1. The first one hits home for me. The anti-depressant that was covered by Medicare/drug plan was inexpensive, but no longer worked. The new one, that works wonderfully, costs $1500 for three months. Frankly, I think in these times, anti-depressants should be handed out like Skittles . . . or M & Ms.

  2. The reference to “Skittles” echos a famous mistake: during the production of “E.T.”, the producers asked for permission to use (and refer to) M&Ms in the movie. The candy company refused, apparently worried that a relationship with a fairly ugly space alien might be detrimental to sales. The producers switched to Reese’s Pieces (who gave permission), and that turned out to be a marketing boom for them.
    P.S. As for “prescriptions”, I had a friend in college who referred to and used extremely dark chocolate as an effective medicinal treatment.
    P.P.S. I think Olivier is way off base. The second one is a complete CIDU for me.
    P.P.P.S. The third one is both disgusting and a rip-off of a very old joke.

  3. “Ihad a friend in college who referred to and used extremely dark chocolate as an effective medicinal treatment.”

    Coincidentally, this was in my comics feed today . . .

    If I ate enough chocolate to overcome the chemical imbalance in my system I’d have to own Willy Wonka’s chocolate factory.

  4. HMOs (Health Maintenance Organizations) are health insurance plans that only have in-network coverage and are reputed to be very cheap on coverage. They presumably will have a long list of drugs that they will consider “experimental” and hence exclude them from coverage. (Experimental drugs are usually not covered.)

    PPOs (Preferred Provider Organizations) are similar types of health plans, but they are more liberal with coverage. (e.g., they will have some sort of out-of-network coverage options) and are likely to have fewer drugs listed in the excluded, “experimental” category.

    The joke here is the patient has an HMO that is so cheap it considers penicillin to still be experimental.

  5. I saw Leon Redbone a couple years before he passed* and he had the line, “I haven’t been at all well. My doctor gave me three pills and told me to take them five times a day and you can’t DO that.” I spent SO much time trying to figure out why that was funny.
    *Which with Leon could have meant a number of different things.

  6. @Pinny: but the rumor is that the PPO is going to remove penicillin from the experimental drugs list.
    Are PPO and HMO both so bad that choosing one over the other is like choosing plague over cholera?

  7. Another thing I don’t understand about #2 is that doctors in HMOs are not going to be covered by a PPO plan, so the doctor is basically also telling the patient to get lost.
    Which might be intentional, who knows?

  8. I’m with those seeing the middle one as a generalized critique on the complications and dodges in the health care and insurance systems, but not going to work on the very specific terms he gives us.

  9. I was usually with Bill on the uselessness of the darn squirrel, but the one with Mary Poppins was actually kind of funny!

  10. Olivier: The PPO is possibly going to remove penicillin from the experimental drug list, and make it a normal drug that can be covered. The HMO is going to leave penicillin on the experimental drug list, where it won’t be covered. So both are bad now, but the PPO might become better.

    It’s not a realistic situtation (and it’s not supposed to be), but it’s works for me as exaggeration of the difficulty of determining and obtaining coverage in the American medical system.

  11. @Scott: A PPO is usually like an HMO with more liberal coverage. Doctors in HMO networks often also participate as in-network doctors in PPOs.

  12. I think in the second one, there are (at least) two confusing ambiguities. First, which one is the “they” who are removing penicillin from the experimental drug list, the HMO or PPO? Second, once they’re removing it, are they putting it in the “not at all covered” category or into the standard pharmacopeia?

    I suspect that the idea is that the PPO is taking penicillin off “experimental” list and putting it into the “fully covered” list, at least, there is a rumor they’re going to. Therefore, since patients will only have to pay the basic co-pay on this foundational drug of modern medicine, it’s a good deal.

  13. Carl, I didn’t quite understand your comment (notionally 3:29 AM), until I noticed the chart or Xray on the wall.* But that looks to me like a poster that stays there semi-permanently for unspecified purposes, rather than a current Xray or scan of Mary herself.
    *Or the inside of the door apparently.

  14. I take it these are recommendations by the named pharmacy staff members (not for them). The sign is the sort of thing you do see now and then, but in quite different contexts. I think of libraries, but it could be other kinds of retail outlet too. The oddity (and maybe humor) is that you can’t just walk into a pharmacy, see a suggestion, and respond “Oh yeah, I think I’ll try some hydrocodone today.” [Brand name Vicodin]

  15. But can you recommend something without having tried it yourself? I wouldn’t recommend a book I hadn’t read.

  16. I would not have chosen those exact drug names, except for hydrocodone. For the others I would have put maybe diazepam, morphine, tetrahydrocannabinol, C2H5OH, lysergic acid diethylaminde ….

  17. @Mark, I agree with the observation that the drugs listed make a kind of arbitrary list, though all are AFAIK prescription-only rather than OTC in most places. But if your suggestion was to go for Controlled, we do have Alprazolam already, which is a benzo and would serve for the slot you may have in mind for diazepam. (Though diazepam is probably better known, it’s true.)

    I worked as a Pharmacy Technician for a few years in the … gosh, the seventies(?!) … in a hospital pharmacy, and rotated among our Outpatient, Inpatient, and IV-additives shifts. Almost everything I learned then is invalid today, but we did have diazepam and it was Scheduled.

  18. Lisnopril is a blood pressure medication – rather common around this house. It is currently the $3/month or $10 for 3 months generic for this class of meds at Walmart – even cheaper on Part D Medicare plan – and works very well.

  19. @MerylA: well, we do live in the same county, though I don’t think you live particularly close to me.

    I took lisinopril for years, right up until I lost 40 kilos and was no longer hypertensive.

  20. Carl Fink – Over the past 15 years I have lost around 85 lbs (last 10 or so since this past March – now only about 15 to 20 lbs overweight) which has had no effect on my hypertension or Type 2 Diabetes – though my thyroid did become low as I lost weight.

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