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Justice from the Drug Man

Who gives unto Caesar?

Who gives unto Caesar?

I haven’t been feeling well. Nothing to break the surface tension of worry, but I would rather stamp it out. My arms have burned with sandpaper inside the skin off and on for the past few months, sparks jumping deep inside the muscle. Then the night sweats started, waking me in the wee hours to a drenched bed. Peeling the undershirt off, I could wring drops out of it. Surely a sign of personal growth is unwillingness to return to the bad old days. Doctor L gets a call.

The meeting in her office of kid drawings and kid pictures on the wall is focused now: we have been here before. My patient records span multiple folders, each thick enough to clobber a big dog. Ahhh, she flips. When did we last do that? Over a hundred here. Not too bad. You still got that crap in your mouth? We discuss, compare. We are old hands at this now. Then the flourish: Ooo-kaaay. So here’s what we’re gonna do. 

Lyme involves a retinue of henchmen and stragglers who cause their own trouble. Two of these are bartontella and babesia, creepy corkscrew things that can hide out, flare up, and hide again. In 2011, six months of medication seemed to clobber them. No more sweating at night, the fatigue and zinging pains were gone, and my mind hummed like a plucked string. I was set.

In 2011, Doctor L suggested Mepron, a powerful new anti-bug juice intended for malaria but which was excitedly reported to lower the boom on Lyme co-infections. At the time I had comfortable insurance through my job, but had pause when the good doctor mentioned it could be expensive. After twenty years of horror stories about the very ill having their insurance yanked when they become unprofitable, and having taken some expensive pills at length already, I called around. In 2011, the cheapest Mepron was from the Costco pharmacy: $1500 for a month’s supply.

Many other treatments–for cancer, say–are much pricier, but fifteen hundred bucks set off alarm bells for me. A discussion with Doctor L winds down to Bactrim, an old, dirt-cheap sulfa drug. The pharmacist showed concern and lectured me intensely in broken Asian English about allergies and reactions, the chief reason the sulfas are not much used. Cheapness or luck was with me, and the big white pills became daily familiars.

Now, come back around in 2014, Doctor L suggests the azithromycin and Mepron as in 2011. No alarms sound this time. Is it my new sense of self-trust? Unconscious retention of Obamacare preventing the chronically ill from getting kicked to the curb? This is America, after all. A new day is always around the corner.

Zith is common enough, but Walgreen’s must send out for Mepron. Waiting tickles my subconscious. I didn’t get this before but don’t remember why. When the stuff shows I remember. 

Look closely at the picture above. Small type at the bottom of the red box proclaims a retail price of $2144.49. The white paper Rx bag contains not a diamond ring but a brown bottle:

Mepron bottle

Mepron bottle

Inside is a washed-out yellow liquid thick as tempra paint. I don’t think it’s made with diamonds either.

I am one of the lucky ones with insurance that will cover such medicine: I’ll shell out the top-level $40 over $2150 any day. To have such insurance one must also have a job, and to have and keep a job one must be well. If you’re missing a piece, well, you console yourself with knowing America is great.

Twenty years ago the carnival of healthcare enraged me. I suppose it still does, but even rage becomes boring. All the time I have been alive, American health care has gotten worse. It serves no one but the few dozen super-executives whose functions have always eluded me. Obamacare’s reforms are so meager compared to the problem’s enormity–and its vast handouts to the health insurance and drug companies–that it makes one question the point of government at all. (And that’s by design too.)

But these are selfish rants. Compared to the poorest billions (billions with a B), I am in the one percent with my clean water, healthy food and internet access. Mepron is effective against malaria grown resistant to everything else. All sufferers of this are in the true ninety-nine percent, languishing in Africa and southern Asia. Where are they supposed to come up with $2150 a month? Or the millions of Americans without insurance, and who will remain without it after all of Obamacare is said and done?

The usual rants about greedy drug companies are in order, their research spending less than their marketing muscle, their resources bent to upping dosage recommendations for profitable drugs instead of making things cheaper. How many types of boner pills do we need? The interwebs are full of people’s stories mugging for the drug companies’ largess, filling out charity forms and jumping through hoops while ill in the hopes of free or cheaper medicine. I have no patience for entities that would visit such indignity on citizens. I have no sympathy for giant corporate whining on their formidable expenses. Twenty-five years ago, the anti-balding drug Minoxidil went for $2000 an ounce. Now I can buy it at Safeway for less than $20. Why should I believe their whining?

The smartest thing is for me to take the medicine, ask no questions, and certainly not call the health insurer. With luck a refill will go by undetected, and then hopefully the breath-holding will be over. The sun will shine and good old stick-to-it-ive-ness will again prove this is America after all.

But I will always know that the poor and sick and stuck are out there, continents of them, and down the street from me living under bridges. There but for the grace of God go I.

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