I have heard, but don't know if it is true that big pharma spends more on advertising and promotion than on research and development. They are in business to make money!
I do know as a fact that it is not unusual for makers of medical devices, such as heart pacers, to provide all expenses paid, short luxury vacations for M.D.'s and their spouses in conjunction with promotional presentations. Perhaps some pharmaceutical companies promote drugs this way. Obviously this is more expensive than other types of less focused advertising.
The U.S. system of medical care is a government protected Cartel. For privately insured patients, the insurance company stands between the patient and the provider. This has not proved to be an effective arrangement for holding down costs. Insurance companies attempt to charge the highest premium they can, while paying out as little to providers as possible. They are also in business to make money. The providers, on the other hand attempt to charge as much as possible. They are in business to make money too.
One result of this headlong rush for Cartel profits by these competition-less enterprises has been that the cost of paper work associated with U.S. health care is, in relative terms, astronomical. If you request an itemized bill from your hospital be prepared for many pages of stuff you had no idea you were being charged for, much of it unrecognizable. Another result of our incredibly complex medical billing is, in relative terms, an astronomical number of billing mistakes. Still another result is the ready opportunity for fraudulent billing. Relatively speaking, the amount of fraudulent billing in the U.S. is astronomical.
Once you're in a nursing home you become a major profit center. The nursing home, that coincidentally also owns the pharmacy from which your many prescriptions issue, wants to keep you alive forever. If your only state is a vegetative one, that's good enough for them. If you cause trouble, they are happy to sell you some more pills that will put you into a vegetative state. If you have insurance for this sort of thing, your insurance company wants you to die as soon as possible. The government, on the other hand, forbids you to choose when and how you die. Your physician is indifferent so long as he gets paid for poking his head into your room every now and then.
When you consider the truth of U.S. health care, claims that it is the best in the world are laughable. But one thing everyone can agree on, it is the most expensive by far.
