actually do get to see the doctor at all (every third or fourth visit) sometimes it is nice to have already heard of a new drug when they suggest it. More than once I’ve had a doctor (or PA or NP) suggest a drug, and been able to say, “Should I really take that with my [contraindication that they’d know about if they looked at my chart for a few seconds]” because of an ad I’d seen.
posted by The Underpants Monster at 12:30 PM on March 9, 2021 [1 favorite]


It’s kinda weird watching an American football game in Britain because they have to fill SO many gaps with minute by minute commentary where the ads would be.

Now I gotta ask: why don't they put ads in there?
posted by polecat at 2:31 PM on March 9, 2021


Now I gotta ask: why don't they put ads in there?

There's always the rugby option, where the ads appear to pop out of the field.
posted by clawsoon at 2:37 PM on March 9, 2021


Now I gotta ask: why don't they put ads in there?

The BBC literally aren't allowed to show advertising. They do some promoting of their other shows occasionally to give presenters a bit of a break from having to come up with stuff to fill the airtime at half-times and similar, sometimes.
posted by Dysk at 7:01 PM on March 9, 2021


Even the other channels are limited to like 12 minutes an hour, isn’t it?

Hell, MTV used to hit 12 minutes of ads every 5 videos.
posted by Huffy Puffy at 7:32 PM on March 9, 2021


Now I gotta ask: why don't they put ads in there?
The BBC literally aren't allowed to show advertising.

The BBC does not show the NFL. We watch it via Gamepass (an NFL service) so in this particular instance the reason there are no ads is because it’s a streaming service that specifically allows us to watch the games commercial free.
posted by like_neon at 6:14 AM on March 10, 2021


(To clarify, BBC does have a program called The NFL Show, which is indeed commercial free per their rules, but it’s a recap show. It’s okay.)
posted by like_neon at 6:17 AM on March 10, 2021


I think we're getting close, guys. According to my calculations, if we get just... 13 more outsider perspectives to remind us of the hell scape we live in and are subjected to every day, things can finally change.

Now you know how the rest of the world feels all the time when their countries and cultures are mentioned in the internet (including here).

For me the biggest medical related shocks when I moved to the USA (I had already done my research, but missed this part) were that unless I opted in for the most expensive plan my employer offered, I could not choose and stick with a GP. I would get whomever was available at the time unless I wanted to wait 2 months for an appointment, and they would spend 5 minutes looking at my history, 5 minutes talking to me, and the remaining 15 minutes fighting the billing and prescription software. Also that I could not get to see a specialist unless the GP authorized it after trying 15 useless thing I had already tried.

Here in my third world country if you are privileged enough to have any kind of private insurance you can establish a lifelong relationship with one doctor, regular appointments last from 30 to 60 minutes, and you get referred to specialists as soon as your symptoms indicate that you may need one.

Last time I needed a specialist here I tried several until I found one that did not patronize me and who understood basic statistics (sensitivity, specificity, PPV, NPV). Insurance was Ok with that, I only had to pay the $4 USD copay for each visit.

Back in the USA I was stuck with a GP who gave me a patronizing lecture when I asked if my dosage should be the same after I had a 25% change in body weight, and would not refer me to a specialist until I had been in constant paint and bleeding for 3 months. The specialist fixed it in 2 weeks with a minor surgery. During those 3 months I was willing to try anything the TV told me.
posted by Dr. Curare at 9:35 AM on March 10, 2021 [2 favorites]


The BBC does not show the NFL.

They show the superbowl for example, which is about af much NFL as most people over here even remotely care about. So yes, watching a game of American football on British TV, it's a decent assumption that you're watching the superbowl on the BBC.
posted by Dysk at 12:50 AM on March 11, 2021


Know who else sees tons of ads? Your doctor. My doc cheerfully prescribed a stupid-expensive inhaler with a fancy dosage system. A cheap inhaler with the same ingredients and boring packaging works fine for me, at 1/10 the cost. Lots of meds for lots of stuff get sold because astounding amounts of money are spent advertising to doctors. It is not in your best interest.
posted by theora55 at 2:35 PM on March 14, 2021 [1 favorite]


biogeo: when the U.S. banned cigarette advertising on TV and radio in 1970, tobacco company profits went up

However... consumption went down. So they made more profit, but the total share of the economy which was spent on tobacco went down. Maybe there's a lesson for American healthcare, there, too?
posted by clawsoon at 6:16 AM on March 19, 2021 [1 favorite]


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