US Pharm. 2008;33(7):3.
For all the hoopla and noise
being made by the two presidential hopefuls over the state of our health care,
there is not much talk about life expectancy in the United States compared
with that in other countries. Despite all the rhetoric about how great our
health care system is, the Central Intelligence Agency's World
Factbook states that the U.S. ranks 47th in life expectancy behind Japan,
Canada, France, Sweden, Switzerland, Australia, Israel, and the UK (to name a
few countries). Although the rankings make for an interesting news item, they
don't explain the factors that contribute to our relatively poor standing.
While some critics will point
to environmental hazards, substandard living conditions, lack of health
insurance, or a host of other possible culprits we deal with on a daily basis
in the U.S., the bottom line is that the low ranking is really about the quality
of health care. Many will argue that even if we did have the best health care
system in the world, there are millions of Americans who are not benefiting
from it because they cannot afford it. Even more disturbing is that, among
Americans who pay dearly for health care provided by insurance companies, many
are not getting the tests, treatments, or drugs they need because of the
restrictiveness of their health plans. And while we may have the best
diagnosticians in the world, it all comes down to the availability of
life-saving drugs. Other critics are quick to blame our poor showing on world
life-expectancy charts on the FDA and its backlog of new drug approvals.
Some pharmacists are even
suggesting that we don't need the FDA at all. My immediate response is: Of
course we do. While the FDA has come under attack lately for some questionable
drug approvals, overall I believe that the FDA does a creditable job of
keeping this country's drug supply safe and effective. And when you think of
the thousands of drugs it has approved over the years and the lives that have
been saved, this is no small achievement. While most health care professionals
are familiar with the FDA's watchdog function over the U.S. health supply,
don't forget that the agency also monitors medical devices, biologics, blood,
vaccines, veterinary medicine, cosmetics, products that emit radiation, and
this nation's food supply, all of which factor into our life expectancy.
Despite this seemingly impossible task, the FDA is woefully underfunded and
understaffed; in fact, it recently announced that it has more than 1,300
positions to fill.
While the FDA may be a thorn
in the side of many companies here and abroad, its mission of protecting the
U.S. population from bad drugs, tainted food, and a number of other serious
health matters is daunting. And despite all of its shortcomings, I am one
American who is proud to say that I feel safer having the FDA on my side. The
FDA has never wavered from its mission of protecting U.S. citizens since its
humble beginnings in 1862 with one chemist in the Division of Agriculture.
Since then it has grown to an organization of more than 9,000 employees and
oversees items accounting for 25 cents of every dollar spent by consumers.
Under its current
commissioner, Andrew C. von Eschenbach, MD, the FDA has recognized its
shortcomings, and instead of burying its head in the sand like some other
government agencies it has strengthened its focus on drug safety. Pharmacists
who dispense the medications that the FDA approves should not be asking
whether we need the FDA. Instead, they should be supporting the FDA with
respect for the magnitude of its accomplishments over the years. They should
embrace the agency's activities because, after all, pharmacists are a key
component of the drug delivery system in this country and an extension of the
FDA's drug safety program. I can only hope that the next president shares that
same respect for the FDA and pharmacists by rewarding both of them monetarily
for the important role they play in prolonging patients' lives.
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