Who pays for your medicine? If you are young and healthy and have a decent job, your insurance probably picks up the tab, while you contribute a modest co-payment.
If you are older, ill and need medicines, you are out of luck. Medicare does not pay for most prescription drugs.
The cost of medications has skyrocketed over the past decade. It is not unusual for a single prescription to cost $100 or more. Pharmacists tell us that some of their most desperate customers break down in tears because they cannot afford an antibiotic for a sick child or an antidepressant for a suicidal spouse.
One reader sent us his distressing story: "I am a 64-year-old kidney transplant patient. Next year, when I turn 65, my private health insurance will no longer pay for my immunosuppressant drugs. They cost over $12,000 per year.
"Medicare will not pay for these medications. What will happen to me? If I have to pay, it will take all of my Social Security benefit. Financially, I would be better off if I stopped taking the medicine, let my kidneys fail, and go back on dialysis for the rest of my life. That's an awful choice for folks of limited means."
Not only would this person's quality of life suffer immeasurably, but having him go on dialysis would actually cost the government a great deal more in the long run.
It's not just transplant recipients who have to worry about high drug bills. We hear too often from readers like this woman: "My prescriptions run from $300 to $350 a month. The prices keep going up. I have to take medicine for asthma, high blood pressure, heart trouble and diabetes. My Social Security check barely covers rent, groceries and these bills. Sometimes I have to skip a prescription to get by."
Nobody seems to care very much about the drug cost crisis confronting the poor, the sick and the elderly. It wasn't always this way.
A decade ago, most people paid for their prescriptions out of their own pockets. They were mad as hell when prices soared out of reach and they let their congressmen know.
Today, three out of four prescriptions are covered by insurance. As a result, most people haven't noticed how much drug prices have risen. If you have to pay only $5 or $10 when you pick up your prescription, how will you know that the sticker price for those without insurance may be $80 or more for the same pills?
Pharmaceutical manufacturing is the most profitable industry in the world. Pills that cost pennies to make are often sold for $2 or $3 apiece. If personal computers were priced like prescription medicines, your PC would likely cost over $40,000.
Unlike computers, medicines are not optional for sick people. Those with heart disease, breathing problems, life-threatening infections or diabetes cannot survive long without their prescriptions.
There is something wrong when the neediest and most vulnerable in our society are gouged for their medicines. Meanwhile, those who are more affluent don't have to pay out of pocket because they have insurance. The United States is the only developed country in the world with such a warped health care system.
It's time for Congress to do something useful. If you share our outrage, contact your representative. Either prescription drug prices should be controlled, as they are elsewhere, or the elderly and uninsured should get help paying for vital medicines.
A weekly pill plan
Q. To make it easier to remember my medicines, I set them out once a week in a special pill box. I take Lanoxin, Ziac and aspirin. My friends tell me this is a dangerous habit.
A. A weekly reminder box is OK for the pills you take. Some drugs, such as nitroglycerin or Tegretol (carbamazepine), deteriorate rapidly when exposed to air. Pill boxes are not appropriate for such medication.
Write to Joe and Teresa Graedon in care of The Buffalo News, P.O. Box 100, Buffalo, N.Y. 14240.