Scoring Drugs In Turkey-- 1969 vs 2018

In 1969 I was in Istanbul, living in my VW camper and on my way to India. Istanbul was so exotic, a city of around two and a half million people. And the Sultanahmet district was seedy with a distinct air of danger. Middle class Turks mostly avoided it and, despite having the 4 top tourist destinations in the city-- Hagia Sofia, the Blue Mosque, Topkapi Palace and the Grand Bazaar. But back in those days, Istanbul wasn't much of a tourist destination. There was only one first-rate hotel-- the Hilton-- and it was on the other side of town. But, in the late '60's into the '70s, Istanbul was a major stop on the Hippie Trail between Europe and India and Sultanahmet was filled with disheveled hippies-- like me. It was also the place the low life types of Turkish society came to rip off the hippies and sell them hash-- and where the police prowled to arrest the hippies and the crooks trying to take advantage of them. That was Sultanahmet in 1969, when I found myself in the Pudding Shop as what became the notorious film, Midnight Express was happening in real time all around me.

Today there is a picture of Bill Clinton with the Pudding Shop's owner in the window. Not many people know what happened 50 years ago to make the place famous. I visited it last week, not the first time since my 1969 trip to Istanbul. I like the city and have been there many times since. Right after the election I needed a veg-out period to regain by equilibrium. One iff my favorite hotels in the world is in Sultanahmet now, a 4 Seasons, no less, one of two in the city. Istanbul has exploded and now has a population of around 16 million, depending who you ask. Sultanahmet is the place to be today. And the drugs... no hash anywhere as far as I can tell but American tourists are definitely there to buy drugs... pharmaceuticals. I spent a couple of thousand dollars buying medicine-- no prescriptions needed-- that would cost at least 5 times more in the U.S., even with crappy insurance from the Republican part of Medicare, the only bad part of Medicare, Part D, Bush's drug plan-- a vision of healthcare meant to help big drug firms and screw patients.

In 2006, Pelosi tried to fix it but there were too many Blue Dogs and New Dems in her caucus and she had to cater to their conservative instincts and the fix-- like everything well-intentioned Democrats try to do when the Republican wing of their party has sway (as it does right now)-- only was a baby step, not the big bold step that was needed so badly.

The costs of medicines-- a pure rip off of the American people-- hasn't been seriously addressed. Politicians talk about it but nothing seems to get done. Well, two progressives who don't try to cater to the corrupt, Wall Street-owned shit-eating New Dems and Blue Dogs, have a new bill they're introducing, the Prescription Drug Price Relief Act. Bernie Sanders and Ro Khanna will introduce it the day the Democrats take over Congress in January.

If the new Dems and Blue Dogs don't screw it up-- they will certainly try-- the bill would require the Secretary of Health and Human Services to make sure that Americans don’t pay more for prescription drugs than the median price in five major countries: Canada, the United Kingdom, France, Germany and Japan. If pharmaceutical manufacturers refuse to lower drug prices below that level, the federal government would approve cheaper generic versions of those drugs, regardless of any patents or market exclusivities in place. Does that thrill you? It thrills me.

When this legislation becomes law, the median price of brand name prescription drugs could go down by more than 40%, and savings for certain brand name prescription drugs could be even greater.

Ro Khanna: "There is absolutely no reason for the big pharmaceutical companies to make Americans pay higher prescription drug prices than they charge our friends in Canada, Germany, and the UK. Today we’re sending big pharma a message: market exclusivity is a privilege, and when you abuse that by price gouging the sick and aging, then you lose that privilege. This bill will bring down drug prices by taking on monopolies and boosting prescription drug competition."

Bernie: "No other country allows pharmaceutical companies to charge any price they want for any reason they want. Somebody in America today can walk into a pharmacy and find out that the medicine they have been using for years can double, triple or quadruple literally overnight. That needs to change. The greed of the prescription drug industry is literally killing Americans and it has got to stop."

In their press released they noted that "Trump said repeatedly during his campaign that he would take action against drug companies and bring down prices. But in the first seven months of 2018 alone, there were 96 drug price hikes for every price cut. And on Friday, Pfizer announced it is planning to raise prices on 41 more drugs in January. Earlier this year, Trump proposed a pilot program to gradually lower the prices of certain drugs covered by Medicare Part B to international price levels. But his proposal does not help the more than 150 million Americans who get private health insurance from their employer, many of whom struggle with high deductibles and copayments, or the more than 30 million Americans who are uninsured and must pay the full cash price of their prescription drugs at the pharmacy. Sanders and Khanna’s legislation would address the needs of both of those populations."

This is the one-page summary of the bill that Ro and Bernie released today:

The Prescription Drug Price Relief Act

The United States pays, by far, the highest drug prices in the world for one reason: we let drug companies get away with murder. Last year, the pharmaceutical industry made more than twice as much money in the U.S.-- $453 billion-- than in all European countries combined. The top five drug companies alone made over $50 billion, while the top five American pharmaceutical CEOs made more than $113 million in compensation.

When Congress gets back into session, Senator Bernie Sanders (I-VT) and Representative Ro Khanna (D-CA) will be introducing the Prescription Drug Price Relief Act.

This legislation would require the Secretary of Health and Human Services to make sure that Americans don’t pay more for prescription drugs than the median price of the following five countries: Canada, the United Kingdom, France, Germany, and Japan.

If pharmaceutical manufacturers refuse to lower drug prices down to the median price of these five countries, the federal government would be required to approve cheaper generic versions of those drugs, regardless of any patents or market exclusivities that are in place.

If this legislation were to become law, the median price of brand name prescription drugs could go down by about 43 percent and savings for certain brand name prescription drugs could be even greater.

For example, under this bill:

 • Premarin, for menopause, which currently costs about $165 for a 30-day supply in the U.S., could cost $94
.• Januvia, for diabetes, which currently costs about $436 for 30-day supply in the U.S., could cost $248.

 • Advair Diskus, for asthma and COPD, which currently costs about $390 for a 30-day supply in the U.S., could cost $222.

 • Xarelto, for blood clots, which currently costs about $432 for a 30-day supply in the U.S., could cost $246.

 • Lantus, which is insulin for diabetes and currently costs about $387 for a 30-day supply in the U.S., could cost $220.

 • Humira, for arthritis, which currently costs about $2,770 for a 30-day supply in the U.S., could cost $1,576.

 • Enbrel, for arthritis, which currently costs about $4,941 for a 30-day supply in the U.S., could cost $2,811.

 • Ventolin, for asthma, which currently costs about $60 for a 30-day supply in the U.S., could cost $34.

 • Xtandi, for cancer, which currently costs about $101 for a 30-day supply in the U.S., could cost $58.

 • Pristiq, for depression, which currently costs about $40 for a 30-day supply in the U.S., could cost $23.


 This is not a radical idea. According to the European Commission, using international drug prices as a benchmark in price negotiations is “the most commonly applied pricing policy in European countries.” The U.S., where Medicare is legally prohibited from negotiating drug prices for seniors, is an outlier.

Although President Trump recently proposed gradually lowering the prices of certain drugs covered by Medicare Part B to international price levels, his proposal does not help the over 150 million Americans who get private health insurance from their employer, many of whom struggle with high deductibles and copayments, or the more than 30 million Americans who are uninsured and must pay the full cash price of their prescription drugs at the pharmacy.

Today, a full 80 percent of Americans say that drug prices are unreasonable and just nine percent think that drug companies put patients over profits. The pharmaceutical industry will continue to rip off American patients as long as it can. The Prescription Drug Price Relief Act puts an end to this highway robbery, and will help save lives and reduce premiums by lowering drug prices.

Have We Mentioned Lately That Bernie Would Have Beaten Trump?

A neighbor's son-- a Trump fanatic-- got rid of his insurance because he's positive Trump is about to offer cheaper healthcare... in a week or a month. He'll hold off on buying healthcare 'til Trump makes healthcare less expensive and better. Poor guy! Yesterday, Robert Pear reported at the New York Times that Trumpanzee has dropped his campaign promise to let Medicare negotiate with pharmaceutical companies to lower drug prices. Pear reminded his readers that during the campaign, Trumpanzee "boldly broke with his party and embraced a longstanding Democratic proposal when he called for the federal government to use its buying power to negotiate lower drug prices for Medicare recipients. The proposal was popular with voters but not with other Republican politicians, who had been battling it for years. Under Part D of Medicare, millions of older Americans receive insurance coverage for prescription drugs. The benefit is delivered entirely by private entities under contract with Medicare. These private entities-- insurance companies and the middlemen known as pharmacy benefit managers-- negotiate prices with drugmakers. But under a 2003 law, the federal government 'may not interfere' in those negotiations." I love Medicare; it saved my life. The only bad part of Medicare in the Republican addition-- "Medicare Part D," which is a giant rip-off. Last month I went to Thailand and spent $5,000 on life-saving drugs that would have cost me-- thank Medicare Part D-- $35,000 here in the richest nation on earth.

The theme of the president’s initiative is “American patients first,” and his plan takes aim at what the White House calls “foreign freeloading.” The administration will, as expected, put pressure on foreign countries to relax drug price controls, in the belief that pharmaceutical companies can then lower prices in the United States.

“Other countries use socialized health care to command unfairly low prices from U.S. drugmakers,” said a summary provided by the White House on Thursday. “This places the burden of financing drug development largely on American patients and taxpayers, subsidizes foreign consumers, and reduces innovation and the development of new treatments.”

The United States spends well over $300 billion a year on prescription drugs sold at pharmacies and other retail outlets, and Medicare and Medicaid account for nearly 40 percent of that spending, according to the Department of Health and Human Services.

Mr. Trump plans to criticize brand-name drug manufacturers for setting high list prices and for trying to stifle competition by delaying the marketing of lower-cost generic drugs. He is also expected to criticize pharmacy benefit managers, saying they profit from rebates paid by drug companies but do not pass on much of the savings to patients.

Mr. Trump has repeatedly said that drug companies are “getting away with murder.”

...As a presidential candidate, Mr. Trump supported two ideas that are anathema to the pharmaceutical industry: allowing Medicare officials to negotiate prices and allowing consumers to import prescription drugs from Canada and certain other countries where brand-name drug prices are generally lower than in the United States.

But top administration officials, like Alex M. Azar II, the secretary of health and human services, and Dr. Scott Gottlieb, the commissioner of the Food and Drug Administration, strenuously oppose those ideas. Republicans argue that the federal government has such overwhelming power as a buyer that it could basically set a price that manufacturers would have to comply with.

And since taking office, Mr. Trump has not endorsed such proposals.

Forbes published a story yesterday by Omri Ben-Shahar about how Trump won because of non-voters and that Trump won because of lower Democratic turnout. Maybe they wanted to see Trump get in so they could get cheaper medicine.

Ben-Shahar points out that the conclusion that Trump won in 2016 because he "succeeded in awakening a popular movement of anger and frustration among white, blue-collar, less educated, mostly male, voters, particularly in non-urban areas. Trump promised them jobs, safe borders, and dignity, and they responded by turning out in masses at his pre-election rallies and eventually at the ballots, carrying him to victory. This story is mostly wrong. Trump did not win because he was more attractive to this base of white voters. He won because Hillary Clinton was less attractive to the traditional Democratic base of urban, minorities, and more educated voters. This is a profound fact, because Democratic voters were so extraordinarily repelled by Trump that they were supposed to have the extra motivation to turn out. Running against Trump, any Democratic candidate should have ridden a wave of anti-Trump sentiment among these voters. It therefore took a strong distaste for Hillary Clinton among the Democratic base to not only undo this wave, but to lose many additional liberal votes."

As we've mentioned again and again since the election, statistics and analysis prove that Bernie would have won. Fuck Putin and Debbie Wasserman Schultz for taking that away from America and shackling this country to Trump.

The story of Hillary Clinton’s defeat, then, is not the Trump Movement erupting in the ballots, nor the fable that some “Reagan Democrats” flipped again from Obama to Trump. The story is altogether different, and very simple: the Democratic base did not turn out to vote as it did for Obama. Those sure-Democrats who stayed home handed the election to Trump.

Take Michigan for example. A state that Obama won in 2012 by 350,000 votes, Clinton lost by roughly 10,000. Why? She received 300,000 votes less than Obama did in 2012. Detroit and Wayne County should kick themselves because of the 595,253 votes they gave Obama in 2012, only 518,000 voted for Clinton in 2016. Mote than 75,000 Motown Obama voters did not bother to vote for Clinton! They did not become Trump voters-- Trump received only 10,000 votes more than Romney did in this county. They simply stayed at home. If even a fraction of these lethargic Democrats had turned out to vote, Michigan would have stayed blue.

Wisconsin tells the same numbers story, even more dramatically. Trump got no new votes. He received exactly the same number of votes in America’s Dairyland as Romney did in 2012. Both received 1,409,000 votes. But Clinton again could not spark many Obama voters to turn out for her: she tallied 230,000 votes less than Obama did in 2012. This is how a 200,000-vote victory margin for Obama in the Badger State became a 30,000-vote defeat for Clinton.

This pattern is national. Clinton’s black voter turnout dropped more than 11 percent compared to 2012. The support for Clinton among active black voters was still exceedingly high (87 percent, versus 93 percent for Obama), but the big difference was the turnout. Almost two million black votes cast for Obama in 2012 did not turn out for Clinton. According to one plausible calculation, if in North Carolina blacks had turned out for Clinton as they had for Obama, she would have won the state. I saw a similar downtrend in my own eyes: I voted in a predominantly African American precinct in the south side of Chicago, and I can testify that the lines for early voting at the polling place were much shorter than they were in 2012.

I don't know... maybe so many Democrats stayed home in 2016 because they were fed up with voting for status quo careerist candidates. And here we have the DC committees-- the DCCC and the DSCC-- trying to shove the same stinky garbage down voters' throats again this year. Everyone hates Trump... but will it be enough to get Democrats to pull the levers for pure trash like Kyrsten Sinema (Blue Dog-AZ), Jason Crow (New Dem-CO), Brad Ashford (Blue Dog-NE), Gil Cisneros (CA), Ann Kirkpatrick (New Dem-AZ), Susie Lee (New Dem-NV), Jeff Van Drew (Blue Dog-NY), Anthony Brindisi (Blue Dog-NY)...? I wouldn't bet on it. People have learned to really hate the DCCC, the DSCC and the DNC. They're on to the scam now. Best of two evils? Voters-- or non-voters, to be more precise-- want better than that.

Why Does Medicine Cost So Much More In America Than Anywhere Else?

When I went to the pharmacy at a cheap grocery store on the other side of tracks, I knew they wouldn't have the medicine, lacosamide, my doctor had prescribed. No one carries it. You go in and show your prescription and they order it and then you go pick it up. The pharmacist told me to come back the next day after 3pm. So I did. And she went through he paperwork and then came back to me in about 15 minutes and said, "Do you know the cost of filling this precription?" I said I did and she asked me how much. I was surprised and said around $850. "That's right," she said. "Do you want it?" Of course I want it; I need it, I said. "OK, we'll have it for you tomorrow."

I just came back from the other side of the tracks with my lacosamide. In Canada it would have cost me $187. But it's illegal to buy it from a Canadian pharmacy-- because paid off conservatives in Congress made it illegal in return for their "campaign contributions."

Before we go on, this chart shows which crooks in the House have taken the biggest bribes from Big Pharma just last year. Notice Speaker Ryan took $395,174. Pretty amazing-- but Ryan has taken $1,133,183 since being elected.

So far this year, the bribes have flowed most strongly, at least so far, towards 6 crooked Republicans who have kept drug prices unfathomably high-- just this year:

• Greg Walden (R-OR)- $249,200
• Paul Ryan (R-WI)- $167,600
• Kevin Brady (R-TX)- $122,000
• Kevin McCarthy (R-CA)- $104,675
• Patrick Tiberi (R-OH)- $98,600
• Eric Paulsen (R-MN)- $89,300

I was able to afford that $850 because I saved money when I was working in a good job. But that's a burden for anyone if you have to do it every month. That's over $10,000 a year. So why doesn't Medicare pay? Good question. I've been fighting with them for months. Medicare, Part D (AKA, "Republican Health Care") is the only part of Medicare that sucks and doesn't work. It was passed by a Republican Congress and signed by a Bush. No Democrats vote for it. It's a major rip off mechanism for the Big Pharma donors who bribe members of Congress.

My doctor is Elizabeth Budde, a Hematologic Oncologist. She and her staff saved my life after I was diagnosed with a rare form of cancer. Dr. Budde is one of the few specialists in the U.S. who know how to effectively deal with it. She's an internationally-celebrated research doctor in the field of immunotherapies for Lymphomas. While she was treating me she won a Damon Runyon Cancer Research Foundation Clinical Investigator Award. But someone at Medicare, Part D-- actually at Humana; but they blame Medicare-- is disputing her prescribing the drug. They claim lacosamide is for epilepsy and since I don't have epilepsy, they won't pay. She's had success in treating her patients who wind up with neuropathy-- a very common and painful degenerative nerve disease many people get from certain kinds of high intensity chemo, me being one of them. Anyway, I know for sure Randy Bryce-- also a cancer survivor-- is going to beat Paul Ryan next year and I'll be able to pay $187/month for my lacosamide instead of $850/month.

Meanwhile I just want to point out that despite Trumpanzee's populist language about drug companies that are "getting away with murder," he has none nothing to help and everything to make matters worse, much worse. This week, The Hill reported that some states-- blue ones-- "are taking matters into their own hands."

California passed a new law that requires pharmaceutical companies to explain a drug’s price tag, and other states are considering similar measures.

“This is not an issue that’s going away, and it’s clear that patients are demanding action on this topic, and if they can’t succeed on the federal level, then they’re going to the states,” said Rachel Sachs, an associate law professor at the Washington University School of Law.

On Monday, California Gov. Jerry Brown (D) signed drug pricing transparency legislation that supporters call the most robust law to date.

“Sacramento is proving we will lead where the folks in Washington, D.C., won’t,” California state Senate President Pro Tempore Kevin de León (D) said at a news conference Monday.

The new law requires drug companies to notify purchasers at least 60 days in advance before raising a price tag by more than 16 percent in a two-year period. Manufacturers would have to explain why the cost increased.

“Certainly all eyes are on California,” said Trish Riley, the National Academy for State Health Policy’s executive director. “It’s a very comprehensive bill, and it could well be a model for other states.”

A trade group for the drug industry slammed the bill as being “based on misleading rhetoric instead of what’s in the best interest of patients.”

“There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers (PBMs) are receiving that are not always being passed on to patients,” said Priscilla VanderVeer, a spokeswoman for the Pharmaceutical Research and Manufacturers of America (PhRMA), in a statement.

“Nothing in SB 17 will help patients get the benefits of the savings that insurance companies and PBMs are getting.”

A handful of states have passed other drug pricing measures.

Last year, Vermont became the first state to put a law on its books requiring drugmakers to justify price hikes. The state will craft an annual list of up to 15 drugs that increased in price at least 50 percent over five years or 15 percent or more over one year. The makers of those drugs will then be required to explain the increase.

New York has a new law that caps prescription drug spending in its Medicaid program.

In Maryland, the state attorney general can take action if an off-patent or generic drug’s price drastically increases. And in Nevada, a new law focuses on increasing the transparency of insulin pricing for people with diabetes. Both measures are facing lawsuits from the drug industry.

Drug companies have argued that critics fail to recognize the value medicines are bringing and say the state-level regulations could thwart the distribution of life-saving drugs.

In response to California’s measure, PhRMA said “it’s time to move beyond creating new, costly bureaucratic programs that don’t make a dent in patients’ costs for medicines. We stand ready to work with policymakers on new innovation strategies that emphasize value while bringing down costs and expanding access to needed medicines.”

In Washington, D.C., lawmakers have put drug company CEOs in the hot seat, berating them for increasing the prices of certain drugs. They’ve launched investigations and introduced a host of bills, yet there hasn’t been any concrete movement on the issue in Congress thus far.

That will be one of the side effects of replacing dozens and dozens of right-wing Republicans in 2018 with progressives, like the men and women whose campaigns you can contribute to by clicking on the Blue America ActBlue congressional thermometer on the right. Imagine being rid of Big Pharma whores like Ryan, Ed Royce (R-CA), Darrell Issa (R-CA), Fred Upton (R-MI), John Culberson (R-TX), Bruce Poliquin (R-ME) and Virginia Foxx (R-NC). Defeat these greedy bribe-taking conservatives and keep them defeated and the prices of medicines will start coming down rapidly, led by committed reformers like Bryce, Dr. David Gill (IL), Dr. Alina Valdes (FL) and Dr. Jason Weston (TX).

Democrats Should Dump Their Failed DC Leaders With Their Outdated Preconceptions And Sweep The 2018 Elections

I was going to put this up as an addendum to an earlier post, but I changed my mind and decided it could stand on its own. Ryan Cooper has a tremendously competent look at Bernie's proposal and why it makes such good politics for Democrats, despite opposition from the party's two clueless-- and failed DC leaders, Schumer and Pelosi. "The plan," he wrote, "would be phased in over a period of four years. In the first year, traditional Medicare would be expanded to cover dental, vision, and hearing aids, as well as people over 55 or under 18, while others would be able to buy in if they wish. In the second year, the age qualification would be lowered to 45, in the third year to 35, and then in the fourth year, everyone remaining would be included. This upgraded version of Medicare would also be a lot more generous in terms of access. There would be no cost-sharing, except for prescription drugs. It is, as Paul Waldman argues, probably best understood as an opening bid-- a symbolic maximal demand rather than the usual pre-compromised [see failed Democratic leaders Schemer and Pelosi] Democratic fare.

We spend $3.2 trillion per year-- literally twice as much as the OECD average as a share of the economy. We pay enough in health-care taxes alone-- that is, the government revenue that goes to Medicare, Medicaid, the VA, and a few other things-- to cover a Canada-style Medicare-for-all system for the whole U.S., and then that much again in private money. In other words, if we could simply copy-paste Canada's universal health-care system into America, taxes would actually go down.

All that means is that America doesn't have to worry much about costs; it has to worry about allocating existing spending properly. We already have a gigantic pool of resources dedicated to health care-- about half private and half public. We just have to adjust that spending so it can support a single-payer system.

So on total spending, for example, BernieCare would have contradictory effects. No cost sharing would make going to the doctor much easier, which would increase spending, while on the other hand it would bring prices down a lot, cutting outlays. It's impossible to know for sure which effect will predominate until detailed studies can be done (and probably not for sure until it is actually implemented). But the fundamental reality is that we are already putting up way, way, way more than enough to pay for a really excellent universal health-care system. Any resource problems we run into along the way-- and there is sure to be quite a lot of disruption during the transition period-- can be solved by adjusting the pot of health-care resources around.

For example, Sanders' funding options present several ways you might finance Medicare for all and leave almost everyone money ahead. Administrative savings alone (due to the fact that Medicare is vastly more efficient than private insurance) would run to something like $500 billion per year. Negotiating drug prices might free up another $113 billion. Meanwhile, a 7.5 percent new employer-side payroll tax would raise $3.9 trillion, while cutting health-care expenses per employee by $9,000 on average. A new 4 percent income tax would raise another $3.5 trillion while saving a family of four making the median income about $4,400 after getting rid of premiums.

...[T]he basic strategy is clear: cut out waste, get prices down, add a few new taxes, and use the resources thus freed up to cover every single American. Even if those details need to be adjusted, it definitely can work, and it will be a spectacular improvement.

That brings me to the politics. Centrist liberals have long been against Medicare for all, because milquetoast, incremental politics rules out such sweeping changes by definition. Hillary Clinton, for example, does not like Sanders' bill, pointing out that fears of people losing the health insurance they have through their employer helped kill her effort at health-care reform in 1994. President Obama, fretting about this same thing, incautiously promised that "if you like your plan, you can keep your plan" under ObamaCare, which while true for most people was not true for millions of others, simply because you can't make large changes to the health-care system without having that effect. That broken promise enraged people.

The truth is that while employer-sponsored insurance is okay for most people who have it, it is also terrible in many ways. First and most importantly, it means that if you lose your job, you lose your coverage-- and perhaps so does your family. That is a huge problem both for people who lose employment-- there were 60 million job separations in 2016 alone-- and for people who are stuck in terrible jobs for fear of losing coverage (or "job lock"). Second, employer-based coverage has been getting worse over time, with the same increasingly higher co-pays, premiums, and deductibles, plus narrowing networks, that have afflicted the ObamaCare exchanges.

The way to get over people's fears of losing their (increasingly lousy) coverage is to promise them something so good that people can be certain they'll end up better off. The prospect of guaranteed, generous coverage at a reasonable price, that works everywhere and can never be taken away, that would abolish medical bankruptcy and the hell of insurance paperwork, fits that bill. What's more, most people are already very familiar with Medicare, and so will be resistant to scaremongering from conservatives and the insurance industry.

Fear of change and knee-jerk moderation is the thinking that made American health care such a disaster in the first place. But at some point America is going to have to rip off this band-aid. BernieCare is an excellent starting point.

A personal note: I retired early from my job at Time Warner, where I worked as the president of one of their divisions, Reprise Records. The platinum-plated health insurance policy that was part of my employment contract was the same for all presidents and chairmen; it has been negotiated and re-negotiated by top attorneys over the years and I was just lucky enough to have it, I thought. Supposedly it is the best private insurance money can buy. When I retired I was allowed to keep it-- via Cobra, which eventually I had to pay for and which is quite costly-- until Medicare kicked in. I was afraid that my coverage would plummet once I was forced onto Medicare. That was very foolish and very ignorant. Pay attention to my next sentence. Medicare is better-- MUCH better. Soon after Medicare kicked in, I was diagnosed with a rare but treatable form of cancer. Two years of treatment went beyond two million dollars. I never got so much as a question or a throat clearing from Medicare. (Medicare Part D-- Republican Medicare, the drug part-- totally sucks and needs to be scrapped entirely and redone and it is currently the bane of my existence, Medicare itself... better than the best thing corporate chief executives get.) I know that no one will believe me-- but I'm not exaggerating. Forget partisan anything; do whatever you can to get Medicare expanded (and improved in the ways Bernie is proposing); it will eventually save your life and the lives of those you love.

As for the politics of this... a random race: CA-49, Darrell Issa's seat in northern San Diego County and southern Orange County. Doug Applegate came within a handful of votes of beating Issa last time. He's expected to wipe Issa out in 2018. And part of the reason is healthcare. Doug, a former Marine Colonel who saw who single payer works in the military, aggressively supports Medicare-For-All. Issa voted for TrumpCare, which would rip health insurance away from 22 million Americans. CA-49 voters will decide.

Republican Health Care = Death

I'm not a doctor or a nurse but I got a good look at the health care system in 2015. I spent the last 16 months battling cancer. (My doctors and nurses and care-givers did most of the battling; but I was there.) As horrible as the whole universe around cancer treatment is, there was one thing that was very lucky: I was diagnosed after my 65th birthday. Medicare. I don't know what the whole treatment wound up costing. I stopped counting after a million dollars. But it was easily double that. I never begrudged paying my taxes and Medicare treated me the same way. I love Medicare. Sooner or later, I suspect, every person will. There's just one part of Medicare that isn't any good-- the drug part... Medicare Part D, AKA- Republican Health Care.

This was some cockamamie Republican big wet kiss to the drug industry and it's the only part of Medicare that doesn't work for the patients. Bush passed it in 2003 and by only one vote, 216-215, 207 Republicans and 9 corrupt right-wing Blue Dogs voted to pass it. Two of the Blue Dogs switched parties and officially became Republicans and all but 2 of the other Democrats were subsequently defeated. The only ones left who helped the GOP burden America with this oppressive system are Steve Israel, who-- after taking $320,500 in legalized bribes from the pharmaceutical industry-- is finally retiring, and Collin Peterson.

The program that was created is estimated to cost between $395 and $534 billion over 10 years, none of it paid for with revenue hikes or spending cuts... all of it thrown onto the backs of future generations, exactly what Boehner (who voted for it), Cantor (who voted for it), and Ryan (who voted for it) had been running around accusing the Democrats of doing. That's especially interesting since this one horrible piece of special interest legislation for the pharmaceutical industry-- which dumped $8,705,484 into GOP campaigns that cycle, double what they gave Democrats, and spent another $143,434,740 on lobbying during the same time period-- cost taxpayers more than TARP, the Stimulus and the auto bailout combined.

David Walker, the former U.S. Comptroller General, has said the prescription drug benefit "was probably the most fiscally irresponsible piece of legislation since the 1960s."

More recently, Bruce Bartlett-- former advisor to Ronald Reagan, George H.W. Bush and Rep. Ron Paul (R-Texas)-- said Part D was "a pure giveaway" to drug companies devised by fiscally irresponsible lawmakers.

"It astonishes me that a party enacting anything like the drug benefit would have the chutzpah to view itself as fiscally responsible in any sense of the term," Bartlett wrote in Forbes last December.

"As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt."

Barlett recounts the drama around a bill that Bush and the House GOP leaders were determined to deliver for their Big Pharma benefactors, a bill that was losing in the first vote, as a handful of principled conservatives and all the Democrats stood pat. And then along came Tom DeLay, the Enforcer:

[W]hen the legislation came up for its final vote on Nov. 22, 2003, it was failing by 216 to 218 when the standard 15-minute time allowed for voting came to an end.

What followed was one of the most extraordinary events in congressional history. The vote was kept open for almost three hours while the House Republican leadership brought massive pressure to bear on the handful of principled Republicans who had the nerve to put country ahead of party. The leadership even froze the C-SPAN cameras so that no one outside the House chamber could see what was going on.

Among those congressmen strenuously pressed to change their vote was Nick Smith, R-Mich., who later charged that several members of Congress attempted to virtually bribe him, by promising to ensure that his son got his seat when he retired if he voted for the drug bill. One of those members, House Majority Leader Tom DeLay, R-Texas, was later admonished by the House Ethics Committee for going over the line in his efforts regarding Smith.

Eventually, the arm-twisting got three Republicans to switch their votes from nay to yea: Ernest Istook of Oklahoma, Butch Otter of Idaho and Trent Franks of Arizona.

...Otter and Istook are no longer in Congress, but Franks still is, so I checked to see what he has been saying about the health legislation now being debated. Like all Republicans, he has vowed to fight it with every ounce of strength he has, citing the increase in debt as his principal concern. "I would remind my Democratic colleagues that their children, and every generation thereafter, will bear the burden caused by this bill. They will be the ones asked to pay off the incredible debt," Franks declared on Nov. 7.

Just to be clear, the Medicare drug benefit was a pure giveaway with a gross cost greater than either the House or Senate health reform bills how being considered. Together the new bills would cost roughly $900 billion over the next 10 years, while Medicare Part D will cost $1 trillion.

Moreover, there is a critical distinction--the drug benefit had no dedicated financing, no offsets and no revenue-raisers; 100% of the cost simply added to the federal budget deficit, whereas the health reform measures now being debated will be paid for with a combination of spending cuts and tax increases, adding nothing to the deficit over the next 10 years, according to the Congressional Budget Office.

Maybe Franks isn't the worst hypocrite I've ever come across in Washington, but he's got to be in the top 10 because he apparently thinks the unfunded drug benefit, which added $15.5 trillion (in present value terms) to our nation's indebtedness, according to Medicare's trustees, was worth sacrificing his integrity to enact into law. But legislation expanding health coverage to the uninsured--which is deficit-neutral-- somehow or other adds an unacceptable debt burden to future generations. We truly live in a world only George Orwell could comprehend when our elected representatives so easily conflate one with the other.

Who took the biggest pay-offs from Big Pharma?

Other than Part D-- the Republican Party prescription drug plan that is oriented towards their Big Pharma campaign donors-- Medicare has been better insurance than the platinum standard insurance Warner Bros gave me as the president of one of their divisions-- not "as good"-- BETTER. Medicare is a wondrous and blessed thing, something every American should be proud of and willing to fight for. We cannot let conservatives wreck Medicare. And we must make certain that Obamacare-- debilitated by hideous GOP-oriented compromises pushed by Blue Dogs and New Dems-- is absorbed into Medicare.

Writing for New York Magazine, Jonathan Chait reiterated-- if less famboyantly-- exactly what Alan Garyson had to say about the Republican Health Care plan during the original debate over Obamacare. There is no Republican Health Care plan for America beyond repealing the Affordable Care Act. "[T]he Republicans," he wrote, "do have a health-care plan: It is to repeal Obamacare and replace it with what we had before Obamacare... Patrick Brennan, one of the more reasonable types at National Review, objected the other day to the premise that the Republican plan is to repeal Obamacare and do nothing."

It’s true-- Representative Tom Price has a health-care plan. Of sorts. It’s a really sketchy plan that Price has not had scored by the Congressional Budget Office, which allows it to serve the purpose of letting Republicans cite it to refute the charge that they have no plan without being held accountable for its effects. This shows the primary obstacle to Republicans uniting around an Obamacare alternative. Reforming the health-care system is very tricky, and requires trade-offs. The Republican position on health care has relied almost entirely on the public’s status quo preference. Republicans have relentlessly attacked every discomfiting policy change in the Affordable Care Act and promised to change the system in ways people desire, without spelling out the very unpopular downside such changes would create.

The House budget illustrates the second obstacle to the adoption of a Republican health-care alternative. If Republicans wanted to replace Obamacare with Tom price’s health-care “plan,” they would include it in their budget. Tom Price probably has the clout to get his health-care plan onto the desk of the person in charge of writing the House Republican budget, who also happens to be Tom Price.

But the Price-authored budget ignores the Price health-care plan for the same reason the old Ryan budget ignored the Ryan poverty plan. It’s a thing Republicans want to say they’re for, but don’t want to make the sacrifices necessary to do it. The place where a party reconciles its competing priorities is its budget.

Now, the Republican budget does not actually reconcile its competing priorities. It is filled with smoke and mirrors. It won’t actually pony up the extra defense spending its hawks want, but it won’t deny their wishes, either, so the budget adds a one-year “emergency” defense hike, then whisks it away in subsequent years, even though nobody really thinks that would happen.

The biggest single gimmick is health care. Since Republicans are theologically committed to repealing every word of Obamacare, they have to repeal not only the law’s outlays, but also the tax hikes and spending cuts it uses to finance them. But they need those savings to pretend to cut the deficit. So the Republican budget claims to repeal them, and replace them with some other form of savings whose nature it won’t even hint at, let alone identify.

So their health-care plan is to repeal all of Obamacare, replace its savings with $1 trillion in magic money, and then spend zero on subsidizing health insurance for the millions of Americans who would become uninsured. If Republicans wanted to spend something on an Obamacare replacement-- tax credits, high risk pools, whatever-- they would need to set aside money for it. They chose not to. As hard as it is to design a health-care plan, designing one that cuts $1 trillion and spends nothing is really hard.

Indeed, even the existing budget fails to account for the party’s competing demands. It doesn’t set aside the extra defense spending that the hawks are angrily demanding. Nor does it account for the trillions in lost revenue that pretty much all the presidential candidates are promising. It’s pretty clear that, when it comes time to turn the Republican budget into reality, the first constituency with its hand out will be the tax-cutters, and the next one will be the defense hawks. There’s no way any money will be left over for health care. Republicans don’t even have the budget room to pay for the stuff they actually care about.

There's not much most of us can do about these Republican predators. But we can-- and must-- stop the conservative Democrats, the Blue Dogs and New Dems, who enable them. Do you recoil at the idea of voting for a Republican? You should have an identical instinct about the idea of voting for a Blue Dog or New Dem-- same anti-family, careerist garbage. We need more Alan Graysons and fewer Patrick Murphys, more Donna Edwards and fewer Chris Van Hollens, more Alex Laws and fewer Donald Norcrosses and more Tim Canovas and no Debbie Wasserman Schultzes. And that is something we can do something about!

And now Paul Ryan says the GOP will finally present their idea of a replacement for the Affordable Care Act. Get ready for Medicare Part D, II. According to Alexander Bolton at The Hill, there are two plans gaining traction among House Republicans, one from Budget Committee Chairman Tom Price and one from the extreme crackpot Republican Study Committee. McConnell says the Senate will not move any of their plans forward this year.

Price’s Empowering Patients First Act would create a refundable tax credit for health insurance coverage. It would provide a $1,200 credit for people between the ages of 18 and 35, $2,100 for people between the ages of 35 and 50 and $3,000 for people 50 and older.

It would also provide a $1,000 tax credit for contributions to health savings accounts and give federal grants to states to provide health coverage to high-risk pools of people who might have trouble purchasing it on their own.

Flores, the chairman of the RSC, in June unveiled the American Health Care Reform Act, which would create a standard tax deduction for health insurance. Qualifying individuals would receive a $7,500 deduction, and families would get a $20,500 deduction.

The RSC plan would promote competition between insurance plans by allowing people to shop for plans across state lines and small businesses to form pools to negotiate for better rates. It would also establish a $15 billion fund for medical research on heart disease, Alzheimer’s and other diseases.

But Republican strategists argue that it might be better to wait until after the presidential election before rolling out a controversial reform bill for GOP candidates to defend.

Either plan would be a death sentence for tens of thousands of Americans... until the GOP tried to also make it the new model for Medicare, at which time it would be the death sentence for hundreds of thousands of Americans.

What Ever Happened To The 9 Corrupt Democrats Who Voted For Medicare Part D?

In 2003, the Republican-dominated House passed a GOP version of healthcare, Bush's Medicare Part D. Today it is, by far, the worst part of the Medicare system and it allows for these systemic ripping off of the elderly by Big Pharma. The final vote in the House was 216-215; it passed by one lousy vote. The leaders of the House Democrats-- Dick Gephardt and Nancy Pelosi-- whipped against it and 195 Democrats voted NO. They were joined by 19 Republicans (with arch conservative Ernest Istook from Oklahoma voting "present"). The 19 Republicans were up in arms because they saw it as a corporate give-away to Big Pharma and among them were Jim DeMint (R-SC), principled libertarians Ron Paul (R-TX) and Walter Jones (R-NC), now-Senators Jerry Moran (R-KS), Jeff Flake (R-AZ) and Richard Burr (R-NC), and a handful of generally deranged lunatics like Tom Tancredo (R-CO), Ryun (R-KS), Mike Pence (R-IN), John Hostettler (R-IN) and Dan Burton (R-IN). Also voting NO, at the time-- along with these 19 Republicans and all but 9 Democrats, was Congress' only Independent, Bernie Sanders.

Now let's take a look at the Democrats who ignored their party leaders to vote for Bush's and Big Pharma's horrible proposal which has brought so much pain and misery to so many seniors. Here's the list-- along with the legalized bribes they've taken from the pharmaceutical industry:

• Rodney Alexander (Blue Dog-LA)- $64,749
• Leonard Boswell (Blue Dog-IA)
• Bud Cramer (Blue Dog-AL)- $46,700
• Ralph Hall (Blue Dog-TX)- $147,133
• Steve Israel (Blue Dog-NY)- $320,500
• Ken Lucas (Blue Dog-KY)
• Jim Matheson (Blue Dog-UT)- $665,378
• Collin Peterson (Blue Dog-MN)- $42,500
• Earl Pomeroy (Blue Dog-ND)- $179,149

So obviously, the only Democrats to cross the aisle and vote for this monstrosity were Blue Dogs. All are very conservative and very corporate-oriented. They were all infamous-- or in two cases are still infamous-- for trading their votes for corporate cash. Two quit the Democratic Party altogether and joined the GOP soon after this vote: Rodney Alexander and Ralph Hall. Bud Cramer and Jim Matheson, rather than face certain defeat at the polls, retired from Congress. Leonard Boswell, Ken Lucas and Earl Pomeroy were both defeated at the polls, after Democratic voters in their own districts just got sick of their constant betrayals and refused to come out and vote for them again. And two are still in Congress, still doing immense damage to working families and to progressive ideals. One is Minnesota right-winger and corporate agriculture's key man inside the Democratic Party, Collin Peterson. The DCCC spends millions of dollars on his reelection campaigns and he votes with the GOP on nearly everything, most recently, as we discussed yesterday evening, to gut the Affordable Care Act and defund Planned Parenthood.

Peterson's protector inside the party is the 9th Democrat, the deciding vote that passed Medicare Part D for Bush, the Republicans and Big Pharma: Steve Israel. Israel left the Blue Dogs when he decided to strive for a position inside party leadership. Although they are ideological opposites, Israel became a Pelosi ally and she eventually appointed him to chair the DCCC. He has been the most catastrophically failed DCCC chair in history, responsible for years of Republican dominance and for the current atrophied state of the organization which is incapable of mounting credible battles against the Republicans and continues to guarantee GOP hegemony in the House far into the future. Steve Israel has done more for the conservative movement in Congress than almost any individual Republican. And the drug industry is still paying him off to this day for passing Medicare Part D-- another $112,000 in 2014 and so-far this year another $55,700.

Bernie Sanders' Bill To Regulate Overpriced Generic Drugs Picks Up Steam

Republicans have a different perspective on healthcare-- pay or die

Last October we started looking at Bernie Sanders' investigation into outrageous generic drug pricing under Medicare Part D. The inherent unfairness towards working families is emblematic of the GOP approach to Medicare; it's their version. When the House voted on Bush's Medicare Part D scheme on November 22, 2003, it passed by only 5 votes-- 220-215. 25 Republicans joined nearly the entire Democratic conference to oppose it. The 25 Republicans who opposed it are against all forms of government involvement in healthcare, and the 16 Democrats who backed the Bush proposal were almost entirely reactionary Blue Dogs, only two of whom, Colin Peterson (MN) and David Scott (GA), are still in Congress-- and still voting for Republican policies that wreck the lives of ordinary working families. The rest were all subsequently defeated or forced to retire to avoid being defeated. As Xavier Becerra (D-CA) explained recently on the House floor, "Congress should be in the business of making life better, not worse, for everyday Americans."

Bernie's bill, S.1364, the Medicaid Generic Drug Price Fairness Act of 2015, is winding its way through a Republican-controlled Congress hostile to the very idea of, in Becerra's words, "making life better, not worse, for everyday Americans." In the last few days Elizabeth Warren (D-MA) and Sheldon Whitehouse (D-RI) signed on as co-sponsors, joining Bernie, Sherrod Brown (D-OH), Mazie Hirono (D-HI), Richard Blumenthal (D-CT), and Al Franken (D-MN). The bill would make generic drug manufacturers reimburse Medicaid for excessive price increases (price increases that are greater than the rate of inflation). If Sanders' bill passes it will save taxpayers $1 billion annually, which would cut into excessive profits by the GOP-enabled pharmaceutical corporations.

One of the most common side effects from chemotherapy is neuropathy, extreme pain in the feet, legs and hands. The pain is nerve damage and normal pain killers have no effect on it whatsoever. Lidocaine-based gels, however, ameliorate the worst pains. And the worst pains are pretty bad; it makes many patients suicidal-- many patients. Lidocaine has always been a relatively inexpensive drug. I used to buy a tube for around $25. A tube lasts 2-3 weeks. Suddenly, though, the generic drug manufactures were all bought up and the price went from $25/tube to $300/tube, making it unaffordable to thousands of cancer and diabetes patients in extraordinary daily pain. That's what Bernie and other champions of working families in Congress are trying to combat.

Attorneys general in Connecticut and Vermont are also looking at possible collusion among some manufacturers. There have been allegations of practices such as buying up several generic drug companies as a way to corner the market-- and set pricing-- for a specific drug.

At the June 6-10 American Medical Association’s House of Delegates meeting in Chicago, the delegates instructed the AMA to pursue efforts to find ways to address the increases.

Many physicians spoke of specific instances of generic drug prices go up multiple times their cost, sometimes abruptly but more often over the past few years. For instance, said Georgia delegate John Antalis, MD, the price of the antibiotic doxycycline now costs $276, up from $70 a few years ago. One physician said a patient called him from a pharmacy to report that the generic version of aripiprazole (Ablilify/Teva) cost more than the brand name of the drug.

At least 12 states require pharmacists to give patients to generic drugs when available and many more allow the substitution. If the plans permitted patients to get whichever version of a drug was cheaper, that could help fight some generic drug price increases. Health plan specifics are a matter of state regulation.

At the AMA meeting, Mario E. Motta, MD, cardiologist in Salem, MA, wondered why generic digoxin, the pharmaceutical version of digitalis (a common garden flower also known as foxglove), cost $180 when it costs about a penny a pill to manufacture and has been used for more than 200 years as an herbal tea.

The key now is to elect more Members of Congress to stand with Bernie and the others taking this seriously. There has been a lot of talk in California about drafting Becerra to give up his safe House seat and run for the open U.S. Senate seat. That's exactly what working families' champions Donna Edwards (D-MD) and Alan Grayson (D-FL) are doing.

I spoke to Donna this morning, and she would certainly be an immediate co-sponsor of Bernie's bill were she to be elected to the Senate next year. Same for P.G. Stittenfeld in Ohio, where Rob Portman as usual is on the wrong side of the issue. "If elected to the U.S. Senate," P.G. told us, "I will always be on the side of the people, rather than the special interests, and that is why on Day 1, I would support the Medicaid Generic Drug Price Fairness Act, ensuring that generic drugs remain affordable to those who need them. Not only is a progressive vision for our health care system the right thing to do, in the case of this legislation it would also save taxpayers a billion dollars." You can help make that happen here.

Ready For The Chemotherapy Side Effects?

I went to college in the middle sixties. My friends and I marked the passage of time in many ways and one involved the release of new albums by our favorite bands-- the Beatles, Stones, Pink Floyd, Who, Airplane, Big Brother, Dead, etc. When we got wind that a new Stones album, for example, was coming down the pike, some of us would shop around for the finest LSD to commemorate the event. When Between the Buttons came out in February 1967, many of us had heard it already because the U.K. company had released it a month early in the hope of stacking up some heavy import sales from America. The American company had a smart defense: two tracks that weren't included on the British release... and big ones: "Let's Spend the Night Together" and "Ruby Tuesday."

By 1967 Dean Tilley had already kicked me off the campus as a danger to other students and I was living in a house in lovely Setauket. I came to consciousness after a full night of non-stop Between the Buttons listening in a tree next to my bedroom where the turntable was set to play side one over and over. Satisfying experience! I climbed down from the tree, got in my car, drove to the campus barber shop and had my head shaved. Hippies didn't do that then. But my girlfriend, Chris, was a model and she kept her head shaved for wigs and I loved how her head felt so... what the hey.

Since then, I've grown my hair and beard out from time to time and I've kept them close-cropped as well. I don't spend much time looking in the mirror and don't obsess over how I look. When I was diagnosed with mantle cell lymphoma and decided to treat it with chemotherapy, I didn't think a lot about the side effects of the treatment. I knew-- intellectually-- they could be brutal. "Could be" often means "but probably not for me." Roland, my best friend and primary caretaker and guide through this mess, seemed most concerned that my hair would fall out. He lives in dread of cancer because of his own hair. Roland takes good care of his appearance and looks fit and at least a decade younger than he is. Losing his hair is as unthinkable for him as it is uninteresting for me. No one who sees me knows if my hair is out because of the chemo or because I shaved it. I don't know either.

But there are other side effects-- and that's the chemo. My doctor's primary concern, of course, is using the chemo to kick the butt of the cancer. She says it's working-- and working very well. The day-to-day confrontation with the side effects, on the other hand... well, that's primarily my problem, the bane of my day-to-day. And it's not hair loss.




I don't want to turn this post into a pity session about the pain and anguish of chemo side effects. It's worse than anything I ever read, but I didn't read as deeply as I probably should have. Maybe if I knew in advance what was waiting for me-- as though there is any way to know; there isn't-- I would have chosen to try curing the cancer holistically with a naturopath. Too late now. I just want to bring up one side effect: neuropathy, a nerve disease related to one of the most virulent of the chemo drugs they were giving me: Velcade (bortezomib). As usual, the explanation starts with "every person’s experience with peripheral neuropathy can be as unique as the individual." So nothing definitive. My doctor told me that only 10% of the patients who mainline the velcade get neuropathy and only 3% of the people who get a fatty tissue injection get it-- and that I would be getting the fatty tissue injections. So a 97% chance of no neuropathy. Today neuropathy consumes my life, and I've learned it sometimes lasts forever and never goes away. Below are some of the symptoms, but keep in mind that they are happening simultaneously with other unrelated side effects-- like the pain from my broken ribs and the debilitating constipation and inability to eat as well as other recurring horrors.

At first, you may notice numbness, tingling, abnormal sensations, or pain in your feet.  Some people feel like they have socks on, even though they are barefoot. Over time, this feeling spreads to your legs and hands.

You may find it harder and harder to walk. Your legs feel heavy. You have to drag yourself up the stairs. You find yourself losing your balance, not being exactly sure where your feet are; so, you stumble into things or fall. To keep your balance, you are likely to widen your way of walking, and your walking becomes less rhythmic or fluid.

As for your hands, you think you have a good grip on something, like your keys, but they drop right out of your hands. In the worst cases, you can end up in a wheelchair. Some neuropathies can be fatal.

Peripheral neuropathy symptoms and signs can vary in how they begin. Some neuropathies come on suddenly; others gradually over many years. There are three types of peripheral nerves affected, and symptoms depend on these nerves and their location:

1 Sensory Nerves: affect sensation
2 Autonomic Nerves: affect internal organ functions; and,
3 Motor Nerves: affect muscles.

Many types of peripheral neuropathy affect all three types of nerves to various degrees, but some affect only one or two.

Here are some peripheral neuropathy symptoms and warning signs as described by patients:

Weakness in the Arms or Legs

Legs: Usually caused by damage to the motor nerves, leg symptoms often include difficulty walking or running; a feeling of "heaviness" in your legs; finding it takes a lot of effort just to climb the stairs; stumbling or tiring easily. Muscle cramps may be common.

Arms: In the arms, you may find it difficult to carry groceries, open jars, turn door knobs or take care of your personal grooming. A common frustration is dropping things.

Numbness, Tingling and Pain

Sensory nerves, when damaged, can cause various symptoms. Early on, there may be spontaneous sensations, called paresthesias, which include numbness, tingling, pinching, sharp, deep stabs, electric shocks, or buzzing. These sensations are usually worse at night, and sometimes become painful and severe.

You may also experience unpleasant abnormal sensations when you touch something, sensations called dysesthesias because they are caused by stimuli.

Or, you may find yourself feeling nothing at all, in this case experiencing anesthesia, a lessening or absence of sensation.

Impaired Sense of Position

When you lose the ability to “sense” or feel your feet, you may find yourself being uncoordinated because when you walk because you are not sure about the placement of your feet. Patients may find themselves walking differently without really knowing how or why they are doing so. Chances are they have either widened their style of walking (in an unconscious effort to keep their balance) or they may be dragging their feet.

“Glove and Stocking Sensation”

This phrase describes what doctors call a patient’s odd feeling of wearing stockings or gloves or slippers when, in fact, the patient’s hands and feet are completely bare.

Symptoms of Autonomic Damage

When it occurs, autonomic nerve damage can potentially cause: a drop in blood pressure and, consequently, dizziness when standing up; intestinal difficulties such as constipation or diarrhea; sexual dysfunction; thinning of the skin (with susceptibility to bruising and poor healing), and other symptoms.

And you may-- or may not-- live an extra 12-15 years into your 70s or 80s. Worth it? Let me mention Medicare Part D, Republican health care. Three doctors prescribed a lidocaine patch for me to help control the pain and to help ween me off the horrors of hillbilly heroin (Oxycontin), the drug Republican health care prefers to push to Americans since it prevents clear thinking. Humana is my Medicare insurance career. They refused to honor the prescriptions and wasted hours and hours of my time and my doctors' time making excuses for why they were refusing to cover the lidocaine patches, even though they are proven to work and Oxy is proven to work much less well.

Medicare is one of the most wonderful things America offers us as a people. Medicare Part D-- which was pushed through by Bush and the GOP and opposed by Democrats-- is an anti-patient system that is geared to fatten the bottom line of the big pharmaceutical companies that contribute so much to political campaigns. Since 1990, Big Pharma has given Republican congressional candidates $94,240,165 and given Democratic congressional candidates $70,327,235. Because of the connection, patients suffer and die. One day the Republican Party would like to turn all of Medicare into this type of a system. How ironic is it that the elderly are the ones they trick into voting for them?

One of my doctors said I shouldn't have used so much acid in the '60s