“What can the West learn from Estonia?” is one of those seminar-type questions that arises from time to time as something of a progress check for Estonia’s march toward Europe’s Five Wealthiest. “E-stuff” is usually the answer.
But a better answer might lie in Estonia’s willingness to question some of the premises on which modern western business and society are built. Lately, talk has centered around Big Pharma.
Last month, the business daily Äripäev raised the question of whether it was ethical for pharmaceutical companies to pay for doctors’ travel (often to seminars in exotic locales). A few days later, the newspaper raised the issue of whether it was ethical for drug companies to pay doctors’ membership fees in professional organizations.
It’s true that Estonian doctors don’t earn much compared to their western colleagues (around 1,600 euros per month on average), but it’s also true they don’t earn so little that the patient is expected, Soviet style, to pay a bribe to receive proper treatment.
Instead of bribes, there is now the corrupting element of a kind which passes for legitimate in the west: the deep pockets of Big Pharma. Last week, Äripäev’s Kadri Jakobson took a hidden camera and attended a “conference” organized by Merck Sharp & Dohme to promote its birth control product NuvaRing.
In the video, a speaker is heard saying that “Nuvaring is suitable for absolutely everyone…” and then merry gynecologists take part in a sing-along to popular tunes rewritten to feature NuvaRing. In the end, an MSD manager, after being asked for an interview, twice tells journalist Kadri Jakobson to minge kuu peale (“Go to the moon,” but closer in spirit to “Go to hell”).
Of course, there’s nothing wrong with a company promoting its product, and doctors are as free as anyone else to take part in a sing-along. And it will eventually be settled whether the event was advertising masked as a conference or just a well-meaning multi-billion-dollar corporation out to help doctors. But what we ought to be most happy about, both as patients and as citizens, is the simple fact that the issue is being so actively discussed.
Doctors, regardless of how much they earn or where they work, are often revered like gods. Modern gods who have something of a special relationship with Big Pharma. It’s only good that Estonia isn’t eager to swallow unquestioningly the established way of doing things.
And that’s indeed something the West might learn from Estonia.