The Frist Factor
Daniel L. Jaffe
Health issues increasingly are at the heart of the debate over the domestic agenda in Washington. Therefore, to understand the political environment confronting the ad community, we must first understand the perceived nexus between the economy, health care and advertising.
At the end of the Clinton administration, it was thought that the major issue facing the political community was what to do with a projected $5 trillion surplus. In this heady environment, politicians did what they do best: make expensive political promises. One of the most expensive of these promises was to guarantee that the government would underwrite the rapidly rising cost of prescription drugs for seniors.
This pot of gold unfortunately proved to be only a temporary mirage, evaporating rapidly from the heat of harsh economic realities. First, the high tech bubble burst. Shortly thereafter, 9/11 dealt an even more substantial blow to the economy. The anthrax scare, the cost of responding to Al Qaida in Afghanistan and elsewhere, plus the passage of a major tax cut to jump-start the economy, suddenly made deficits rather than a surplus the operative political fact of life.
Now politicians find themselves in the embarrassing position of being stuck with the promise of prescription drug benefits for seniors without the bucks to pay for it. With red ink projected to gush from the federal budget for the next five years, the White House and the Congress face a difficult political dilemma: how to keep this politically popular promise without increasing the hemorrhaging.
Not surprisingly, politicians facing this dilemma are desperately seeking any means to lower government health care costs. Two main strategies so far are being pursued. First, a number of politicians have attacked prescription drug advertising, claiming that it fuels the rise in health care costs. Second, some members of the medical community, in conjunction with trial lawyers and certain politicians, charge that a wide range of unhealthy lifestyle choices cost society hundreds of billions of dollars. Again, the culprit singled out is advertising.
So what are these 'hot-button' advertising issues? They include prescription drug advertising, tobacco advertising, alcohol advertising and food advertising as it impacts obesity. In each of these instances the critics prescribe taxes, bans or severe restrictions on ads as the cure-all for either protecting kids or drastically lowering health care costs. These critics unfortunately are trying to make society's increased focus on health unhealthy for advertisers.
With this increasingly hot spotlight on advertising and health, it is significant that Senator Bill Frist (R-TN) suddenly and unexpectedly has been catapulted into the leadership of the Senate. Senator Frist, the only doctor in the Senate, long has made health issues the centerpiece of his political activities. Frist now can set the agenda and control the political timetable and has made clear he intends to do so.
Frist starts with some important assets. So far, his colleagues and the press perceive him as that rare breed, a politician who not only has his eyes and ears open but his mind as well. Furthermore, in the words of the Chairman of the powerful House Ways and Means Committee, Bill Thomas (R-CA.), Frist starts with the underappreciated advantage of a 'good bedside manner'.
He will need it. Not only does he have to minister to a sick economy but also to an increasingly anxious electorate. However, because of his lifelong focus on health, Senator Frist is far more likely than his recent predecessors to try to force these health issues to a final resolution.
Fortunately, some recent developments provide new ammunition to help us in some of these on-going battles. Several surveys of doctor and consumer groups provide growing evidence of the value of prescription drug advertising. A Food and Drug Administration (FDA) survey of 500 doctors demonstrated important benefits from DTC prescription drug advertising. In fact, 80 percent of the surveyed doctors felt that the ads made patients aware of health problems, while 85 percent felt their patients were more likely to use their prescriptions properly because of the ads. Furthermore, 78 percent thought these ads led patients to seek treatment for potentially serious conditions.
Despite these facts, some doctors still oppose DTC advertising because they feel pressured to prescribe specifically advertised products. However, a far larger percentage either is not opposed to DTC prescription drug advertising or is strongly favorable.
A survey by the National Medical Association, which also represents African-American physicians, provides strong support for DTC advertising. These doctors are acutely concerned that their community still lags in regard to health care information. The survey demonstrates that the majority of these doctors believe that prescription drug advertising helps to close this information gap and substantially improves communication between patients and physicians.
Interestingly, a major consumer group, the National Consumers League (NCL), also released a highly favorable survey concerning DTC advertising. As Linda Golodner, the NCL President, forcefully stated, the NCL survey demonstrates that: 'With DTC ads, large numbers of consumers are made aware of medical conditions and treatments that they may otherwise not know exist'.
In fact, almost two-thirds of the NCL survey respondents disagreed with the statement that ads for medications should only be in medical magazines for doctors. Golodner also noted that these types of ads often 'help destigmatize conditions that may have otherwise gone untreated due to patient embarrassment and limited medical knowledge'. Nonetheless, the DTC area is certain to continue to be controversial in this Congress, but the ad community is increasingly prepared to counter unfair and misguided attacks on this important information source for the American public.
In the food-advertising arena, we also have gained some important ground. Recently, a federal judge threw out a lawsuit against a major restaurant chain. The lawsuit alleged that the restaurant chain had utilized an onslaught of advertising and toy promotions to entice unsuspecting children into developing unhealthy eating habits that eventually led to obesity and serious health problems.
In dismissing the suit, U.S. District Court judge Robert W. Sweet noted that if consumers knew or should have known the consequences of their overindulgence, 'it is not the place of the law to protect them from their own excesses'.
We should heed, however, the words of George Washington University law professor, John Banzhaf, who helped design the legal theories for these food-advertising lawsuits, when he stated that 'We will not go away quietly'. We must stay on alert if we want the advertising community to continue to remain healthy. We must assure that truthful advertising is not made the scapegoat for the health problems in our country. In politics as in health, an ounce of prevention is worth a pound of cure.