Cultivating a Culture of Sickness

Healthcare has become the buzzword for what used to be the field of medicine. While medicine implies the healing of dis-ease, healthcare, in its raw meaning, sounds like it is about taking care of our bodies so we will not need to resort to medicine. And yet, it has become exactly the opposite.

Healthcare has become an institution based—not on promoting healthy humans—but almost solely on profit. It has become an oxymoron. Healthcare in the United States is now Big Business, shrouded in media marketing and frequent corporate mergers.

Last week, I heard a radio commercial from a large healthcare system say to its audience: “We haven’t seen you a while. Don’t forget, our urgent care offices are open seven days a week and we can help when you or your family get sick from…” fill in the blank. It went on to list multiple common problems, some of which, like a cold, have no clear treatment options, while promising the convenience of being in and out in less than an hour. I happen to know that company’s offices are understaffed and overcrowded.

The source of this commercial is the establishment that manages your neighborhood healthcare clinic, 160 sites large and growing, which purports to be there for you and your health. The purpose of this commercial is to make you, the patient—the consumer of healthcare—consider that perhaps you aren’t feeling as well as you thought you were, that perhaps you are in fact ill, and maybe you should sit in a waiting room with standing-room-only people coughing and sneezing and wearing their masks under their noses—if at all. 

Please make the distinction: this was not a well-intended notice that you should consider getting your colonoscopy or mammogram or other standard preventive medical procedures. This was not for primary care. It was not a cardiologist suggesting you get a stress test if you are over the age of sixty.

This was for an urgent care office, a place that takes care of urgent medical problems, and it was prompting you to evaluate yourself for an urgent medical need. As if you needed to be told when you are ill. It was suggesting to the general population that they are sick and need medical attention. Why? Because healthy people do not go to an urgent care facility, and therefore, they do not contribute to the profitability of that arm of the organization.

This was solely for the purpose of generating revenue. It was not in the interest of your health. Furthermore, it encourages unrealistic expectations on the part of the population, which has been promised the eradication of any discomfort in the utmost convenience.

Consider another commercial. You may have heard it. A woman is relaying a heartfelt story about having been so ashamed to be seen in public that she felt compelled to wear sunglasses even in the dark, because her “thyroid eye disease” (exophthalmos) was so disfiguring. Of course, this is an advertisement for a drug, and after she takes the drug, we see her happy as a lark, socializing at the pool or with her friends.

Now, please understand that some of these patients do have serious symptoms associated with hyperthyroidism, and of course, should be treated. (The sunglasses could be for photophobia). But the “hook” in the advertisement is to tap into their basic insecurities and make them self-conscious about their appearance, and that seems rather cruel. How many people with Grave’s Disease were not focused on how they appear to others but who, after viewing the commercial, now lack confidence to go to a gathering? How is this contributing to the welfare of this population?

Have you ever found yourself wondering, after watching one of the myriad of commercials for antidepressant medications, whether you yourself might, in fact, be depressed and need to be medicated? Wouldn’t you love to take a drug that would transport you to those beautiful fields or beaches and run with your dog at the edge of the sunny surf and feel wonderful? And the music is so calming and delightful. Can taking a medication make you feel that good? Because that is exactly the subliminal message you are receiving.

In short, we have become a culture of sickness. Disease has become an expectation, fostered and cultivated by Big Pharma, Big Healthcare, and Big Business. It is an industry that goes far beyond traditional medicine or ethical values. 

In 2005, Ray Moynihan and Alan Cassels wrote the book Selling Sickness. It called out specific pharmaceutical companies whose outright stated goal was to turn the entire population into patients. To make buying medicine as commonplace as buying chewing gum, and to therefore, make them rich. They have indeed succeeded.

Since 1997, television in the United States has aired commercials convincing people that they were depressed, tired, unfocused, too focused, that they have headaches, allergies, are too fat, too skinny, and on and on, and—most importantly—that they cannot cope with life without pharmaceutical intervention. 

And the American population has consumed this information and made it part of their personal reality.

We have fought back, to be sure. How many businesses have cropped up encouraging healthy eating, yoga practice, and meditation? We have naturopaths and reiki healers. But underneath it, the carpet upon which our society has been laid, is the pharmacy and the doctor’s office. The places where sickness is not treated, but sold.

This is the logical outcome of peddling health and human life the way we would sell Apple TVs. The business model has no place in the practice of medicine. Except, of course, for profiteering.