Sickening: How Big Pharma Broke American Health Care and How We Can Repair It

by John Abramson

CEO salaries skyrocketed from “only” 30 times more than that of their average employees in 1976 to 276 times greater in 2017, more than twice as much as in thirteen other wealthy countries. Lest this be considered old news, by 2019 the ratio of CEO to average worker compensation had grown to 320. And then, as ordinary Americans struggled economically during the first thirteen months of the coronavirus pandemic, American billionaires’ net worth increased by an astounding 55 percent. The United States had fully entered the era of gloves-off capitalism.

The median wealth of non-retired Black families is now less than 10 percent of white families’ ($13,460 versus $142,180). And the median wealth of African-Americans with college degrees is less than that of whites without college degrees.

In 2019, the U.S. minimum wage ($7.25 per hour) actually provided 30 percent less purchasing power than the country’s minimum wage had fifty years earlier. With the rising costs of housing, health care, and education, along with growing indebtedness, people living in the United States are now more than twice as likely to be stressed by rent, mortgage, or the cost of meals as citizens in ten other wealthy countries.

From 2008 to 2018, the increased cost of employees’ share of health-insurance premiums and out-of-pocket deductibles exceeded the growth in the median income in every state in the country.

Further exacerbating this imbalance in the distribution of income, the increased cost of health care squeezes funding from virtually everything else in state and local budgets, which — unlike the federal budget — must be balanced each year. In Massachusetts, for example, the 63 percent increase in state health-care spending between 2001 and 2014 has been offset by cuts in public higher education (down by 26 percent), early childhood education and child care (down by 28 percent), local aid (down by 44 percent), and support for parks and recreation (down by 43 percent).

the greater a country’s income inequality, the worse its health and social problems.*

Why do drugmakers charge so much more in the United States than in other countries? Because they can.

In fact, shaping doctors’ beliefs has become the drug companies’ primary job. To this end, the majority of the largest drug companies spend twice as much on sales and marketing as they do on research and development of the drugs themselves. And a quarter of those companies spend ten times as much on sales and marketing.