Itchy and Scratchy

Oh, the agony of da feet.  Or at least the discomfort.  Well, mild discomfort, at least.  I mean, I didn’t even notice it until that awful day….

.

My podiatrist gently broke the news to me – the news that no one ever wants to hear.  His caring, sympathetic eyes gazed up at me over my bare tootsies:  “looks like you have a little Athlete’s Foot, here, Rick”

Curses!    Could this really be happening to me?  I mean, I always shower every day, and wear clean socks.  I never walk around barefoot.  How could this happen to me?!!

As I rapidly passed through the varying stages – Denial, Anger, Bargaining and finally Acceptance (this all happened while I put my socks back on), the doctor delivered some positive news.  He asked if I had prescription coverage.  When I told him that I did, he smiled and handed me a prescription savings card for Naftin Cream, and a script for the same.  “This will clear it up shortly” he told me smiling.  “And with this prescription card, there will be no out of pocket expense”.

Thank God and Country for this minor miracle in a tube.  Thanks to Naftin, and my prescription coverage, I didn’t have to worry about a future plagued by itchy feet.

Now, I have been working professionally with the Podiatry field for some 25 years now.  I knew that the go-to drug for many years was Lotrimin.  So, where did this upstart Naftin come into the picture?

First of all, Naftin isn’t cheap.  The best price I could find online for this fungus-fighter is $330.00 a tube.  This means, of course, that, in spite of my discount card, my health insurance carrier was paying out the wazoo for this stuff.  In fact, without that savings card, I would have had to pony-up a $60 co-pay for my 60 grams of Naftin.   But, like most people, my feet are important to me.  I use them almost every day of my life.  Nothing but the best for my two not-so-little buddies!

I was therefore very upset to discover that Naftin wasn’t even the best treatment for my fungal foot funk.  Statistically, ol’ reliable Lotrimin was.  Naftin isn’t even the second best choice – it actually comes in a distant third in the battle against Tinea Pedis. 

So why didn’t my Podiatrist prescribe Lotrimin to me instead of the less-effective Naftin?  Well, there is a VERY GOOD reason for this.  Lotrimin has a very serious fault.  The patent expired on this one-time champion drug, and it is now available over the counter for a couple of dollars.  The economics just don’t work out.

Of course, up in the Great White North (Canada, that is) Lotrimin is still king.  That’s because both Lotrimin and Naftin are available over the counter,  both for the same price as a couple of Maple Sugar Donuts at Tim Hortons.  And who would pay a Toonie  for a tube of third rate foot cream when they could get a better working cream for the same price?  Naftin isn’t a big seller with the Labatt Blue crowd.

Luckily for Merz, maker of Naftin. It’s still a prescription only product down here in the lower 48.  Merz can still pay its reps to visit podiatry clinics bearing gifts of free lunch and discount prescription cards, in order to convince them to continue to write scripts for their $330.00 underperformer.

Who says that the US Healthcare system in this country is broken?   Certainly not Merz Pharmaceuticals.


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Joni Mitchell

I've looked at life from both sides now
From up and down and still somehow
It's life's illusions I recall
I really don't know life at all

         - Joni Mitchell

In my last post, I ranted about how the increase in gun violence can be directly attributable to our failing mental health system.  My darling niece, who has bravely faced her own struggle with mental health (and with the assholes in t her Health Insurance Carrier’s Claim office) pointed out to me that not all people who face mental health challenges are violent.  She is, of course. 100% correct on this, and I apologize to everyone if I somehow implied this in my last post.

Let me elaborate further by looking at the Flip Side of the Sandy Hook tragedy.   The gunman who slaughtered the innocents obviously suffered from his own demons, but he was (thankfully) in a violent minority of people with mental health issues who are somehow intertwined in this tragedy.  Witness if you will the throngs of the Westboro Baptist Church, the tiny independent fundamentalist Christian church based in Topeka, Kansas.  Seems that they planned to ‘protest’ at the funerals of the victims of the Sandy Hook Elementary School shooting and declaring“God sent the shooter.”  You may recall that this is the same group that has protested many funerals of slain American soldiers.  ‘Freedom of ‘religion’ aside, these people, are, in my layman’s opinion,  as mentally troubled as the shooter himself.   

Sadly, there are even more mentally unbalanced groups who are being drawn to the Sandy Hook tragedy like moths to a flame.  There apparently a group of ‘Truth Seekers’ who are organized and are demanding the ‘truth’ about what happened at Sandy Hook.  Yhey are apparently harassing and threatening some the Sandy Hook first responders and their families.  They somehow feel that the events of that awful day are not being reported truthfully, and they are demanding that the ‘real’ story be told.  Mind you, these people have no other connection to Sandy Hook – they are just self-appointed guardians of ‘the truth’, and they therefore feel that it is their duty to investigate imaginary alternative scenarios that explain the awful events of that day.  Some say that Sandy Hook was a the start of a government plot to take their guns away.   Obviously, there isn’t a rational person among them.

I know that ‘conspiracy nuts’ have been around for a long time, but it seems that this country is growing a bumper crop of these mentally unbalanced folks.  Of course, their actions will no doubt further upset the real victims and families of Sandy Hook, and drive many of them further towards the cliffs of sanity.  Mental Illness can be contagious – in many cases, it can be downright virulent.

Many dismiss these conspiracy theorists as harmless ‘nuts’, but this is not the case at all.  I shudder when I imagine the additional pain, anguish, and emotional damage that they are bringing to the grief stricken families.


Must be because I had the flu for Christmas
And I'm not feelin' up to par
It increases my paranoia
Like lookin' at my mirror and seein' a lit up police car
                                   -- David Crosby

These unbalanced individuals also can bring a great deal of harm to themselves.  I knew a Doctor who was a skilled diagnostician, well respected by his peers, loved by his patients and staff.  His whole career unraveled when he became involved in a 9-11 conspiracy group.  Fueled by meetings of like-minded individuals and internet postings, his obsession with 9-11 conspiracy became all consuming.  He soon could not have a conversation with anyone – including a patient – without espousing the latest 9-11 conspiracy theory.  This once sober minded physician’s eyes would open wide, his nostrils would flare, and he would literally dance around as he regurgitated the latest ‘theory’.  In spite of repeated warnings from the clinic administrators, he just could not control himself.  Ultimately he lost his job as a result of his inability to control his obsession.

The mass hysteria continues to proliferate throughout our society.  There are now several television shows about ‘doomsday preppers’ who spend ungodly amounts of money (often which they do not have) to build expensive underground bunkers to protect themselves and their families from Armageddon.   

There have always been a small group of conspiracy theorists  living on the fringe of our society, but with modern communication fueling their fire and limited ways of controlling their angst, it seems that their ranks have been growing at an alarming rate.  The mental health crisis continues to grow, largely unchecked, due largely to the mental health being ‘managed’ by health insurance carriers.  Certainly, these conglomerates are making windfall profits, and their executives make salaries that would make Carnegie jealous, but at what cost? 

I am beginning to sound like I’m starting my own conspiracy theory here, so let me dial things back a few notches.  Am I 100% convinced that there is a direct cause and effect between lowered mental health coverage and the growing number of paranoid people in our society?   Absolutely not.  However, I do believe that it’s time that this phenomenon is studied by persons more learned than myself.  At the very least, our leaders need to start having the conversation.

It’s the rational thing to do.

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M.C. Hammer

I’ve been asleep at the wheel for quite some time now. After this long of a nap, it would take some extraordinary event to wake me from my blogging slumber.

 Unfortunately, we all just lived through such a terrible wake-up call. It’s now time to post another blog entry. It’s Hammer Time.

 Most Americans of my vintage associate the phrase ‘Hammer Time’ with M.C. Hammer, the baggy pants wearing pop star of the 1980’s. Personally, I have a different, disturbingly violent association.

 I used to live in a very nice town house. It was spacious, well built, and it had plenty of room for my growing family. It also looked a lot like a hundred similar units in my development. And this led to a very frightening turn of events one evening.

My townhouse had a street number of 123. So did an identical-looking unit a few blocks over. My wife and I both went to Rutgers University. So did the residents of the doppelganger unit. Fortunately, this is where the similarities ended. Thank God for that.

 You see, one evening the man living in the doppelganger unit #123 decided to murder his wife. Not with a Glock 9mm or an AR-15 assault rifle mind you – he used a much more brutal weapon - a Stanley 16 ounce hammer. Bashed the poor woman’s skull in. I guess she shouldn’t have nagged him about leaving the toilet seat up…

 This soon turned into a minor nightmare for me when the story hit the local news. Video about the ‘Rutgers man’ who murdered his ‘Rutgers wife’ with a hammer showed the exterior of the doppelganger house, complete with a very distinct #123 emblazoned on the front door.

It wasn’t long before the phone calls started. Friends and relatives soon started calling the house and asking ‘if ‘everything was OK’. Every caller was indeed surprised when I answered the phone. Some insisted on speaking with my wife to re-assure themselves that she was still among the living.

 Of course, as the days wore on, my entire neighborhood was abuzz with discussions of the random violence that happened, quite literally, in our own back yards. Everyone was shocked by how our neighbor just snapped. It was all so surreal. That terrible incident was 20 or more years ago. I’ve long since moved from that neighborhood.

 Unfortunately, while I haven’t since been suspected of the violent murder of a loved one, similar events continue to happen in this country – in fact, it seems as if they have grown in frequency and scale. 20 years ago, during the many ‘over the fence’ discussions about the murder, no one once ever mentioned ‘hammer control laws’. While the Second Amendment doesn’t mention ‘the right to bear hammers’, no one – not even once – called for making hammers illegal.

While this may sound facetious in light of the horrific incident at the Sandy Hook Elementary School, please bear in mind that I have an important distinction that many seem to have lost post Sandy Hook. Regardless of what side of the gun control argument you may align yourself with, the guns used to murder those innocent children were not the root cause of this - or any other – murder. Like my murderous ex-neighbor, the primary cause of the violence was a sick mind. A sick mind that was undiagnosed, untreated, or both. No normal mentally healthy person could ever be driven to take the life of innocents or loved ones so cavalierly.

 I am not a ‘gun-nut’ – not by anyone’s definition. I am, however, very afraid that the anti-gun lobby is using these recent tragedies to promote their agenda. While there objectives are undeniably admirable, I think that they are unconsciously diverting our attention away from the root cause of these horrific events – namely, a failing mental health system. Diseased minds hell-bent on murder will always find a way to accomplish their mission. If an AR-15 isn’t available, a 16 ounce Stanley will accomplish the same terrible results.

 Some may argue that a hammer isn’t well suited for mass murder like an automatic rifle is, and they have a point. But let’s remember that 168 innocents were murdered in Oklahoma City using just Diesel fuel and fertilizer. Or 3,000 plus were murdered on 9/11 by an insane band of brothers armed with nothing more formidable than box cutters. The increase in volume and scale of these violent murders are more directly attributable to the decline of our mental health system.

 As health insurance carriers started ‘managing’ mental healthcare, they invariably ‘cut off’ treatment for those who truly need it. If you can’t get your head straight after 12 visits, you’re out of luck and on your own. And please don’t get me started on those $500.00 a month anti-psychotic meds that aren’t covered by your prescription plan.

 I am very fortunate that my immediate family and I haven’t faced the challenge of mental health issues so far, but I am not so naive as to ignore those who do suffer from the curse of mental illness. It is a debilitating a disease as cancer, MS, or Parkinson’s. It is a disease that not only affects the sufferer, as well as those around them. We can no longer afford, as a nation, to allow this disease to be left increasingly untreated or under-treated.

 So ‘Obama-Care’ isn’t fair to health insurance carriers or pharmaceutical companies? So it will force them to deal with ‘unfair’ competition or price controls? Tough. It’s time for us to decide as a nation what’s more important – continued landmark corporate profits or the lives of innocent children.

 Let me make myself perfectly clear – if you think that United Healthcare’s CEO’s salary or Pfizer’s annual dividend payment are more important than the lives of a classroom of first graders, you need to have your head examined. If you truly do believe that the continued windfall profiteering is more important (and many Americans still do), I can only hope, for everyone’s sake, that your healthcare plan covers Psychiatric Care and your anti-psychotic meds.

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House of Cards

The phrase house of cards refers to an institution whose very infrastructure is so fragile and unstable that they are prone to collapse at any moment.

That's not what I'm talking about.

I'm talking about your local drugstore. Walk into any modern drug superstore and you're likely to find at least one or two aisles dedicated to greeting cards. Whether it's American Greetings or Hallmark, or some other offbrand of expensive, colorful cardboard, the greeting card business would appear to be the primary function of your local apothecary.



That's not what I'm talking about either.

Here's a fun little exercise. Walk to the back of your local drugstore, grab a seat in the waiting area, kick up your heels, relax, and enjoy the chaos. What was once a fairly quiet and serene place, the back of the pharmacy counter, is most likely going to be more busy than New York's Grand Central station at rush hour. The pharmacist, who used to work solo, is now swarmed by a flock of minions, who busily rush around, to and fro, processing paperwork.


I think I know why Martin Mull's character, Russell the pharmacist, has a substance abuse problem. I know that I would have one if I had put in long hours in such a crazy environment.



The pharmacy counter changed from its serene origins into a crazy place that it now is when prescription drug coverage came into vogue. Where once the pharmacist only had to concern his or herself without the act of filling prescriptions, they were forced into becoming insurance clerks, checking coverage and formularies for every new prescription. They were forced to take on added help in order for them to complete this grinding task. This mirrored the transformation of the physician's office several decades before when they had to start processing insurance forms along with providing health care for their patients. In case you haven't noticed, the modern medical office no longer resembles the Norman Rockwell ideal.



" You want me to check the heartbeat of your doll, kid? Take a hike!"



Recently, the game behind the pharmacy counter has been turned up to its now frenzied level. This is due entirely to the advanced of the co-pay prescription card. These cards are now gleefully handed out by most major pharmaceutical companies to help combat high co-pays imposed by prescription insurance companies. The problem seems to be that none of these cards actually follow a standard way of processing. Worker bees at the pharmacy must cajole, swipe, and telephone the different entities who process these cards on behalf of of the pharmaceutical company. To add insult to injury, if the patient fails to hand the pharmacy clerk there prescription card upfront (as most of them do), the clerk is then forced to scrap the entire transaction and start all over again. I personally experienced this when I used such a card while filling a recent prescription. And yes, I was the douche bag who forgot to give them the card before they processed my claim. Long story short, it took a over one half an hour for me to pick up my overpriced prescription.

So what does this mean to the healthcare consumer?

Well it should be obvious to anyone that the added people working at the pharmacy counter don't work for free. In addition to their salaries, there are benefits to be paid, 401(k)s to be financed, FICA taxes to be filed, and a whole host of associated expenses. And ultimately, the healthcare consumer will be footing the bill for these added employees.

After witnessing the chaos at my local CVS firsthand, I realized what a tenuous state that my local pharmacy was in. The anarchy behind the pharmacy counter made it appear that the whole shebang was about to collapse.

So maybe your local pharmacy does follow the true definition of " House of Cards" after all.

So, what's the solution to this impending disaster? I, for one, believe in" out-of-the-box thinking" in order to solve these new world problems. Now is not the time to be coloring inside the lines.

So, I would propose that we start staffing our pharmacies with cheap labor. And in the United States, this means either illegal immigrants or prisoners. Since the news media seems to be against all forms of illegal immigrant labor, I think it's best that we embrace the incarcerated labor force. Prisoners work even cheaper than migrant farmworkers, and we certainly have more of them. This is not a perfect plan. For instance, you're going to have to drive to your local county clink instead of your neighborhood Walgreens to pick up your overpriced Boner pills. But such is the price of progress.



" Mr. Green, your prescription is ready. Please see Mr. Tiny. He is the one with all the homemade tattoos wearing the red bandanna. And, if I were you, I wouldn't bring up the fact that you have a co-pay card and that he's going to have to reprocess your entire order. When he was raping me in the shower this morning, he mentioned that he's fashioned homemade shiv out of a plastic beach pail shovel that he stole from aisle three."

when you think about it, they've been using the scared straight approach to keep kids off of illicit drugs. Perhaps the same scared straight approach will work to help break Americans from their addiction to overpriced pharmaceuticals.


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Highlights

For me, as a youngster, the best part of going to the Doctor was reading those “Highlights” magazines in the waiting room. They usually featured great picture puzzles that would keep me entertained and distracted until I was called back into an exam room where I would wait, cold and naked, to get a needle jabbed in my butt and a thermometer rammed into an orafice that was designed to be an exit and not an entry.


One of my favorite picture puzzles was where they would present two pictures, side by side, and the reader was asked to determine ‘what is the difference between these two pictures’. For the sake of recreating that medical office fun, I’ve decided to recreate that little game, right here in my blog.

Are you ready for some fun? I hope so!

Here we go:







Picture ‘A’ is a photo of Athlete’s foot vream that my wife purchased at Walmart.

Picture ‘B’ is a tube of Athelete’s Foot Cream that I bought at the local CVS.

So, my eagle-eyed viewers, what are the differences between these two photos?

Give up? Well, just turn your computer monitor upside down and read the fine print bebeath the photos – or just read on.

Difference 1: The Walmart tube is smaller than the CVS tube. In fact, the CVS tube contains almost 3 times as much cream as the Walmart tube.

Difference 2: The WalMart cream says to use it once a day for 4 weeks. The CVS cream says to use it twice a day for 4 weeks.

Difference 3: Picture ‘A’ is a GENERIC drug – basically the non-prescription version of Lotramin. Picture ‘B’ is a name brand prescription drug..

Picture ‘A’ cost my wife 77 cents for the tube. So, for the same amount of cream as Picture ‘B’. It costs a whopping $ 2.42. I don’t really know what Picture ‘B’ costs since I have a prescription plan. However, a Google search shows that I can but the same tube of cream from a website called ‘Cheapo Drugs’ for $ 821.25.

Aren’t these side-by-side puzzles fun?

Both creams have a lot in common as well. Both have a proven track record of curing athelete’s foot. Both do it in about the same amount of time (although the prescription version has to be applied twice a day vs. Once a day for the Walmart cream. But there are more differences between the 2 products that escape the eye.

For instance, Walmart never buys my Podiatrist lunch, or gives him fancy tote bags. They never visit him at his office to extol the virtues of their 77 cent tube of ceam, or scold him for not writing enough prescriptions for their cream.

Oh yes – I just thought up another difference. That tube of Walmart cream costs almost the same amount of money as a cup of McDonalds coffee (and my local Walmart has a Mc Donalds right inside their store. This means that if you were down to your last dollar, you can choose between being sleepy or having itchy feet).

On the other hand, the CVS prescription cream costs more than I paid for my first car.




But, to be fair, I bought that car way back in 1977, and you have to allow for inflation.

I blame Obama for this runaway inflation – don’t you?






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Lazy Days

Yeah, I know. I haven’t posted to my blog lately. It’s a real shame, too. My blog just had it’s 20,000th visitor, and I still keep getting a lot of traffic in spite of my lack of new content.

It’s really not my fault – the lack of posting is due to a newly diagnosed medical condition. It seems I suffer from something called ‘Chronic Laziness Disorder’, or CLD. You say you never heard of CLD? Don’t worry – as soon as Big Pharm comes up with a drug for it, you’ll be seeing commercials for it on ‘The Price is Right’. Rumor has it that Pfizer is partnering with Starbucks and developing a cup of Joe that has twice the caffeine that a normal cup of their ‘over the counter’ coffee has. It will be available only by prescription and cost $25.00 a cup. Leave it to the American Pharmaceutical industry to make a cup of Starbucks even more expensive.



Pfizer is also planning to release a caffeine-enhanced prescription Frapuccino for the summer months that has twice the caffeine and sugar as the regualr stuff. In fact, it will have so much sugar in a cup that it will send many people into a diabetic coma. This is seen by Pfizer as a great cross-market for it’s line of diabetes medicine and glucose meters. Too bad that the prescription Frapuccino will be so expensive that most prescription plans will label it a ‘tier one’ drug with a ludicrously high co-pay. Fortunately, Duncan Donuts will soon offer it’s own prescription ‘Coolata’ at a much lower cost, so your med carriers formulary will allow you to get this drink for only a$20 copay so long as your MB (or Medical Barista) didn’t check off the ‘no substitution’ box on your prescription.

Until these new drugs for my CLD are released, I will have to suffer (and nap) in silence.

Although prescription coffee may sound ludicrous, the idea really isn't that far-fetched. After all, Big Pharm has been offering ‘Prescription Strength’ versions of over-the-counter meds like aspirin, tylenol, and various antacids for years now. And we’ve been blindly paying outrageous fees for them for years, instead of buying the over-the-counter versions at Wal-Mart and doubling up on the dose.

My Podiatrist recently gave me a prescription for Athlete’s Foot cream that sells for close to $300 a tube. Now, my Athlete’s Foot isn’t that bad – in fact, I didn’t even know I had it. (When I was in High School, I never had the makings of a Varsity Athlete - at least that’s what my Uncle Junior used to say).
So why don’t I just buy a $2.00 tube of over-the-counter cream at Wal-Mart? Good question. Luckily, my prescription came with a special copay card that allows me to pay a zero copay for the cream. This way, I can get ‘the good stuff’, and not have to worry about the price – until I’m hit with my new health insurance premiums next year. Like most Americans, I’ll probably follow the advice of ‘The Yardbirds’ and “Live for Today”. In fact, I think that this just might be the next Classic Rock song that’s used in a television commercial – Merck – I’m looking in your direction.


In case you were wondering, this whole diatribe was provoked by a link my buddy PG posted on his Facebook page. What first struck me as funny seemed less farfetched the nore that I watched it.

I hope you will enjoy it as much as I did.



Now, let me get back to my nap.....




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Warning Labels

Since I was on the topic of all those scary FDA-mandated warnings that are the end of almost every prescription drug commercial on TV, I got to thinking “why do they bother?” After all, most of us have become so numb to this little medical horror stories that we automatically tune them out. Besides, shouldn’t be warned about harmful side effects by the doctor writing the prescription or the pharmacist dispensing the medication?

Don’t get me wrong – I think that commercials for prescription medications should include stern warnings – but I think that these warnings should be more along these lines:



WARNING: Accountants have determined that use of this medication can cause irreparable harm to your bank account. One month’s supply costs more than your car payment. If you have prescription coverage, please realize that drugs like these are the reason why your premium id going up by 20% next year.




WARNING: This drug really isn’t tested as well as it should be. We’ve cut as many corners as possible in order to get it to market before the competition releases their overpriced pill. As a result, we’re probably going to discover some unforeseen side effects somewhere down the road. The only reason why we’re telling you about the bad side effects that we currently know about is because the FDA is making us do it. Besides, our lawyers tell us that this may prevent you from suing us in the future when your hair falls out and you lose your senses of taste and smell.




WARNING: Even though this drug was designed, tested, and manufactured in the USA, it sells for a lot less in every other country in the world. That’s because foreign governments set prices and limit what we can charge for it. Bastards.

That’s what we love about America. Here, we can pay lobbyists tons of money to ensure that your government won’t let this price fixing happen here. Our lobbyists even got your government to pass laws that prevent you from buying these drugs cheaper from another country over the internet. Our lobbyists are very good. They are also very expensive, but that’s OK – we just pass the costs on to you.




WARNING: Only one person in a thousand actually has the illness that this drug is for. You might ask yourself “How can they afford to advertise it on national TV?” It’s really quite simple – we just pass the costs on to the people who actually need the drug and are forced to pay the outrageous price tag..




WARNING: This drug doesn’t treat your condition any better than that $4.00 Generic medication. The generic medication is well tested and we know that it won’t have any unforeseen side effects. The only thing that’s wrong with the generic drug is that its patent has expired, and we can’t overcharge for it anymore.

We’re going to lead you to believe that the generic drug is somehow lower quality. The truth is, we make it on the same factory as the new drug that we’re trying to sell you.




WARNING: The statistical evidence that we’re presenting about the superiority of this drug are really questionable. Statistics are easy to manipulate. We use them to lie to you.




WARNING: Our profit margins are astronomical. We take a few pennies worth of chemicals and sell them for hundreds of dollars. We do have high costs, but they have nothing to do with the manufacturing of this drug. Take this TV commercial, for instance. It costs us many thousands of dollars each time we air it. And we air it many times a day all over the country. It’s OK, though, because we’re passing the costs on to you.



WARNING: You can’t buy this drug on your own. You can’t decide that this is the right drug for you. That’s really your Doctor’s decision. So why do we spend millions advertising it directly to consumers? Good question.




WARNING: This might not be the best drug for you. However, we’er going to bribe your Doctor so that he or she will prescribe it. We do this with free lunches, theatre and sporting tickets, special all expenses paid travel junkets, and free pens , post it notes, and other office supply goodies. Most Doctors never have to spend a penny for pens and note pads. Most Doctors never have to buy lunch for themselves or their staff either. We buy this for them, and then we pass the cost on to you.



WARNING: This drug is really expensive. Doctors don’t really care what these drug cost, because we give them all they could use for free. Same goes for their staff, family and friends.




WARNING: This drug is really expensive. Your insurance company doesn’t want to pay for it so they’re going to charge you a really high co-pay in order to discourage you from buying it. That’s OK, though, because we’re going to give you a special discount card so you don’t have to pay a lot of money out of pocket. You’ll just end up paying for it next year when your insurance premiums skyrocket, but that’s OK too because we know that you’ll blame your insurance company and not us.



WARNING: This prescription pain killer doesn’t cost us any more to manufacture than that bottle of generic pain killer that you bought at Walmart last week. Doesn’t even work much better, either. But we can charge 100 times more for it. Isn’t that awesome?


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