Drugs and Television
There is a lot of crap on television. In fact, people tend to get nostalgic about the "good old days" of television. For some it’s "The Honeymooners" and for others it’s "Mash" or "Cheers" or "Cosby." However, the recent increase in crap on television is one of the greatest developments in the history of entertainment.
"Crap on TV" is viewed by most people as a symptom of something negative. They look at it as a sign of declining cultural standards, a lack of creativity, even a sick society. It is, in reality, a symptom of unprecedented creativity, diversity, and quality.
Twenty short years ago there were three networks plus PBS. They offered a limited variety of shows. Sitcoms and dramas in primetime, soaps during the day, news at 5:30, late night talk shows, and an occasional sporting event were offered up by every network. The networks did produce some quality shows, but most of the time they produced crap. However, because there were only a few choices, the crap was not as pervasive as it is today, and the few good shows seemed great by comparison.
Fast-forward to 2004. We now have several hundred channels and the crap count has reached astronomic levels. There are shows called "Wife Swap" and perhaps more horribly, "Trading Spouses," which must be a rip off of the former. There is a show in which people eat horrible things for money, at least seven shows featuring fat, bald middle-aged men with hot wives, and an entire channel devoted to home and garden care. However, it was not all bad news. "The Sopranos" and "Sex and the City" put HBO on the map and spawned viewing parties across the country. Other networks started experimenting with quirky shows as well, breaking away from the cliches of the typical network show.
USA came up with Monk, about an obsessive-compulsive detective. It is basically a quirky version of the old fashioned detective show (a la "Sherlock Holmes," or, if you prefer, "Murder She Wrote"). FX produced "The Shield," a gritty detective drama that cast officers as corrupt anti-heroes. TLC took a popular British show, "Changing Rooms," and Americanized it into the hugely popular "Trading Spaces." And a group of 100,000 or so nerds has now single-handedly managed to get "Farscape" back on the Sci-Fi Channel on two separate occasions. This last feat was accomplished through the awesome power of DVD sales, which has further increased the ability of networks to cater to very specific tastes.
In the days of the "Big Three" networks, successfully competing required drawing as large an audience as possible. There were only 2 competitors, and as a result, if a show failed to draw several million people it had to be cancelled. A network had to cater to wide ranging tastes, and when one attempts to cater to everyone they usually satisfy no one. This was the situation of television production for as long as there had been television. With the introduction of DVD, a cheap, compact means of recording and distributing large high-quality collections of programs became feasible. Suddenly, a show did not need to draw millions of viewers to be a success. If a network could sell 100,000 DVD collections at fifty dollars each, the show would be as profitable, if not more profitable, than if it had been a big hit. Networks could cater to even smaller audiences and re-release old shows on DVD for almost no overhead cost.
The result of this surge in productivity has been a lot of crap, but it has also created enough "good" programming so that there is not enough actual time to watch it all. And as this is the case, it doesn't matter that all of the crap exists. Crap is a necessary byproduct of innovation, but the good results are worth every "Out of This World," and "Bob Patterson."
So what does this have to do with drugs? Simple. As with television, people tend to focus on all of the "Perfect Strangers" that results from drug development in the US, while ignoring the "Sopranos" that are produced.
There are a few major criticisms of pharmaceutical companies in the US, and I assert that each can be applied with equal force to television production.
People claim that drug companies have a lot of unnecessary overhead, as they employ a lot of bureaucratic staff, advertising departments, managers, in addition to R & D. First of all, you could make this argument about any company, but, if a drug company is being inefficient, then shareholders should abandon it and it should go out of business. Drug companies, like all other companies, are trying to make money. It is logically inconsistent to accuse them of taking in record profits and at the same time accuse them of employing too much overhead, yet people do this all of the time. It would be like accusing HBO of employing an advertising department instead of focusing solely on show production, while at the same time claiming that they were "overcharging" and taking in "record profits." This argument makes no sense.
People also claim that advertising is worthless for a drug company, and that it drives up costs. This charge also makes no sense. The argument is that money that could go into research or lowering prices instead goes into an ad campaign, but this is not how ad campaigns are funded. Ads are run with the intention of bringing in more revenue. They do not cost money, they make it. This money can go into R & D, or into lowering prices to increase competitiveness, and if an ad fails to do so, then the company will stop running the ad. When NBC advertises that "Scrubs" is on Tuesday’s at 8:00, the money they used to broadcast the ad did not drive up costs for their advertisers, nor did it detract from the production of "Joey." In reality, the value of "Scrubs" is increased, which is a benefit to advertisers, and may even keep "Joey" going for a few episodes longer than it otherwise would.
Finally, people often complain about the production of seemingly frivolous drugs, or of drugs that are basically copies of existing drugs. This is in stark contrast to many other countries where drug production focuses on "serious diseases." I will refer to this as the "foreign system."
The foreign system is just like the old three-network set up of television production. They attempt to cater to a broad audience and as a result, focus only on widespread health problems. Cancer, heart disease, lung disease, and other common (and serious) problems are researched, and I admit that some truly important breakthroughs have been produced in this fashion. In the American system, we have a dynamic drug industry that caters not only to the diseases of the masses, but also to ailments that affect a small number of people, or that treat less serious illnesses. This system has many beneficial side effects.
First and foremost, the American system creates a larger knowledge base. Diverse research can lead to techniques that are applicable for multiple ailments. Perhaps someone looking into a cure for sickle-cell anemia could stumble upon a cure for Leukemia. It may have seemed silly to sell a show on DVD when "The Sopranos" first attempted it (Note: another show probably did this first, but for the sake of argument, I am going to assume that it was "The Sopranos"), but because they did so successfully, other networks followed suit, and I now own several seasons of "The Simpsons."
Second, the American system protects minorities better. Some people have rare ailments. In a centralized system, it is inefficient to devote much time to rare diseases. However in the American system, as long as those people provide a market, they will be serviced. While many people may be afflicted with a "Seinfeld," we should not simply ignore those that are afflicted with a "Farscape," yet this is precisely what happens under the foreign system.
P.J. O’Rourke was recently on "Real Time" with Bill Maher. He was arguing with Cornell West about drug companies, and Cornell got off on a long rant about how drug companies squander resources by researching frivolous drugs. West asked:
Would you prefer drug companies that looked for more remedies for sexual impotence or a vaccine for AIDS?
To which O’Rourke responded:
It depends on if I had AIDS.
This is the beauty of the American system. In the foreign system, a disease is deemed to be important by researchers and politicians. In the American system, a disease is deemed to be important by the people suffering from the disease.
No health care system is perfect, but it is worth remembering that we get what we pay for. In countries with centralized health care, everyone does get to watch TV, but the set is stuck on "Full House." In America you still get "Full House," but for a little more you can get "The Sopranos," and "The Sopranos" is worth every penny.