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Showing posts from March, 2009
In Bruce Weber's latest book, "As They See 'Em: A Fan's Travels In The Land of Umpires," he wonders a bit at why someone would put himself (note: they are all men) in the position of being routinely spat on, cursed, and hollered at. I realize that I too could have been a baseball umpire. All of us in retail pharmacy, it seems to me, have the requisite training and inherent abilities to be a big league ump.I've had spittle discharged in my general direction as a matter of course. Cursed? Practically every hour of every day. Yelled at? Please. Only the linoleum saves my shoes from being covered in dirt. 
And the comparison does not stop at the abuse. Pharmacists, like umpires, must make split second decisions and then move on, ready for the next. I continue to recall the episode on "I Love Lucy," where Lucille Ball gets a job in a chocolate factory. The chocolates speed down the line faster than she can pick them up. Finally she begins to shove them in…
It all depends on who you talk to.
So I'm filling a prescription for insulin. Simple right? Nope. Not anymore.
The prescription for NPH insulin, an intermediate acting insulin, had been filled and refilled many times for this person. But this time her insurance rejected the claim. Apparently, as the rejection showed on the computer screen, it needed a prior authorization. For those of you not yet aware of this little bug-a-boo, this is when the insurance company says that the doctor needs to make a written statement showing that the treatment is indeed necessary, otherwise the insurance will deny. This is usually encountered for high priced medications new to the market. Usually a drug like Coreg CR or Ambien CR, where the drug maker reformulates to make it last longer but where the real benefit comes to the company making the drug because it gives them another year of patent life. But for insulin? Why would insulin need a prior authorization?
So I call. I get this nice sweet voice o…
Bad bugs the new white meat?

As reported by Nicholas Kristof in The New York Times recently (Sun, Mar 15th, "Pathogens in Our Pork), hog farms are now infected with the dangerous bug known as MRSA (pronounced "Mersa"). As estimated by the University of Minnesota, up to 39 percent of pigs on hog farms harbor the superbugs which are resistant to almost all forms of antibiotics. (More people die from MRSA in the United States than from HIV.)

Why? Same reason as why doc's give out prescriptions to treat viral infections like colds and ear infections: mis-use of antibiotics. As Kristof writes, more antibiotics are given to livestock in North Carolina alone than goes to treat the entire U.S. population.

This is all due to the tremendous leverage that the agribusinesses have on Washington politicoes. The citizenry is being plowed under for the sake of increasing the yield of hog, cow and chicken farmers.

It's as if the Congress is doing as Marie Antoinette, saying instead,…
From Economist.com (Mar 9, 2009, "The view from West Virginia"):

[Obama] insists that Americans who like the health insurance they currently get through their employer can keep it. But Michael Tanner of the Cato Institute, a libertarian think-tank, predicts that government insurance will crowd out private insurance. The government could offer insurance cheaply by dumping part of the cost on future taxpayers, and so crush its private competitors.
If that happens, hospitals will be squeezed. Currently, patients with private insurance cross-subsidise those in government schemes. (A typical hospital enjoys a profit margin of 48% on each privately insured patient and suffers a 44% loss on each patient covered by Medicaid, the government programme for the poor, according to McKinsey, a consultancy.) If that subsidy disappears because there are fewer private patients left to pay it, hospitals will have to cut back. European-style queues may form, the sceptics fret.

Firstly, why would …
What now, Republican?

David Frum in the Mar 7 Newsweek sums up Rush Limbaugh pretty well:
And for the leader of the Republicans? A man who is aggressive and bombastic, cutting and sarcastic, who dismisses the concerned citizens in network news focus groups as "losers." With his private plane and his cigars, his history of drug dependency and his personal bulk, not to mention his tangled marital history, Rush is a walking stereotype of self-indulgence—exactly the image that Barack Obama most wants to affix to our philosophy and our party. And we're cooperating! Those images of crowds of CPACers cheering Rush's every rancorous word—we'll be seeing them rebroadcast for a long time.

Why is that important for a pharmacy blog? Because if you are a Republican, as I am, your party may well be responsible for either sidelining universal health care or watering it down to where the insurance mafia wins what it needs to win for its survival.
As Rush becomes the arbiter of Repu…
We want the best and we want it now!

As The New York Times reported today (A Hurdle for Health Reform: Patients and Their Doctors, Mar 3, 2009), what fundamentally drives the costs in America's health care system is the desire on the part of doctors and patients for the best--meaning the costliest to most--new treatments and medicines. It doesn't matter if the upside is slim to none. Stick a high price on something and a few slick ad pages and Bam! you've got a winner on your hands. Ever check out the number of beta-blockers out there? How about ACE inhibitors? Gazillions and none of them work appreciably better than the first ones out of the block twenty-five, thirty years ago.

The Times cited a 2004 study (published in The American Journal of Public Health) that showed that only 1 in 16,000 people benefited from recent technology as regards their health.

Today I finally convinced someone not to bother with Tamiflu for her daughter. Was I being too harsh? You decide. Her dau…
The return of Harry and Louise?
Remember those ads featuring Harry and Louise, the middle-aged couple worrying over the governments plan for national health care back in '93? Largely credited for destroying Clinton's plan for the country they are back. Last year, during the 2008 Democratic Convention (and the Republican Convention as the Dems paid for the ad to be aired then too--smart!), the two were reprising their role, this time to explain that too many people were "falling through the cracks." Even the lobby--America's Health Insurance Plans--that created those original ads says it wants to play a different role this time (see The New York Times, Sun, Mar 1, 2009, "Liberal Groups Are Flexing New Muscle in Lobby Wars").
Well, good. Maybe Obama has the political momentum to get this done. I do think he has given too much power over the details to congressman. Who do you trust more to deal with this problem, Obama and his policy wonks, or those congres…