For the week of March 12 - 18, 2003

Lets jump into the middle of the health care process

Commentary by BETTY BELL

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Health care costs have been zooming up and away for so long it’s hard to understand why someone smarter than this ripely middle-aged lady hasn’t 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.

It’s such an itty-bitty adjustment that’ll do the trick. All we have to do is get a few laws tweaked here and there so that regular citizens—the laity, as the Pope calls us—can 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 Celebrex—I guess she keeps a supply in her pocket—and 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.

That’s when I had my epiphany. Why should the doctor be the middleman in the prescription business? He gets his drug information from the pharmaceutical rep—one of those city-suited, briefcase-toting types emerging from the doctor’s inner sanctum long past your appointment time. It’s estimated—well, OK, it’s my estimate—that only 37 percent of the folks in the waiting room reading magazines you’d 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." It’s time, fellow and future invalids and cripples, to take charge of how this huge chunk of health care is divvied out. And it’s 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 they’re perfectly positioned to, get the Citizen Prescription License bill passed—all they have to do is get on the phones and call in their chips from their sort-of-under-contract congressmen.

We aren’t 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 aren’t 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 I’ve decided I won’t 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 you’ll 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 don’t know how you Band Aid a seeping stomach.

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

Here’s the plan: Write to Larry Craig back there in the U.S. Senate. Put some pressure on him. It’s not totally impossible, you know, that he’s 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 need—and dare—to take, watch health care costs plummet like a thermometer in a chilled martini.

 

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