Re the April 18 letter “Argument to invest more in drugs hard to swallow,” in response to the article “To spend less on health care, invest more in medicine (Ideas, April 10). I cannot agree more with the two letters by Drs. Dean Wasserman and Bruce Ring regarding the conflict between a venture capitalist focus on profit-making vs. drug innovation for the people’s health. However, the original article and the two responses neglect a main cause of high health care costs, i.e., the appallingly low level of government support for preventive health measures.
The US public health system has been massively underfunded for many years, and it is only getting worse. With the recent notable exception of money for the development of the COVID-19 vaccination (a major primary prevention activity), the government and the medical care system in general focus too heavily on treatment of people after they have fallen ill (secondary prevention) rather than on health system measures to prevent them from getting to that point.
The Globe has had many recent articles on the social determinants of health, including clean air, clean water, access to primary care (particularly maternal/child services), nutritional support, health education, immunizations, occupational health and substance abuse/mental health programs, etc. If any part of the health care system needs more investment, it is those services. But it is more sexy to spend money and gain journalistic or professional plaudits for a “breakthrough” drug that is likely only a tweak of a previous well-working remedy than to fund adequate preventive services for a wider population, which garners little attention or applause. In addition, providing sufficient staffing with adequate compensation within those same services would also do much for the efficiency of health care overall. This is a shift in thinking about health care (not medical care) that is badly needed.
Barbara P. Madden
The writer is a registered nurse.