Marcia Angell quotes:

Brand-name drugs have no competition, since the government grants them very long, exclusive marketing rights.

Alternative medicine plays into this exaggerated notion that you can prevent disease simply by doing the right thing.

Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself.

There is something so biologically implausible that your attitude is going to cure a disease. There's a tremendous arrogance to imagine that your mind is all that powerful.

You see that the people who are drawn to alternative medicine are often fairly healthy and they go to alternative medicine for what I call the 'symptoms of life.' Fatigue, joint pains, inability to concentrate, perhaps, the kinds of things that anyone over twenty-five gets at some point.

The pharmaceutical industry likes to depict itself as a research-based industry, as the source of innovative drugs. Nothing could be further from the truth. This is their incredible PR and their nerve.

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.

Japan has very long hospital stays. Ah, it's almost a rest cure. People in Japan who are hospitalized might lie around the hospital for a week or two just to take a rest.

Illness and death are not optional. Patients have a right to determine how they approach them.

Liberals are wrong to think that opposition to health reform is a rejection of big government. If health reform consisted of extending Medicare to everyone, people would be delighted. There are millions of 64-year-olds out there who can hardly wait to be 65.

For all of life's discontents, according to the pharmaceutical industry, there is a drug and you should take it. Then for the side effects of that drug, then there's another drug, and so on. So we're all taking more drugs, and more expensive drugs.

A review of seventy-four clinical trials of antidepressants, for example, found that thirty-seven of thirty-eight positive studies [that praised the drugs] were published. But of the thirty-six negative studies, thirty-three were either not published or published in a form that conveyed a positive outcome.

Drug companies say they need to charge ever-higher prices to cover their research costs, but they spend far less on research and development than they do on marketing and administration, and afterwards they actually keep more in profits.

Just look at herbal remedies. It's essentially a throwback. It's saying you go to a plant and you mush it up and you stick it in the jar and you sell it and you eat it and it's going to cure what ails you. And that's the kind of stuff that people believed in the early 19th century.

The pharmaceutical industry isn't the only place where there's waste and inefficiency and profiteering. That happens in much of the rest of the health care industry.

The United States is the only advanced country that permits the pharmaceutical industry to charge exactly what the market will bear, whatever it wants.

Unlike the federal government, most states don't have the option of running a deficit.

There's a certain libertarian right-wing view that there should be no FDA, that people can decide for themselves whether medicines are safe and effective. That's nonsense. Most people don't have the expertise or the resources to mount a proper study to find out whether a treatment is safe or effective.

I think doctors are really suffering now. They're suffering in the sense that they feel torn between serving their patients in the best way they can and dealing with all of requirements of the insurance companies and the HMOs and the hassles and the paper work and the increasing pressures to do less and less for their patients.

The use of psychoactive drugs - including both antidepressants and antipsychotics - has exploded...[yet] 'the tally of those who are disabled...increased nearly two and a half times.

Few things a doctor does are more important than relieving pain. . . pain is soul destroying. No patient should have to endure intense pain unnecessarily. The quality of mercy is essential to the practice of medicine; here, of all places, it should not be strained.

It's not just the right-wing crazies who oppose health reform. In addition, there are many sane Americans who worry about committing a trillion dollars to it.

When death is imminent and dying patients find their suffering unbearable, then the physician's role should shift from healing to relieving suffering in accord with the patient's wishes.

Probably most dying patients, even when suffering greatly, would choose to live as long as possible. That courage and grace should be protected and honored, and we should put every effort into treating their symptoms.

In economic terms, health care is a highly successful industry - profitable, growing, and virtually recession-proof - but it's a massive burden on the rest of the economy.

Health care is a need; it's not a commodity, and it should be distributed according to need. If you're very sick, you should have a lot of it. If you're not sick, you shouldn't have a lot of it.

I do think that we are an overmedicated society.

There is something so biologically implausible that your attitude is going to cure a disease. Theres a tremendous arrogance to imagine that your mind is all that powerful.

Why should anyone - the state, the medical profession, or anyone else - presume to tell someone else how much suffering they must endure as their life is ending?