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Sun Mar 9, 2014, 04:23 PM

Poor Folks in the U.S. Can No Longer Afford Treatment for Pneumonia

Yes, this is a scary headline. Almost sounds sensational. It isn't. It is a cold hard fact. At this moment, if you are counting your pennies, trying to scrape up enough to pay for a $4 drug at Wal-Mart or Target, you can not afford an antibiotic that will treat your walking pneumonia---meaning that you could end up in the hospital saddled with tens of thousands of dollars in medical bills.

For years, doxycycline has been a valuable drug for physicians who treat the indigent --- unemployed or underemployed folks without insurance. A staple of $4 drug lists, it can be used to treat everything from bronchitis to "walking" pneumonia to urinary tract infections to skin infections to acne to venereal disease---and it covers some rarer infections like Lyme's and is sometimes used for malaria prevention, too.

For as long as I can remember--and I am pretty damn old---doxycycline, a twice a day form of tetracycline has been widely available and cheap as dirt.

And then, this winter, something surprising and very troubling happened. A patient with a list of medical problems longer than his arm and no income (he was still appealing a Social Security Disability denial) came down with bronchitis, possible early pneumonia--the two can be difficult to differentiate. I wrote him a prescription for doxycycline. He took it to the pharmacy. They wanted over $50 for it. He did not have over $50. He had $4. That was how much the drug used to cost at the same pharmacy.

He is not alone. Here is an LA Times Story about someone who had the same problem last year. Turns out that the difference can depend upon which generic drug manufacturer is making a specific medication at any given time. And apparently, right now, the one making doxycycline charges an arm and a leg for it.

http://articles.latimes.com/2013/mar/07/business/la-fi-lazarus-20130308

A CVS pharmacist in Los Angeles, who asked that his name by withheld because of fear of retaliation by the company, shared with me the average wholesale price of different makers' doxycycline, as made available to pharmacists by the McKesson Connect online ordering system.

The system shows that the average wholesale price of 100 doxycycline pills made by Watson with a strength of 100 milligrams is $328.20. The same number of doxycycline pills at the same strength made by Mylan cost $1,314.83.


Mylan? Where have I heard that name before? Oh, yes. ALEC. As in "The Koch Brothers" and their corporate welfare mentality.

http://www.sourcewatch.org/index.php/ALEC_Corporations

Where else have I heard of Mylan? Oh yes, the great lorazepam price fixing scandal.

http://abcnews.go.com/Health/story?id=117795

The Federal Trade Commission approved a $100 million settlement with Mylan Laboratories, the largest monetary settlement in the commission’s history.

The agency had charged Mylan, of Pittsburgh, Pa., with conspiring to deny four competitors ingredients necessary to manufacture widely prescribed generic versions of anti-anxiety drugs. The practice resulted in a 3,000 percent boost in the price of the drugs, according to the FTC.

“Anti-competitive acts in the pharmaceutical industry potentially cost consumers millions of dollars in higher prescription prices,” says Richard Parker, director of the commissions’ bureau of competition.


Mylan is now the third largest generic drug manufacturer in the world since it acquired an Indian generic drug manufacturer--meaning that it is in great shape to corner the market on these all important key ingredients needed for drug manufacturing.

http://triblive.com/x/pittsburghtrib/business/s_582510.html#axzz2vVDPxdWb


Not so long ago, the nation watched as patent drug manufacturers paid generic drug makers NOT to produce their product---keeping drug prices high. Keep that in mind as you ask yourself why a drug as popular as doxycycline is in short supply. This is not one of those orphan drugs that no one wants to make because almost no one needs it. This stuff sells itself. The more that is made, the more we will see it used. Why isn't supply attempting to keep up with demand? Where is the bottleneck in the so called "free market economy"?

If this were a fictional mystery, I would now tell you why doxycycline has gotten so expensive that poor folks can no longer afford it. Since this is real life, I don't know. If someone out there knows the answer, please tell me. Meanwhile, when a patient without money and without prescription drug coverage comes in which bronchitis/and or pneumonia, I am going to be hard pressed to get him treated with what is currently available on most $4 lists.

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Reply Poor Folks in the U.S. Can No Longer Afford Treatment for Pneumonia (Original post)
McCamy Taylor Mar 2014 OP
bemildred Mar 2014 #1
erronis Mar 2014 #2
Scuba Mar 2014 #3
lunasun Mar 2014 #40
Adrahil Mar 2014 #4
840high Mar 2014 #17
G_j Mar 2014 #5
Diclotican Mar 2014 #6
Name removed Mar 2014 #7
Marrah_G Mar 2014 #8
uppityperson Mar 2014 #10
Stargazer99 Mar 2014 #26
Marrah_G Mar 2014 #28
hollysmom Mar 2014 #29
malaise Mar 2014 #9
rafeh1 Mar 2014 #11
passiveporcupine Mar 2014 #12
nenagh Mar 2014 #30
passiveporcupine Mar 2014 #33
McCamy Taylor Mar 2014 #31
passiveporcupine Mar 2014 #34
arikara Mar 2014 #44
passiveporcupine Mar 2014 #47
unapatriciated Mar 2014 #13
grasswire Mar 2014 #14
freshwest Mar 2014 #15
Babel_17 Mar 2014 #16
Rex Mar 2014 #18
frwrfpos Mar 2014 #19
HeiressofBickworth Mar 2014 #20
murielm99 Mar 2014 #41
glowing Mar 2014 #21
bvar22 Mar 2014 #22
LarryNM Mar 2014 #23
Auntie Bush Mar 2014 #24
theHandpuppet Mar 2014 #25
zazen Mar 2014 #27
moriah Mar 2014 #32
Crunchy Frog Mar 2014 #35
jtuck004 Mar 2014 #36
KatyaR Mar 2014 #37
murielm99 Mar 2014 #42
Hekate Mar 2014 #38
Romulox Mar 2014 #39
Turbineguy Mar 2014 #43
truedelphi Mar 2014 #45
NCarolinawoman Mar 2014 #48
RoccoR5955 Mar 2014 #46

Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 04:26 PM

1. +1. nt

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:10 PM

2. Thanks for this info - we'll be looking into it. The FDA and Dept. of Commerce

NOT

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:15 PM

3. This is an important topic and an illuminating post. As a career hospital administrator ....

 

... I have some insights into the American healthcare system, but the mysteries of Big Pharma remain beyond my grasp.

Suffice to say the system appears rigged to reward pharmaceutical manufacturers well beyond the value they provide. We know that unethical and dishonest pharmacy sales tactics are widespread; to suggest there is no other corruption in the industry would be laughably naive.

This is a classic case where better, not less, regulation is required, yet the advocates of industry "self regulating" have made significant inroads in this arena. None of this benefits consumers.

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Response to Scuba (Reply #3)

Mon Mar 10, 2014, 10:45 AM

40. +1 well said

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:17 PM

4. At Meijer stores here in Indiana (and presumably elsewhere), most common antibiotics are free. NT

 

I'd like to see that countrywide, everywhere.

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Response to Adrahil (Reply #4)

Sun Mar 9, 2014, 06:43 PM

17. Some stores in Ga. have it free.

 

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:20 PM

5. crucial information

and a HUGE red flag!!

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:27 PM

6. McCamy Taylor

McCamy Taylor

Horrible - just horrible....

Have been a nasty attack of phnumia myself 6-9 mounts ago - well I got Phnumia, kidney problems - and a attack of aridities to boot at the same time - I know how bad the body could be . I even ended up in a hospital for 3 weeks - as my kidneys was not to well - and my phnumia was rather serious - not just another bronchitis I have had a few times over the last couple of years... And if I was living in US, I would either be dead -or burden with debt I would never be able to pay back...

I'm not sure how much the hospital stay was cost me, but I would guess it was into the ten of thousands - but thankfully in the country where I live, we have something Universal Health Care - where you correctly assumed pay a higher tax base than in the US - but at least I was not going broke for getting life saving health care, both for my phnumia and for my kidney problems - who was rather serious - have been true no less than 3 operations so far to stabilize the whole thing - and now I'm off to another surgery next Wednesday to fix the problems once and for all (I'm not sure what it is called in english, but it is fairly routine operations compared to many other things - hopefully they will not cut me in two )

It is barbaric to deny poor people medicines they might need, if they get sick - because the medicines is to "expensive" for them - it should be outright criminal to deny any sick person their treatment - that be with medicines - or operation procedures - everyone who want to deny their right should be convicted on crimes against humanity - and put in a prison cell for the rest of their natural life - and that everyone on the cell block would know why they was in prison...

I think I told about my experience with universal health care too, I suspect it is amiable somewhere on DU..

Hopefully US wil also get univeral health care sometime down the road - but I guess it wil take many years and many dead pepole before that wil happend... Barbaric... Just Barbaric...

Diclotican

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Response to McCamy Taylor (Original post)


Response to Name removed (Reply #7)

Sun Mar 9, 2014, 05:35 PM

8. This could qualify for the stupidest post of the day!

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Response to Marrah_G (Reply #8)

Sun Mar 9, 2014, 05:39 PM

10. Antibiotics for pneumonia, bad. Kale, good.

sometimes she baffles me

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Response to Marrah_G (Reply #8)

Sun Mar 9, 2014, 09:44 PM

26. Stupid! You gotta be kidding-my daughter died due to lack of medical care

because she could not afford it despite working (the conservative solution to anything)

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Response to Stargazer99 (Reply #26)

Sun Mar 9, 2014, 09:48 PM

28. The post I was commenting on was hidden

I was not commenting on the OP

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Response to Stargazer99 (Reply #26)

Sun Mar 9, 2014, 10:33 PM

29. I am sorry to hear that, Was this recent? n/t

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:35 PM

9. Thanks for posting this

Lovely to see you

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:42 PM

11. unbridled capitalism and health care

unbridled capitalism and health care is a bad mix. Read dickens. I had the experience one time I was at pharmacy and this lady was trying to get some anti biotic medicine which was like $37 or so. I could see she was shaking and she did'nt have money. So I called pharamcist on the side and told him to give her the medicine and put it on my card. The pharmacists who was a Muslim or Indian felt guilty and gave her the medicine but refused to charge my card..

We sure need a better system

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:54 PM

12. There is another pretty common drug that is too expensive

and that is a rescue inhaler for asthma patients. You can get nebulizer meds for $4/month, but who can hold down a job if they have to use their nebulizer several times a day for serious asthma? My rescue inhaler (cheapest generic brand) is now just under $50 each. I sometimes use two a month. There are other drugs that can control asthma better to reduce the need for the rescue inhalers, but for me, the one that works is Pulmicort, and it's over $200 for one inhaler, so I can't buy it. How many poor people are out there with asthma? I suspect a lot. I am not living in poverty, and I do use my nebulizer, but I still sometimes go through two rescue inhalers a month (albuterol). Even $95 a month for me is a hard hit, especially since that is only one of the meds I need.

These used to be pretty cheap until they switch to CFC free. Then the prices started going up dramatically, and now they go up almost every month, and I don't understand why, when it is such a common item necessary for asthma sufferers. They are much cheaper overseas. So much so, it's infuriating. Plus, asthma sufferers are usually very prone to bronchitis and pneumonia.

According to the government, about 1 in 12 people (about 25 million) have asthma

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Response to passiveporcupine (Reply #12)

Sun Mar 9, 2014, 10:57 PM

30. Hi passiveporcupine.. In Ontario albuterol is called salbutamol , brand name is Ventolin.

Around 2003, because of new legislation, we in pharmacies were required to change to the CFC free propellant product.

But ALL brands of Salbutamol (albuterol) Metered Dose Inhalers changed formulation including BOTH the brand name Ventolin and two generic brands... all with the new HFA inhalant.

I find it nearly hard to believe that in the USA, there is not a generic brand of albuterol Metered Dose Inhaler.. because it has nothing to do with the fact that it cannot be manufactured... because we in Ontario have been dispensing the generic brand CFC free salbutamol inhaler since 2003.

There was a very large legal fight here, which the Government won.. in which ratio-brand generic company, a different arm of SKF pharmaceuticals.. fought over being able to sell the generic product at a higher price than the listed price that the government would pay. They lost the legal case.

Part of the legal case about the sale of ratio-pharm salbutamol at a higher price had to do with patent rights and part of the case was about interpretation of the Gov't to set a standardized price.. and when I read "patent" in the legal case... it took little imagination to realize that corporate legal teams for Big Pharma will have "patent" rights redefined so that the case would not be lost in 2015 or whenever.

As a member of the Health Care profession... I am very sorry that you do not have a generic albuterol CFC available.

We must, must fight the TPP...


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Response to nenagh (Reply #30)

Sun Mar 9, 2014, 11:45 PM

33. Ventolin is our generic brand. It is the cheapest brand I can get here. And it is almost $50/mo

I hope some day someone fixes this problem so that everyone can get the prescriptions they need.

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Response to passiveporcupine (Reply #12)

Sun Mar 9, 2014, 11:25 PM

31. Might not work for everyone but if you can get a neb machine

the refills for it are cheap cheap cheap (on the $4 list at Wal-Mart). Some of my patients who can not afford the hand held inhalers are using their neb machines instead. And if you have asthma, chances are that your kids have it too, and their SCHIP will cover a neb machine for them--which anyone in the family can use.

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Response to McCamy Taylor (Reply #31)

Sun Mar 9, 2014, 11:48 PM

34. I have a nebulizer and I use it often, but it's not with me when I am away from my house.

And it doesn't help me in bed. I use my rescue inhaler when I'm outside, away from home, or in bed at night.

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Response to passiveporcupine (Reply #12)

Mon Mar 10, 2014, 02:56 PM

44. I heard they changed to CFC free

Is it true they don't work as well since the change? I didn't realized that the price went up as well. That explains why they changed then, those little puffs couldn't have been contributing much to climate change in comparison to say... the tar sands.

My daughter went on one of the newer ones and she got so sick and confused on it that she called me to ask what to do. She was living in the US and me in Canada. I told her to call an ambulance and get right to emergency then had to sit and worry. It all turned out ok but she went back to the older ones, I think pulmicort.

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Response to arikara (Reply #44)

Mon Mar 10, 2014, 06:52 PM

47. Pulmicort is a steriod, not albuterol

Which is why it works so well. And it should not be used like a rescue inhaler.

CFC free inhalers do not work as well as the old ones did. I'm not sure why. You are supposedly getting the same amount of the same meds as before.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:56 PM

13. Thanks for the article and link.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 05:59 PM

14. Keep posting, keep posting.

You have been missed on DU.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 06:25 PM

15. Thanks for continuing to speak out on this. How many illnesses are not being treated because of the

scare over diseases becoming anti-biotic resistant?

A lot of people are given the absolute minimum or none at all, when they could be cured of some conditions with a longer course until the disease is put down, or even a short one. JMHO.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 06:35 PM

16. So sad (nt)

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 06:44 PM

18. GREED.

 

nt.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 06:47 PM

19. important..rec

 

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 07:15 PM

20. I've run into this, too.

For me, getting the right blood pressure med is tricky -- find one that is effective without causing damage to my already failing kidneys or conflicts with other medications I take. I was on one med for a couple of years. It was $9.98 at Costco for a three month supply. When my three month supply ran out, the renewal price this time was $78! I spoke with the pharmacist, got a supervisor, etc., but was told that the manufacturer changed the price to Costco so Costco had to raise the price to the consumer. So, back to the doctor to figure out what drug to substitute. A different drug was substituted and the cost for a three month prescription was $17. But at least it wasn't $78.

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Response to HeiressofBickworth (Reply #20)

Mon Mar 10, 2014, 12:11 PM

41. I take propanolol,

and I have Medicare D. I used to pay my share, $25.00. Now it went up to $55.00. The pharmacist told me that big pharma has raised the price of generics. I am going to the doctor next Monday, to see if there is another, cheaper beta blocker that I can take. I can't pay that for one drug every month, when I have four prescriptions.

Maybe I can find a better Medicare D plan, but I have to wait for the open enrollment period.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 07:28 PM

21. That's why my kids c-pay was $30.00 instead of the normal

 

$10.00 generic price... There's another medicine that is in the higher tier as well that should be in the $10.00. I guess this was what we got when the ACA didn't take in Big Pharma which is a racket!

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 08:14 PM

22. But we have the BEST Health Care in The WORLD....... (for the very RICH).

Painful Reality of Life in These United States for the not so 1%.
This is a brilliant clip about 3rd World Health Care by Jon Stewart and Aasif Mandvi
from The Daily Show last Thursday.


http://www.thedailyshow.com/watch/thu-march-6-2014/third-world-health-care---knoxville--tennessee-edition

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 08:19 PM

23. More Take From the Many and Give to the Very Few

in all aspects of our lives.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 09:32 PM

24. We NEED he Gov to investigate into why the cost of drugs are escalating so fast. Something crooked

or illegal is going on. We have to find the reason soon before the cost of PartD goes so high people won't be able to afford it.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 09:39 PM

25. Thank you for posting this.

The word should be spread far and wide, to expose this outrageous scam.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 09:47 PM

27. CDC finally acknowledged last year how Lyme is greatly underdiagnosed

and 3-4 weeks of doxy is the primary approved treatment. It's not always enough, but I find this interesting . . . .

Lyme _is_ massively underdiagnosed, and the politics of IDSA around the vaccine were fishy enough, which has held back hundreds of thousands of patients from getting appropriate treatment.

Once it becomes more accurately diagnosed, there's a lot of money to be made on those doxy scripts.

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Response to McCamy Taylor (Original post)

Sun Mar 9, 2014, 11:36 PM

32. Cipro is on the $4 list at Fred's and several other pharmacies.

Good luck.

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 12:13 AM

35. I have an overseas, online pharmacy that I use.

We have lots of deer ticks and Lyme here. My mother got it in the back yard a few summers ago, and the doctors around here are worthless for treating it properly.

We ordered stashes of Doxy and amoxicillin (two young children). We will self treat if we have to (treated one of the kids last summer after I pulled a tick off him), and it is not expensive.

Just checking on their site, and they also have the cheap inhalors.

Fuck American pharma. I will go around them if I have to, in any way that I can.

Good reminder that I should probably be ordering fresh medications for the upcoming tick season, as the last batch is getting kind of old.

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 06:08 AM

36. And the TPP is likely to make it even worse with the new protections for drug patents,

 


especially reaching out of the country to shut off some of those outlets.

Bastards.

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 07:11 AM

37. The $4 lists will be gone soon.

My generic thyroid that I must take every day went up the end of last year from $4 a month to $11. All the generic thyroid meds from that manufacturer went up so much that they no longer qualify for the $4 plan.

A friend takes a compounded thyroid med, and it has gone up from $60/month to $160/mo. Her hormone meds have gone up a crazy amount, as well.

I guarantee you this is retaliation for the healthcare act. I guess there will be a lot if people dying from lack of meds. Talk about your death panels....

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Response to KatyaR (Reply #37)

Mon Mar 10, 2014, 12:12 PM

42. My Armour Thyroid went up to $15.95.

I know it is very cheap to produce!

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 07:28 AM

38. KnR

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 08:20 AM

39. Mandatory, for-profit health insurance doesn't solve a damn thing. nt

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 01:13 PM

43. I recall reading somewhere

that many deaths during the Great Depression were put down to pneumonia. It seems that at Mylan they think that dead people continue to buy drugs.

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 03:43 PM

45. So grateful that the 2009 health care reform efforts of everyone from

Rahm Emanuel to members of Congress made this an unlikely scenarios, she said sardonically.

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Response to truedelphi (Reply #45)

Mon Mar 10, 2014, 10:48 PM

48. Yes, I remember.

Senator Dorgan tried to make importing cheaper drugs from Canada legal. He was ignored and then he chose not to run again.

I also remember reading about all the secret meetings between Democrats and drug companies.

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Response to McCamy Taylor (Original post)

Mon Mar 10, 2014, 04:32 PM

46. Capitalism will kill us all! n/t

 

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