The Consumer Republic: Heal Thyself

A year ago, few Americans cared about toenail fungus--even if they had it. Nor were they aware that this common condition, which thickens and discolors the nail, was a social embarrassment. In our ignorance we figured that a soft gut or lumpy thighs were reason enough to feel self-conscious on the beach. The good news is there's help for the humiliation of horny toenails. I know because I saw it on TV. Pharmaceutical companies touting cures for the heartbreak of fungal infections, relief from allergies and migraines, reduced risk of heart attacks and suppression of herpes have taken to the airwaves to pitch prescription drugs to their end user, the consumer. Indeed, television viewers are bombarded with new drugs, boasting names concocted in the test tubes of branding specialists with a predilection for the nether reaches of the alphabet: Zocor, Valtrex, Zyrtec, Imitrex, Fosamax. According to Competitive Media Reporting, makers of prescription drugs spent $146 million on TV advertising from January through November 1997--and the category is just picking up steam. Peddling relief, the drug companies are using television to talk directly to the sufferer. Take control, they urge. Become empowered. Ask your doctor. Consumer, heal thyself. The prescription drug companies are relatively new to this game, which may explain why ads for allergy medicines are practically indistinguishable from pitches for cholesterol drugs. Whatever the ailment or the cure, in these ads it's always morning again in America. Oldsters jog and paddle canoes; couples bike under a canopy of trees; families gambol among the flowers. Suns rise and waves beat against the shore. A female voiceover is heard over this Sierra Club scenery. As these spots launch into the required-by-law side-effect disclaimers, these caring, creamy she-voices make unpleasant details, such as nausea and liver damage, seem palatable. In fact, the chirpy femme narrator of a spot for Allegra, an allergy medicine, delivers the line "Anyone sensitive to its ingredients shouldn't use Allegra" with such an upbeat spin, you'd think side effects were a product benefit. Even without the promises of brighter days and the proffered money-saving coupons, these end runs around physician gatekeepers and doctors would still find a receptive audience. The 1997 edition of the Yankelovich Monitor reports that when presented with the proposition, "I have a great deal of confidence in advice from my doctor," only 59 percent agreed, down 10 percent from 1987. Physicians fare better in the Monitor survey than other authorities and institutions (such as advertising, for instance). Yet the medical profession has also been affected by the trend toward distrust and disintermediation that is sweeping away the experts and middlemen in favor of our preferred expert on everything: ourselves. For consumers determined to take health matters into their own hands, there are plenty of alternatives--from the ancient wisdom of Eastern medicine to venerable herbal remedies. Information abounds in hundreds of Internet sites, in the self-care books distributed by HMOs eager to keep patients out of the doctor's office and in the pamphlets, magazine inserts and toll-free numbers promoted by prescription drug ads. The plus side of do-it-yourself healthcare is that we aren't held hostage by medical know-it-alls. The downside is that the burden of knowing falls on us. That quintessential '90s virtue, being proactive--"ask your doctor"--requires labor and time. We feel it, too. The Yankelovich Monitor also reports that 81 percent of us are looking for ways to simplify our lives, while 78 percent want to reduce stress. Why do people feel stressed in a culture devoted to providing us with more control and convenience? Some studies blame it on our expanding workweek, only to be contradicted by other stats that show we work less than we used to. Suffice it to say, many of us feel like we're working more. But we're not necessarily doing it in our workplace. Consumption has become a form of labor--and an unpaid labor at that. Networks used to program our evening's entertainment for us. Now we have to navigate our way through multichannel media. Home bankers do the work once done by bank tellers. In New York City, you can choose which public school you want your children to attend, but doing it well requires exhaustive research and effort. Everyone knows consumers love convenience and choice. Yet it turns out that nothing in life is free, not even freedom of choice. We pay for it with our time and our labor. It is enough to send a stressed-out consumer to the health-food store in search of a calming dose of St. John's wort. Available without prescription.

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The Consumer Republic: Heal Thyself

Debra Goldman

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Debra Goldman