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Comment by DoreenMichele | Hacker News Reader

Evergreening props up pharmaceutical profits but prevents lower-income populations from ever benefitting from the drugs. It keeps enormous swaths of the global population, without insurance or financial resources, from accessing lifesaving treatments.

It seems the pharmaceutical industry has largely forgotten why it makes drugs in the first place: to save lives.

No, not really. They are in it to make money.

We used to think of medication as something you took occasionally during a crisis. Now we take it as a given that a large percentage of the population will be on maintenance drugs for life.

Then we act all shocked at the fragility of the global pharmaceutical industry and the growing issue of antibiotic resistance.

But if you make some prosaic observation about this overall pattern, you can expect to be basically booed, not taken seriously as trying to talk about the problem in some sensible fashion.

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> We used to think of medication as something you took occasionally during a crisis. Now we take it as a given that a large percentage of the population will be on maintenance drugs for life.

Not disputing this, and it certainly supports your point about the pharmaceutical industry making money.

But is there evidence that we are actually worse off for it? Did previous generations benefit from better mental and physical health than we do now.

My instinct is that we're healthier than ever before. We're treating conditions that weren't even identified a generation ago. Now that might not be due to our pharmaceutical intake, but I'd be surprised if it wasn't partially responsible.

Of course it's possible we've gone farther towards drugs than needed, which perhaps was your original point.

Did previous generations benefit from better mental and physical health than we do now.

There are a large number of differences between the past and the present. It's really hard to talk about comparisons between the past and present and try to boil it down to a single metric.

Many years ago, a friend and I were talking and I was making sort of the same argument you are making -- that things are better than they used to be. And she stopped and said something like "I'm not comparing it to the past. I'm comparing it to what I think is possible given present day knowledge and technology."

And she also said something about "low standards" or "low expectations" -- like "Why should we settle for this crap just because the past was worse?"

And that really stuck with me.

I have gotten off all drugs for a condition where that isn't supposed to be possible and that strongly shapes my views and opinions in ways that I can't back up with studies or the like to the satisfaction of other people. But I'm convinced we can raise the bar and do better than this and one path forward is to begin thinking more broadly about the fact that "life is chemistry" and stop acting like a pill is the most important and powerful means to interact with human biochemistry when it's really just one of the most convenient ways to manipulate biochemistry that is profitable in our current economic arrangements.

> But if you make some prosaic observation about this overall pattern

If you outlined a pattern in your comment I failed to deduce it. Something about negative externalities of increased drug consumption? I’m sure there is a point there that deserves a better argument.

These days, we conflate medical care and health care. Basic health care is stuff like eating right, exercising, good hygiene, etc. We overprescribe drugs in part because things have swung too far in a commercial direction. A drug is a solution we can sell. A walk for your health is not.

And then we wring our hands when this leads to the kind of situation described in the article. But I know from long experience that no one will take you seriously if you try to talk about non drug solutions.

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