I will translate:
Something or someone has to be evil.
Nope. It has to do with pharmaceutical companies, patents, and profits on one side - destructive, but not "evil" - it's the nature of the entire industry, unfortunately. The goal of the companies that make medicine, just like insurance, is profit not better health. As corporations, they simply have no choice in the matter or they would be accountable to the stockholders.
On another side, it's regulators and lawmakers who don't understand the topics they are legislating, which is so often the case - with medical, technology, or pretty much any other topic that requires expertise that gets delivered by paid representatives of one specific viewpoint (lobbyists).
And on yet another, where too many doctors are just uninterested in patients experience, more interested in folks taking a regimen of pharmaceuticals on a daily basis, and puts all their stock into the latest set of opinions in whatever study is prominent at the moment, the "bandwagon" mentality. Particularly when in this case the effectiveness studies were flawed from the start (see below). This is what led us to decades of a obsession about cholesterol in foods that we only recently (and without much hubris) found out
actually was largely pointless (your cholesterol is not generally affected long term by the foods you consume).
So no, not "evil" - not even a conspiracy - just a bunch of different folks acting in self-interest, which in this case worked together without any coordination necessary - because everyone who had a place at the table had their own agenda, and the folks who actually are affected by it had no voice in the matter, and their health/quality of life was completely marginalized by people with little or no knowledge of the disease.
Care to elaborate on this point with examples?
It's obviously a very complex topic, but here are the highlights. I was admittedly being a bit glib by blaming it all on the EPA - as I explained above, it was all the folks advising them. It mostly centers around asthmatic inhalers and CFC's, which is why the EPA was involved. The EPA regulations that resulted halved the effectiveness of the medications by compromising their delivery method, and the reformulations it required led to a massive increase in the cost of the medications and new patents all around to be exploited financially for decades.
The problem was, everyone else who became involved acted in their personal interests and the patients who depend on life saving medication were completely marginalized. One congressman, way too late, unfortunately, tried to stop the final blow - but the damage had already been done and since everyone is
making more money than ever now on asthmatics (tens of billions a year in the US alone), it's not going to change.
* In the 1970's and 1980's, asthmatics were largely treated with what is now retroactively being called "rescue" medications, which were once daily medications - the inhalers you see folks use, and oral steroids. Large amounts of steroids (particularly one called Slo-Bid, which is no longer regularly prescribed for asthma because of it's copious side effects). The inhalers were extremely effective, inexpensive, and asthma was easily manageable. Most patients grew out of needing steroids and simply needed the inhaler to maintain their lifestyle.
* In the 1990's, the medical community decided that inflammation was the true enemy, and for awhile before COPD exploded as a diagnosis with their own new industry of pharmaceuticals, went so far as to claim that using the "rescue" inhalers as they now decided they were, we causing lung scarring and tried to scare folks with that. You still find some resources that postulate that, but when you start researching you realize just how the thoughts about how to treat asthma have just flip flopped so much over the years as even "authorities" tend to disagree or contradict. They all seem to agree now, though, that it's preferable for patients to be on a cocktail of medications for what is going to be a chronic disease no matter how much or how little you treat it.
* In the early 2000's, the move to ban CFC's (the delivery method of asthmatic inhalers) led to the creation of "HPA approved" inhalers that a) cost up to 4x as much as the older inhalers, and b) were far less effective. The medical community argues that they clinically are shown to be just as effective, but fail to note that they largely tested on machines - not people having asthma attacks. Anyone who has ever had or witnessed an asthma attack knows that when having one, especially if you are only to be taking these inhalers in an "emergency" basis - you aren't able to take controlled deep breaths like a machine emulates, because if you could you
wouldn't be taking the dang medication to begin with.
* The pharmaceutical companies and pharmacies tried very hard to get folks to switch, years before they actually became the only legal way to get the medication. Unfortunately, in those years, no one in the medical community or in the private sector was able to get a proper body to listen to the objections to the new delivery method, because this medication that you could squirt in your mouth and directly into your lungs was deemed too environmentally risky. There was no attempt to improve the delivery method either, because no one saw a reason to spend more money on it.
* Now, once they were totally out of prescription medication, they only remained in over the counter (Primatine Mist). Primatine Mist has always been an "evil" to the medical community (and was the topic of some media scares because some sister of some model died after using one once, and high school athletes would "huff" them, making them a media darling to hate), but mostly because it allowed someone with mild asthma to have an inhaler and not spend thousands of dollars a year on doctors offices and tests and more medication.
So when the bill was introduced to allow them to be excepted from the regulation, it was too late because the larger pharmaceutical companies had already switched over, and were now seeing record profits in both the newly formulated inhalers and all the other medications that patients now require because of how ineffective the current inhalers are. They were cheap, effective, and prevented a lot of unnecessary medical care - so they were pretty much doomed as the enemy from the get go.
(...and, this just hurt on a larger level as well - I never used Primatine Mist regularly, but I tell you - it sure was nice to know it was there on the few occasions I needed it - when traveling, medications get lost/stolen, not every town has a 24 hour pharmacy even if you carry a written prescription etc. - it was a lifeline knowing that if worse came to worst, you wouldn't need to make a trip to the emergency room, you just had to find a 24 hour grocery store.)
So that's it...in a nutshell. No, no one was evil - but because of what happened, people are spending far more on medication, taking way more medication, and the day to day quality of life for the average asthmatic is lower than it once was just a few years ago (and not even thinking about what the long term effects of more adult steroid use on the body which we have no idea about).
The statistics on Asthma deaths is usually several years out of date, and difficult to interpret (because there usually are other factors) but I'm willing to bet that in the next few years for the first time we are going to see an increase in asthmatic deaths vs. the trend for the past 30 years. In any case, unfortunately they don't really measure the "quality of life" stuff - how many folks don't go for that walk anymore, or who have curbed their activities because the only medications that worked for them or were accessible have been made illegal.
