School Lunch

The local High School District decided to privatize their cafeteria lunch program this year. This was done as a way to trim salaries from the school budget.

My son tells me that, all in all, the new meal program is a significant improvement from the one that was run by the school district. The overall quality of the food has improved, and the students can now choose from two different menu items. In addition, depending on the student’s appetite and budget, they can choose either a regular or double-sized portion. The students really prefer this new system. On the downside, the cost of the meals has risen by 10 or 20%.

Many might see some parallels between this school lunch program and health care reform. By instituting ‘Obama-Care’, the country will be moving in the opposite direction of the school district, converting a system that currently is largely privatized and converting it to one run by the government. The end result will be some minor savings, but we will loose a lot of quality and freedom of choice in the exchange.

While both sides of the health care reform argument has their pros and cons, neither side addresses the third side of this argument – the side that I wholeheartedly support. Namely, why can’t we have both?

Proponents in both camps like to think in absolutes – it’s one way or the other. Plus, they will try to convince that there is no middle ground. But there is really no reason why we can’t have a basic, government run health care system and the option to pay for more preferential service.

My daughter is spending a semester abroad in a country with nationalized health care. While she is finding the quality of health care to be excellent, she is challenged and frustrated by the bureaucracy associated with the system. For example, you can only call to make an appointment between 8AM and 9AM. While this ay be fine for most people, some might find it oppressive, and be willing to pay extra for the privilege of having better access to the health care provider. Actually, this is already happening in our current system – many entrepreneurial physicians are limiting their practices to just 400 or 500 patients, and charging them each a substantial annual fee for 24/7 access to the doctor. Many patients are more than happy to pay for this kind of service. While some may find these doctor’s actions repulsive, I see nothing wrong with this approach – why shouldn’t a doctor be able to offer this kind of service? This is America, after all, and we should be able to let the free market decide if this type of arrangement should exist or not.

Opponents to this type of arrangement might argue that health care should not be treated like a commodity, but why not? After all, if everyone is getting the health care that they need, why shouldn’t everyone be given the option of paying for the same health care being delivered in a little nicer package? Do you really think that a US Senator would agree to be restricted to making an appointment between 8AM and 9AM? Don’t kid yourself – whatever national health care entails, there will always be people who are able to rise above the system. Why not embrace the idea?

It’s like the new school lunch program. Every kid is getting the nutrition they need. Some are getting it in the basic lunch of chicken croquets, and others, who are willing to pony up the additional 50 cents, are getting it in the form of Kung Po chicken. The most important thing is that no one is starving.

Pass the ketchup, please.

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Tough Times

Yes, the economy sucks. The real estate market has tanked, unemployment runs rampant, and things are tough all over – except, perhaps, in the pharmaceutical industry.

According to IMS health, a pharmaceutical information and consulting firm, sales of prescription medicines worldwide rose 7% to $602 billion in 2009. 7% annual growth is spectacular in the best of economies – pulling off this kind of growth during a worldwide recession is beyond remarkable. This is not as rosy of a picture as you might think. Here in the USA, growth was ‘only’ a pitiful 5.7%. Luckily, the slack was more then taken up by emerging markets like China, Russia, South Korea and Mexico. In those countries, pharmaceutical sales skyrocketed by 81% last year. Who says that there’s a recession?



Here are some interesting facts about these statistics. Prescription drug sales in the US in 2009 were $252 Billion dollars. This translates to just under 42% of the worldwide total sales. This 42% of worldwide sales comes from a country that comprises only 5% of the worldwide population. Which means that, here in the USA, we are paying, per capita, over 8 times more on prescription medicines than the rest of the world on the whole.

Based on a population figure of roughly 307 million people, this means that we are spending, roughly, $850 per person, per year, on our prescription medicines. This includes all the young healthy people who rarely need a prescription (remember those carefree days?). It also includes all those people who are lucky enough to use those $10-for-a-90-day-supply generics.

Unfortunately, we’ve all become immune to large numbers from watching CSPAN, so here’s some much needed perspective. The $252 Billion dollars in US sales are almost 10 times the annual budget of the entire State of New Jersey. The $602 Billion in Worldwide sales approaches 90% of the US military budget – and we’re fighting 2 wars with that money.

Well, there is some good news in all of this. If these financial statistics make you feel nauseous or lose sleep, they have pills for that now. They’ll only run you around $300 a month.


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Evita

So, does anyone feel sorry for Pfizer after they had to recall all of that Liptor last week? 191,000 bottles of Lipitor has a ‘street value’ of over 31 million dollars – surely this has to effect Pfizer's bottom line?

Probably not. Since it was the bottles that were bad, and not the pills inside, they most likely can just repackage the pills – if the FDA lets them, that is. Even if they can’t repackage the pills and have to toss them out (or ship them overseas to a country with less stringent drug purity laws) Pfizer shouldn’t be troubled by the 31 million dollar loss.

You see, Lititor is the A-Rod of prescription drugs – a bonafide superstar – numero uno on the prescription drug hit parade. Last year alone, Lipitor racked up over 11 billion (with a B) dollars in sales. So a measly 31 million shouldn’t even be noticed by the bean-counters at Pfizer – they can just chalk it up to a rounding error.

Which makes me wonder – why does Lipitor come in the form of a a dull white pill? They should make the pills in a nice shade of American green.





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Something Stinks Around Here!

Maybe it’s that bottle of Lipitor in your medicine chest. It seems that Pfizer has just recalled 191,000 bottles of Lipitor due to reports of a musty odor in Lipitor bottles.

You might ask “Why should this affect anyone?” – according to Pfizer, this odor does not affect the product or it’s safety. You would think that this would only bother the pharmacist who repackages the pills – right? This might have been the case in past years, but not in today’s marketplace.

This news story actua;;y brings to light a nasty little trend in the pharmaceutical industry – prepackaged medications. Pharmacists no longer prepare or even repackage most prescription drugs anymore – they simply dispense retail bottles that were pre-packaged by the manufacturer.

This is a good thing – right? It sounds like an economical way to save labor. Actually, in my opinion, this is a bad thing – a very bad thing.


Pharmacists are slowly being eliminated from the important role that they once served in the world of medicine. Your local pharmacists used to be a highly trained professionals who knew their customer as well as the medications they used, and acted as a good source of advice as well as a needed double-check system on the dispensing of medications. Very often, it was the pharmacist who caught a mistake by a prescriber who wrote a prescription that might have had an ill effect on the patient. This extra layer of security has become even more important today because of all the specialists and sub-specialists who may be unaware of what other meds a patient is on when they write them a prescription. A knowledgeable professional, who knows about drug interactions and personal sensitivities is needed at the dispensing point. Don't believe me? According to the Center for Disease Control, the death rate for 'unintentional poisoning' - usually attributed to people taking the wrong prescription drug or taking a prescription in the wrong dosage - has almost doubled according to the most recent statistics.

Drug companies don’t really like pharmacists, as they often recommend less expensive, yet viable, alternatives to expensive name-brand drugs.

When is the last time that you saw a drug rep in a pharmacy? If you’re like me, the answer is probably ‘never’ – and this is really quite strange when you think about it. After all, the pharmacies are the ones who actually purchase the drugs in large quantities from a pharmaceutical company - they are the wholesalers in the pharmaceutical industry. But they never get any of the perks that most high-volume customers would normally receive in most any other industry. In the multi-billion dollar pharmaceutical market, the perks are reserved for the physician who neither buys or resells prescription drugs. Pharmacists have to buy their own lunch.

Pharmacists have been hard hit by the recent changes in medicine. They used to be a respected business person and confidant – a valuable member of the community. Today, they are almost certain to be an employee of a large corporation.

Insurance companies also are squeezing out the pharmacists. They offer incentives to their subscribers so that they get their medications from a large mail-order company (that is usually owned by a pharmaceutical giant). They want to be the ones who tell the patient what drug to buy and not leave that advice to an independent 3rd party like your local pharmacist.

Sadly, your friendly local pharmacist is rapidly becoming an anachronism with little place in the current health care system. And this is very bad news for the patient, who is losing an important health care advocate in the process.


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Abbott and Costello

Poor Abbott Labs – they had to pull their diet drug Meridia off of the market. It seems that this drug had the unwanted side effect of increasing the risk of heart attack and stroke for those taking it.

Pity. Meridia was one of the lowest cost name brand prescriptions out there – a Meridian prescription only used to cost around $100 a month – chump change in today’s overpriced pharmaceutical market.

Physicians prescribing Meridia don’t seem to be too upset about the drug going off of the market – apparently they found that it didn’t really work al that well, with the average patient losing only around 15 pounds before reaching a plateau. For an overweight person who needed to be on weight control drugs to manage their weight, 15 pounds is just a drop in the bucket. Well, what did you expect for just a hundred bucks a month – significant weight loss?

I am saddened by the passing of Meridia for one selfish reason – I never had the pleasure of seeing an Abbott rep hawking Meridia bring in a fattening lunch spread for a doctor and staff. This would have had a real Zen significance for me if I had the pleasure of witnessing it. Ho Hum – I guess I’ll have to be satisfied by that huge cheese platter I saw that was brought in by the Rep pushing Lipitor.

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Sister Mary Elephant

Did you ever hear ‘Sister Mary Elephant’? This is a classic Cheech and Chong routine about a soft-spoken nun who would be worked into such a lather by her misbehaving class that she would have to bellow ‘Shut Up!’ at the top of her lungs to restore order in her classroom. If you’ve never heard it (or if you want to stroll down memory lane) here’s a link for you to enjoy:

http://youtube.com/watch?v=IhG__-Ql8_I

(Ignore the stupid video – it was the only copy I could find on youtube)

As the victim of a Catholic education, I am here to testify that I have experienced LOTS of Sister Mary Elephants in my lifetime – frail little nuns with voices that could be raised to a decibel level louder then a 747 on takeoff.

Back in my formative years, political correctness was unheard of. Corporal punishment for misbehaving children was no big deal. My right ear is still slightly deformed where it was grabbed and twisted by a nun way back in 2nd grade (thanks a lot, Sister Mary Jane!). So understand that screaming at a class and telling them to ‘shut up’ was no big deal. In fact, it was the norm. Ditto on referring to a child as ‘stupid’ or even ‘retarded’. One of the few things that I remember from High School French class is how to say ‘Shut Up’ en francais.

Fast forward to fall 2010. I find myself nostalgic for a real-life Sister Mary Elephant to make my life better.

I’m not talking about silencing misbehaving youngsters – I want her to address our politicians who continue to beat the same dead horse.

Here’s the deal. We get it. You’ve successfully drilled it into our brains. Obama is a communist who is mortgaging our future. Bush’s economic policies have failed. Pelosi is ugly and a socialist. Palin is an idiot with a retarded child to match.

We get it. Move on.

Instead of spending millions of dollars on TV commercials kicking each other in the butt, how about trying a new tactic this campaign season? Here’s a fresh idea – why not tell us what you are going to do to fix this mess and, if elected, actually do it? Like Nero’s fiddle, the current crop of political commercials are an affront to my sensibilities. Wise up, Washington (and Trenton, and Harrisburg….) – our economy is in the toilet, and our health care system is going down in flames. You politicians were elected to make certain that this kind of thing never happened, and, if it did, fix it. You’re all not doing that. Instead of addressing these issues in an unbiased, positive matter, you spend your time attacking one another like a group of bickering fifth graders. And it looks like the only way to puy and end to this whole matter is to have a real life Sister Mary Elephant address our elected ‘leaders’, i.e.”

Congress……Congress…..CONRESS….SHUT UP!

Thank You.


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