My elderly father hates the Pharmaceutical Industry. His library is full of books such as “Hidden Healthcare Disasters” and “How the Drug Companies are Killing You”. I also have a long time friend that makes a very good living selling natural supplements. He recently said on a blog post “Mother nature is the source of all natural healing”.

When I hear these things, and the thousand other daily attacks on “Big Pharma”, I just sigh.

I am old enough to have spoken to doctors who practiced in the 1930’s, before antibiotics and most useful medicines, and their stories of the “bad old days” were harrowing.

When the doctor came to your house with his little black bag, he had four or five drugs of any use. Morphine, digitalis, nitroglycerin and belladona. Maybe ether. He knew that for many diseases, there was nothing he could do but offer emotional support.

19 year old boys would be seen in the morning with a cough, and be dead the next day with pneumonia. Small cuts on the hand would result in gangrene or death. Minor surgeries lead to sepsis, people would die within hours. Typhoid, cholera, and malaria still killed thousands in America every year.

High blood pressure and its myriad complications could be measured, but not treated. President Roosevelt died in 1945 from a brain bleed related to his uncontrolled high blood pressure and congestive heart failure. Heart disease remained the silent killer because little effective treatment was available.

Cancer was a surgical disease, if you could not see it and remove it all there was little hope. When I was young, I lost two friends to Hodgkins disease, now curable by those very drugs I hear so many “horrible” things about. The millions of cancer survivors around the world would disagree with my father.

The list goes on and on. Aids, high cholesterol, multiple sclerosis, TB, schizophrenia, asthma, pain control, depression, diabetes, arthritis, ulcer disease, etc. etc. were difficult or impossible to treat until modern drugs became available.

That said, the anti-drug crusaders do have a point. Drugs can be very expensive, often aren’t that much better than what they replace, and certainly can have side effects. Most importantly, the shear sized and political clout of the Pharmaceutical Industry seems incongruent with it’s purported role in helping people. The apparent single minded pursuit of profit by some participants, well publicized side effects, and high prices people actually pay has soured many to the entire industry.

Bottom line, drug costs are high, a substantial portion of the huge increase in national health care costs. and will get higher. New drug development is going to get even more expensive, and many of the new “biopharmaceuticals” are extravagant even to the most jaded observers.

The goal of Dr. Berwick, and Obamacare, is to pick those drugs that are “good enough”, without breaking the system. More to come.