British Royals, American TV

I collected British reactions to American advertising during the live broadcast of Oprah’s interview with Meghan Markel and her husband Harry. Their shock and disgust at an American media staple, the pharmaceutical ad, was a grim demonstration of how unique America’s healthcare system is. The thread reached over 12 million impressions - with non Americans adding their own surprise at American ads and Americans expressing surprise at their surprise, dejectedly realizing what it meant.

The broadcast on CBS included ads for the drugs Skyrizi, Kisqali, and Jardiance. Which were all new to me, since I haven’t watched live tv in a very long time. A Washngton Post article based on my thread added “Researchers at Dartmouth College found pharmaceutical companies nearly doubled the amount they spend on marketing between 1997 to 2016, and sales of prescription drugs came close to tripling during that same period.” These costs are passed on to the consumer, aka people seeking treatment now faced with exorbitantly high mark ups on their medication. and Business Insider both reached out to me with questions. I’ve included the transcripts of the exchanges below, which better explain my motivation for creating the thread.

Questions from Sean Cooke of

What first jumped out to you about this trend of Brits reacting to US pharmaceutical ads, as a forecaster and someone who’s been tracking this sort of phenomenon online for a long time? Is it fairly unprecedented for British viewers to interact with American live TV to this extent?

Given the increasing irrelevance of American awards shows, this interview was a rare moment of outsiders viewing American live tv. For most of my life in this country, Americans - both anecdotally and more officially via the government and media - have operated with an ignorance of how unnecessarily painful and strange this country is. Opportunities to remedy that have always stood out to me as valuable because it makes me, as an observer, feel less alone in my reaction, and more importantly establishes the possibility of remedy. The US loves circulating its views about other countries and what they need. Over the last decade or so, particularly through social media and how it connects Americans to the wider world in ways their education and news media fail to, there’s been a chance for a more informed perspective. And for Americans to be seen the way they usually see others - as primitive, impoverished, and severely lacking. It’s a shame, but shame is politically useful. And this country is in urgent need. I feel the more obvious it becomes to Americans that they’ve been conscripted into normalizing what is not in fact normal, and does not need to be, the more political will can be generated towards positive change - in this case towards healthcare as a human right and not a business. 

You mention in a reply how our drug commercials are just another mundane horror we’ve normalized along with GoFundMe healthcare funding. Do you think there’s value in the residents of other countries becoming more aware of these dehumanizing conditions?

I think the value is to Americans. But given the record of America’s actions in the rest of the world, countries are entitled to some schadenfreude about the state of this country now. 

Maybe an obvious thing to notice, but the Harry and Meghan interview feels like the most made-for-Twitter event in recent years. Why do you think this sort of live event inspires these reactions, in a way that, say, sports or award shows might not?

Typically, sports and award shows could and would, but there are few American sports events that draw an international audience and award shows just aren’t as compelling anymore. Online users do a better, and more efficient, job of curating the highlights anyway. The value proposition of experiencing ‘event tv’ live has shifted as the quality of live tv has decreased. The productions are awkward and we’ve gone from ‘event tv’ being the chance to feel in community with people watching together and commenting events as they happen, to skipping the stilted and archaic shows altogether. This interview was special for many reasons; for the subject, for the skilled interviewing by a master of the form, but it was also a rare return to a bit of glamour - which has been missing from live tv for a long time. 

And just a simple logistics question — do you know if these British viewers saw American ads by watching illegal streams online, or if a British network just aired the original CBS broadcast?

Illegal streams online. The UK’s ITV network will be airing the interview tonight, or at least a version of it. But it makes sense that UK viewers would want to watch it sooner and straight from the source, so to speak. Ironically many Americans who no longer have live tv watched by signing up for free trials for niche streaming services that carried the channel. Which I hope they all remember to cancel before the recurring payments. The interview was a significant response to years of vitriol directed at Meghan Markel. But like all tv, it was produced primarily as a vehicle for advertising. In this case, for Oprah’s interview series and for American networks trying to recoup viewers that have moved on to competitor streaming services.

Questions from Allana Ahktar of Business Insider

When did you notice British people tweeting about pharma ads during the Oprah interview last night?

I noticed during the broadcast. Many of the people I follow are based in the UK. I was curious how people were reacting to the interview and followed what trends were emerging out of the commentary.

Were you familiar with the confusion before the interview aired, or was this the first time you noticed Brits speaking out about US drug ads? 

I knew pharmaceutical ads like those in the US were uncommon to the rest of the world. What was more interesting, and worthwhile, to me, was showing Americans that something considered banal here is actually quite remarkable, and worth questioning. It raises the question, why are we among only two countries in the world where advertising prescription drugs is legal? Why is it done here but not elsewhere? Which leads to the recognition that healthcare as practiced in the US is business before it is health care. 

What do you believe the overwhelming response your Twitter thread received says about the relationship to healthcare in the US and in the UK?

One of the most interesting recurrences in the British reactions to American live tv was shock at the idea of "advertising medicine". To have even phrased it that way was so conspicuously not American. Because to us, the ads are for brand name drugs...which can be a far cry from the medicine available to us. In 2021 Americans are more likely to describe a juice as medicinal. To describe drug ads as generically belonging to the category of 'medicine' seems luxurious compared to the complexities Americans must navigate when trying to receive healthcare. In the US people are tasked with being informed customers, rather than simply beneficiaries of a healthcare system - with all the inequalities of access that implies.