A Christmas Story

Seasons greetings from the American Pharmaceutical industry. In his season of giving, they are delivering an extra-special holiday gift for you!

Actually, it’s not a NEW gift, technically. It’s really just an old product that is being repackages in a new, larger form. I guess it’s kinda like they are re-gifting us (insert Seinfeld reference here). But, boy oh boy, it is just sooooo damn exciting, who cares?!



Four separate drug companies have announced that they are seeking to release a new pill containing the highly addictive painkiller hydrocodone,. This is the stuff inside popular poppers like Vicodin . But the ALL NEW AND IMPROVED versions will contain up to 10 times the the amount of hydrocodone as existing medications such as Vicodin. Four companies have begun patient testing, and one company — Zogenix - is planning to apply early next year to begin marketing its super-charged pill which they call Zohydro.

What makes this superpill especially noteworthy is that it will be the first time anyone can legally buy pure, unadulterated hydrocodone.
Physicians are extremely excited about this new pill – one in particular comes to mind.



Namby-pamby worrywarts are fearful that this new pill will be abused by patients. But hey, just because the new pill happens to contain ten times more of the second most abused prescription drug in the US doesn’t necessarily mean that people will abuse it. After all, just because I buy my laundry detergent at Costco in boxes that are ten times size of a regular box that you buy at the supermarket doesn’t mean that I do more laundry. (OK – that’s a bad analogy. But, rest assured, the Spin Doctors are hard at work as you read this. They will soon be able to justify this pill in a dozen different ways).

April Rovero, president of the National Coalition Against Prescription Drug Abuse. Complains ""I have a big concern that this could be the next OxyContin”.



Poo-poo on you, April. You say that like it’s a bad thing, In 2008, Big Pharm sold 2.5 Billion dollars of the stuff in the US alone. From the viewpoint of Big Pharm, being the next Oxycontin is a VERY GOOD THING.

It’s really just a matter of perspective. After all, isn’t addiction just an extreme form of brand loyalty? To paraphrase Milo Milobender “"What's good for Big Pharm, is good for the country".

My biggest fear is that the FDA will drag their collective feet on this new horse pill. You know, like the way that they do with non-addictive pain killers like Medical Marijuana. Hey FDA – the economy needs a big boost. There are billions to be made here. So what if we have to deal with a few million more Americans with a monkey on their backs? Monkeys are cute – aren’t they?



So, I say, Godspeed, Big Pharm. Santa (or is it Sandoz?) Claus is on his way with a new bag of goodies for us all. Get out of the way, FDA. Let’s rush these exciting new drugs to market as quickly as we can. After all, what’s the worst that could happen?”





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Bar Bets

Wanna make some money? Here’s some easy bar bets that you can use to take some money from your friends and acquaintances. (It does help if they had a few beers before you make these bets, but it is not 100% necessary.

BET #1: Hey, I bet you don’t know what Neil Armstrong said when he became the first man to step on the moon!



99% of people who take this bet will say “"That's one small step for man, one giant leap for mankind”. Great answer, but they’re wrong. What Neil actually said was "That's one small step for A man, one giant leap for mankind.” It seems that NASA’s crappy 1960’s radio cut out at the most inopportune moment and nobody here on Earth heard the ‘A’. Subsequent digital analysis of that famous sentence proved that there was an ‘A’ in there. Plus, the quote makes a heck of a lot more sense with the extra ‘A’.



BET #2: Hey, I bet you don’t know who the first American in space was!



While not quite as much of a sure thing as the Neil Armstrong quote, this one should still make you some money. Most people will confidently say that John Glenn holds that honor, but again, they’d be wrong. The first American in space was Alan Sheppard. John Glenn was the first American to ORBIT the Earth – Alan’s short flight was a simple up and down affair, but he did reach the edge of outer space. For some reason, people forget all about Alan’s flight and give the honor to John Glenn, who must have had a better Press Agent.

Alan also had the greatest quote ever issued by an astronaut (in my humble opinion).. When he was asked what thoughts were doing through his mind in the seconds before blast off, Alan quipped that he thought “My God! This thing (his rocket ship) was built by the lowest bidder!!


BET#3: While on the subject of firsts in flight, I bet you don’t know who made the first non-stop flight across the Atlantic Ocean!



Pshaw! Even a 3rd grader knows that Charles Lindberg, ole “Lucky Lindy” himself, made this historic flight in the “Spirit of St. Louis”, the plane that now hangs in the Smithsonian! Yeah. That’s an easy one, but once again, it’s the wrong answer. The feat was accomplished by British aviators Alcock and Brown who made the first non-stop transatlantic flight in June 1919, eight years before Lindbergh made the first SOLO flight.


BET#4: Here is a straightforward bet without any trick answer. Most people know that the B-29 named the “Enola Gay” dropped the first atomic bomb on Japan in World War II. The Enola Gay, now fully restored, also sits in the Smithsonian.



I bet you that you don’t know the name of the airplane that dropped the second atomic bomb – you know – the one that actually ended the war.

Most people don’t know the answer, and for the simple reason that it’s important to be first. Like the loser of the Super Bowl or the World Series, second place just doesn't seem to count for much in America.

Regardless of the order of their feats, Armstrong, Glenn, Sheppard and Lindbergh will always retain their well deserved place in American History. They all brought glory to the USA by their historic firsts, and they have cemented their place in the Pantheon of American Heroes.

We need our heroes. In fact, need one in New Jersey right now. Here’s why:


In spite of the Medical Marijuana law being approved in New Jersey and passing all the legal hurdles, the program has yet to get off of the ground. One major sticking point is that physicians are scared stiff of being the first one in the state to write a prescription for it.

Even though Medical Marijuana is now legal in New Jersey, it is still a Federal crime to possess it. And since the DEA, the organization that gives physicians the right to write prescriptions is a federal agency. Physicians are afraid of losing their DEA license if they write a prescription for medical marijuana.

A physician without a DEA license is almost worthless. In fact, in states like California, physicians writing scripts for Medical Marijuana usually prescribe no other medications, so they have nothing to lose. They are depicted as being a bit of a joke, but they are just victims of the ridiculous Federal system- the only doctors who feel safe prescribing marijuana have nothing left to lose.



It’s time for the Federal government to step up and repeal the ridiculous laws that are crippling the use of Medical Marijuana. These prejudiced laws were written back in the days when alcohol was banned, Bonnie and Clyde terrorized the Midwest, and many American still didn’t have indoor plumbing. Federal laws against Medical Marijuana need to go the way of Flappers, Speakeasys, segregated water fountains, and outhouses. We’ve grown as a nation in so many ways since the days when marijuana was depicted as the evil weed. We now know much better. The Feds need to throw yet another anachronistic prejudice aside. They need to allow their suffering citizens legal access to this medicine.

The gig is up – everyone knows that the only reason why this isn’t happening is because Medical Marijuana doesn’t come in a little brown plastic bottle, and it isn’t manufactured by a multi-billion dollar corporation.

Oh, and by the way, the airplane that dropped the second atomic bomb on Nagasaki Japan on August 9, 1945, practically single handedly ending the greatest war the planet has ever experienced was called ‘Bockscar’. It resides in the National Museum of the United States Air Force, in Dayton, Ohio.

You owe me five bucks.



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The Deer Hunter

It’s hunting season again.

Deer hunters in Day-Glo Orange junp suits have been sighted at WaWa, sipping coffee in the dark-early, fortifying themselves for a day sitting up a tree on an uncomfortable piece of metal.




Turkey hunters are practicing their calls, hoping to entice some fat Tom into shotgun range.

Slick, fast-talking pitchmen are reaching out to senior citizens, imploring them to enroll in their Medicare programs.



Just like that 5 point buck or Tom Turkey, those poor seniors who answer their call are in for a nasty surprise.

Believe it or not, Medicare is great health insurance. It covers almost every medical procedure a person may need. Plus, the US Government puts a strict limit on what providers can charge Medicare patients, and this fee is much less then the going rate. If a procedure is denied by Medicare (unless the patient agreed to it up front) the provider cannot balance bill the patient.

Medicare is not free, of course. The patient is responsible for a co=payment that amounts to 20% of the government mandated rate, Fortunately, there is supplemental insurance that can cover even this expense.

Medicare is not perfect, however. There are things that is basic Medicare does not cover at all, like prescription medications. However, there are supplemental insurance plans that cover these expenses.

Most seniors these days can afford the out of pocket expenses from traditional Medicare. Unfortunately, some cannot. These poor souls are the ones targeted by the TV pitchmen.

For several years now, the government has allowed ‘private’ health insurance carriers to operate their own form of Medicare. Patients who opt for this coverage lose their traditional coverage and receive their coverage through one of these alternate plans, which are, in effect, a HMO.



Seniors are enticed by promises of lower co-pays, free gym memberships, and prescription coverage, but they usually don’t realize what they lose – great, cover-all health insurance. Once they sigh on the bottom line, for the next year at least, they are subject to greatly reduced coverage under the HMO plan. What sounded great on TV often becomes a sad story of seniors being denied access to health care that was covered by traditional Medicare.

I pity these hapless souls, just like I pity that beautiful Buck tied to the hood of that Chevy pickup in the Wal-Mart parking lot.


Like Joni said, “don’t is always seem to go….”

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Who’s the Boss

Was it Tony or Angela? That was the ongoing question in the long running sitcom. Personally, I never really gave a damn. It was never one of my favorite TV shows. I always preferred Tony Danza’s character in Taxi – now that was a sitcom!


OK, so if we don’t really care “Who’s the Boss?”, let us ask instead, “Who’s the Doctor?”

I spoke before on how PhD’s in medicine are the only people who are routinely given the social title of ‘Doctor”. Right or wrong, it is the social norm. But now we are being faced with a new dilemma.

There are people who are getting PhD’s in medical fields who are not normally addressed as ‘Doctor’, and they’re out to change the social norm.


A person who has their PhD in Nursing or Physical Therapy are by definition Doctors – but in the past they would never dream of being referred to as such. This is no longer the case. Many such health care providers are asking to be referred to as ‘Doctor’ – which in a professional environment will surely lead to vast confusion.

Traditionally, in health care, Only persons with degrees of “MD”, “DO”, “DC”, “OD” and “DPM” were addressed as ‘Doctor’, as were those who had their PhD in Psychology. Now, if this trend continues, we may be looking at nurses and physical therapists claiming this coveted title.

This trend, if it is allowed to get traction, will surely lead to great confusion amongst health care consumers.

I am sure that it is already being exploited by the health insurance industry.

Right now, some poor sod is surely getting a call from their health insurance carrier saying something like “I’m sorry Mr. Jones, but our Medical Director, Dr. Smith, has reviewed your file and determined that surgery to remove your brain tumor is not medically necessary”. Too bad no one bothers to explain to Mr. Jones that “Dr. Smith” is a retired pediatric nurse with flat feet and a PhD in nursing.




So don’t be surprised when your prescription carrier won’t pay for your ED meds because Gene Simmons says that “Real Men don’t need Viagra”.

After all, Gene has long ago claimed the title of “Dr. Love”.






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Hit Me With Your Best Shot

It’s that time of year again.

The beaches are closed. The leaves are falling. There’s a definite chill in the air.

….and, oh right – it’s time for my annual flu shot.

Like most people north of 50, I’ve been getting a flu shot every fall. So far, it seems to be working for me, as I haven’t had a real bad flu since I started getting the shots. The older we get, the less our bodies can fight off a flu infection.

Thanks to modern medicine, the flu is a lot less dangerous than it was 90 years ago, when it killed millions world wide. And while it is less dangerous, the flu can still be fatal to the elderly and those with compromised immune systems. Not that I’m elderly, mind you, but I’ve been getting my vaccine every year for the past ten years ago.



My experience with this important vaccination every year has proven two things:

First, the shots do work – I haven’t had a serious flu since I’ve started getting my annual vaccine.

Second, it warms my heart that at least SOMEONE in the healthcare field is finding a way to make the system more affordable and better.

Here’s what I mean. When I first got my flu shot, I got it at my doctor’s office. This meant making an appointment, waiting in line, and paying for an office visit.

Over the years, the routine has been changed. I started going to my local pharmacy for the shot. At an appointed time, a nurse would be available to jab me in the arm with the anointed needle. Not only was this more convenient, it saved me money, as I didn’t need to pay for a separate office visit. (even if the visit was covered, remember, always, Star Trek Economics).

This newer approach even saved me some pain – nurses are always better at giving injections than a MD is.

My health insurance company also got it right – in order to encourage me to use this more economical method of vaccination, the waived my co-pay, so I paid nothing out of pocket for my date with the hypodermic devil.

This year, there was a even a newer twist – I could now walk into my pharmacy at any time and get my flu shot. Plus, the deadly deed was dealth by a pharmacisit (who was working there anyway). This is an even less expensive way of delivering the vaccine. Face it, jabbing a needle into someone’s muscle ain’t rocket science. It makes sense that the most convenient – and cost effective – method be used to deliver the vaccine.



As an added bonus, by making the vaccine easy and cheap, more people will be encouraged to get it on an annual basis. This will, in term, same many of us from the prolonged illness, lost wages, or even more dreadful consequences of a nasty flu.

Everybody wins.




Wow, a move to more effective, convenient, and affordable health care in the United States. I’d never thought I’d see the day.


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Consumer Reports

Consumer Reports has been saving America money for over 50 years. Many thrifty Americans have grown to depend on heir sage advice, unbiased product reviews, and money saving tips. Many of us won’t make a major purchase until we consult Consumer Reports.

I only wish I did before I bought that Yugo.



Recently, however, Consumer Reports gave some advice on how to save money at the doctor’s office. Unfortunately, uncharacteristically, this piece of advice was bad. It could get your doctor into big trouble. Yikes!

Consumer Reports recently suggested that you negotiate with your physician in order to get a lower price on your medical care. So your doctor wants $800 to remove that mole? “Tell you what, Doc – let’s just make it $400 bucks and we’ll call it square. There is a doctor down in Tijuana that’ll lop that sucker off for $25, but I’d rather give the business to you….”



On the surface, this seems to make sense. After all, most of us are inclined to negotiate other professional services, like having our house painted or our tax forms completed. So, why shouldn’t we try to negotiate with our doctors as well?

The primary reason why this is a very bad idea is that the doctors can get into trouble for foing this. A lot of trouble.

You see, around 95% of all doctors ‘participate’ with at least one health insurance carrier. This means that they have a contract with that carrier, where the carrier will allow their subscribers to treat with that provider under their health plan and, in return, the doctor will agree to a lower (then their ‘normal’) fee for the services that they provide.

These contracts are very specific how they constrain the doctors, and in almost every case they place severe penalties on the doctor if they were to provide discounts to non-contracted parties.



In other words, let’s say that Dr. Jones has negotiated a contract with Blue Cross to be in their network. Dr. Jones, who normally charges $100 for an office visit, agrees that she will accept only $60 from Blue Cross for the same service – a 40% discount. In return, Blue Cross will provide Doctor Jones with a steady stream of patients. Now, Blue Cross won’t be very happy if they discover that another patient has negotiated a fee of $50 for the same office visit. That patient doesn’t have insurance, and therefore doesn’t have a contract that entitles them to the discount. This means that the $50 charges for the visit is really the ‘normal’ fee, and Blue Cross really should have a 40% discount off of that figure. They should only be paying Dr. Jones $30 for an office visit. They may demand (and are contractually entitles to) a refund from the doctor of $30 for each office visit they paid for under the contract. Ouch.

By the way, Blue Cross doesn’t care if the doctor gives carriers a discount, so long as they too have a contract with the doctor. There is honor amongst thieves, after all.

You might ask “So what if I got a discount – who’s to know?” Well, it turns out that the Health Insurance companies are very good at finding this information out. Usually, what happens is that the patient who received the discount turns around and submits the claim for the discounted visit to their insurance carrier. Once they do this, the cat is out of the bag, and the doctor is in big trouble.

There are ways around this, of course. A clever provider will code the discounted office visit differently then their normal visits – clling it a ‘consultation’ or a ‘brief office visit’. So long as they never use these billing codes for insurance visits, they should be covered, but since they really don’t benefit from giving their patient’s discounts, why should they take the risk of being discovered and persecuted? After all, the repercussions are great, financially and otherwise.



The clever solution to this dilemma are ‘health discount plans’. These plans are sold everywhere, including Costco. For a small annual fee, you get a card and a list of providers who are contracted to give discounts to plan members. Because the providers are under contract, they are immune to the pitfalls of of the cuff discounting. These plans are not health insurance – the’re more of a buying club. However, they can save you a lot of money, and save the doctor a lot of aggravation. And they can help cut the health insurance carriers out of everyone’s’ finances.

They’re a Win-Win-Win solution.

***** Found this Interesting, Entertaining or Informative? Please read the complete blog at: *****
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