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Sunday, February 19, 2006

Cash Cow: The Medicare Part D Benefit and Drug Company Profits

Why does the United Sates capitalistic free market allow for the sale of so many prescription drugs? Drug companies tell us it’s for safety purposes.

In almost all other countries, many drugs sold to help people get well are actually “over the counter” or “OTC” purchases. In Mexico, for example, you can buy any non-narcotic drug from the Physicians Desk Reference (PDR) by simply pointing to a picture of it in a book sitting on the drug store’s counter. Also, the clerk who sells you the drug in Mexico probably isn’t a pharmacist, either. People in Mexico don’t seem any less healthy because they purchase their drugs OTC rather than by prescription, do they?

Why does the US require prescriptions for many common drugs while other civilized countries don’t? And the answer is, because prescription drugs cost more than OTC varieties.

Well, the American people are in for a wonderful new enlightenment as the Medicare Part D Benefit rolls out to “help” our senior citizens pay for the high cost of buying life saving drugs. I predict we’ll see more and more of these life saving expensive drugs become “OTC”.

And just how are drugs deemed "prescription" on one day and "OTC" the next day?

“Hello!?!”. Because, drugs sold without prescriptions aren't covered by any benefit – from Medicare Part D or otherwise. Make no mistake, the powerful drug companies can make this kind of public policy magic happen.

Bingo! Senior Citizens are now coerced into buying the Medicare Part D benefit – because, for them to pass on the option causes a penalty when they need to subscribe. These same beneficiaries will pay their premiums directly to the drug companies regardless of whether or not they take any drugs at all.

Talk about a cash cow benefit for the drug companies? Yes, indeed!

Meanwhile, for years, drug companies with their political gunpoint have held off those consumers who want more access to over-the-counter drugs – precisely because OTC eats away at profits and drug companies want the dough. Well, now these consumers will get their wish to come true as the drug companies will have a reason to give the American consumer what we want – more OTC drugs, as the Medicare Part D benefit fills their coffers.

A cash cow? And How!

Does this sound better than a mega-bucks get rich quick scheme? Well, unfortunately, it’s not a scheme; rather, it’s entirely legal.

With the Medicare Part D Benefit, drug companies will become increasingly rich on the profits made from premiums paid on plans that will become less useful as commonly covered prescriptions become OTC retail and non- benefit-covered purchases.

Each Medicare beneficiary who buys the Part D Benefit makes out a check to the plan they choose,– all with co-pays and deductibles and none really “free”.

We’re actually signing checks over the drug companies who will eventually make your expensive drugs less costly when they become OTC.

Of course, not all drugs can be OTC –not with the federal Food and Drug Administration (FDA) oversight. Nevertheless, mark my words, OTC will be “up for sale” by the drug company lobbyists who will convince Congressmen and Senators about the salient features of OTC versus the politically unpopular regulatory influences of our FDA.

I’m not a public policy psychic, but based upon my years as a nurse sitting in on public hearings alongside drug company lobbyists, there’s no doubt in my mind about where the Medicare Part D benefit is going. Moreover, money paid by beneficiaries but badly needed to support the federal Medicare program, will instead go directly to the bottom line of already rich drug companies. Even more incredulous, drugs made by these rich companies are produced, more often than not, in off shore tax sheltered environments.

What can Americans do about this? It’s simple. Given we’re apparently stuck with this expensive cash cow, we can demand for a provision in the Medicare Part D benefit to cover prescription and non-prescription drugs including vitamins.

Regardless of how it’s designed and packaged, the Medicare Part D Benefit is the drug companies’ public policy cash cow. I doubt the public policy impact of this hatshell trick disaster can ever be repealled during my lifetime.

Sunday, February 12, 2006

Islam and Me: A Series of True Stories

I truly happen to own an English language version copy of "The Koran".

Moreover, a picture of the Islam prophet Mohammed is printed facing the title page: "The Koran - By George Sale: Commonly Called The Alkoran of Mohammed; translated into English from The Original Arabic".

A lovely soft black and white photograph of the prophet Mohammed printed inside looks almost exactly like a young Jesus Christ wearing a white Arabic robe. In the startling picture, Mohammed is walking with two other prophets; I assume one of them is Moses. Both of Mohammed’s companions carry hooked canes – not exactly shepherd’s canes; but they’re hooked at the end.

Unfortunately, the copyright page with date is torn out of my hardcover book but a red stamped seal at the back of the book is inscribed "Libro Bindery: June 24, 1948, Orange Mass (? – I can’t read the last two letters in the word "Mass", so I’m extrapolating). This red stamp likely refers to when the book was re-bound in a library cover.

I recall purchasing this well worn book with a brown library cover many years ago during a used book sale at Biddeford’s (Maine) Macarthur Library. A six page single spaced introduction by Sale is written in a complicated English style reminiscent of something printed during the 1920s.

Certainly, I’m no etymologist, so dating is entirely my conjecture.

The author Sale begins "To The Reader" in his introduction: "I imagine it almost needles either to make an apology for publishing the following translation or to go about to prove it a work of use as well as curiosity. They must have a mean opinion of the Christian religion, or be but ill grounded therein, who can appreciate any danger from so manifest a forgery; and if the religious and civil institution of foreign nations are worth our knowledge, those of Mohammed the lawgiver of the Arabians and founder of an empire which is less than a century spread itself over a greater part of the world than the Roman were ever masters of, must needs be so, whether we consider their extensive obtaining, or our frequent intercourse with those who are governed thereby."

In other words, Sale says he’s curious about why people would question his publication motives in this translated version of "The Koran" when the followers of Mohammed have prospered and multiplied under the book’s Arabic mystique. Reading between the lines, Sale’s seems to say "Look here! Read this book and figure out why this religion of Mohammed is so appealing to the numerous Arabic masses."

Scanning the extensive 336 page structure of "The Koran" which is nearly void of paragraphs, I find on "page 62 in Chapter V" of Sale’s translation the following statement: "Therefore fear God, for God knoweth the innermost parts of the breast of men. O true believers, observe justice when ye appear as witnesses before God and let not hatred towards any induce you to do wrong; but act justly; this will approach nearer unto piety; and fear God, for God is fully acquainted with what ye do."

Obviously, this statement from "The Koran" could be attributed to an Old Testament prophet, regardless of the scriptural text.

I’m not sure what my life expectancy is now, after disclosing my ownership of "The Koran" published in English with a picture of the prophet Mohammed inside. There’s worldwide panic going on in Arab nations over the printing of Mohammed’s likeness in a cartoon and I own a rather handsome likeness in an old photograph.

Nevertheless, reading what I can glean from the text offers me at least some insight into Islam.
What I know about Islam leads me to believe this worldwide hysteria about printing a cartoon of the prophet Mohammed in a small newspaper that nobody I know reads from the tiny European country of Denmark, is evil incendiary trouble making, deliberately stirred up by zealots who hate nearly everybody. You have to wonder if followers of Islam really read their own prophet’s writing (albeit translated by Sale), as quoted above?

I’ve visited at least two Muslim Mosques – one was by invitation located in Washington DC, a beautiful Arabic shrine (I’ve been twice to this shrine on various tours). Another Mosque I visited was located in downtown Singapore, where my husband and I wandered around inside, totally NOT invited. Even at the time we were Mosque browsing there, during the 1980s during a tourist visit to Singapore, we were awed by our ability to get in and out without being kidnapped. Perhaps we surprised those inside the Mosque who didn’t have time to act out against our curiosity – and me without a veil. Also, I doubt the Muslims inside the Singapore Mosque were in the middle of one of their eight-times-a-day of prayer because it didn’t look like anybody was praying, although several men were standing and reading a book, which I assume was The Koran.

Thankfully, my husband and I survived this Singapore Mosque episode and with photographs, too. In those days, we took slide pictures which I clearly need to have re-printed for digital transmission.

During the 1990’s, while working for 6 years as the Director of Emergency Medical Services (EMS) in Southern Maine, an administrative position, our agency trained Muslim paramedics who practiced in Saudi Arabia. I knew many Arabs during this period of time, all young men who came to Portland, Maine to learn how to be paramedics.

One particular group of Arab students even hosted my husband, and me, and a few other administrative employees to an amazing dinner party where they – the men - cooked the food and cleaned the kitchen afterward. They prepared an impressive and delicious multi-course Arab meal including some of the best tasting rice I’ve ever eaten – loaded with pine nuts and mashed garlic.

During the lengthy after-dinner conversation, we listened to fascinating stories about lives in their Saudi homeland which included a romantic description of the reverent esteem they hold for Arab women. Of course, everybody is polite during a dinner party, especially when the Arab cooks are intent on cleaning up the kitchen. Therefore, as dinner guests, we were too well-mannered to raise questions. Remember, too, this special light entertainment by the Arabs was prior to September 11, 2001.

Islam, to me, is a religion clouded in mystery, duplicity and beauty. Exactly who’s "permitted" to own an image of the Islam prophet Mohammed, anyway? I have clear evidence that such images exist. Therefore, why can’t others see him as I can, while writing this essay?

Why does the author Sale feel compelled to open an old English translation of "The Koran" with an apology?

How can an ancient culture which is the basis for the beautiful "Tales from the Arabian Knights" and founder of our Arabic alphabet be driven to violently destroy those they appear to disagree with?

Rhetorical questions won’t move the cultural divide forward with any resolution, but it’s alerting to read how at least one author perceived his own writing many years ago about the Islam culture: "...those (followers) of Mohammed the lawgiver of the Arabians and founder of an empire which is less than a century spread itself over a greater part of the world than the Roman were ever masters of,....".

For me, Islam is growing by default due to the productive progeny of Arab women.

In my opinion, women hold the key to the future of this growing culture in their own bodies and minds. Consequently, Islam and me are related by gender, but not by belief.

I only wish our Southern Maine EMS agency had been allowed to train women Saudi paramedics, instead of men only. If given that hypothetical bonding opportunity, I would feel much closer today to Islam than I do.

Now, I own a potentially lethal copy of an image of the prophet Mohammed.

Surely, I don’t want to contribute, in any way, to even more excuses for needless and harmful Arab rioting because I happen to own a photograph of the prophet.

Just the same, I dare intend to keep my picture of the prophet of Mohammed. Mohammed’s uncanny and apparent likeness to the printed images we see of Jesus Christ is.....well, what can I say? Surely, if I was an Islam woman instead of Christian, I would want to ask this very same "image" question in reverse.