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For the week of March 12 - 18, 2003

Opinion Columns

Lets jump into the middle of the health care process

Commentary by BETTY BELL


Health care costs have been zooming up and away for so long itís hard to understand why someone smarter than this ripely middle-aged lady hasnít had a Eureka minute in which the obvious cost solution was revealed. The simple solution hit me last week as I kicked a soccer ball to my closing-on- 3-year-old granddaughter, who needs only the length of the sofa to test her skills.

Itís such an itty-bitty adjustment thatíll do the trick. All we have to do is get a few laws tweaked here and there so that regular citizensóthe laity, as the Pope calls usócan be certified to write our own drug prescriptions.

This hit me as I yelped at a stab of pain in my bum knee at the exact moment the silver-headed lady on TV yelped and grabbed her own bum knee. Talk about symbolism symbiosis. But the TV lady merely popped a CelebrexóI guess she keeps a supply in her pocketóand in accelerated TV time, she recouped her silver-headed athletic prowess.

Sure, I thought. Nice for you to have your pill handy.

"Ask your Doctor if Celebrex is right for you" urged the ad. Right. Hobble to the car, hoist the kid into the car seat, waste a gallon of gas finding a place to park, sit in the waiting room the standard 45 minutes, and then ask if Celebrex is right for me.

I already knew Celebrex was right for me. The ad graphically depicted my symptoms and it showed the simple cure. What I wanted to do, and right that minute, was make my painful way to the pharmacy and write myself a prescription.

Thatís when I had my epiphany. Why should the doctor be the middleman in the prescription business? He gets his drug information from the pharmaceutical repóone of those city-suited, briefcase-toting types emerging from the doctorís inner sanctum long past your appointment time. Itís estimatedówell, OK, itís my estimateóthat only 37 percent of the folks in the waiting room reading magazines youíd never buy are already bona fide or soon-to-be patients. The rest are drug reps, equipment suppliers, investment brokers, and maybe an occasional Mercedes salesman.

What we need is a dramatic new niche in health care for those of us willing to complete an intensive three-or-four-week pharmaceutical course and earn the "Citizen Prescription License." Itís time, fellow and future invalids and cripples, to take charge of how this huge chunk of health care is divvied out. And itís propitious that the pharmaceutical companies, who preach 24/7 about their new miracle drugs, are exactly the right place to start. With their armies of lobbyists theyíre perfectly positioned to, get the Citizen Prescription License bill passedóall they have to do is get on the phones and call in their chips from their sort-of-under-contract congressmen.

We arenít told everything we need to know about a drug in a 30-second ad, so, of course, we have to learn crucial things, details like possible serious side-effects. At a million bucks a second, those arenít the things an ad dwells on. I found out about possible serious adverse reactions to Celebrex in the self-study program I started right after I realized that a major solution to health care costs is to offer pharmaceutical courses for citizens

Under Celebrex I read about "edema/fluid accumulation, erosion of stomach lining with silent bleeding, gastrointestinal bleeding, anemia, kidney function decline, and liver function changes with possible severe reactions (rare)."

And guess what happened. Since I started my self-study program Iíve decided I wonít write myself a prescription for Celebrex after all. In addition to the above listed catastrophes, the reference book details 11 "CAUTION" items, and, writ in bold like that, they captured my attention. Number one, for instance: "The FDA requires a warning noting that people who have three or more alcoholic drinks a day may have increased risk of stomach bleeding if they also use NSAIDS (problems may also occur with lower alcohol use)." How about that little zinger in parenthesis? You take a Celebrex so youíll be able to bend your legs into a chair at the dinner table in comparative comfort, drink maybe just one little old glass of wine, and then your stomach starts to bleed? I donít know how you Band Aid a seeping stomach.

And number eight? "These medicines may cause fluid retention, complicating high blood pressure or heart failure treatmentóthis effect may generally be managed by an inexpensive and well-tolerated water pill (diuretic) such as low-dose hydrochlorothiazide." Iím not about to sign on for a 19-letter pill I canít pronounce and can only spell with intense copy care. Iíll stick with ibuprofen.

And therein lies the beauty of the Citizen Prescription License. When we ordinary citizens take on this responsibility, a lot of us are going to opt NOT to prescribe to the latest miracle drug we saw on TV. Scares the heck out of me, the stuff Iím finding out.

The drug companies will have to slash their "Be bionic" TV ads after we know "the rest of the story". We pay for that 24/7 spiel, you know, and with our new savvy, those ads will fade into the sunset like the Marlboro Man.

Hereís the plan: Write to Larry Craig back there in the U.S. Senate. Put some pressure on him. Itís not totally impossible, you know, that heís one of those sort-of-under contract congressmen. And then get your bumper sticker: YES TO CITIZEN PRESCRIPTION LICENSES! When great numbers of us hang our licenses on the wall and figure out what drugs we really needóand dareóto take, watch health care costs plummet like a thermometer in a chilled martini.

 

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