A Socratic dialog on health care reform (IV)

The philosopher Socrates seeks advice from Apothos the sorcerer for a potion or pill to dampen the discomfort in the wound on his foot.

Socrates:  Hail, Apothos, purveyor of pharmaceuticals.  I trust that you might be of service to me this day.

Apothos:  Good Socrates, hail.  Tell me your needs, and I will prescribe a pill or potion guaranteed to restore you to homeostatic health.

Socrates:  Lately, I have lacerated the sole of my foot on a stone.  Aesculapius the physician cleaned and dressed the wound; yet even though I have been careful to guard it from further harm, I fear that it has suppurated.  (lifts his foot to show the wound)

Apothos:  Aye, you speak truly, as a philosopher is bound to do.  The purulence reeks of infection.  Let me peruse the bottles on my shelves.  Ah, here we go—just the medicinal substance to cure the vile suppuration.  One pill swallowed twice daily for three days will surely have you back on your feet in no time.

Socrates:  But tell me, Apothos:  what is this substance which you advise me to take?

Apo:  The substance, you say?  Why, nothing more than the most powerful antibiotic yet concocted by one of the most highly respected laboratories in the sorcerers’ guild.  It just appeared on the market last week.

Soc:  How new!  But tell me:  has it been tested properly before its release for public consumption?

Apo:  Of course, Socrates.  All of our medicinal substances undergo extensive field trials before they are released to the market.

Soc:  Then I take it that you vouch for the safety of the product?

Apo:  My dear Socrates, it is not I, a mere man, who vouch, but rather the sorcerers with their collective years of experience and expertise who stand behind the drug.

Soc:  And are there scientific studies published that substantiate its efficacy and safety?

Apo:  (chuckling) Of course, but of course, Socrates.  Here is one I just happen to have in my files vouchsafing the data on this particular drug.

Soc:  Although my eyes are dim with age, I perceive the fine print which states that this particular double-blind study was underwritten by the very laboratory firm that developed the drug and authored by sorcerers employed by the same company.

Apo:  A mere trifle, Socrates.  Science is science, not political opinion.

Soc:  Thank you for enlightening me on that point, Apothos.  Now then:  what would be the cost for this course of treatment?

Apo:  Of the cost you needn’t concern yourself, Socrates.  I will bill your health insurance directly.

Soc:  But I have no health insurance coverage, Apothos.  Alas, we philosophers have lately been forced to pay out of pocket.

Apo:  I sympathize with your plight, Socrates.  If you wish to purchase the medicine, it will cost 100 drachmae.

Soc:  One hundred drachmae!  For six tablets?  That’s 12-1/2 drachmae per pill!  Have you nothing equally efficacious and cheaper for those who must pay from their purse?

Apo:  If you wish, Socrates.  But this latest medication is by far the more modern drug.

Soc:  (shakes his head)  I can not afford to purchase it, Apothos.

Apo:  Then here—this will undoubtedly work as well.

Soc:  What’s this?

Apo:  An ancient generic drug of the penicillium mold.

Soc:  How much?

Apo:  (looks away)  Two drachmae.

Soc:  Two drachmae—compared to 100?  Such a decision is easily made.

Apo:  Suit yourself, Socrates.  You get what you pay for.

Soc:  (laying two coins on the counter)  Tell me, Apothos, what is your opinion of the debates in the Senate on reforming the Athenian health care system?

Apo:  Such proposals, I fear, would ruin the pharmaceutical industry.

Soc:  How so?  Please explain your reasoning to me.

Apo:  From what I understand there is talk of rescinding the ban that forbids the government to negotiate lower prices for drugs with the sorcerers’ guild.  If the ban is rescinded, prices of prescription drugs will drop, and market share will plummet as cheaper medicines are imported from Thrace and Macedonia.

Soc:  But would that not be a good thing for the citizens of Athens?

Apo:  Of course not.  If pharmacologic prices drop, profits will follow suit.  There will be less silver coin available to invest in research to develop newer and more expensive drugs.  Many of those in the sorcerers’ guild would lose their livelihoods.  The unemployment rate would continue to rise.  More and more of our citizens would lose their health insurance and with it, coverage for prescription drugs.  I would be forced to resort to peddling the ancient medicines like foxglove and acetylsalicylic acid, drugs to be had for next to nothing.  Why, I might even lose my apothecary shop!

Soc:  What might you do then?

Apo:  (ponders a moment)  I would consider opting for a career in politics and run for a seat in the Senate—or perhaps become a professional lobbyist for the sorcerers’ guild.

3 comments on “A Socratic dialog on health care reform (IV)

  1. DJE says:

    Sad, but true. Good piece and thought provoking. “What differentiates man from animals is man’s desire to take medications.” Not sure if it was Osler, O.W. Holmes or someone else who said this.

    • Brian says:

      The quote is from Sir William Osler’s essay “Thinking and Teaching: The Two Functions of a Medical School,” delivered orally at McGill Medical School on October 1, 1894: “As I once before remarked, the desire to take medicine is one feature which distinguishes man, the animal, from his fellow creatures.”

  2. ~ t says:

    Fortunately, our family doc always opts to prescribe generics first. Most times, he’ll dig through his sample cabinet to see if there’s something he can provide for free. Dr. B’s a rare one today. It doesn’t hurt that I solved an electrical problem for him that no one else would. He exuberantly called me a genius, but we all know the real truth of that ….

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