If I Can't Solve The Problem, I'll Laugh At It

A Better Health Plan



A prominent Canadian doctor was visiting an American hospital. During his tour of the floors, he passed a room where a male patient was openly and vigorously masturbating.



"My GOD," said the visiting MD, "that's disgraceful. What is the meaning of this?"



The local doctor that was leading the tour explained; "I'm afraid this man was diagnosed with a very unusual, yet serious condition where the testicles rapidly fill with semen. If he doesn't relieve himself in this manner at least five times a day, he has to endure incredible pain and the potential rupture of his testicles."



"Oh, yes... of course," replied the visiting doctor, as if he were quite familiar with the condition.



On the next floor they passed a room where a young nurse was giving a male patient a blow job.



"GOOD GOD!" exclaimed the Doctor, "How do you explain this?"



The American doctor replied, "Same illness, better health plan."

The High Cost of Medicine

Freddie was a patient I had in my case load. His psychiatrist put him on a new drug named Consta. Actually, Consta is just an injectable, long acting form of Risperdal. Injectables have certain advantages for patients who are often unwilling to take their medication regularly or are unable to take their medication properly due to their thought disorder. Therefore, Consta was a good choice for Freddie.



It is my job to make sure patients have a place to live once discharged along with continuing treatment AND a steady supply of their medication. In Freddie's case, he had Louisiana Medicaid, and it was the kind that pays for medication. This scenario is the best I can hope for, because we just have to call his prescription into a pharmacy and he can pick it up with a $3 copay. Now Consta is not a medication a patient can administer themselves. Since Freddie attended the local mental health clinic, they could take care of that little task. I have been doing this job long enough to know not to take anything for granted. I called Medicaid just to make sure Consta was on their formulary (list of drugs they administer.)



What follows is the typical "catch 22" where healthcare and medication are concerned. Medicaid did not cover the medication yet. No surprise, they just put aspirin on the formulary last week. Now I had to dig deeper into the social work playbook. I called the drug company and told my story to the requisite 5 people before I got transferred to someone who could help me.



Most of the time, drug companies sample new medications. They give it away so MD's will try it. The thought being, if you try it you will like it. Consta, however, was not sampled because it cost $500 per dose. A dose can last from 2 weeks to 1 month. Freddie needed $1000 worth of Consta per month. I am not sure, but I think crack cocaine is cheaper and their customer service department is more user friendly. The catch 22 is that there was no patient assistance program for Freddie because he had drug benefits (Louisiana Medicaid.) I explained to the nice lady that LA Medicaid did not have Consta on the formulary. She said, "I know, it's kind of a catch 22 huh?" I am no stranger to situations like this. Deeper into the social work playbook I dove. "If I call our drug rep could she help somehow?", I fished. "No sir, at this time, we are not sampling Consta because it is too expensive." I knew I was defeated at this point unless I could pull, either a large sum of money or a large supply of Consta from my ass.



"Ok," I continued and thinking ahead, "this patient cannot stay on Consta. What is the equivalent of regular Risperdal, since we have to convert him to that drug?" So we talked, and after her disclaimers about she couldn't really say, and the doctor really needs to be the one to do this, and I am not really saying this, but. . . (lawyers are responsible for this crap) . . . she finally gave me an answer. Freddie was switched to regular Risperdal and the great Consta experiment was over. Consta may be a fine drug, but the population it is designed for cannot afford it.

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I have talked to drug reps and they always give me this line how they spend so much on R&D. They say a drug takes years to develop and the cost is a means of recovering their investment. It seemed rational, but I do not believe it anymore. There is nothing wrong with making profit, but don't masquerade as a human service organization when you are only about money and drug companies are only about money.



Why are drug costs less in Canada? Because the United States subsidizes them. Canada has national healthcare. They say in essence. We will pay X for this drug, take it or leave it. The drug companies take it, because they can bilk the US citizens to make up for it.



Here is an interesting little chart I found here.









Drug companies spend almost twice on marketing what they spend on R&D. I knew the cute girls in short skirts bringing lunch and passing out expensive pens could not be cheap. Drugs do not need this kind of marketing. If the drug is good, MD's will find out. The drug compainies pay physicians consulting fees, which is just money under the table to Rx thier drug over some cheaper, equally effective version. The devil is in this I know it.



I do not have the answers. This is a huge problem. I have health insurance and medications are expensive for me. Those without insurance and not eligible for government programs cannot afford medicine. They get sick and go to an emergency room. The emergency room must treat the person or be in violation of EMTALA laws. The government loves to penalize hospitals. We are in a quagmire of policy, law, free enterprise, politics, and a lot more. Bush can't fix it, neither can Kerry or any president or party. They are part of the problem.



The drug companies are companies who answer to stock holders and are profit machines. It is not in their best interest to sell medicine cheaper if they can get higher prices. Still, if they could see Freddie, a guy who lives in a group home and has nothing to his name except a drug bill greater than the drug executives annual green fees. Who will help the Freddies of the world?



I don't know.



Until the next time

John Strain

Kites

I am still in my first year of blogging. I like it when I have a thought or a memory which sparks a post. Today's post is a result of just being outside and because of the windy weather and the smells of springtime, I thought about kites.



Kites conjure happy images of childhood. I was born in March, so pictures of kites were always on the big wall calendar at school. Kites are signs of springtime and playing outside without coats. Do you remember the feeling of a kite pulling on the ball of string you are holding? Can you smell the sweetness of the fresh grass and flowers? If you try, you can see a dancing kite in your mind's eye, darting about in the bright blue sky, with its tail flowing behind. If you try, you can hear children's voices and happy screams. Those were the days.



When I was a kid, kites cost about 10 cents. They were made of paper which tore easily. A string ran along the perimeter of the kite and it served to hold the balsa wood frame in place. Some kites never made it past the assembly stage. Either the stick would break or the kite would tear. Few things devastated me more at the time than my dreams of kite flying dashed, due to such tears and breaks.



Assembly was not complete without a trip to the rag pile to fashion a proper tail. Any decent tail had a series of knots tied into it about every 8 to 10 inches. My dad was called in for technical support to tie the string on the front of the kite and to tie the ball of string to the kite itself.



With the kite ready, one only needed a windy day. In Kansas, spring held many windy days. Some days were too windy. The gusts would come and go. The wind that cooperated in lifting the kite might also slam it in the ground shattering the kite and any hopes of kite flying for that day. The best days were with a steady wind from one direction. If I had help, I would go into the backyard or on the street. The friend would hold the kite in the air and I would run. If the kite climbed, I would let out some string. Before long the kite would be flying and I would be in the magic zone. Looking up into the blue heavens watching the flying speck tethered to my ball of string.



Those moments were short lived and most of the kite flying experience was running with a kite behind me rising to heights of 10 feet, then back to the ground. I usually got enough success to keep me at it for a while - long enough to sear pleasant memories in my brain to recall now. The wind and the smells of spring make these memories fresh again.



I never got one of the box kites. They were bigger and had more pieces. My dad said they did not work anyway, so we always got the 10 cent kite. As I got older, they began to introduce plastic kites with plastic frames. I had a few of those. It seems they had super heroes on them like Superman and Batman.



Today, kites have gone high tech. Made of space age material and engineered in wind tunnels, they practically fly themselves. They are nearly indestructible. Kids today may not ever know the feeling of having their prized kite dashed to splinters and scrap paper by an ornery March wind. What will they ever do to build their character?



So that is my walk down memory lane. I feel like flying a kite now, maybe I will.



Until the next time

John Strain

Manresa On The Mississippi

I am going on another road trip this week. Thursday through Sunday is my annual pilgrimage to Manresa on the Mississippi. This beautiful place of 130 acres is located in Convent, LA, which is midway between New Orleans and Baton Rouge on the Mississippi River.



It is a Jesuit retreat center. The unique thing is these retreats are silent. After dinner on Thursday there is no talking until lunch on Sunday. This will be my 7th time to attend. At first, the silence was difficult, now I look forward to it.



The grounds are magnificent. Oak trees several hundred years old with spanish moss are plentiful. Egrets lazily fly along the river. It is a peaceful, serene place.



I will write a bit more about Manresa. Check out their website I referenced above. Here are some photos I took two years ago.



















Here's to a three day work week



Until the next time

John Strain

He Is Risen!

He is not here; He is risen, just as he said. (Matthew 28:6)



Think for a moment. You saw Jesus crucified on Friday. There was no question he was dead. Your hopes were killed along with him. Still out of love and sorrow you are going to his grave Sunday morning. On your way to the tomb, there is an earthquake, then when you arrive, a messenger from God tells you Jesus has risen just like he said he would. How would you feel? Confused, disbelief, shock, happiness, elation, all of these?



Easter morning for Christianity is what sets it apart from other religions. "We serve a living Savior." "Because He lives, I can face tomorrow." As the songs go.



A Christian is told how to live and how to die. As Paul said, to live is Christ and to die is gain. Being a Christian is a life of joy. When sorrow comes, there is a foundation of hope. When death comes, there is the promise of new life.



May your Easter Sunday be a happy and meaningful one.

John Strain