Dear Governor Haslam,

Governor Haslam: You’re Missing the Point When Offering Free Tuition

In your recent State of the Union address, you introduced your plan to make community college free to graduating high school students. You even suggested how you’d pay for it. Sadly, Governor, you’re ignoring a much greater need.

Consider, Sir, that the best way for success in college is preparation in K-12. It is there where the need is greatest. It is there where you should place your emphasis, and the state’s monies.

While this may seem like a cheap shot, I assure you it isn’t. It is a call for practicality over political showmanship. Community colleges across the nation are the dumping grounds students needing remediation before education. Fully sixty percent of students entering colleges of any sort (2 yr./4 yr./technical, it doesn’t matter) are functionally unprepared for the rigors of learning at that level. 

That’s not just a Tennessee problem. It’s endemic everywhere. A report by higher education.org, offered the following insights:

“While access to college remains a major challenge, states have been much more successful in getting students into college than in providing them with the knowledge and skills needed to complete certificates or degrees. Increasingly, it appears that states or postsecondary institutions may be enrolling students under false pretenses. Even those students who have done everything they were told to do to prepare for college find, often after they arrive, that their new institution has deemed them unprepared. Their high school diploma, college- preparatory curriculum, and high school exit examination scores did not ensure college readiness.”

In a nutshell, community colleges, indeed all colleges, have to provide courses to educate students in things they should have mastered throughout their K-12 years. So, offering students a pathway to a free education on the state’s dime will have the same result as sending them to school on their own money. The drop out rate will be the same, performance will not improve and our workforce will not be enhanced.

I’m not suggesting that community college should not be free. To the contrary, education should be free for all four years. But the quality of students entering these august bodies has to be at the level necessary to insure the success we all want: higher performance, students completing college on time.

Governor, if you’re serious about improving the education system in the state, you’ll necessarily have to focus on pre-K. You’ll necessarily have to invest in eliminating poverty, the proven cause of poor performance at all levels. Children entering school ill-prepared to learn for lack of basics will soon enough be the students failing in reading and math, the students who act out in class and disrupt learning for everyone else.

Investing early guarantees that we won’t be paying a lot more later through social systems interventions.

Governor, you’re not facing an either/or situation. You’re looking at and ‘AND’ opportunity: the opportunity to prepare children early, when results are better and longer lasting; and, the opportunity to provide free educations for young people who are prepared for its rigors.

Joe Malgeri

Dandridge, TN

http://www.highereducation.org/reports/college_readiness/CollegeReadiness.pdf 

Di Angelo 2

Angelo approached the dinner table with a broad smile on his face, satisfied that he had just finished a productive session at the computer. The words had flowed forth and, when the bell rang to announce break time, he was at just the right point to put things away.

Linda, his wife of 26 years, walked from the kitchen carrying  small plates of pork chops in one hand and yellow squash in the other. It was their  attempt at eating healthier, and it seemed to be working.  

Angelo pulled her chair from the table and motioned for her to sit, then poured the Merlot and took his seat.

“Are you studying chivalry in class, too?” she asked, teasingly. 

“No. It was a spontaneous move. You were there, I was there, Seemed like the thing to do.”

“Well, keep it up. I like it.”

Angelo raised his glass. “To us, and to retirement. Four more years.”

“To us.” she echoed, a lilt in her voice. 

Linda looked intently at her husband, sitting some six feet away, far enough for her to take in his physical wholeness. She felt a sensation of his strength even at a distance. 

“That writing class has changed our lives. You are not the man I married.”

Angelo absorbed the words, letting the meaning settle into him. “I think you’re right, And, yeah, this class has made a big change. Louisa has us all digging deeper into ourselves than we ever have. I never thought I’d see grown men tear up. but in this class they do. We’re finding more about ourselves than we ever knew existed.”

He cut his pork chop and began his meal, savoring the flavor and analyzing the texture of the meat. Where once he would have downed his meals in short order, these days he found himself intentionally enjoying them. He sipped his wine now, letting it sit for a moment on his palate. Life was indeed different now. Better.

“Louisa gave us a piece to read the other night, by Nietzsche. He wrote, ‘We are unknown to ourselves, we men of knowledge - and with good reason. We have never sought ourselves - how could it happen that we should ever find ourselves? It has rightly been said: "Where your treasure is, there will your heart be also"; our treasure is where the beehives of our knowledge are.””’

Smiling softly, he let the words sink in. 

“My treasure is with you.”

He looked into Linda’s eyes and said no more. She returned the look and moisture filled her eyes. “You really aren’t the man I married. You’re so much more now. I don’t recognize you but I love you so that my body quivers.”

They sat quietly for a while, as the food cooled on their plates.

                               ------------------

Memories of the night lingered with him as he sat in the squad car, John Mercer at the wheel. In moves that had seemingly been scripted, Linda and Angelo left their meals, stood to meet each other along side the table and kissed, softly and with passion like their first days together. The plates remained until she removed them in the morning, largely untouched.

“A penny for your thoughts,” John said to stir his partner. You in there?

“Yeah, I’m here.”

Angelo quietly returned to live in the moment. 

“Linda and I started our meal last night but we left it for other things. John, I’ve got to tell you, life is getting better.”

“I’m happy for you. To tell you the truth, whatever’s going on in your life, we all see it. You’re a different man. Better.”

“Linda said the same thing last night. And, she cried when she said it. Louisa. She’s changing us all.”

“That’s all I hear anymore, Louisa, Louisa. She cast spells on all her men?

“And the women, too. Some of them aren’t women, really. They’re girls. They’re in their twenties, and what this class is doing for them is growing them a whole lot different than we grew girls when I was twenty. She’s teaching them to think deeper. She’s making strong, capable, confident women.”

“And the guys? How many are boys?”

“None in this class. There are no twenty something men in the class. Their all old like me, in their forties or better. For some of them, this is painful.”

“If it’s painful, why do they stay with it?”

“Because they’re discovering so much about themselves that they can’t leave. It’s painful because they’re raising questions about their lives. They’re saying, ‘I didn’t know this or that. If I had known, things would have been different. So many regrets. So much to do over, and wrongs to make right.”

“And you, any regrets?”

“Buckets full. But, hey! I’m young! We’re healthy. We’ve got time.”

“Wow. where do I sign?”

“You should do this, too. Come to a class with me.”

“I’ll think about it. I worry it might take the edge off my game. You need edge to be in this game. A cop always needs edge.”

Angelo’s head tossed back slightly as John’s words penetrated his head. He knew exactly what John meant. It was something he feared, especially now that he was changing. He turned toward John and studied his face.

“Am I losing my edge,  John?”

John kept his eyes on the road , saying nothing. His eyes blinked with increased frequency as if flipping through photos or watching video.

“No, I don’t think you've lost your edge. In fact, I know you haven't. You just shot a guy to protect me. There was no second guessing there. You saw your duty and you did it. So, I’d say you still got it.”

John pulled the car into a parking spot at Genlott’s Diner. Turning the car off, they sat quietly in the cruiser for some time. John was the first to exit the vehicle. As he stood, left arm draped over the door, he looked over the roof of the car at Angelo. “I think what’s different is the ‘how’.” 

They shut their doors and headed to the diner. As they entered, John looked quizzically at Angelo. “Beethoven. Really?”

Di Angelo

POLICE CAPTAIN’S OFFICE          CHICAGO                          LATE AFTERNOON

Disbelief mixed with anger fills Captain  RALPH  GILLIS’s face as he confronts  Detective ANGELO DI ANGELO

                                   CAPTAIN

 Four times, Angelo! You

shot him four times!

                                  

DI ANGELO

Yeah.

                                  

                                   CAPTAIN

What were you thinking?

                                   DI ANGELO

 He was killing my partner.

  What’d you expect?

                                  

                                   CAPTAIN

        But four times. Once wasn’t

 enough? Maybe twice?

                     DI ANGELO

                     You weren’t there.                           

CAPTAIN

You’re right. And it isn’t the

number, anyway. It’s the how.

                                  

DI ANGELO

                     How?
                                   CAPTAIN

How you did it. You blew

out his knees and his elbows

DI ANGELO

I immobilized him

CAPTAIN

You think?

A brief calm dissipates the tension. The Captain motions DiAngelo to sit as he takes his seat behind his paper-laden desk.

                                   CAPTAIN

What I don’t get is,       

how could you shoot him

so strategically. What were

you thinking?

                                   DI ANGELO

                     It was a right brain action,

                     Captain

                            

CAPTAIN

                     What the hell does that mean,

right brain action? Our shrink’ll

have a hell of a time with that.

  

DI ANGELO

I mean I was operating off

the right side of my brain,

the creative part.

DiAngelo leans in toward the desk, his forearms touching the edge.

             

              DI ANGELO

Captain, he had John wedged

up against the pillar, his forearm 

crushing John’s Adam’s apple.

DiAngelo’s right arm raises, his hand making a simulated handgun.

                                  

DI ANGELO (Con’t)

Shooting his legs out from under him changed all that. He fell to the ground 
like a lead weight

                                   CAPTAIN

You couldn’t stop then?

                                   DI ANGELO

Of course not. This guy’s

a soldier. He’s been shot

before.

 DiAngelo leans back into his chair

DI ANGELO (Cont’d)

A bullet or two was not

going to take him out.

As he fell, I saw he had

a gun in his hand.

DiAngelo Raises his two arms, bent at the elbows to demonstrate:

       DI ANGELO (Cont’d)

He landed flat on his

back with both arms up,

so I shot his elbows, first the one with the gun, then the other.

DiAngelo drops his arm, rests again in his chair, smiles broadly a Cheshire Cat grin

DI ANGELO (Cont’d)

I thought I did it creatively,

don’t you? In fact…

DiAngelo lifts his arms gently, his fingers outstretched as if conducting

DI ANGELO (Cont’d)

...I heard music playing in 
my mind while it happened.  
Beethoven, I think.

The captain shakes his head in wonderment, then looks up to see JOHN MERCER walk through the door. Di Angelo stands up, moves toward his partner. They embrace heartily, John kisses Angelo on his left cheek. Mercer pulls back slowly, smiles

                                 JOHN MERCER

I owe you one

                                 DI ANGELO 

Nah, not at all. I was telling

the captain, here, it gave

me a chance to be creative…

Di Angelo touches his right index finger to his right temple

            DI ANGELO (Cont’d)

…to give my right brain

free rein over the left. I can’t

wait to tell the guys in my

writing class

                                 CAPTAIN

                            Enough of that crap, Angelo                                 
                            Save it for the shrink

Captain leans back in his chair, his right arm raised, a pen in his hand.

     CAPTAIN (Cont’d)

Tell her how you cost the

City  half a mil to reconstruct

this guy’s limbs.

                                DI ANGELO 

                            Don’t forget the 50 thou a year 

                            to keep him in prison.

       He’s a young man.Could 
      be millions

  The captain shakes his head, chin to chest                                        
                            
                                CAPTAIN

                     One bullet to the head and

we’d have had closure   

Captain shakes his head wryly, looks directly at Di Angelo, who returns the look with a grin

                                   
                               DI ANGELO 

That’s not closure, Captain.

Not for me,

Angelo again moves toward the desk, eager to reinforce his opinion

                                  

                                   DI ANGELO 

He and his friends blew out

a building. They killed eleven

civilians and two rent-a cops.

Di Angelo sits back slowly, continues

                                   DI ANGELO (Cont’d)

If I killed him, there’d be

open wounds, and questions.

‘Why them, why today, what

were they thinking?’

DiAngelo pauses for effect, looks at the two men in turn

              

            DI ANGELO (Cont’d)

 It’s no difference with suicide,

 all that sadness and anger– but 

 without answers. Now it’s 

 different. Better.

                                   CAPTAIN

                      Tell that to the Comptroller.

                      You just blew the budget for

                      the year on hospital bills.

                                   DI ANGELO

                       I’m not responsible for budgets

   sir, just my partner.”

The captain pushes himself from his chair using the arms

CAPTAIN

                      File your reports, both of you       

Captain turns to Di Angelo, a softer look on his face

      CAPTAIN
And, Angelo. Make your 
appointment with the shrink. 
Now.

  

I found this terrific article by Senator Elizabeth Warren posted on my FB page.

Coming to a Post Office Near You: Loans You Can Trust?http://www.huffingtonpost.com/elizabeth-warren/coming-to-a-post-office-n_b_4709485.html  

It opens with this:

"According to a report put out this week by the Office of the Inspector General (OIG) of the U.S. Postal Service, about 68 million Americans -- more than a quarter of all households -- have no checking or savings account and are underserved by the banking system. Collectively, these households spent about $89 billion in 2012 on interest and fees for non-bank financial services like payday loans and check cashing, which works out to an average of $2,412 per household. That means the average underserved household spends roughly 10 percent of its annual income on interest and fees -- about the same amount they spend on food.

"Think about that: about 10 percent of a family's income just to manage getting checks cashed, bills paid, and, sometimes, a short-term loan to tide them over. That's more than a full month's income just to try to navigate the basics.

"The poor pay more, and that's one of the reasons people get trapped at the bottom of the economic ladder."

This is an AWESOME IDEA. The infrastructure is already in place. It is accessible even in remote areas. It helps the people who need it most.

If you have never gone into a payday lending store, you should. They are, by law, obligated to display their fees in APR so people know what they are getting into. In Tennessee, people are paying over 400%. In TX, good ol' boy Rick Perry's domain for the moment, the APR is over 1100%. They don't just steal from the poor. They rape, ravage and discard them.

In days gone by, people could take their paychecks to the bank used by the employer. They didn't need a checking account. Then corporations got smart and realized that it they used an out of state bank, it would take time for the checks to clear their accounts -- and they could make money on the float. In the end, all their behaviors are influenced by money, and the easiest way to make money is on the backs of the poor. They have few choices, after all. For them there is little recourse.

http://www.huffingtonpost.com/elizabeth-warren/coming-to-a-post-office-n_b_4709485.html 

Mail Order Pharmacies  -- What you don’t know 

Mail order pharmacies grew out of the market need for greater convenience and efficiency at lower costs. 

At the time, it seemed logical enough. Place your orders, get your prescriptions at home. What could be better than that?

What was left out of the analysis included the following:
 Customer-pharmacist relationship
 Changes in doctors’ prescriptions
 Weather Sensitive drugs
 Delivery issues
 Ownership

Customer-pharmacist Relationship

Most people trust their doctors but they trust their pharmacist more. They see the pharmacist as the last line of defense when it comes to their health, and their lives. Mail order houses are fine if all you want is a drug. If you want advice, if having a local pharmacist to consult with is important to you, then the package in the mail box is not for you. It’s not for me, either.

But, if you are getting the same drug month after month, and you know that’s how it’s going to be, then maybe the savings take precedence, especially if you’re on a fixed income. After all, look at all the people who get their diabetes drugs that way. Works for them, doesn’t it? 

Life is always a balance of values. What is more important is always the deciding question and the answers are not often easy. The decision is made harder if you’ve bought prescription drugs for some time and have developed a relationship with your pharmacist. You come to rely on their advice. In 2013, “Gallup’s annual Honesty and Ethics survey* show that pharmacists ranked second, finishing ahead of physicians and second only to nurses. It is the ninth consecutive year in which pharmacists have ranked in the top 3.”  

Sometimes the choices are not left to you. Increasingly, insurers are encouraging their clients to use mail order to keep prices down. One way to do that is by adjusting the patients’ co-pays. For example, you can fill your prescription at your preferred pharmacy and pay a co-pay ($4 or more). Or, you can fill it through mail order and have no co-pay. The choice is still yours but there’s a cost to you. What do you value more? If you’re on a limited budget, there really is no choice.

Pharmacies across the nation are facing a challenge to their existence. It’s not the first challenge they’ve encountered and it’s certainly not the only one. They will try to adapt as they always have, and some will succeed. Some pharmacies offer special on-site services, such as blood sugar testing and personal consultation. Others are offering classes on topics of interest to patients. The value of these services often moves the balance in their favor. Competition drives creativity.

Changes in doctors’ prescriptions

Most prescription drug users change prescriptions frequently, especially in the first few months of treatment, when there’s a learning curve involved.  Each patient is different and so are the drugs. Whether for ADHD or depression, blood pressure or diabetes, a drug that works fine for one person may be less effective for another. This even applies to something as simple as the dosage. A 20mg dose that’s good for you is too much for someone else. 

Mail order houses don’t respond well to such changes. As a result, you may institute a change but you still get the same drug shipped. Or, as often happens, you get two scripts. The result is that your medicine cabinets fill with stuff you didn’t need and certainly didn’t want. Either way, the mail order house gets paid.

Time is also an issue. If the doctor wants to change your medications, it can take a few weeks until the new drug arrives. The solution to that dilemma is the local pharmacy, if it’s still in business.

 Weather Sensitive drugs and Other Delivery issues

Many prescription drugs are temperature sensitive. Some require refrigeration to remain effective. Delivery by mail is risky, especially in rural areas or for full-time workers who cannot be home to take delivery. It is not uncommon for a person to find a package delivered to the back porch, set next to the garage or placed somewhere the homeowner never considers to look. A misplaced book is one thing. A mis-delivered prescription is more serious, if not deadly.

None of these issues exist with community pharmacies. Many community pharmacies will even deliver prescriptions to people who cannot make it in themselves. It's the neighborly thing to do, after all.

Ownership

What is a mail order house, anyway? It’s a huge warehouse-distribution center, not unlike amazon.com. Tens of thousands of drugs, each in its own large container, each dispensed in specific quantities into smaller containers, labeled and shipped. Nothing magical here. 

Mail order houses came about to fill a need for efficiency in drug distribution. Insurance companies could save a small fortune using an outside source other than a pharmacy to dispense drugs. In a way, it eliminated thousands of middlemen and all that cost. 

What could be better? One thing. What if the insurance company owned the mail order house. What better way to keep costs in check. 

Today, the largest pharmacy chain owns its own PBMs, along with the metaphorical ‘keys to the kingdom.’ So, when your employer gives you a prescription drug benefit, chances are it is one of two PBMs which, together, account for over 95% of all prescriptions filled across the nation. They, in turn, offer you choices: a low co-pay if you choose a preferred pharmacy, like their own; a zero co-pay if you use mail order, also their own; a higher co-pay if you use a non-preferred pharmacy; and a higher co-pay if your doctor prescribes a drug that is not on their “formulary’ ( a euphemism for a drug they can’t make enough money on).

To carry the story to its conclusion, after you’ve made your selection, picked up your meds and are using them as prescribed, the PBM then charges your employer whatever it wants, sometimes as much as 40x what the pharmacy was paid, and even more than when its own mail order house was the fulfillment source.

No Co-pay?  --  It’s not always such a deal

Unless you’re a cash buyer, you may have no idea what the drugs you use really cost.* For example, I priced out my script for Clopidogrel (generic Plavix) at my local community pharmacy**. I paid $12. That’s the total cost.

If I use insurance, I can pay a small co-pay of about $7. That’s a savings, right? Yes, it is -- to me, but it is not the total cost. If your insurance is through your employer, the total cost to the company can be $20 or more. In some cases, your employer might be paying millions in overcharges and neither you, nor any of your co-workers will ever know. Heck, your CFO may not know it, either. If you are on Medicare Part D, they might get charged $20 or more, too. (Read my blogpost**)

This stems from the relationship between the insurer and the Pharmacy Benefit Management company (PBM) that manages their prescription drug process. As a consumer, you more than likely have never heard of a PBM, the guys who process all those claims. But, they’re there, and their actions border on the criminal.

A great way to explain this process is, as one expert put it, to talk about pizza. Let’s say you own the company and that you love your employees. Every few weeks you throw pizza parties at all your different facilities. Over the course of a year, you’ve bought lots of pizza, of all sorts -- plain, multiple toppings, deep dish, Chicago-style, you name it.

Now pizza is not your business. Your company makes things or provides valued services. That’s what you focus on. The pizza is an employee benefit. Buying so much pizza is complicated. So, you hire Ralph, world renowned for managing pizza benefits. You tell him to bring you a pizza and you give him a crisp $100 bill. He returns with a piping hot ‘Supremo’ pizza, extra large, the aroma from which fills your office. He gives you $21 in change. So, it stands to reason the pizza cost was $79, some for the pizza, some for the ‘process’. 

What you don’t know -- and can’t know, is that the pizza cost Ralph $14.99. The retail price is $24.99 but Ralph buys in such volumes that he can negotiate for the best prices. Over the next few years, the price of pizza increases by 12-15% per year. By year five, that same pizza now costs your company $158! 

So, you call Ralph in for a ‘discussion’. He says, look, raw materials and labor have gone through the roof. That’s what pizzas cost today.  You have some tough decisions to make. Do you make your employees pay a co-pay? Do you find that you may have to stop giving the benefit altogether because it has become too expensive?

You ask someone in HR to look over the contract you have with Ralph but it’s almost impossible to understand. What is clear, though, is that by agreement, you cannot talk to the pizza maker. Oddly enough, in Ralph’s agreement with the pizza maker, he cannot talk to you, either. And what you don’t know, and what he can’t tell you, is that the price he gets for the pizza has only gone up $2 over that time. Guess where the money went.

You decide you’re going to audit Ralph. Fine, he says, but you have to use an auditor of his choosing. It’s in the contract! You wonder who, if anyone, in your company, ever read the contract before it was signed.

You decide to shop around with one of Ralph’s competitors. They confirm that prices have been going up at outrageous rates but, they’re system will save you future expected increases. That’s one way to go. Chances are, you’ll end up with similar results, just from a different vendor.

You, dear reader, may think this is all fiction. I point you to a recent article in Fortune Magazine (Painful prescription By Katherine Eban***), a quote from which says,

 Schenk decided to figure out where Meridian's money was going and why its drug costs were    escalating. That was no easy task because, like most PBM customers, Meridian received data only on what it was being charged for each employee prescription. Meridian didn't know what it cost the PBM to fill that order.

 Then Schenk had a stroke of inspiration. He realized that Meridian had a second stream of data that almost no other PBM customers had: Its in-house pharmacy was paid by Express Scripts for many prescriptions. That meant Meridian could see both what the  PBM was paying to buy drugs and what it was selling them for.

 When he compared the two lists, the mild-mannered pharmacist was shocked: Express Scripts was making huge gross profits (known as "spreads" in the PBM world) ranging  from $5 per order to many multiples of that. In one particularly extreme example, Meridian was billed $92.53 for a prescription for generic amoxicillin filled at an outside pharmacy. Meanwhile, Express Scripts paid $26.91 to Meridian's own pharmacy to fill the same prescription. That meant a spread of $65.62 on one bottle of a generic antibiotic.

   

The Same PBM that is ravaging US corporations is also managing the Medicare Part D, Medicaid and TriCare. Go figure. You may not know that Part D came into existence under president George W. Bush, and that the law: 1) kept the regulator from negotiating drug prices with Big Pharma; and, 2) prevents the regulators from looking behind the curtains to see how much the pizzas really cost. When you as ‘Joe and Jane citizen’ hear legislators cry out that government costs too much and that Medicare is a major drain, it was they who passed the bill into law! It was they who kept the regulators from doing their jobs.

"What do you think?

Would you rather pay $200

for a prescription of AstraZeneca's heartburn medicine Nexium

or $620?"

Those were the opening lines of an article posted at fiercepharma.com* reporting on Maine’s new law allowing importation of prescription drugs from Canada, the UK and Australia. And, it reinforces the reality that some of the greatest mail order services for American consumers are outside our borders. 

How is it that possible? There are two reasons. First, the Canadian government negotiates prices with drug manufacturers. Their prices for brand name prescription drugs are significantly lower than those paid by consumers at pharmacies in the United States. That in itself makes Americans ask, “Why do they get the deals and we don’t?”

The answer, in a nutshell, is that their legislators work for the people, while most of ours work for corporate interests. It’s not exactly a secret.

Drug manufacturers and pharmacies are furious that their US customers should go off shore. They point out there are laws against it, citing the health risks of buying from unknown foreign sources.  They fail to mention that what Americans are buying were made by them and sold to Canada, Australia, New Zealand and the United Kingdom. Each product has all the tracking information on it to prove its validity. 

American pharmacies want the practice stopped because it hurts their business. But all consumers want are fair prices that permit them to buy the drugs they need at prices they can afford.  

The facts don’t support their spurious claims. Facts are not their friends. But politicians are. One look into Big Pharmas’ contributions to federal, state and local politicians’ coffers and it’s easy to see a correlation between those contributions and legislation favoring pharma’s interests over consumers. As is all such cases where the consumer comes last, the way to be sure is to follow the money trail.

The Extra 8 Per Cent Discount

Most of us don’t live near a border but those of us that do really appreciate and understand exchange rates, the difference in value between the US and Canadian dollars. For us, it’s like getting a discount on our purchases. That’s the second benefit of buying Canadian. 

Currently, the Canadian dollar is worth 92 cents US, an 8% discount for someone buying with US dollars. This, in addition to the already low prices for the drugs, is an added bonus.

The Right American Solution

There’s an easy answer to this Made in (Corporate) America dilemma, with its spill over effects on retailers. Stop gouging consumers. Big Pharma can charge the same prices in the U.S. that it charges Canada and, POOF! Problem Solved.

Now, you and I know that Big Pharma doesn’t see it the same way. To make sure they get their way, they are taking steps to pass laws to outlaw the sale of drugs from Canada, or anywhere else for that matter. The only way you can protect your rights is to contact the same legislators, to let them know that you want them to do their job, which it to protect your rights. Make it clear that your vote in the next election is predicated on them doing right by you.

There’s more you can do. Write letters to the editors of local newspapers. Form associations with other, like-minded people. Contact local TV and radio stations to let them know what’s going on. There’s plenty for you to talk about.

Start with this. Maine is the first state in the Union to legislate buying from Canada. The city of Portland ME alone will save some $200,000 a year on drug costs.  The same goes for employees of a single company, Hardwood Products, who also save $400,000. You can extrapolate from there. We’re talking about hundreds of millions of dollars in savings, and huge savings for you as an individual.

Tell them about Julie (not her real name), the woman I reported on. Her depression drugs, Seroquel, Strattera and Abilify were costing her over $1,300/month. She now gets them from Canada a Canadian mail-order pharmacy for $180/month shipping included. While the order is through Canada, the drugs can arrive from England, Australia or New Zealand.

Imagine what Julie could do with the $1,150 savings. More importantly, you should know that she, like millions of other Americans, does not have $1150 sitting around. She cannot pay those prices. She faced the real threat of doing without. 

Now, it’s critical to understand how Big Pharma will try to spin their efforts to derail Maine’s law. First, they’ll talk about safety. They’ll use scare tactics to make it seem like you’re buying bogus drugs of questionable quality. Hey, they’ll say, you could die from these products. 

The truth is that Americans have been buying prescription drugs from Canada for years! Were there ever problems? Yep. Some years ago, CanaRx once shipped an insulin medication that needed refrigeration without proper controls. It fixed that problem and hasn’t had a complaint. since.

A second fear tactic used by Big Pharma is that companies will pop up all over the globe to fill the demand for low cost drugs. So what?

Two points stand out. First, the Canadian companies have decades of service to the US market (if not you, then your friends, for sure). Any new suppliers will have to earn their way into the market. In the meantime, you have proven sources.

The only reason Big Pharma is against the importation of their own drugs, is that they have for decades owned the market and made outrageous profits at our expense. It’s your turn to correct that injustice.

Support your Local Community Pharmacy

Don’t blame your local community pharmacist for this mess. The blame lies completely with the drug manufacturers. If they elect to adjust their pricing to the new realities, then prices locally will adjust and you’ll have another option open to you. In any case, the 80% of drugs purchased are generic, and they are cost effective locally, PROVIDED YOU SHOP AROUND. Be sure to buy from your LOCAL INDEPENDENT COMMUNITY PHARMACY, not the NYSE traded big box stores.

The ball is in your courts, my friends, in two ways. First, it’s in the courts of law because Big Pharma wants to use our court system to their advantage – and to our disadvantage.

Second, the ball is in our metaphoric court. It is up to us to act in concert for what is good for American consumers, you and me.

Can we count on you?

* http://www.pharmacytimes.com/news/Pharmacists-Are-Among-the-Most-Trusted-Professionals-Says-Survey

** http://whiletherestime.blogspot.com/2013/11/lets-talk-about-medicare-part-d.html

*** http://money.cnn.com/2013/10/10/news/companies/pbm-pharma-management.pr.fortune/

 index.html

 Full article at 

 http://katherineeban.com/2013/10/23/painful-prescription-fortune-com/ 

If the FTC was truly serious about health-related issues resulting from prescription drugs, it would be more aggressive to curb the numerous illicit actions by criminals, which includes doctors, people who adulterate full strength drugs and sell them on the grey market as full-strength. There are so many other ways consumers are put at risk with prescription drugs. Ms. Eban’s exposé, Deadly Doses. is a must read for people who want to learn more.

Leaves Falling

Leaves are wonderfully attractive on the branches during the spring, throughout the middle seasons, and even as they cover the ground, given up by their hosts as a contribution to the earth.

I miss you and I feel somewhat like the leaf in late fall, adrift and falling gently through space, buoyed by the patterns of air, unsure of my resting place. Since I grew from a bud I have impacted my environment in many positive ways. As a bud, I announced the emergence of new life; as a leaf, I created my share of the chlorophyl that sustains my parent; as I grew in size, I brought shade to the earth and protected the ground from heavier rains. At each stage of my journey, my colors captured the attention of humans who in turn have made metaphors of them: signs life’s renewal, the source of romantic love, the coming of winter, and so many more. While my time here is brief, I have nurtured my host, sheltered wildlife, inspired authors and artists of all kinds, and as I release myself to the earth I renew life yet again.

In many of these moments I have done for you as well. I made you smile as you gaze upon me from your deck. I sheltered you from the sun as you walked in moments of quiet reflection. I gave you pause to consider the richness of your life, reflected in the bountiful colors, green, yellows, oranges, reds. 

You have given your share in return. You laughed heartily and sent resonant tones into the universe. You cried and gave your tears to the clouds. You nurtured the soils and created gardens to brighten your spirit and those of others. 

Your life cycle is not unlike my own, Your birth gave joy and symbolized rebirth; your life was filled with contributions as well as challenges; and the ways in which you faced them affected the outcomes, not unlike the ways we faced the challenges of rain and sunshine, floods and droughts. The ways in which you demonstrate your character parallel my own. Calm in the face of angry winds, welcoming and embracing the harsh sun as a friend, holding no ill will; accepting the harmonies of life.

Your time here is longer, hence you experience greater quantities and varieties of life’s gifts and pains, much like the trees that host their leaves. Accept and embrace them all for the thrills and feelings they elicit, All attest to your vitality.

I leave you now your reward for the day. Somewhere in the cosmos someone loves you beyond measure and accepts you willingly as you are. Somewhere in the cosmos someone longs to be with you in the flesh but accepts that it is enough sometimes to feel your presence in his heart and your love in the blood that courses through his veins. 

Be well,

No Place for Me

There was no place for me

Amid the clutter

No place I could retreat

There was no nest for me in which 

to feel comfortable and relaxed

Save the couch and then mostly when 

I was with you, Or in your bed where 

we could cuddle and share our thoughts

The kitchen rolls into the living place,

The open space below covered in excess

Items that may never find a use

A couch, a working table, junk all round

The futon for your daughter’s visits

With barely enough space to negotiate

I cannot go to bed so early some nights

My mind bids me think

And it cannot be done either prone or supine

Lest I wander off to sleep

And wake just hours later, or less

Well before the dawn 

whence I must rise to renew my thoughts

and walk through cat litter to the couch

A well worn path

But not a nest

This doesn’t bother you

It barely gets a thought but

To me it was a test 

Of my love for you and my willingness 

to accept you as you are but I would

think at times that when we would 

at last be together, how could we make 

a place for visitors

You will not understand this

And it really doesn’t matter

I accepted you unconditionally for the 

wonder of your mind and the joy of your spirit 

when it was not taken by your demons

and even then

We made light of your Rubenesque form

But truth is, I loved it every inch

For it was you and you were comfortable in it

And it gave me pleasure to feel it in my arms

To share your gifts when were willing, and not too tired

Tho some times we forgot that or set it aside to 

Give each other pleasure and drift off entangled

In peace

I miss you more with each word I write

As the memories rush in

You gave me more joy than I deserve

and much more still lives within

Reflections

I awoke this morning early (for me. You would be in the kitchen at that point, feeding the cats and making your lunch).

Someone on Twitter brought to my attention an article on compassion. It dealt with insensitive oncology doctors treating her mother’s cancer while mistreating her. It brought me back to last meeting on the deck, when I demonstrated none of that.

I feel your pain more now than then, and with greater awareness. And, I am sorry to my marrow for it. It was triggered by your rigidity, which I realize was your defense mechanism.  I failed to demonstrate proper deck-side manner.

That was not the only trigger. I saw that you were prepared for our fierce conversation. You had written it out longhand. THE LIST. The record of my failures, promises made but not kept, time schedules included. Little record of the things I might have done right, or the compassion I showed at any given moment other times. Thank you for thanking me for mowing your lawn, though you made it clear you didn’t understand why I would have done that. I recognized then that you really didn’t, that the things I did do during our time together were a puzzlement to you, other than when I cleared out the garage so you would not have to deal with a snow covered car on wintry mornings.  

So, knowing there was no baby in there, you rightly chose to throw out the bathwater. For my part, I was not prepared to sit through the litany of my failings. I am list averse.

I feel your pain more now than then, and with greater awareness. And, I feel mine, as I have done with greater intensity every day since we parted. Tonight would be our night together per our agreement. I will miss that. I will miss preparing dinner for you, and watching the news, sharing the events of your day and swelling with pride as I watch you grow and develop in your roles. I will miss your hugs and the beauty in your eyes, the soft glow that envelopes your face. As I see your visage in my mind’s eye, warmth fills me, mixed with sadness. You were the greatest love of my life. I regret not showing you.

I write this as my way of healing, I guess. But in so doing I have discovered epiphanies of my own. On those nights when I returned home, it was not to be ‘home’ with her. It was to be in a place where I am comfortable, except for her presence, which I can accept for the moment. It is my home, and it is clean. I realized then how uncomfortable I was in your home. I see myself consciously cleaning it to as close to my standards as I could. Change the litter boxes, scrub the floors, vacuum the carpets and clean the kitchen. How many times did I think, “What if we had friends over? What would they think?” So, I did the laundry and tried to figure out how I would rearrange the lower level to receive guests? I went home because it was neat.