Old Man Talk

I'm old. When you read this, I will be older in accordance with that convention regarding birthdays, wherein you age a year all on one day. I hate convention but it's all I've got so I embrace it like a bald man embraces his comb-over.

The Special Theory of Relativity says that you don't age so much as you hurtle, at enormous speed, up your world-lines in the space-time continuum. (I've always wanted to say "up your world-lines.") It's a good thing we are hurtling into the future where nothing has happened yet. If we hurtled into the past we would constantly be stubbing our toes and banging our noses against events that have already been, and is/would be there now, were now to become then.

[Above: A depiction of a naked man hurtling up his world-line. Not 100% accurate. Though it may appear that his past light cone is hurtling up him, I can assure you that is not the case.]

Another good thing about being old and getting older so fast, for me, is that it runs out my biological clock. Barring an unforeseeable catastrophic medical miracle, I will miss the 22nd Century. I've read that the 22nd Century will be the pits. There will be no oil and no coal, so even though there will still be hair dryers and toaster ovens, they won't work. Or, thanks to solar and wind power, they will work if you make an appointment with the power company in advance, or can wait until hurricane season. There will be no food banks, either, because there will only be just enough food in the world to feed the rich.

Here's something to ponder: Food is essential to good health. If you've got scurvy, the prescription is going to be a lemon. But lemons, and all other foods, are over-the-counter. So drug plans won't cover them.

The practice of drug plans not paying for OTC medicine is what I wanted to talk about this week. Being old, it's taken me 5 paragraphs to get to it. Also, being old, I take lots of medicine and some of the best stuff is OTC, and my drug plan won't pay for it, so it's personal.

Doctors are helping patients deal with this situation by prescribing alternative medications that are not OTC. This trick also works if your drug goes generic and gets bumped off your drug plan's formulary. If the patient can't afford Tylenol® in the quantities he needs, prescribe an opiate, instead.

A prescription-only drug can be re-evaluated by the FDA and made OTC, at which time drug plans will stop paying for it, even though the drug has not changed and the consumers' needs for it have not changed, and even if a doctor continues to prescribe it. What prompts the FDA to make the change in status is evidence that the drug is safer than previously supposed. So, if anything, it should be prescribed more. Instead, patients get switched to prescription-only drugs that as a rule are more dangerous.

If we could only get the principle established once and for all that it's people's health that matters and not the health of drug companies, we could have the sort of health care we deserve. We'd also get, as a side benefit, the means to direct public funds to end homelessness and malnutrition in this country, when doctors can prescribe food and shelter, and public health plans have to provide them.

I should live so long.

Bonus Meander

Let's manage our roads like drug plans. You'd have a Road Plan. You'd opt in at the beginning of the year. There'd be a list of roads you'd be allowed to use at reduced tolls. All other roads would be pay as you go, full price. If the roads listed weren't right for you, you could shop for a new plan for 2009. In the meantime, you get what you got, except the Road Plan company can raise the tolls or drop any road off your list at any time between now and Dec. 31, 2008. If you don't like it, what are you, a communist? Why don't you go live somewhere they don't have roads?

[Below: Your Road plan may pay for you to drive northbound on Aurora at certain hours, but make you pay to drive south. This will be called Managed Transportation Care. We already have this, only they call it "HOV lanes."]