Archive for the ‘Economy’ Category

Your health care dollar at work, 2

August 1, 2009

Medco is one of the largest pharmacy benefit managers (PBM) in the country. Millions of patients fill 90 day mail order prescriptions through them. In partnership with insurance companies such as Blue Cross, their database contains vast amounts of information. When you go to the doctor, use your insurance to pay for the visit and then get a prescription filled, Medco knows your provider, your name, your diagnosis and your medication.

Medications for epilepsy, which are also used to treat bipolar disorder, have recently been identified by the FDA as being associated with suicidality. In June I received a letter from Medco informing me that one of my patients had been prescribed one of these anticonvulsants. It informed me that I should be aware that he might be suicidal.

I received that letter in June. The medication was first prescribed for him the previous December.

They advertise their ability to provide this information as being good for you, as improving medical care.

Think about this: I got their letter 6 months too late to have done any good. Medco has that patient labeled in their computer database as potentially suicidal.

Medco’s CEO’s total compensation in 2008 was $13,134,243. In 2008 the annual premium for an employer health plan covering a family of four averaged nearly $12,700. His compensation would pay the annual premium for 1,034 families.


Your health care dollar at work

July 23, 2009

Today I received an invitation from Shire (makers of Adderall and Vyvanse) to a dinner and discussion on August 5, 2009, two weeks from today. They sent it FedEx priority overnight and I had to interrupt my work to sign for it.

Can we, as a country, think?

January 1, 2009

“If you can only fight or run away, you have to find something to fight or run away from.” — Bion

That might not be the exact quote, but it is close.

When confronted with a problem, the alcoholic mind responds, “I don’t know about that.” When facing potential shame, it accuses, “If only….” We understand these excuses as from the intoxicated, and dismiss them. When spoken by someone who recovered and was reborn, we try to make sense of them.

Sober thought is not exciting. It does not inflame emotions. It does not run from problems or resort to unproven ideologies.

Our country has spent eight years destroying everything it could. Destruction provides immediate gratification. It requires, often, a refusal to learn and the bully’s fear of the difficult.

Can we tolerate the uncertainty of working toward solutions? Creation is slow and requires knowledge and skill.  Such abilities take time to acquire, and education.

Are we a Christian nation?

December 15, 2008

A Christian nation would minister to the poor, the hungry, the sick, the homeless, and the imprisoned. Its people would love one another other as themselves. It would not put the moneychangers in charge of the temple. Its leaders would seek to rescue the lost and comfort the afflicted. They would be honest and free from spite. They would seek to influence by example, not by force.

Ours is not a Christian nation; it is Caesar’s.

Can we become a Christian nation?

Why not bail out the car companies?

December 4, 2008

Let me see if I understand this “bailing out the car companies” problem.

First, full disclosure. I have never owned an American made car. I have driven them in the hopes that I would buy American. But why buy a car with drum brakes, leaf springs, skinny steering wheel, torque steer, column mounted three speed transmission, short lived seats, sagging rocker panels and lousy gas mileage. My current ride is a 2003 VW Passat wagon with 96,000 miles on it. It’s been trouble free, gets over 30 mph on the freeway and over 25 mph in the city. It has some cosmetic damage, but basically still looks new.

The “Big 3,” along with the businesses associated with them, employ one out of ten American workers. They provide their workers with health insurance and retirement plans. They are the second largest contributor to the consumer economy, after housing. For years they have built the cars and trucks Americans wanted to buy. Sure, there was the environmental fringe complaining about the CAFE standards, but it was effectively marginalized by our government.

Now the same people who protected them have turned against them. The people who wrote the laws favoring SUV’s and pickup trucks are now castigating their builders for lack of foresight. Now, with the recession putting the brakes on car sales, the “Big 3” are the bad guys who deserve to fail. How soon do we find scapegoats.

If they go broke, we add 10% to the unemployment rate. All those families lose their health insurance. Who knows what happens to their retirements? A 25 or 38 or 47 billion dollar loan would keep that part of the economy available for when money starts flowing again.

The “financial system,” however, deserves 7 trillion dollars, no strings attached. These are the folks whose contribution to American productivity was to guarantee each other’s incomes. Instead of using their money to provide health insurance to several million people, they put it behind screens and “poof,” it’s gone. If they lose their jobs, they will move to their chateaux on the French Riviera.

Hank Paulson can give $20 billion to Goldman Sachs or whoever during a weekend and nobody makes a peep. The Democratic congress has to spend hours raking auto executives over the coals before telling them to come back with a plan to – do what the environmental fringe has been talking about for years.

This makes no sense.