American Sickness, Tax Day Blues, & Your Friendly Neighborhood Selling Machine

Illustration by Susan Coyne

This week: Obamacare survived its near death experience, but ails still and ever. The three trillion dollar headache that has no relief in sight — with Elisabeth Rosenthal, Adam Gaffney, Jonathan Bush, Matt Bruenig, Jonathan Gruber, and Nancy Tomes. Tune in today at 2 pm on WBUR or anytime on our website.

Elisabeth Rosenthal’s important book, An American Sickness: How Healthcare Became Big Business and How You Can Take it Back, caught our attention this week, and since she was in town on a Thursday night, we organized a health care show around her. There’s no shortage of outrage about the problems Libby Rosenthal details — about the way financial incentives and big business have destroyed our health care even while we were arguing about it, but it’s one of those subjects people have become psychically numb to, which can make it harder to start a discussion that sounds new and interesting.

There’s interesting history, though, which the historian Nancy Tomes told us about (turns out these same conflicts over the common good and individual choice go back to FDR and the New Deal; doctors won the argument back then, too; they opposed a government-sponsored plan after watching the feds bungle their “noble experiment” with Prohibition. And who knew that doctors were writing prescriptions for booze!).

We were inspired by Adam Gaffney and a young doctor’s passion and idealism about medicine (and by his writing too) and pleased that Jonathan Bush, the entrepreneur with a famous last name (brother of Billy, cousin of George W), agreed to stand in for the capitalist marketplace and keep us from preaching to the single payer choir. Jonathan was spirited and more honest than lots of people are about the truth of pricing and the scam of medical industrial complexes like the ones around Boston getting non profit status. Chris mentioned our friend and hero, Dennis Burke, orthopedic surgeon to the stars (including Bobby Orr), who blew the whistle at Mass General Hospital last year about concurrent surgeries and got fired for it. This Globe Spotlight Series is the real deal. What ever happened to First Do No Harm?

Bancroft Prize winning historian Nancy Tomes on the history of the drugstore & marketing in medicine

Zach Goldhammer: I had a lot of fun working on this video for Nancy Tomes’s history of the modern drugstore, included in her terrific book Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers. It gave me the chance to go back and watch a ton of these retro pharmacy ads, including this 1990 CVS spot with Frances Conroy (later of Six Feet Under and American Horror Story fame) selling head lice remedies.

One theme that stands out to me in many of these commercials across the decades is how often some version of the faux folksy slogan “your neighborhood drugstore” is used. It’s a strange sort of a desire, the wish to feel that these chainstore extensions of capitalism —these “ selling machines” as Tomes calls them—are just organic features of your particular neighborhood. But I know that I’ve felt that too. I can’t help having some sentimental attachment to my CVS in Porter Square, the one I grew up with. When I stop and think about it, it’s probably the one store I’ve been to more times than any other in my life.

A friend once told me how she realized her CVS ExtraCare card had probably collected more personal information about her than anything that could be gleaned from her phone. She’d been using the same little red piece of plastic at the drugstore for over a decade. In some sense, it knew not just what candy she liked or what shampoo she used, but also the cyclical purchase of tampons, condoms, UTI medications, and other more intimate things. All these purchases, she figured, were tracked and monitored and marketed back to her, in one way or another, through coupons and gift card offers. If it really were just a neighborhood store, this ambient knowledge of a person and her shopping habits would be no big deal. But the idea that this information can be distributed to multinational corporations and marketing teams is more than a little disconcerting.

So while it’s easy to laugh at cheeseball 1970s Alka Seltzer commercials or to mock the sensual schmaltz of a Cialis commercial, it’s harder to recognize the ways in which ads like these have already succeeded; how they are, in a banal sense, difficult to resist. I’m not going to stop thinking of Porter Square CVS as my drugstore, but at least now, thanks to Nancy Tomes, I might realize that the pharmacy’s layout—prescription drugs in the far back, candy and other distractions in the front—wasn’t just designed to make it easier for me, personally, to grab a Butterfinger. It was designed to sell, sell, sell.

Illustration by Susan Coyne

Susan Coyne: I went to the Tax Day protest on Cambridge Common yesterday and documented a few scenes. This man looked bereft, but the (mostly older) crowd was buoyant for the most part. I was also happy to see my friends perform a few songs with the Vocal Opposition protest choir, which a friend created after Trump came into office. Speaking of Trump, he tweeted today that the nationwide protests were privately funded, so as the official illustrator for the Cambridge Common contingent, I’m waiting for my paycheck.

Spring Cleaning

We’re trying to clean up our email list. This noozie goes out to lots of inactive addresses, and the only way we can make room for new readers is to cull out the dead wood. Please reply to this newsletter and tell us you want to keep receiving it, and if you feel like it, tell us what you like and don’t.

Once Upon a Time…

Chris and I were in the big city this weekend for a podcast conference at Columbia University. Chris and Dave Winer gave the keynote on the origin story, and so we’re reminded that an exploding new medium might not have ever been born if it weren’t for the fateful meeting and collaboration of these two at Harvard back in 2003, at the very same time, Dave told us, that a dude named Zuckerberg was just across campus working on a dating website. Ben Walker says the other critical ingredient in the special sauce was the “radio bosses” and gate keepers who blocked the creatives in their midst. Ira Glass, famously, pitched “This American Life” first to NPR, but they passed on it, saying he didn’t have a voice for radio. Plus ca change…



MM: Speaking of podcasts and radio, I caught up with my old friends the Kitchen Sisters, this weekend. Davia Nelson and Nikki Silva are the talented duo behind so many great audio projects — Lost and Found Sound, Hidden Kitchens, Fugitive Waves, The Hidden World of Girls. They’re audio curators and sound artists of a particular type, and their productions are jewels of the medium we work in. Their latest podcast is an incredibly rich audio portrait of Tony Schwartz, one of the great sound recordists and collectors of the 20th Century. Chris also knew Tony Schwartz well; here’s his appreciation.

Peep Peep

“The Peeple v. O.J. Simpson,” winner of the 2017 Peeps Diorama Contest

“The Peeple v. O.J. Simpson” by Larisa Baste

Happy Easter! Haven an egg-celent week!

Mary, Zach, Susan and the OS crew



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