The Hamster Wheel of Healthcare

By Ashlee Phillips

“I think we have failed our society in this process. Because we truly believe those who

have more, deserve more.” claimed Julie Leishman, when asked about her ideas regarding drug

shortages. My aunt, Julie Leishman, is a Pediatric Oncology Nurse - bone marrow transplant.

She currently lives in San Francisco, CA and works at UCSF, the University of California at San

Francisco, and has been an Oncology Nurse for 9 years now. Her job entails, working with

children who have a diagnosis of blood disorders and also cancer diagnosis that range between

sickle cell, leukemia, rhabdomyosarcoma, and many more. Especially at UCSF, they have found

that nursing actually provides most of the treatment plans. Once they give the chemotherapies,

the nurses are responsible for monitoring all of the symptom management for the patients.

Recently, I completed a research project where I looked at the causes and effects of drug

shortages in the United States. I wanted to interview someone and get an inside perspective on

this topic. I knew that Julie’s 9 years of first hand knowledge of the pharmaceutical industry

would make her a great choice.

Throughout the interview, I asked Julie questions about her own experiences with drug

shortages, how they have affected her career, along with her opinion of potential solutions. To

begin the interview I asked Julie what her professional definition of a drug shortage is and what

causes them. Immediately, I could tell that Julie is very passionate about this topic and the

healthcare system. She answered, “I believe that a drug shortage is, generally speaking, a trickle

down problem for those on the top who have money.” She believes that all of these people with

power are playing this game of always trying to find where profit is going to come from next.

Something interesting that she said was, “We believe that they make the drugs because they want

to cure us and they want to make it so we can be healthy human beings for the rest of our lives.
Surprisingly, those drugs that actually help cure disease and diagnosis don’t make a lot of

money.” The main point that she made is that drug shortages are caused because people want

money; and they don’t care how they get it. Those people on the top have a lot of power and

would much rather make money off of something that people will continually need, instead of

making money from something that only needs to be used once.

Next, I asked Julie if she had any personal experiences of the effects of drug shortages

within the pharmaceutical industry. A thought-provoking story that she shared with me was

about a young girl she is currently treating who has this disease called GVHD; also known as

Graph vs. Host Disease. What happened was, after receiving a transplant and with all of the

chemo she was given, her entire GI tract, or digestive system, became the equivalent of swiss

cheese. Tylenol was the main thing that would help to mitigate her symptoms. However,

anything that she digested would not absorb and therefore wouldn’t be helpful; specifically

tylenol. Since she couldn’t take tylenol by mouth she had to have Tylenol IV. Julie explained

that this type of IV drug has only been available in the medical field for the past 8 years and for a

while they had to get special permission from multiple people to get it. During the process of

trying to get this overpriced drug approved by the FDA, this young girl was in a lot of pain. She

had such a high fever that they ended up having to beg the FDA for tylenol IV just because of all

of the barriers this patient had. “The sad truth”, Julie explained, “Is it comes down to how much

we are able to negotiate with somebody’s human body with pharmaceuticals and also through the

availability and who needs it the most.” Medical professionals have to negotiate with some type

of hierarchy in caring for a child. According to Julie, this is a common theme within the industry

with drugs that are either overly priced or in a shortage.

 After discussing the causes and effects of drug shortages, I asked Julie what she believed

would be the best solution to help with this issue. She shared an interesting perspective that not

many people like. She believes that we need universal healthcare. She claimed, “We need to

universalize this concept where we take the money from the richer people and stop letting the

companies that have a monopoly have a say regarding people’s lives.” Julie can’t imagine any

other way to breakdown the hierarchy that we have developed in America because “we love our

freedom of choice.” Following this statement, I asked her what negative effects she thought

could come from this universalized healthcare idea. She brought up the common argument that

people are scared that our specialists and the number of those who are more experienced will

decrease. She also shared that during her Master’s course, she found out that we have a version

of a universalized healthcare system in the US. The emergency department. Julie pointed out that

the people you find there are those who are in really bad medical shape and in a lot of cases can’t

afford to go to pediatricians or general practitioners who can watch over them. The emergency

room spends thousands of US tax dollars to try and support a patient who, according to Julie,

“doesn’t have the “right” to receive healthcare the way that you and I get to receive it.” Because

we have enough money to pay for it.

Julie also illustrated something unique about San Francisco, California. There is

something called the San Francisco Health Tax. If you go to dinner in San Francisco, every

single person who is sitting at the table will pay $1 towards the Healthy San Francisco Tax. It is

non-negotiable. Julie stated, “Their concept is, if you have enough money to be going out to

dinner, then you have enough money to pay a dollar for someone to get healthcare.” This idea,

fully supports the concept of helping those who can’t help themselves. As human beings, rich or

poor, everyone has a right to receive healthcare. As Julie said, “I think we have failed our society
in this process. Because we truly believe those who have more, deserve more.” Isn’t this what

our country is about, freedoms and our rights as citizens?

In closing, I asked Julie to summarize what the biggest problem causing drug shortages is

and what we need to focus on first. She started by saying that we need to be a voice for those

who have so many barriers and aren't able to receive healthcare like we do. Barriers like

education, low income, and fears of immigration. She believes it will be a slow trickle effect. but

that we need to be putting pressure on those around us and challenging those around us by

recommending the idea that others deserve more. She stated that it is important to vote for those

who support the concept that we are all “deserving of getting healthcare that is standardized

amongst the rich and the poor”. We need to get people into office who can get us off of this

hamster wheel of healthcare. Instead of only being willing to save lives because of money, we

should be saving lives because everyone matters.