Persnickety

  When the status quo works so well, I mean. That's the impression I get when I visit the government affairs section of APhA, the site for the American Pharmacists Association. On the docket for the Advocacy Agenda is … Single-payer insurance? No. Health care reform of any sort? Nope. How about controlled substance policy and medguide management? Well, of course. You know, the really important things. After all, we need to nip these medguides in the bud. In…the…bud! We're bud nippers at APhA, that's what we are (apologies to Barney Fife). Why doesn't APhA get it? Not sure. I suppose they might be afraid their members could be on the short end of the stick (again), but if that is so it seems to me that the smart course of action would be to get in on the ground floor and advocate for change that benefits pharmacy. And change is coming, sure as shootin'. APhA might also like the existing system. Nah. No one likes this system short of the insurance companies. So what ...

Fads come and go, they say, but one that keeps on coming back is the Detox Diet. This is where you take certain herbs, or adjust your diet, or even put pads on the feet—I'm not kidding!—and the body is detoxified, rid of dangerous poisons. Exactly what are these toxins? The ads don't like to say, but they're dangerous, taking years off our lives, we're told. The one getting all the attention is called "Master Cleanse." This diet has you drinking about ten glasses of a lemon juice, cayenne pepper, and maple syrup concoction. Expect to spend your next ten days in the bathroom. Essentially you are starving your body, thereby releasing "toxins" from fat cells. What you are really doing is forcing your gut into diarrheal states for ten days. Not a good idea. Another is the Martha's Vineyard Diet, started by a nurse (so it has to be good for you, right? Wrong.) Here you get to drink a lot of distilled water, protein shakes, vegetable shakes, and a lot ...

"Imagine waking up one day and all your medical decisions are made by a central, national board," says one Richard L. Scott, who seems intent on bashing Obama's plan for a health care re-do. Before we get to Mr. Scott (see New York Times article "Health Critic Brings a Past and a Wallet," Thu, Apr 2, 2009), I'd like you to ponder that sentence. First, waking up at all is a nice thing these days, given the state of care in this country. If you're a pregnant female, a child, or an elderly person, or anyone with a chronic condition such as diabetes, debilitating pain, heart disease, etc, then God help you. Doctors are too busy with insurance issues to care too much for you and your problems. And they are too afraid of you to actually get to the bottom of things. Afraid you'll end up suing them, so they end up testing you for anything, but don't want to say too much, or spend time with you listening. Just test, bill, test, bill. But let's say you...

Fox News (I'm sorry but saying that always makes me cringe) has a recent piece of propaganda that must have been hot off the Republican National Committee To-Do List press. In its Media Matters for America segment ( http://mediamatters.org/items/200903300029 ) Betsy McCaughey (ex-lieutenant governor of New York) and Martha MacCallum speak on the topic of Natasha Richardson's recent death. The Republicans are trying to derail Obama's health care reform. They, being bought and paid for shills of the insurance lobby, hope to convince Americans (remember Harry and Louise???) that single-payer health care is the devil's plaything. Trying to pin the blame of the gifted actresses' death onto the Canadian system, McCaughey invokes the "cost-benefit" analysis innuendo. As if Canadian doctors carry around calculators and clipboards along with their stethoscopes. As one of the commenters on the site remarks, " I find this "report" appalling on so many ...

www.thepetitionsite.com/1/conservadems-you-should-be-replaced Someone I follow on Twitter gave me this site. I think you should read it and sign it. Anyone interested in fair health care for Americans needs to get on board. Here is the petition:   EVAN BAYH (IN) has organized a conservative democratic caucus called CONSERVADEMS specifically organized to oppose several Obama agenda items that we voted FOR him because we hoped they would be … accomplished! There are 15 senators that are willing to admit to being CONSERVADEMS AND 3 OR 4 MORE WHO attend the meetings but refuse to be named.  They actually want to PREVENT HEALTH CARE LEGISLATION FROM PASSING BY MAKING SURE THAT IT IS BROUGHT UP IN A WAY THAT WILL BE SUBJECT TO REPUBLICAN FILIBUSTERING.  They also want to water down the president's climate change legislation and reduce federal spending.     Didn't we work, contribute and vote for President Obama and his agenda for a reason?  Now 59 days into his term and they are...

  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 ...

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...