Archive for the ‘Politics’ Category

Your health care dollar at work, 3

September 11, 2009

I have a patient who has taken a certain medication for about 10 years. It has hoped her maintain her life. Without it she becomes profoundly depressed. Recently her health insurance company was changed. The new one will not cover the medication. Your doctor might prescribe a medication you need. You might have to find out which insurance company covers it.

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.

What to do with the insurance companies.

July 11, 2009

Buy them.
Let’s put the profits that health insurance companies make into the public coffers. The overhead of private insurance companies exceeds 20 percent. For Medicare it is less than five percent. Which system works better? When you turn 65, you qualify for Medicare, no matter how sick you are. If you are younger than 65, you had better keep your job.

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.