<<Disclaimer: Verify this information before applying it to your situation.>> Happy weekend everybody! I wanted to put in my 2 cents worth about this subject because I think it's important and that good dialogue is valuable. I'm the pharmacist in Texas that writes in occasionally and reads posts daily. This list is so great and I learn so much from it. Thanks to all for your posts. When Clinton came to office we had a golden opportunity to change the health care system in this country. Mrs. Clinton had some of the greatest minds in health-care and open brainstorming was encouraged and they looked at health-care systems all over the world. I thought it was an excellant idea to have the most successful, and effective insurance companies in the various states become the 3rd party payers for our healthcare and to have universal coverage for all citizens. It sure was a can of worms though and all the little insurers freaked and some of the big ones, and lobbiest took over and the fear of the government becoming the controllers for our health-care kept any action from taking place. Since then pharmaceutical companies have bought insurance companies (Pharmacy Benefit Managers or PBM's) and are now dictating to doctors and pharmacists what drugs they will pay on by inforcing closed formularies. And guess what? The drugs they choose on their formularies are the drugs they produce. Sure, you can get the drug you and your doctor think is the right one, but you may have more out of pocket cost. Not all insurers have resorted to this but many have and more do every day. It contains costs for them, and brings in bigger profits. Now the pharmaceutical industry that has always had a huge lobby power, (and huge profits) has the insurance companies lobby combined with it and I don't think single payers for healthcare will ever become a reality in this country. Now we have people sitting at desks that have never been to medical school deciding for insurance companies what protocols are cost efficient and which tests will be paid for and how much is a fair price. So a person may be charged for a procedure and the insurance company will only pay their going rate then the individual is charged for the rest. It has happened to be and my 20% turned into 40%. Doctors are plagued with paper work and less profits because of additional office workers required to do all the excess involved in billing 25 different insurance companies. I don't know how it is in other states, but here in Texas the government alone has 4 different payers requiring 4 different ID# for providers for billers like my pharmacy. Most pharmacies won't accept the programs that supplement medicaid for children of indigent parents who can't afford things medicaid doesn't cover, like bandages and tape, or diabetic supplies because of the hassle of billing. It would have been so much easier and cost efficient for all healthcare providers to bill everyone's tab to say PCS and have their health-care needs met. Sounds simple but it's a red-herring now because the lobby to keep the status quo for pharmaceutical companies like Merck who owns PCS now by the way is so strong and in place I think the health-care system has taken on a life of it's own and the managed care companies are now beginning to show big profits and those of us not covered by them or those not covered by any insurer are suffering from healthcare neglect because it is unaffordable. The doctors, pharmaceuticals, and hospitals, and labs all continue to jack their prices up in an effort to make their ends meet and the insurers that have all the contracts with employers that pay these health care entities continue to pay a fraction of that cost. So if your not covered and you don't have a doctor willing to take a loss on a cash paying patient you get billed outrageously, and in most cases I think people stay away from the system and self-treat, and have sub-optimum healthcare. There is no easy answer I know and all in all we do okay here and have great medical schools and research engines in Universities and freedom to choose and learn and have access to libraries and learning tools on the net and access to pharmacists who can be very helpful in many ways, and home health care. But I guess at the same time I see room for improvement and am curious how it will pan out in my lifetime. To close I'd like to say that to think that our healthcare is not controlled by politicians in the United States is ridiculous. It is all political, and I think that it is each persons responsibility to take care of themselves and take responsibility for their health-care, but realize at the same time (because I see it everyday) that alot of people and their children are falling through the cracks and I hate to see our country become like a poor 3rd world country with starving, sick, and hopeless human beings laying in the street dying while the rich get richer in this great, abundant nation of ours, with so much to go around. Cindy Laney-Fisher,RPh in Texas