Let the market right itself

Published: June 21, 2010 at 10:27am

pills

People have to buy medicines all over Europe, but in Malta those medicines are a political bone of contention. Electors complain about prices and availability and political parties react with threats to importers.

What the political parties should be doing instead is taking the long-term approach of going to the heart of the matter: Malta’s drugs-dependency culture. People here just love their medicines and talk about them like familiar friends. This is a society in which people are actually on first-name terms with brands of antibiotics.

I’ll get into conversation with somebody in a queue and she’ll say she’s taking something that sounds to me like the name of a low-growing shrub. I look at her blankly and she looks at me like I’ve just returned from 40 years in the desert. It’s like I’ve just demonstrated ignorance of Nescafe or Smarties.

They love being chronically dependent on drugs and they accept the situation as a given, instead of looking for alternatives or even considering that there might be alternatives to look for.

Elsewhere, finding out that there’s something wrong with you would be considered a problem. Here, it’s a godsend, because it means a prescription, and drugs. Goodie.

People fight and argue with doctors who don’t prescribe drugs and who tell them that these are not necessary. They brandish their prescriptions like a badge of honour and talk with pride and perverse pleasure about the medicines they’re taking.

I can’t seem to go anywhere nowadays without being skewered on the prongs of a monologue about medicines, doctors, chronic this and chronic that. They keep talking at you about their pills even when your eyes have glazed and you’re quite obviously about to keel over.

The rampant, raging hypochondria and enervating self-absorption are enough to make me climb the walls. Here’s some advice for free: even if you are afflicted with cancer, don’t mention it until asked, and when asked, dismiss all enquiries with dignity. “Oh, I’m getting along, but thank you for asking.”

I’ve lost count of the number of people who don’t seem to understand that ‘how do you do’ is a greeting and not an invitation to list the entire contents of your medicine cupboard. The only people you should bang on to about your aches, pains and concerns are your spouse, your mother and your best friend, and you can push it even there.

So many people here seem to love to be ill, as long as it’s not life-threatening and will not leave permanent scars. And when that illness involves pills and potions, they’re thrilled. The more pills they have to take, the more important they feel. No, I don’t get it either.

It’s a whole new field of attention-seeking behaviour. But strangely enough, these same people who love their drugs won’t take the cheapest and most effective one available and are deeply suspicious of it.

They won’t pop a couple of paracetamol and instead drag on through the day with a banging headache and the attitude of somebody about to be broken on the rack.

“Have one of these,” you say, chucking a packet at them, and their response is: “Le, ta, hi. Jien ma niehux minn dawk. I prefer to let it run its course.” It’s enough to make you want to turn up the music and switch on a hundred vacuum cleaners all at once. Maybe taking a headache pill removes the claim to temporary martyrdom which having a bad headache gives them.

They get more pleasure from groaning around with a headache than they do from popping a pill which takes the headache away. Taking courses of antibiotics or other ‘serious’ medication, conversely, gives them a claim to martyrdom where none might exist otherwise. A cold is a cold is a cold, but if you’re on antibiotics for that cold (pointlessly), then. . . wow.

People have created this suppliers’ market with their desperate demand for medicines of all kinds and shapes, and with their insistence on prescriptions for things they don’t really need but so obviously want. They complain about the price of antibiotics and when told ‘Just don’t take them’, their reaction is ‘But what do you mean?’

Simple, what I mean is this: very few of those complaining about the price of antibiotics – the main bugbear in the market for medicines – actually need to be taking them. Before you begin complaining about the price, think about why you’re swallowing them in the first place.

Then there are all those who have hooked themselves onto cholesterol-lowering drugs while not making the lifestyle changes that would sort the cholesterol out in a few months.

We’re a nation of drug addicts – legal ones. While the people of northern Europe do what they can to avoid taking medicines, we see what we can possibly do to get a prescription. And then we have the added pleasure of complaining about the price.

Then the politicians weigh in, with all the wrong answers. The government thunders at importers that it is considering importing some medicines itself – fabulous, government as a commercial enterprise; what a ruddy stupid thing to say – and the Opposition criticises the government for saying this but then goes one better by telling the government to “name and shame” importers who are not behaving themselves.

If the government is truly considering importing medicines to make up for interrupted supply, then what can I say except that it has probably cracked under pressure and temporarily taken leave of its senses. It is not the business of government to fill gaps in the market. It is not the business of government to be in business, full stop.

Gaps in the market are filled by the market. The market, like nature, abhors a vacuum. Those gaps stay open only for the length of time it takes to notice them and then work out how to fill them.

In a highly competitive market like the Maltese market for pharmaceuticals, where demand is consistently high, the gaps are filled by parallel traders if they are not filled by the appointed agency.

The consumer is not interested in the pros and cons of parallel trading versus the appointed agency. The consumer is interested only in being able to buy the real thing when he wants it, and if it’s cheaper then so much the better.

Whatever and however, the market should be left to sort itself out through the forces of demand and supply, and the government should stay out of it. Its only role here is to conduct a series of campaigns, through the agency of its health information department, seeking to wean people off their drug-dependency and their drug culture.

But then, of course, the importers might object even more vociferously than they do at the suggestion that the government might enter into competition with them.

While the government kvetches about the supply of medicines, the Opposition stays in character and kvetches about the price. Joseph Muscat, true to his former master’s voice, has instructed the government to broadcast the names of importers who are ‘abusing’ the price of medicines. So we have child abuse, drug abuse, alcohol abuse and now, price abuse – a new form of addiction and perversion.

The last time we had anything of this sort was back in the summer of 1997, when Muscat’s erstwhile puppet-master, after almost a year of dismantling value added tax and replacing it with the convoluted CET, took to the stage to denounce and expose to public opprobrium those businesses which, he claimed, had put up their prices and blamed his lovely CET for the hike.

And now here we have Sant’s loyal disciple, urging Lawrence Gonzi to do the same thing. I don’t know about you, but the sight of the prime minister pettily reading from a list of importers and denouncing them for overcharging – real or imagined – would drive my regard for him right down through the floor.

But then I was raised in the Mintoff era, when this sort of behaviour had real resonance and the price of a can of mackerel was an issue of national importance, recited by the finance minister in his budget speech. All I can say is: il-Bambin jehlisna.

The government, Joseph Muscat said, should make sure that consumers are protected against businessmen who raise their prices unnecessarily. Businessmen, eh? Not businesses, but businessmen (and not even businesswomen) – because companies don’t exist in his netherworld. Also, Muscat seems to be unfamiliar with the essential principle of selling goods for the highest price they can fetch on the market, a price which is then knocked down by falling demand and increasing competition.

His is the kind of reasoning that wipes me out with mental exhaustion. Haven’t we moved way beyond the mentality of the nanny state protecting the poor, weak consumer from nasty overcharging by horrid and unscrupulous merchants who spend their evenings counting their money? It is not for the government to regulate prices. The market does that. Look how the price of everything has fallen in real and relative terms since the onslaught of extreme competition in the aftermath of EU membership and the outsourcing of production to the Far East.

Clothing is now so cheap that girls buy something new to wear every Friday and chuck it away after a few weeks. Furniture – ditto. White goods – ditto. Food – ditto. Electronic and digital equipment – ditto and ditto. Medicines are no different. The days of the market being monopolised by authorised agents are long, long gone. Parallel trading is now the order of the day, and whether the authorised Malta agents of pharmaceutical manufacturers love it or hate it (they hate it, of course) is irrelevant. It exists, and it is one of the strongest dampeners on prices that you can get.

Price control is bad news for everyone, but it is especially bad news for consumers, who are best served, in the end, by the proper functioning of the market. Price control is one of those deeply unpleasant statist measures which might appeal to the uneducated and the uninformed but which, to others, sound some very loud alarm bells.

Instead of quibbling about the price and availability of pharmaceuticals, the government and the Opposition should try to find out why so many of their electors consume them in vast quantities. Knowledge about the market, especially where it affects health and the ensuing cost to social services, is their proper role; interfering in the market is not.

This article was published in The Malta Independent last Thursday.