The "funding cut" to Alberta pharmacies

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I know I haven't posted anything in ages, and I apologize, but I'll try to be a little more regular in the future.

What's finally got me out of my writing funk is the recent announcement that the Alberta government was "making significant cutbacks to community pharmacy". "100's of rural pharmacies might have to close their doors". Check out this site I care about my pharmacist for what pharmacists are saying about it. As a pharmacist myself how can I not be outraged at something like that?

Maybe because it's a load of bullshit.

First off, the government doesn't "fund" community pharmacies. They are independent businesses (or members of corporate chains) who have contracts with the government to provide pharmacy services for specific Alberta citizens (seniors, social services, disability, etc). These contracts limit the amount they can charge patients on government sponsored programs for filling their prescriptions. To simplify, this consists of the actual invoiced cost of the drug, a tiny "inventory allowance", and a dispensing fee. All in all, the pharmacy makes about $10 "profit" on each prescription. (this is before all other expenditures, such as rent, wages, supplies, etc, so the actual "profit" is much, much less)

So where is this big "cut to funding" coming from? Did the government change the contract so they are paying less of a dispensing fee? Did they axe the inventory allowance (a tiny amount that is almost insulting anyway)? No. So what did they do?

They made the drug itself cost less. They made deals with the pharmaceutical companies, and negotiated a direct cut to the cost of generic drugs. And since pharmacists do not mark-up the drugs, this is a savings that will transfer straight to Albertans, either directly or as savings for the government drug plans.

So now, you're probably wondering, how the hell this is being portrayed as a "funding cut to pharmacies". I mean, look at it. With everything presented here so far, it should be completely revenue-neutral to the pharmacies themselves. Hell, if anything, it should be beneficial, as they will have to carry less inventory just sitting on the shelves waiting for a customer to need it.



Ready for me to tell you the real story?

The one little thing that the articles (and that crybaby pharmacist website) forgot to tell you. Or they hinted at it, but didn't explain. A large portion of pharmacy "funding" comes from the drug manufacturers in the form of rebates. It's been a while since I've been in a position to see the actual dollar value, but it's a very significant amount. Basically, the drug companies will pay the pharmacy to sell their product over a different companies product. So, yeah, when a person gets a prescription, they pay what the pharmacy paid for the drug, with no mark-up, but they don't get any benefit of that little kick-back rebate payment. That goes right to the cash register, and to the black side of the ledger.

But that still doesn't explain where this "government cuts to funding" has come from. Pretty easy to close the loop from here, but I'll do it for you. They have forced a reduction in the up-front cost of the generic drugs. In the end, the drug company isn't going to take the hit to their bottom line, so the rebate payments will be reduced, or axed outright. This is the "funding cut" that the stories are telling you about.



So, that still sounds pretty bad, why aren't I concerned?

Well, for one, I'm simply annoyed at how dishonestly the pharmacists in the news have been portraying this. THE GOVERNMENT DID NOT CUT YOUR FUCKING FUNDING!!!! As far as I can tell, they didn't even ban rebate payments (like they did in Ontario). They simply have negotiated a better "at-the-register" price for themselves and for all of your customers. Really, this isn't about the lost money. It's about doing things the way they've always been done, and resisting a change when it comes.

Personally I don't think the rebate system had any place within our socialized medicine system. Progressive pharmacists are always whining about how our only source of revenue is tied to a product. Well, who made it that way? You certainly didn't do yourself any favours by having the rebates for selling generic drugs be the only way you could be profitable.

Even when we've had the chance, we haven't charged people for our additional services. Remember that "pharmacist prescribing" that was such a big step forward a couple years ago? How much money do you charge for that process? Er....if you're like every pharmacy I've seen it's a big fat $0. When that came through I was working for Shoppers Drug Mart. You can say a lot of things about them, but one thing I've always thought they've done well is charge a fee for services, and justify it. But when pharmacists got the right to prescribe, what did they charge. NOTHING. They decided that gaining another dispensing fee for the filling of the prescription was enough.

So there's a spot these hard-done-by pharmacies can make some of their "cut" funding back. Charge for your pharmacists time involved in prescribing. If someone asks your pharmacist for that service, you charge for it. And even if the pharmacist decides that the person doesn't meet the criteria for a prescription, you charge them for the time it took to decide that.

Raise your OTC prices. Or even better, charge directly for OTC consults. Do you think the $0.50 you make on a bottle of $4 cough syrup is reasonable when your pharmacist spent 10 minutes finding out whether it was safe for the patient and explaining how to use it? What if the pharmacist spends 10 minutes counseling a patient on something and they don't buy anything. Why the hell is that free? What if the patient grills your pharmacist for 20 minutes, finds out 10 products he needs to get to cure all of his ills, and then goes to Walmart since they have it all for cheaper. Why is that free?

That's where your money should be coming from. Not from sneaky little back-room deals. If you're calling yourself part of the "government funded health care system", then your revenue for what they pay for should be up front and on the table. And seriously....we're the "most trusted profession"....so don't go to the media with a story that hovers on the edge of being an outright lie. If you're too embarrassed to admit what the government cuts really are, then maybe it's time to get a new source of revenue. One that you're proud of and would put right in the headline of the news story if some group tried to take it from you.

Do I look like I'm a Christian?

Ah, the things you hear at work sometime.

I don't know why it came up, but one of the Muslim women at worked asked another lady, I'll call her "Jackie", if she was a Christian.

Her reply, as is the title of this post was, "Do I look like I'm a Christian?" with a fair amount of .....almost disdain in her voice. I was thinking, well, not really any of my business, but you look about as Christian as anyone else.

"Jackie" then went on to explain that she was Indian by descent and "brown" so therefore it was a silly question. I wholeheartedly agree that it was a silly question....but not for the reasons she listed. I really don't think questions about religion, even ones as basic as that, have any place at work. I mean if you choose to declare your affiliation by wearing a turban, or head scarf, or have a pentagram tattooed on your forehead, that's your choice.... but it really shouldn't be a question that anyone should be asking.

Of course I already knew "Jackie" didn't share this opinion since she confronted me at Christmas about how lucky I was to be not working the holiday since I was a Christian (I'm not.....). She even called me a liar when I told her I wasn't. Social graces are not "Jackie"'s strongest skill.

So yeah, back to her declaration that she must not be a Christian because she's Indian. I think she needs to run some numbers. There's actually as many or more Christians in India than in Canada. On the last census info I could get, 2.3% of the Indian Population was Christian, compared with 77% of Canadians. "Er, Ren...." you say, "77% is way more than 2.3%", to which I reply....yes, but 2.3% of 1 billion-ish is as much or more than 77% of 30 million. The last numbers I could find listed India as having 24 million Christians and Canada as having 21 million.

Basically, if you're just driving down the sidewalk hitting people with your car, you're more likely to get a Christian if you're doing it in Canada, but I'd certainly suggest you try to hit just as many Indian-looking people as you did whites just to make sure you don't miss a bunch.

So, to answer you "Jackie"....yes, you do look an awful lot like a Christian.

I don't quite remember this part

Ok...I remember getting taught the facts of life....but I'm pretty sure it didn't involve freaky rednecks, frogs, hippos, or owls.

Anyone?

How does this happen?

My dodgeball team, the ROY G BIVS (best/lamest name ever all at the same time) won our league this season. It was a "really-rec" league where they don't judge you on wins and losses but on your sportsmanship and the amount of fun you have.

What confuses me is that our team didn't really go out to have fun and our sportsmanship was questionable at best. We were playing to win....and I don't think a bunch of rage cases hucking balls at people as hard as they can is really the epitome of either good sportsmanship or having fun.

Woohoo.

Basically, the league champ was determined by having the captains vote for which team was their fave for the year based on overall fun. I can only assume we were voted for because people wanted to vote for the team they thought would get the least votes so they'd have the best chance of winning. Looks like that backfired.

Love

Stolen and barely modified from http://xkcd.com/112/

I'm confused

This post is meant as a bit of a joke, and maybe at the same time a bit of not-a-joke.

Why....in the middle of an "obesity crisis", are women (and men even) still complaining about the media "bombarding them with unrealistic images of what they should look like"?

The last report I looked at stated that 65% of americans are overweight or obese. On the other hand, 5-7% of american women will suffer from anorexia or bulimia during their lifetime.

I will never try to argue that eating disorders do not cause significant health problems and I definitely won't make light of that fact, however, I think anyone could agree that obesity's list is mighty impressive. Obesity can contribute to your chances of getting diabetes, high blood pressure, high cholesterol, fuck...I'm not going to list them all....look here if you really don't know what being fat does to your health.

Now, I understand that eating disorders are serious, and that even in the absence of an eating disorder, people can experience low self esteem and feelings of anxiety or inadequacy due to not looking as good as they think the people on tv or in the magazines do. But is the media's message really the problem? I'll admit that I have no use for fame for fame's sake and therefore do not read "People" and their ilk....but I've always found they have a variety of shapes of people within their pages. Why do women automatically associate the skinniest thing in front of them with what everyone thinks is ideal? Maybe a few years ago that was the case, but it seems lately that the super-skinny is being stigmitized almost as much as the super-fat.

Maybe it's just me being so confident in my body image that I'm missing this stuff....except that's not it. Ask anyone who actually knows me, I have my hang-ups. There's stuff about me that I wish was different. I wish my arms were a bit beefier. I wish my jaw-line was more defined. I don't know what I'd want my hair to be.....but I really don't like it. I wish that I didn't feel so ugly that pulling the "You won second prize in a beauty contest" card in monopoly causes a momentary sense of pride. And yeah there are famous people, and even not famous people that I wish I could look more like....but it doesn't keep me up at night. And why would it?

Hell....if I go to the magazine rack there's all sorts of stuff there trying to make me feel inadequate. All the houses and gardens in the Home and Garden section look better than my house and my garden. Most of the cars in the car magazines are cooler than mine, and they're definitely newer. All the computers are faster, smaller and more powerful than mine, and all the tv's are bigger and brighter. Do I wish my stuff was more like that stuff....sure. Does it make me feel bad that my stuff isn't more like that stuff. Yeah, a bit. Am I outraged that they don't put more dumpy houses in the magazines with garages full of older, uncool cars and rec-rooms filled with small tv's and big, slow computers. No....not really. It's nice to look at nice and fancy stuff that's better than mine. And for me, when I actually do look in a magazine, it's kinda nice if the people in it look a little better than the people that are hangin' out at the mall.

And even if the ideal is set a little too far on the skinny side of things, is that necessarily a bad thing? Remember..... 65% of americans are fat at this moment. Is it a bad thing to surround them with images of people who are skinnier than them? But what about the people who end up getting eating disorders. Well, for starters....let's look at things on a completely indifferent, numbers-only level. Less than 10% of americans will suffer from anorexia or bulimia in their lifetimes. Which of those numbers is bigger?

And pretty much everyone agrees that there is a pretty large psychological component to eating disorders. Obsessive-compulsive disorder and depression seem to go hand-in-hand with anorexia and bulimia. What's to say that even if every environmental/societal trigger for these diseases was removed that the same people who would have had these problems wouldn't succumb to something else. A vicious cycle of never-ending home-improvement. Frequent upgrading of vehicles despite there being no problem with the old one. Compulsive shopping perhaps? Hmm...looking at the current economic crisis and the credit crunch, maybe it's already happened.

So yeah, for all you women (and men) in the middle. Maybe you should stop whinging about "the media" making you feel inadequate by bombarding you with unrealistic body images, and start thinking for yourselves. Take a look at yourself and be as healthy as you can be, and stop worrying. Sure there are people on TV who are hotter than you....but that's ok. I bet your boyfriend or girlfriend thinks you're pretty alright. Do you think you'd even bother with TV or movies if the people weren't better looking than you or doing more interesting stuff than you? If you don't like the people that are on your tv or in your magazines, there's a simple solution. Stop buying the magazines, and turn off the tv. If it's really burning you up inside then stop buying the products that are advertised during the shows that offend you and write letters to the companies. Personally I say leave things the way they are. There are way too many fat people and they need someone to look up to.

Oh yeah, maybe put the credit card away for a bit too, last years stuff is fine.

More curry

For those of you who look here more often than you look at dodgycurry.ca I'd just like to give you a heads-up that there are 3 new reviews up.

Personally I think they're pretty good. Worth waiting three months for? Well...I wouldn't go that far, but they're pretty good.

I do want to get some more up sooner than later....currently our review of "The Taj" is the newest review and therefore the closest to the top, however I wouldn't say it's the best example of our writing. It's more of an in-joke for regular readers and I'd hate for it to be the first (and then probably only) thing that a new reader clicked on.

Well, check em out. And send us an email, or comment here....we love getting feedback.

Woman gives birth to..... block of cheese?

There is no way I could possible do this justice, so I won't even try. At first read I thought that she had actually stuffed the cheese inside herself, but it looks like she was carrying it on her outside. Too bad. Story would be that much better the other way. LINK


Woman Gives Birth to Block of Cheese

Berlin, DE -13 Feb. 2009- A pregnant woman rushed to the hospital to give birth shocked doctors and staff when it was revealed that what she had passed off as a fetus for months was in fact a large block of cheese.

The woman, whom hospital administrators have refused to identify due to confidentiality rules, has a history of mental illness, according to medical records obtained from people close to the situation. Not only has she been detained in the past for public disturbances, but she has been on significant doses of anti-depressant and anti-psychotic medications for many years.

One attending doctor, speaking on the condition that they remain anonymous, remarked that it is not uncommon for some individuals to fake medical conditions in order to gain attention and financial support. Using cheese to fake a pregnancy, however, seems to be unprecedented, even among the mentally ill.

“Beyond weird,” remarked the doctor. “I don’t know how one would do it, but it must take an unwordly level of self deception to even conceive of something like this.”

What’s more, the woman had apparently registered herself at several stores for an upcoming baby shower and had been regularly consulting an obstretician by phone.

With so much contact with others, it is unclear how she was able to keep from revealing herself for so long. According to sources familiar with the matter, all of her neighbors believed her to be pregnant, and had helped her pay her rent and shop for baby clothes and furniture.

Around 4 am on Thursday, after the woman was heard complaining loudly of severe pains outside an apartment building. Neighbors, assuming that she was in labor, took her to an emergency room where doctors uncovered a sodden and moldy mass of what they later determined to be several bricks of cheddar cheese bound together with twine.

Residents of the apartment building refused to comment, and the woman has been detained pending further psychiatric evaluation.