No matter the news outlets you frequent these days, you cannot escape the constant drumbeat that the US healthcare situation is bad – and getting worse all the time. The nation’s healthcare crisis is one of the biggest stories in the media today, and a top-three issue in the presidential campaign (along with the sagging economy and the war in Iraq).

You’ve no doubt heard the particulars: Forty-plus million people in the richest country in the world without health insurance; costs continuing to rise much faster than any other economic category; medication errors plaguing hospitals; and chronic diseases like diabetes and hypertension now threatening our nation’s wellbeing. Make no mistake about it, healthcare in America is ailing.

It probably won’t come as a big surprise to readers of this blog that healthcare marketing is also hurting. I am frequently amazed at what passes for healthcare marketing in the US, and I am not just talking about the TV ad campaigns like “Viva Viagra” and the Ricardo Montalban sounding bumble bee in the annoyingly ubiquitous Nasonex spots.

In the ranks of unintentionally funny culture, the disclosures in pharmaceutical direct to consumer (DTC) marketing communications rank right up there with the oeuvre of actor Patrick Swayze (if you’ve seen “Road House” or the cult classic “Point Break,” you know exactly what I mean). Usually spoken at rapid fire speed, these drug advertising disclosures include world-class doozies like:

• Call your doctor right away if after taking Lunesta you walk, drive, eat or engage in other activities while asleep. (If you drive while sleeping, you may not be calling your doc anytime soon!)

Or the most famous:

• If you experience an erection lasting longer than 4 hours, called priapism, call your doctor immediately. (This warning rightly inspired a generation of stand up comics. But, apparently this condition is very real. A physician friend of mine told me that the medical indication for priapism involves a big needle… Nuff’ said on that one!)

The unfortunate reality is that the healthcare marketing problem is not just about bizarre and unintentionally hilarious advertising. It really comes down to marketing fundamentals, like really listening to and understanding your customers, being relevant, committing to quality customer service, delivering strong value, actually coming up with brand names that don’t strain credulity. You know, marketing 101. Too many healthcare companies just don’t deliver on these essential marketing tenets.

One of the underlying problems of the healthcare industry – this is particularly true in the pharmaceutical sector – is that the companies are oftentimes not even talking directly to consumers (no less trying to build positive, two-way relationships with them). For example, the structure of the pharmaceutical marketing business has traditionally been that the drug manufacturers sell directly to physicians. This involves a lot of former cheerleaders and athletes calling on doctors’ offices to peddle pills and give out free samples (the use of cheerleaders and jocks is literally true, by the way). Drug marketing has also typically included wacky drug ads in medical journals, honoraria paid to physicians who become “key opinion leaders” for various drug brands, and boondoggle meetings at cushy resorts. Not a consumer or patient in the mix.

So, instead of building a relationship with consumers (the patients who use and might need their drugs), the pharmaceutical companies have principally marketed through the physicians channel. This marketing structure was, of course, largely mandated by the government. And that is where the DTC advertising came into play, along with the machine gun style disclosures and side effects warnings at the back end of TV and radio spots, and in the tiny print on the subsequent pages of print ads. (Does anyone in their right minds ever read those things, except the lawyers and compliance people who wrote them?)

But, even with the FDA regulations and curbs on drug advertising, healthcare marketing could (and should) improve dramatically across the various industry categories. I am not just talking about the state of play in pharmaceutical advertising. This healthcare marketing gap is a big reason why major online players like WebMD and now Steve Case’s Revolution Health have been making a direct play for consumers on the web. The healthcare companies largely ceded the opportunity to build direct relationships with consumers/patients, so these savvy web media companies jumped into the breach.

Now with the growing push to digitize medical health records (healthcare is one of the last great industrial sectors where paper records still rule), other powerful players are diving into the game. Companies like Google, Microsoft and many other well known tech players are starting to compete for the mindshare and loyalty of consumers to get them to electronically store their health records on their platforms (thus giving these tech media giants the opportunity to sell a ton of advertising and search). This is just more dis-intermediation between the healthcare marketers and the people they should be engaging directly with: consumers/patients.

The fact is, healthcare companies are uniquely qualified to play a much bigger role in educating consumers about their health, and demonstrating real value that speaks to the true health and wellness needs of patients. No one knows better the issues involved, and what needs to be done to cure the problems in healthcare. But, too often healthcare marketers have seemingly preferred to just sit on the sidelines when it comes to interacting with consumers. This is either because of regulatory mandates (and concerns about same), or just the inertia of a business that never seemed to learn to understand and communicate well with the people who actually use their products and services.

The interactive power of the web and other digital media and marketing channels have opened up many new possibilities for healthcare marketers to engage more deeply and relevantly with consumers. This means educating and informing them about critical health and wellness issues, but it also involves bringing consumers and patients into affinity groups and communities of interest that benefit everyone. Most importantly, the Internet is allowing healthcare companies – from drug manufacturers and hospital systems to insurance companies and medical device makers — to listen much more to the real needs, interests, hopes and frankly fears of consumers (their patients). Some companies are even starting to use these tools and channels to “co-create” products and services with their patients. Ultimately, this patient-driven approach will only be a positive thing for consumers and the healthcare marketers alike.

It even appears that some smart healthcare marketers are starting to get that “old time” consumer marketing religion. I have been impressed recently with a major insurance company’s consumer advice and education programs. They use an integrated media strategy to reach out to patients to engage and involve them in this educational marketing effort. And, the drug manufacturers are implementing very innovative adherence programs to educate patients on the vital importance of actually taking and staying on the medicine prescribed to them (this adherence or compliance issue is one of the biggest problems facing healthcare, particularly as it relates to treating people with chronic diseases).

Progress is thus being made in healthcare marketing. But, there is still much that must be done to strengthen the necessary relationships and dialogues between the healthcare companies and the people who can most benefit from their advice, attention and support.

And, who knows, perhaps one day soon, the “hip” Boomer rock and rollers in the infamous “Viva Viagra” spot will be put out to pasture…where they belong.

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