Bill Moyers moderates as Obama adviser Chris Edley and Clinton superdelegate Maria Echaveste debate whether Obama can win. In addition, award-winning journalist Melody Petersen talks about the dangers of Big Pharma.
BILL MOYERS: Welcome to the JOURNAL.
Before we get to politics with a power couple whose pillow talk sounds like an Obama-Clinton debate about gender and race, let’s look at what happened in the Senate overnight.
The public’s voice actually penetrated the fog in Washington.
Many of you will recall that a few months ago the Federal Communications Commission voted 3-2 to let one company own both a broadcast station and the major daily newspaper in the same market. This narrow victory for the industry came after the commission held hearings around the country where thousands of citizens turned out to say “Hell, no, we don’t want more media consolidation.”
SEATTLE FCC HEARING PARTICIPANT: We told you a year ago that media consolidation is a patently bad idea, no ifs ands or buts about it. So with all due respect, I ask you, what part of that didn’t you understand?
BILL MOYERS: Ignoring public sentiment, the majority on the FCC gave the conglomerates what they wanted.
But despite that setback, pressure continued from public interest groups and organized labor. And overnight, the United States Senate said, “Whoa! Enough’s enough.”
SENATOR BYRON DORGAN: The issue here is simple; we have far too much concentration in the media.
BILL MOYERS: In a near-unanimous voice-vote the senate passed a “resolution of disapproval” that would nullify the FCC’s decision.
SENATOR BERNIE SANDERS: The ayes do have it…joint resolution is agreed.
BILL MOYERS: President Bush, whose scorn for journalists is balanced by a soft spot in his heart for the conglomerates they work for, threatens to veto the Senate action. Keep in mind that when the public was asked to submit comments to the FCC about consolidation, only one percent approved it. The President may not be listening, but the Senate is, and the public won this round. The House has a similar resolution under consideration.
That Senate vote was like a flare in the sky, signaling that if you care about standing up to big media, and many people do, you are not as alone as you thought.
BILL MOYERS: As everyone knows, on Tuesday Hillary Clinton won West Virginia by a mountainslide. While following the returns, I happened to tune in into BBC radio.
JIM BARBER, BBC RADIO: And they say if it is just him they will go Republican. 98 percent of the people are for Hillary, and they don’t care much for Obama.
WOMAN: No I do not think he can win.
BBC CORRESPONDENT: Why?
WOMAN: Because he is black.
BILL MOYERS: There it was — no longer a whisper but out in public, on the record: Because he is black. The fault line in American history is now a dividing line in this election and it’s changing the conversation.
SOLEDAD O’BRIEN: You gotta look at race first and foremost. We know that it’s a state that is 95 percent white and she’s always done well among white voters. No question about that.
BILL O’REILLY: What’s the racial component here? Is anybody going to tell an exit poller, “I am bigot and I won’t vote for a black guy.”?
CHRIS MATTHEWS: How do we get back away from these where people like Hillary Clinton so loosely say “hard working white workers?”
BILL MOYERS: We heard it all week and now the political world is asking: Could the candidate who has won more votes, more states and more delegates lose in November and could the reason be race?
A lot of people are having this conversation right now, but no one more intensely or intimately than my guests.
Maria Echaveste is a Superdelegate pledged to Senator Clinton whom she also serves as a campaign advisor and consultant. Her husband, Christopher Edley, advises Senator Obama.
Chris Edley is Dean of the University of California’s Berkeley Law School where Maria also lectures. Both are political insiders. Maria was Deputy Chief of Staff to President Bill Clinton before leaving to found the Nueva Vista group — a consulting and lobbying firm specializing in immigration, labor and health care issues.
Christopher Edley served President Jimmy Carter as a Senior Advisor on Domestic Policy and then many years later was back in the White House as Special Counsel to President Clinton. He’s on the Credentials Committee of the Democratic National Committee.
Maria, Chris, welcome to the JOURNAL.
MARIA ECHAVESTE: Thank you.
CHRIS EDLEY: Thanks, Bill.
BILL MOYERS: Let me ask both of you how has being on opposite sides of this battle for the nomination play out at home?
MARIA ECHAVESTE: We have some pretty intense discussions. Well, there have been some times when I’ve hung up the phone.
BILL MOYERS: On him?
MARIA ECHAVESTE: On him.
MARIA ECHAVESTE: I think it had to do the time I suggested that perhaps Senator Obama was naive in thinking that it was gonna be easy to bring the people together, Congress together, and the —
CHRIS EDLEY: You know, I totally lost it. I totally lost it. It plays into a stereotype. I think it’s the naive, it’s the minstrel, it’s the boy. It is discrediting I think the sophistication, the maturity, the judgment. Now, the question is …Is it racial paranoia? Or is it instead a legitimate, a reasonable reaction to code words whether intended or not, have the potential to summon up the worst instincts in a segment of the population.
BILL MOYERS: But surely you wouldn’t think your wife in using the word “naive” about your candidate had a racist background to it.
CHRIS EDLEY: No. But coming from her it’s either an insensitivity to the way in which it might be heard by African Americans and others or it’s parroting the lines, the messages of her candidate without really stopping to think about the consequences for the racial dynamic in the election.
MARIA ECHAVESTE: There ought to be a way in which you can challenge lack of experience, which I think is hugely important, one of the reasons that I chose Hillary Clinton, not just because I’ve known her for many years, but because I’ve seen how tough the job is, having worked as President Clinton’s deputy chief of staff.
It’s like what the next President is facing is gonna require such a set of skills and experience and strength of character that I just felt Senator Obama, who I do admire and I do think that he can be a great leader. I just felt, “How do you challenge that lack of experience without it being seen through this racial-”
CHRIS EDLEY: Well, you—
MARIA ECHAVESTE: “-lens?”
CHRIS EDLEY: Well, first of all, you don’t have to be ad hominem. I think there’s a difference between saying “unrealistic” and saying “naive.” The larger point is that this is the first time we’ve gone through this. Race, gender, at the very top of our exercise in democracy. We don’t know how to do it. We just don’t know how to do it.
We don’t know where the lines should be drawn. Which to me means that we people of goodwill have to bend over backwards to be scrupulous, to be exceedingly careful about these code words, about these messages, so as not to inflame the evil angels in our nature, if you will.
MARIA ECHAVESTE: But I think we’ve what we’re learning is that we still have a long ways to go in terms of both race and gender. I mean, one of the questions for November, and it looks like it’s gonna be Senator Obama. We do have to finish —
CHRIS EDLEY: Well, what was your first clue?
MARIA ECHAVESTE: We have to finish the rest of the calendar, but it does look like Senator Obama is locking up the delegates and will be the nominee. But the fact is starting now we don’t know whether Americans, a majority of Americans, are prepared to vote for an African American or a woman. In both —
CHRIS EDLEY: But I just want to be clear. I mean, those West Virginia voices that we heard — I think there’s just simply no denying the fact that there’s a group in the population, we don’t know how large it is, who are just ready to get a signal that it’s okay to vote their fears rather than their hopes and to vote their prejudices rather than their aspirations. Listen, we started all of this with me being deeply pessimistic about whether the country was ready. And I have been amazed and extraordinarily gratified to see what his candidacy has become.
MARIA ECHAVESTE: But we shouldn’t deny and sort of ignore that we also have the first female candidate who has really shown that a woman could run for President and do so and be very viable. Remember, this race is very close. It reflects the fact that we have two excellent candidates.
BILL MOYERS: Let me hear your explanations talking to each other of why West Virginians rejected the presumptive Democratic nominee by more than two to one? I mean, a state that Bill Clinton carried in 1992 and 1996, think of it, almost half of the Democratic primary voters, typically the most partisan Democrats in that state, said they would vote for Republican John McCain rather than Obama in November. Is that because of race?
MARIA ECHAVESTE: I think there probably is a piece, some part of it is race, but it’s not the whole answer. There has to be, I think, some anxiety about experience and about basically not feeling that Senator Obama understands who they are and what their experience is, not because he’s black but because he’s from Illinois and East and Hawaii, and he doesn’t know what it’s like to be in West Virginia.
CHRIS EDLEY: It’s “Who can I connect with?” Who can I connect with? And the very fact that Clinton carried West Virginia, right, the name recognition factors and so forth, I mean, that’s a piece of it. And race is certainly a look, on some of the best political advice I ever heard was during the Dukakis campaign. I was —
BILL MOYERS: 1988.
CHRIS EDLEY: I was his national issues director. And I remember during the debate prep, one of the debates, and one of the advisors said to him, “Governor, you have to understand, the American public is sitting there and they’re watching this debate. And they’re trying to figure out which of these two characters do they want to have with them in their living room every night for the next four years.” That’s the first question.
And I think that was absolutely right. I mean, your issues, positions, and all the rest, that’s way down the list. It’s who do I want to have in my living room with me? And that question of who do I feel some sense of connection with I think dominates our choices.
BILL MOYERS: So, what did you both think when you heard Senator Clinton say she had the support of, quote, “hard-working white people”?
HILLARY CLINTON: There was just an AP article posted that found how Senator Obama’s support among working, hard-working Americans, white Americans is weakening again and how the whites in both states who had not completed college were supporting me. And in Independents, I was running even with him and doing even better with Democratic-leaming independents. I have a much broader base to build a winning coalition on.
BILL MOYERS: Did you think that was a statement of reality? An observation of nature? Or was it trying to stir the pot?
MARIA ECHAVESTE: I think that she was making the case to the super delegates about who can win in November, looking at all the different demographic groups. And which you build a coalition so you can win. And I think that the way it came across, though, of by focusing on hard-working white Americans just — it rubs people the wrong way, and I cringed when I heard it ’cause I know that’s not what she meant.
CHRIS EDLEY: Yeah. It’s — I agree with that. I don’t think that there was certainly anything in her heart of that nature. I certainly believe that she conflated two different ideas. She conflated the campaign rhetoric about hard-working Americans with the dry demographic analysis of the voting patterns. And she stuck those two things together in a simple phrase, which made it seem uglier than anything that was in her heart. She’s still fighting. And she’s still trying to make out the case that she would be the better nominee, she would be the better President. And I think it’s past the point of being constructive. And it’s this is a personal crusade on her part now. And it’s an indulgence. And I think it’s unfortunate.
MARIA ECHAVESTE: An indulgence? Wow, that’s a pretty strong word considering that there are just hundreds of thousands of Hillary Clinton supporters — many women, many women, who feel that she has to stay in there until the end.
BILL MOYERS: Why?
MARIA ECHAVESTE: Because they believe, and I think to some degree I share this view, that Hillary Clinton did not get a fair chance with both media perspectives and the subtleties on the gender discrimination. I think there was in the media particularly there’s a zone of protection around Senator Obama on race where none existed on gender. And it may be that in so many ways for her to be capable of being commander-in-chief, being the tough person that she — that people want — it also raised all kinds of pretty misogynistic views about women and that woman in particular. And a lot of women are angry about it.
BILL MOYERS: What is it, Maria, that you think might happen here at the end of this long race that would cost Obama the nomination? I mean, is Hillary waiting for lightning to strike? Is she waiting for some revelation about him?
BILL MOYERS: They see the longer she stays in there, the more these doubts grow about Obama, right?
MARIA ECHAVESTE: I think those doubts have been there from the beginning. I —
CHRIS EDLEY: But she’s doing everything she can to reinforce them now. And —
MARIA ECHAVESTE: Look, the question is who can beat John McCain in November? And I think there really is a question in a lot of people’s minds as to whether Senator Obama can do it or whether she can. Senator Obama has barely had the attacks that the Republicans are gonna throw. And I think that what we’ve seen in the last few months is that he can’t quite take a punch and —
CHRIS EDLEY: Oh —
MARIA ECHAVESTE: – and I really think that everything that’s known about Hillary has been dissected, rehashed. They can’t throw anything new to her. For some people that is an argument that she would be the better candidate against McCain.
CHRIS EDLEY: Rarely have you said so many wrong things in so few words. Look, there are a lot of negatives about Hillary that did not come out in the campaign, a lot of baggage that she and Bill have that was not discussed in the campaign. So to suggest that everything has been considered is simply not accurate. Number two, it is true that there are doubts within the party. But they’ve been litigated. They’ve been litigated long enough to know what the outcome is going to be.
And now the question is how to heal. And instead of continuing to reinforce those concerns, she should be trying to allay those concerns. Now, she says that starting as soon as this is resolved, presumably in June, she will start to turn her attention to allaying those concerns. The question is, well, why not start now since the outcome is inevitable?
The only principled reason I can think of for that, and it’s an important one, is at the end of the day she has to work her heart out to heal the party and for us to win in November. And whatever she has to do over the coming days and weeks to get herself psychologically and to get her supporters psychologically to the point where they’re willing to do that, that’s what I’m for. And if it means that she’s stays in, fine. But I think she’s gotta be very careful about her communication strategy.
BILL MOYERS: I’ve been following this discussion the conservative press because it seems to me they’re gonna be gatekeepers for some of their own followers as to how far you go in exploiting race if Obama is the nominee. Columnist Tony Blankley said, “If we’re honest we run the risk of having two conversations, a polite public one that uses euphemisms or evasions about race and a nasty private one that is likely to dredge up the worst within us.” Has that ugly conversation started already with West Virginia?
MARIA ECHAVESTE: I have to be hopeful.
CHRIS EDLEY: Yeah, ’cause your immigrant tradition —
MARIA ECHAVESTE: Be —
CHRIS EDLEY: – is being hopeful, right?
MARIA ECHAVESTE: I have to believe in the best of America. And the reason I do is I look at Indiana, the results in Indiana and North Carolina. Look, I was disappointed as a Hillary supporter. But the fact is, is that he won North Carolina and came very close to winning in Indiana after all of the Reverend Wright and after all of the negative attacks. And it seems to me that there were a lot of white Americans who said, “I’m still gonna vote for Obama because I like what he’s saying.”
But one of the groups that’s really, he’s gonna have to work hard and also will be an interesting discussion for the months to come is the role of the Hispanic voters and, you know, that’s —
BILL MOYERS: They’re nine percent of the electorate, right?
MARIA ECHAVESTE: That’s right. And if you got Florida, New Mexico, Colorado, Nevada particularly in play. But he also needs to not forget California and New York. The fact is, is that Hillary had two-to-one support among Latinos for her and not Obama. And I think the fundamental reason was that they didn’t know Senator Obama.
CHRIS EDLEY: And the second was that Obama did not have as strong a political effort, a communications effort with that community as he should have. And I think he kind of caught up late. And he had a lot of work to do because of the name recognition factor. And now he can — now he’s gotta focus on that.
MARIA ECHAVESTE: And we’ve got this situation in that John McCain actually is known by Hispanics. He comes from Arizona.
BILL MOYERS: He’s the one Republican most likely to appeal to his Latino voters, right?
MARIA ECHAVESTE: Absolutely. And he’s already started to do some websites and outreach and trying to show a different face. And this is really going to be an issue in —
BILL MOYERS: Growing up in Texas it was obvious to my wife and me that there was antipathy between — even back then, you know, 40, 50, 60 years ago — between Latinos and blacks. How do you explain that?
MARIA ECHAVESTE: Well, I think it’s caught up in all of our history, meaning our racist history and the sort of — let me put it this way. One of the challenges, especially since, like, something like 40 percent of the Latino population is foreign born, is — and one of the new issues is how do we integrate all these immigrants, right? And one — I always say integrating into what? Integrating into a society which has always had African Americans sort of at the bottom?
Well, if people are coming in sort of going, “I’m gonna skip over this part. I’m gonna emulate the rest of society,” well, of course, you’re gonna have that antagonism. Or do we find an opportunity to not repeat the patterns of the past and actually see the common ground? If you look at the state of California, the children who are not receiving the education that they should are both black and Latino children. And together they would represent a majority of progressive voters in the state of California. And the state is still very, very broken. So there’s —
BILL MOYERS: They’re fighting over the scraps.
MARIA ECHAVESTE: Exactly. So —
BILL MOYERS: And that’s why they oppose each other so much?
CHRIS EDLEY: But as Maria said, if you’re an immigrant and you come to this country you see two possible narratives. There’s the hopeful, striving, up, succeeding immigrant narrative, right? And then there’s the downtrodden, minority — class structure, rigid class structure narrative of being black in America. If you have a choice between which of those narratives do you want to identify with — it’s a no brainer.
BILL MOYERS: Isn’t it also possible to be unfair to the white working class people that we’ve heard some of whom are expressing racial sentiments, racist sentiments, isn’t it possible that they feel this competition, too, in this society where there’s so much of a gap between the rich and poor that they see the immigrant, they see the African American, and now they, too, are at the bottom of the economic ladder. And so you’ve got this three-way competition between people who are all fighting just to get —
MARIA ECHAVESTE: Exactly.
BILL MOYERS: – through the day.
CHRIS EDLEY: Exactly right. And I think that to Barack’s credit, he’s talked about that. Some of that was in his Philadelphia race speech. Some of that was, unfortunately, framed in his comments about bitter voters and so forth. I think that the honest discussion about what are the sources of tension, what are the sources of difference, is really valid. I used to have this argument sometimes with Bill Clinton when I was in the White House and we were working, that it’s a little too easy just to talk about the things that unite us. It’s a little too easy that the real —
BILL MOYERS: A little naive?
CHRIS EDLEY: Yeah, the real challenge of leadership is to find ways to talk about the things that divide us and help us figure out how to bridge those not by ignoring them but by, in some sense, overcoming them, resolving them, accommodating them. And, if we can have that kind of a campaign, you know, I’m not for ignoring race in the sense that it can’t be ignored. It’s gonna be there no matter what.
If you ignore it in the sense of simply not talking about it then you’ve failed to do anything effectively to deal with the cancer.
BILL MOYERS: Let me ask you both about how the Clinton and Obama supporters for the next six months can live together and work together without a divorce?
MARIA ECHAVESTE: I think that because we share some very strong common values about what we want in the future, I mean, just a lot of our work is about trying to, in our own different ways, is trying to change and help move progress forward in this country on so many aspects, And though you may be supporting Obama, you may be supporting Hillary, that, ultimately, the things that we want for our country overshadow this difference at this moment. And that we have to respectfully disagree right now and be united at the end and just work towards understanding what’s at stake in November.
BILL MOYERS: To what extent do you think you were influenced by the fact this is the first woman and you were influenced by the fact this is the first black man to really get close to it? How much do you think you were affected by that, Maria?
MARIA ECHAVESTE: I think that’s a certain piece. I mean, the fact that you could have a woman who is also a mother. I mean, it’s just there — the roles of women is just to have that be—in the President, I mean, we see this in the business. You see that having people with different experiences just adds to a richness of your ability to make decisions. And that is exhilarating.
But it’s only a piece of it. And only a piece of it, I mean, I ultimately it was all about who I thought could do the job pretty immediately.
CHRIS EDLEY: Look, I think that it — I confess that — I’m sure that part of it is that he’s black. No question about it. But it’s the qualities of mind and character more than anything else that attracted me to his candidacy and made me confident having worked in two White Houses that he has the capacity to be a spectacular President. So race is a part of it, but, boy, if he were not in the race I would be thrilled about Hillary’s candidacy and as a first but also the things that I respect about her.
BILL MOYERS: Her mind, her vision —
CHRIS EDLEY: And —
BILL MOYERS: What is it you respect about her?
CHRIS EDLEY: Look, I do think of myself really as a policy wonk. And she is a policy wonk par excellence. So I love that. And I do think there are important advantages to having somebody THERE that who knows how to do it. I mean, look, I watched Jimmy Carter flounder.
BILL MOYERS: You were in the White House.
CHRIS EDLEY: I was in the White — I watched Bill Clinton flounder —
MARIA ECHAVESTE: The first year.
CHRIS EDLEY: The first year or two.
BILL MOYERS: Well, that’s what they say about Barack Obama. He’s not gonna be ready on Day One because he has no experience that would make you think that he knows what to do the day he takes that oath —
CHRIS EDLEY: He both has personal qualities that I am confident will make him ready, including his ability to take a punch and be steady and serene in a crisis but also —
BILL MOYERS: You ever punch him? You ever see how he can take a punch? Ever want to see how he takes a punch?
CHRIS EDLEY: But also he’s not gonna make the mistake that both Carter and Clinton did —
BILL MOYERS: Which was?
CHRIS EDLEY: – of excluding from their staff —
MARIA ECHAVESTE: People who —
CHRIS EDLEY: – people who had substantial experience. Look I was one of two Carter alumni in the White House.
BILL MOYERS: Under Clinton?
CHRIS EDLEY: Under Clinton. One of two out of hundreds of people in the White House. And the other, a fabulous guy named Bo Cutter, Bo and I used to kind of sit and commiserate with each other about all the mistakes that they were making in terms of process, in terms of strategy, because we’d seen it before. And Barack isn’t gonna make that mistake. I’ve had that conversation with him.
MARIA ECHAVESTE: I’m hopeful. I tease him. I say if Senator Obama becomes President you’re moving to Washington. The kids —
CHRIS EDLEY: No.
MARIA ECHAVESTE: – and are I staying in California. He’s gonna need all the help.
CHRIS EDLEY: Been there, done that, bought the t-shirt.
BILL MOYERS: Maria Echaveste and Chris Edley, thank you for being with me on THE JOURNAL.
BILL MOYERS: One of the other issues we’re going to be hearing a lot about in the next few months is the high cost of prescription drugs. Most of us can testify to the fact that drugs save lives. When I had heart surgery fourteen years ago, my own life was saved by a skilled surgical team, a caring wife, and some remarkable drugs. But drugs are costly -and it seems their price keeps rising. The sticker shock has sent many people -especially the elderly — across the border to Mexico and Canada in pursuit of affordable medicine. And a report this week says that because of the cost, many middle class baby boomers are trying to do without. The pharmaceutical companies say you get what you pay for, they say it’s not cheap to develop new medicines. But in journalism as in medicine, it’s always helpful to get a second opinion. So if the cost of your daily meds leaves you feeling sad and depressed, unable to sleep or eat, I have a prescription for you — a consultation with the journalist Melody Petersen, who has written a powerful new book about what ails us.
Once upon a time — she says — around 25 years ago, in fact — prescription drug ads were rare on television. Now you can’t escape them.
AD #1: …with one little pill taken just once a day…
AD#2: I feel anxious. Can’t make any decisions…
AD#3: …fortunately, there’s Mirapex
AD#4: Paxil CR
AD#6: VIOXX is there to help
AD# 7: Viva VIAGRA
BILL MOYERS: In a single generation, ads like those have helped to make America the world’s greatest medicine show. That’s journalist Melody Petersen’s term for it in her book, OUR DAILY MEDS.
As a reporter for THE NEW YORK TIMES Melody Petersen covered the drug industry for four years, winning one of the highest honors in business journalism — the Gerald Loeb Award. Then she spent another four years researching and writing this book. She concludes that selling prescription drugs — rather than discovering them — has become the industry’s obsession.
She found companies pitching drugs with cartoon characters, popping up on email and websites, on buses and street corners, at NASCAR races and even at the world-famous state fair in Iowa where Melody Petersen grew up….
MELODY PETERSEN: It was like Disneyland — this little critter, which was the mascot for Lamisil, a pill for toenail fungus. He was out there doing a jig with the children — and I found these marketing tactics just about everywhere.
BILL MOYERS: Here you are possessed to stay with one subject for eight years. Most journalists I know who spend so much time, do so much research, so obsessed with one subject will tell me that they had an epiphany, they had a moment when they said, ‘This is what I’m going to do -the big investment of my life.” Was there a moment for you?
MELODY PETERSEN: It was actually gradual. When I started writing about the pharmaceutical companies for The Times I didn’t know anything about the drug companies and I actually thought that they were a lot about science. That’s what they tell the public. They are all about science and discovering new drugs. But as I started to follow their daily activities and talk to executives, I learned that really it was marketing that drove them.
BILL MOYERS: Was there something you saw that precipitated this choice?
MELODY PETERSEN: There’s a study that the FDA often cites—
BILL MOYERS: Federal Drug Administration?
MELODY PETERSEN: Uh-huh. That a 100,000 Americans die every year from their prescription drugs — that they took just as the doctor directed. This isn’t when a doctor or a pharmacist made a mistake or the patient accidentally took too much. This is when everything supposedly went right. So, that just shows you how dangerous these products are.
BILL MOYERS: Petersen reports that Americans spend more on medicines than do all the people of Japan, Germany, France, Italy, Spain, Great Britain, Australia, New Zealand, Canada, Mexico, Brazil and Argentina combined. The relentless marketing has enriched corporate executives and sent stock prices soaring.
BILL MOYERS: What’s the most conspicuous example of the aggressive marketing?
MELODY PETERSEN: The obvious example is the television ads. Only those ads are only allowed in the United States and New Zealand. So those are pretty much an American creation.
BILL MOYERS: You mean drug companies can’t advertise in other countries on television?
MELODY PETERSEN: No. They can’t advertise anywhere directly to consumers. They can advertise to doctors in other countries but not to us.
BILL MOYERS: You write, “This book is about how America’s for-profit medical system, filled with incentives to make money and disincentives for good care has failed. In too many cases, whether a medicine helps or harms a patient has become secondary to how much it will bring shareholders in profit. Why should the drug industry be an exception to what all corporations, all business does?
MELODY PETERSEN: With medicines we’re talking about life and death. With Wall Street driving it, there’s this constant pressure to exceed the level of revenues that you made the year before. The result of this push from Wall Street-executive stock options depend on it. If the drug companies don’t do this, their stock price goes down. Executive salaries go down. It’s just driven to get those profits up. I write about one study in Iowa. A group of researchers looked at Alzheimer’s patients who had just been diagnosed to see what medicines they had been taking before this diagnosis, they found that 30 percent of these patients were taking medicines that could cause dementia. Rather than stopping those medicines, the doctors just added a prescription for Alzheimer’s. And we just learned with the antidepressants like Zoloft and Paxil they found that in about half the studies dozens of studies that were done of these antidepressants, the sugar pill- the placebo worked just as well or better than the drug.
BILL MOYERS: What do you conclude from that?
MELODY PETERSEN: There’s a lot of money to be made.
BILL MOYERS: From selling a drug that works no better than a placebo?
MELODY PETERSEN: Uh-huh. If it doesn’t work, if the patient still has the problem, what happens in American medicine today? The doctor prescribes yet another pill. So there is a lot of money in selling drugs that don’t work.
BILL MOYERS: Petersen reports that almost 65 percent of the nation now takes a drug available only by prescription. Aggressive marketing has turned what were once normal life events into maladies that can be treated with a pill. With our consumer-driven culture, she says, America was ripe to become “a perfect medicine market,” where the power of marketing can take an obscure niche drug and turn it into a best seller.
DETROL AD: The worry that your problem is as obvious as if you’d announced it to the world. But the good news is that overactive bladder is a real medical condition the symptoms can be treated. And the great news…
BILL MOYERS: “It’s a real medical condition” the announcer tells us, guessing few had heard of it.
DETROL AD: Gotta go, gotta go, gotta go…With just one pill…
BILL MOYERS: The existing condition was called incontinence, and only a small percentage of people suffered from it. But the makers of Detrol weren’t satisfied with so tiny a market. They needed a best seller. So they funded seminars and wined and dined urologists to persuade them that, in fact, there could be a new medical condition…it’s all part of a grand marketing strategy of which ads are only the most visible tip
MELODY PETERSEN: A very powerful technique that the drug companies spend millions and millions of dollars on is hiring physicians to give lectures to other physicians on their drugs. So, it looks like this physician is up there giving his independent opinion on this drug. But, he often, he’s been trained by an advertising agency. His slide presentation has been created by an ad agency. It looks like independent science, but it’s not.
BILL MOYERS: Writing a story about the pain killers VIOXX and CELEBREX, she made an interesting discovery.
MELODY PETERSEN: I wanted a rheumatologist to just give me his opinion about these drugs. So I called a leading society of rheumatologists in the country and told them I want an expert. But I don’t want anyone who’s being paid by either one of these companies. And they said, “Well, we have lots and lots of experts. But they’re all being paid by one of these companies.”
BILL MOYERS: The marketing techniques, she found, extend far beyond simply rewarding agreeable doctors and go to the science, itself.
MELODY PETERSEN: They have a technique, which they benignly call publications planning. And what this is they want to get as many articles published in our medical journals as they can that show their products in favorable lights, and will get physicians to prescribe them. So, they often hire a Madison Avenue ad agency to write up an article for them or a study and the name of the ad agency rarely appears in the published version. Instead, they hire doctors to put their names on as author.
BILL MOYERS: Boosted by medical experts, the makers of Detrol were able to convince millions they might have a new ailment…
DETROL AD: …You’ve got better ways to spend your day then worrying about wetting accidents or rushing to the bathroom.
BILL MOYERS: Presto! A blockbuster drug exploded in the market. Companies had figured out how to create a billion dollar hit……no matter that later research revealed that Detrol also made it difficult for older people to walk or take a shower or even feed themselves. Encouraged by record-breaking, share-boosting profits, she writes, the companies have poured even more resources into their marketing efforts pushing the boundaries for what might be considered a disease.
PAXIL AD: I’m always thinking something terrible is going to happen, I can’t handle it.
BILL MOYERS: People who worried too much were encouraged to believe they might be suffering from a condition known as “generalized anxiety disorder.” Paxil, once prescribed as an anti-depressant could ease it.
PMDD AD: A week before my periods, I get super moody …
BILL MOYERS: Even women suffering from PMS were told they could have premenstrual Dysphoric Disorder or PMDD.
PMDD AD: Sarafem…a distinct medical condition…
BILL MOYERS: Prozac, once an anti-depressant, was re-packaged and re-purposed as Sarafem.
PMDD AD: Only prescription medication for PMDD…
BILL MOYERS: What are the dangers as you see them from all this medication?
MELODY PETERSEN: First of all, that people are taking drugs they don’t need. Because every drug is a balance between its potential benefits and its potential risks. If you take a drug you don’t need, then you can only suffer the risks.
BILL MOYERS: Ads, by law, mention some of those risks-but on television they come in a fast-talking, easy-to-avoid package.
COMMERCIAL VOICEOVER: Side affects may include decreased appetite, dry mouth, sweating, nausea, constipation.
MIRAPEX AD: Or if you experience increased gambling, sexual or other intense urges…
COMMERCIAL VOICEOVER: Some risk of dependency. Side effects may include unpleasant taste, headache, drowsiness…
BILL MOYERS: Don’t you think a lot of people are willing to take risks to have a better life? More joy? More life experiences as the ad says? More sleep?
MELODY PETERSEN: Uh-huh. We want to believe in this. We want to believe that we can just take a pill and life will be better, our problems will disappear.
BILL MOYERS: You say, “The medicine merchants have learned to sell us hopes and dreams. A pill for every desire. Too few of us realize the dangers. ”
MELODY PETERSEN: All you have to do is watch television and you will see this. It’ll show patients hiking through the woods. They’re dancing on a dinner cruise. They’re running on the beach. They look like they are having such a good time. So yes, they’re selling you what you wish you could be or wish you could do.
COMMERCIAL VOICEOVER: Maybe you’ve tried medicine but you’re still waiting to enjoy life again…
BILL MOYERS: In many cases, Petersen writes, it is the marketers and not the scientists who decide which drugs are right for the new you.
COMMERCIAL VOICEOVER: You’re unable to feel. You get overly startled and may have trouble sleeping.
BILL MOYERS: To boost sales of the anti-depressant Zoloft, Pfizer sought to expand the potential market by commissioning studies that suggested that the disorder PTSD was not as rare as most believed.
ZOLOFT AD: These are some symptoms of Post Traumatic Stress Disorder. A serious medical condition affecting over thirteen million Americans. While the cause is unknown …
MELODY PETERSEN: A few years back, I kept getting information from a group called the PTSD Alliance. PTSD is Post Traumatic Stress Disorder. And one of the main messages of this group was that five percent of the American public suffered from PTSD. And this is estimate was millions and millions more than the government actually said suffered from this illness.
And later, I learned that this group wasn’t actually what I thought it was. It was the creation of a public relations firm working for Pfizer to sell more Zoloft. In fact, it was staffed by the public relations firm. Its offices were the same address of the public relations firm.
BILL MOYERS: She found example after example of science compromised by marketing.
MELODY PETERSEN: You know, it’s gone so far that some independent scientists are starting to view our medical literature as propaganda. I’ve learned that there are so many different ways for a study to be designed to get the data that will help you sell your drug. If you want to make it look more powerful than an older drug on the market, you give the volunteers in your trial the older drug at a dose that is too low to really help them so your drug looks better. If you want your drug to look safer than an older drug you boost the dose up of the older drug in the volunteers so they have more side effects. If you have one study that showed it worked, and one study showed it didn’t, you publish the first study over and over again with the help of your advertising agency. And you don’t publish the second one.
BILL MOYERS: Are we being deliberately misled?
MELODY PETERSEN: Yes.
BILL MOYERS: Intentionally?
MELODY PETERSEN: Yes, looking at documents from inside the drug companies, yes. I would say we’re being misled deliberately.
BILL MOYERS: I was fascinated to read an attack on your book. A seething review in THE NEW YORK POST right here in New York. “Hard Pill to Swallow.” It’s very critical of your book. By Robert Goldberg. It says nothing about who Robert Goldberg is. But when you do a little investigation he turns out to be vice president of a group that receives funding from the drug industry. But, he does not disclose this fact in this review in THE NEW YORK POST.
MELODY PETERSEN: Exactly.
BILL MOYERS: Now, what does that say?
MELODY PETERSEN: This is what they do over and over again. The drug companies are very good at putting their words in the mouth of someone who looks independent to get their message across. Bill Moyers responded to Goldberg’s attack in THE NEW YORK POST with a letter that alerted readers to the fact that Goldberg was not the objective reviewer they were led to believe. Her letter ends: The drug companies learned from the tobacco industry that the public would believe their message if it came from someone who appeared independent. People need honest information about medicines, not propaganda.”
BILL MOYERS: Doctors, themselves, she writes in her book, can be part of the propaganda machine
MELODY PETERSEN: Unfortunately physicians have lost their way. And I don’t think the public really understands this. But, in 1951, Congress changed the law so that we would require prescription for certain drugs. Before, we could go into the drugstore and get whatever we wanted. And Congress wanted an educated physician who had the best interest of his patients at heart and was independent from the pharmacies and the drug companies to be the gatekeeper. But, now, a lot of the physicians in America take gifts or cash from the drug companies. Some physicians take hundreds of thousands of dollars a year.
BILL MOYERS: Congress, too, is in the grip of the industry. Petersen reports that in a recent six-year period Big Pharma spent more on lobbying than any other industry and now employs two lobbyists for every member of Congress. With doctors and congress compromised, what about that other gatekeeper, the Federal Drug Administration?
MELODY PETERSEN: Actually, the drug industry pays the FDA too. There was a change in the law in 1992. Before 1992, the FDA had one customer and that was us, the public. But, in ’92, the drug companies started to pay fees to get their drugs reviewed and approved. And so, the FDA has another customer now, the drug companies. And you can talking to scientists inside the FDA, you learn that there’s an awful lot of pressure for the FDA to do what the industry want them to do.
BILL MOYERS: So after her exhaustive diagnosis, Melody Peterson has some prescriptions of her own.
MELODY PETERSEN: The system is so out of whack the way it is today, you really have to be careful. Don’t take any drug without understanding the risks that it could have. Find the doctor who has thrown the sales reps out of his office, who has said ‘I’m gonna do what’s right for my patients’. And there’s a growing number of doctors who feel that way and think the thing that could do the most good is to have a law that bans doctors from taking money from drug companies. We need our doctors to be our independent advocates again.
BILL MOYERS: The book is OUR DAILY MEDS: HOW THE PHARMACEUTICAL COMPANIES TRANSFORMED THEMSELVES INTO SLICK MARKETING MACHINES AND HOOKED THE NATION ON PRESCRIPTION DRUGS.
BILL MOYERS: Melody Petersen thank you for joining me on the JOURNAL.
MELODY PETERSEN: Thank you so much for having me.
BILL MOYERS: Just last week, Congress opened hearings on the marketing practices of Big Pharma. Committee Chair Bart Stupak echoed Petersen’s warnings about the dangers in his opening remarks.
REPRESENTATIVE BART STUPAK: The purpose of this hearing is to examine the potentially misleading and deceptive tactics used in direct to consumer advertisements for prescription pharmaceutical products. Research shows that some DTC advertising results in patients seeing their doctor and discussing previously undiagnosed conditions.
BILL MOYERS: Lawmakers were shown television ads from such blockbuster medicines as LIPITOR and VYTORIN, both widely prescribed to lower cholesterol. Industry executives defended the ads as “educational” or as a conversation starter for physicians and their patients. Experts from the American Medical Association and others described them as deceptive, designed to sell a product -not to inform consumers. More hearings are scheduled. In the meantime, read Melody Petersen’s book. Then keep it in your medicine cabinet.
BILL MOYERS: Now I want to update some of the stories we’ve been reporting over recent weeks.
You’ll recall that last week I interviewed the international lawyer Philippe Sands. He had just testified in Congress about his book TORTURE TEAM. The book is based on his conversations with the Bush administration insiders responsible for the use of “enhanced interrogation techniques” — torture — on detainees at Guantanamo. Sands mentioned in particular Detainee 063 — Mohammed al-Qahtani….suspected of being the missing “20th hijacker” in the 9/11 attacks. The administration offered al-Qahtani as proof that coercion works, and the White House said he had provided “valuable intelligence.” But Sands knew differently…
PHILIPPE SANDS: I do have actual information on Detainee 063. I spent time, as I describe in the book, with the head of Mohammed al-Qahtani’s exploitation team. And the bottom line of it was, contrary to what the administration said, they got nothing out of him.
BILL MOYERS: This week, after al-Qahtani had been in confinement for over six years, the charges against him were dismissed “without prejudice” by the presiding authority for military commissions. No reason was given, but it’s being speculated that the evidence obtained by al-Qahtani’s torture would not stand up in court. This is just one reason, many people argue that such trials should be more open and moved out of the military courts. In the meantime, Philippe Sands has written an incisive essay on these events of the week. We’ve posted it on our web site at pbs.org. Earlier this spring our colleagues at Exposé reported on those billions of dollars in taxpayer subsidies to the richest farmers in the country. Because demand for food has driven prices sky-high and corporate farmers are earning record income, you might think this an ideal moment to cut out profligate subsidies to farmers who don’t need them. But as we heard from David Beckmann of the non-profit organization Bread for the World, the farm lobby has a stranglehold on Congress.
DAVID BECKMANN: The main thing is that the people who are getting, who have their hands in the cookie jar are well organized. And according to the Wall Street Journal, they spent eighty million dollars last year lobbying Congress to defend those subsidies to affluent people.
BILL MOYERS: Sure enough, this week Congress overwhelmingly passed a new farm bill. It contains more funds for nutrition programs and food stamps, but continues to funnel billions of dollars to the largest and wealthiest landowners. There was an effort to prohibit subsidies to farmers making $250,000 or more a year, but it failed. Representative Ron Kind of Wisconsin, a Democrat, said the new bill is “well designed to avoid every opportunity for serious reform…while actually piling on additional layers of unnecessary spending.” Republican reformer Tom Petri, also from Wisconsin, calls it “a bloated disaster.”
The Bush administration has wanted to cut the subsidies while opposing raising new revenues to pay for the increase in support for food stamps and other programs in the bill. The President is now expected to veto the bill, but Congress has the votes to veto the veto.
A final update. Last month Victor Navasky of the COLUMBIA JOURNALISM REVIEWtold us about how all the talk about military strikes against Iran reminds him of the arguments made for invading Iraq five years ago
VICTOR NAVASKY: If you read Norman Podhoretz’s account…where he says that we have a carrier right off the coast of Iran, and all the President has to do is say “go”. And that the non-military solutions have not worked. You can’t not take it seriously.
BILL MOYERS: Since then, the talk about bombing Iran has only increased. And the biggest talker of all is the Connecticut hawk, Senator Joe Lieberman. The Democratic candidate for vice president eight years ago has now endorsed Republican senator John McCain for president and become his alter ego on the Middle East. Wherever McCain goes, Lieberman is sure to show up. Earlier this week Lieberman called air strikes against Iran “a distinct possibility,” and on Wednesday he and talk show host Bill Bennett coupled their banter about Hillary Clinton with some hopeful praise for her own hawkish policies toward Iran.
BILL BENNETT: This is a girl who puts on her pearls, goes down, throws down a shot of liquor, and bombs Iran…you know…lookout Mrs. Bennett, this is my kind of girl.
JOE LIEBERMAN: … it does have an appeal to it.
BILL MOYERS: For his part, President Bush this week once again indicates we will be in Iraq for a long, long time. To pull out he said, to fail to maintain what he calls “a forward presence” in the Middle East, would send the wrong signals. The President also disclosed that out of respect for the sacrifice of American soldiers and their families, he had given up golf, although there were sightings of him on the course reported after the renunciation. I’m not making this up.
That’s it for THE JOURNAL. We’ll see you next week.
This transcript was entered on May 25, 2015.