Tuesday, February 15, 2011

USAmerican Style

The price of an extended period of fairly rigorous physical activity, for me, has been some challenging pain, pretty doggone severe edema, and evening flares that include moderately high fevers.  I was tossing back ibuprofen tablets with wild abandon until my stomach rebelled -- not just against the NSAID, but in profound rejection of the antibiotic and prednisone, as well.  The evening I took all three at the same time was brilliant.

"Oh, oh," was the extent of my commentary that evening.  I did the old nibble-on-crackers routine but in the end opted for that god send, zofran.  Generic zofran, to be precise -- ondansetron. 

That stuff is expensive.  Even though blessed with insurance now, I quiz myself closely before allowing myself to dissolve one under the tongue. 

During the period of time that I was uninsured, roughly a year, I was most worried about being able to afford my medications.  I found that, with some hard work researching drugs, prices and myriad details, there are tolerable alternative choices and affordable price tags.  The amount of cost-cutting that we were able to do was amazing. 

Why, then, cannot the insurance companies do the same?  I have tried hard not to revert to laziness now that my costs are again covered -- and I tell every doctor I see that I want them to please continue that work, as well, to keep costs of medicines, tests, and treatments within the Realm of Reasonable.  Still, convenience, like gravity, tends to win out and there are times I simply don't care about details, lost as I am in the forest of trees.

[That was the confessional moment for today.]

I found a 2008 article about a 12-year-old with cancer and her family.  She relied a great deal on Zofran/ondansetron during her course of chemotherapy but her parents struggled with the price, not covered by insurance for some reason.  It may have been because her need for the drug exceeded the amount considered acceptable by some bean counter, some Seinfeldian Zofran Nazi.  No Zofran for you!  Their outrage was compounded when they discovered the tremendous disparity in pricing among pharmacies.  $502 for 20 pills was the first price they paid.  After shopping around -- something very advisable, sure, but not always practical or possible -- they filled the identical prescription for $32 elsewhere.  The article, by an investigative reporter for Portland's KATU, didn't garner much notice -- perhaps because the news in it was not new or at all pleasant to think about -- but the two comments it did get made me snicker.

That's right, snicker.  Arched lip, one flared nostril, a bad attitude.  The first person related a similar experience of price gouging over Zofran/ondansetron, then ranted about boycotting the pharmacy with the highest price. 

I get pissed off easily at USAmericans.  All the blither and blather about "Obamacare" and the evils of socialism, of the left.  Yet, put someone in a situation that is purely and pristinely (i.e., nonsensically) controlled by the much-vaunted conditions of The Market, and it's Whine Time.  Big Pharma and its underlings are simply charging what The Market will bear. 

What?  Oh.  I see.  That's fine when we're talking about something pharmaceutically elective, like an antidepressant (you know, for the guilt ridden liberal without sufficient character to just will himself out of the clinical blues).  That'll work for the floozy leftist feminist who doubtless relies on a near constant supply of antibiotics to fight her slew of sexually transmitted diseases... but in the case of an emergent situation -- say, the upper-middle-class child with a fever of 105 and a proven-by-culture strep throat?  Well, everyone knows that in that case, the pharmacy and the drug company have no right to profit. 

Is health care a special category in capitalist economic systems?
How about foodstuff?  Fuels?  A public education?  Your Mama?

Within categories, do we distinguish between dramamine and ondansetron, insulin and subsidized wellness center memberships, a respirator for me and a respirator for you?  Should my tax dollars buy your family a bag of apples but not, perhaps, applesauce?  A ValuPak of pre-seasoned, pre-battered formed fish fillets versus 3 pounds of fresh extra jumbo black tiger shrimp?  Shall we foot the bill for advanced placement U.S. history classes but draw the line at world history and ESL? Should physical education and recess be done away with in elementary programs to make time for sex ed and the testing instruments -- as determined by best practices -- that monitor our declining achievement?

The Evil Me wants to scream "caveat emptor" to anyone on the right wing complaining about being gouged by their monthly health insurance premium or by the price of their cholesterol-modifying meds and Viagra.  If we fiscally retarded leftists, dipping our wriggling Birkenstock-bred toes in greeny socialist ponds, have to continue to dress up our concerns in the besotted falsehoods of capitalism... well, I'm just gonna spit

What am I talking about?  I am talking about how change must be made palatable to be made possible, how if I call you a "capitalist tool," that is widely taken as a good thing and not a cutting disparagement.  Our conversations, such as they have been -- our chatter, really -- about race and gender, have had to be held well outside any context of economic or class analysis, no matter how prevalent or instrumental that context.
Liberal idealism marginalized Marxism, dancing from Marx to Weber...

Oh God, now I have a headache.
You, too, no doubt.

It's just that I feel shut out of important conversations because people are afraid of my favorite words, and like I said, now I just wanna spit.

Yeah, so I don't feel so good at the moment and apparently, I am a little bit crabby, too. 

We love the new floors, my wheelchair, especially, and I've softened up as much of the space as I can by the swift purchase of  seven area rugs.  (I find purchasing swiftly reduces some of the pain inherent in such shopping -- much as a duct tape gag needs a fast and merciless yank to avoid excessive discomfort.)  Left to my own devices, I'd have chosen some far out designs and gone wildly into colors.  Knowing that everything had to pass Fred Muster and not be repellent to any living Haddock, however, I ended up with seven woven testaments to all that is neutral, resistant to dirt, and immune to cat piss.

I find some small comfort in the fact that I, alone, am driving the economy.

Yay, me.  Where'd I stash that Zofran? (Only 5 more days of antibiotics.  For my BONES, damn it!  For my bones...)

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