eighty-nine dollars and fifty-two cents

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eighty-nine dollars and fifty-two cents
by kevinbarry at 6/4/2011 9:01:38 PM

This morning I watched the HBO special “How to Die in Oregon”, which deals with people wanting to end their life because of terminal diseases.

The Oregon law, that allows doctors to prescribe a lethal dose of drugs to a terminally ill patient who has made a written request to die, was passed in 1994 by 51 percent to 49 percent and has been upheld by court challenges.

Opponents of the Oregon law promise continued legal fights even though the Supreme Court has held that states have a legitimate right to pursue such laws.

The beginning of the film showed a gentleman purchasing his “dying with dignity” medicine at his local pharmacy. When the pharmacist said “eighty-nine dollars and fifty-two cents”, it stuck in my head and it does not appear to be going anywhere soon.

The drug he purchased was Seconal, the brand name for a drug containing an active ingredient called secobarbital - a barbiturate that is classified as a sedative-hypnotic, meaning it acts as a depressant and makes you feel sleepy.

Seconal is used to treat insomnia, and may also be prescribed to reduce anxiety or to help calm patients before surgery, but when enough is taken at one time, near term death is the expected outcome.

At Drugstore.com a bottle of 100 capsules of 100mg Seconal lists for $1169.90 but you only need to take 1500-1600mg, or 15 to 16 tablets, to end your life, so the manufacture is making a killing – selling you an excessive amount of pills, more than are needed to end one’s life.

Wikipedia describes the word "medicine" as: “A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.”

The pills one purchases to assist a person in dying does not seem to fit the description above, even though they might be considered medicine if used in smaller doses for medicinal purposes. I may be looking at the wording too critically, but it just doesn’t seem right to have pills of this type, when used to end life, to fall under the category of medicine.

If a person is of sound mind yet suffering from a terminal disease with no expectations of ever getting better and that person decides to not continue living, then it makes sense to provide that person with the resources and the wherewithal to die with dignity - in a timeframe of his or her choosing, and in a manner required by state laws.

Most individuals exploring options to end their own life are frequently enrolled in some kind of health plan – be it Medicare / Medicaid or some other health plan coverage. These plans are very costly to individuals, to the health plans themselves, and in some cases governments and taxpayers.

Individuals choosing to end their life do it for a variety of reasons. They might have seen an erosion of their net worth due to increasing medical costs and after realizing they will never get better, they want to be able to leave their loved one’s with as much of their “estate” as possible – be it cash, stocks, real estate, or other tangibles and intangibles.

Other individuals might choose to expedite the dying process because they are simply tired – tired of living, tired of pain, tired of the loss of dignity, or tired of being a burden to others.

After watching the HBO movie, I am of the belief that the choice of dying lies with the individual who is choosing to die with dignity. Anyone else – family, friends, acquaintances, business associates, health care providers and even government employees at all levels are secondary. There will be those who are supportive of the decision and there will be others who will be very vocal in their opposition.

Once the timeline has been thought out and the appropriate “medicine” has been obtained, a suitable location has to be chosen. In addition, the last major decision to be made is regarding who will be in attendance. Anyone not supportive of the decision should not be “invited”, so to speak. The last thing a dying person needs is for someone to complicate the process – either vocally or physically.

Now, regarding the title of this blog - “Eighty-nine dollars and fifty-two cents.”

I can understand how a person would want to pick up the appropriate pills to be used to expedite the dying process.

What I cannot understand and I strongly object to is for any health plan to expect the person to pay for his or her own pills. I believe the pills should be provided by the plan itself without any CO-PAY – considering that all medical related costs to the various health plans will be coming to a screeching halt – i.e. no additional room fees, no future procedures, medicines, or services.

Instead of prescribing 100 pills at a cost of $1169.90, why don’t doctors prescribe 30 pills at a cost of $350.97. Thirty pills still represent twice the number of pills necessary to expedite death. With the $819.07 savings to the health plan, they should be able to easily spring for the entire cost.

On a side note, I do not feel that anyone taking their “last” medication needs to take an expensive brand name drug. I have been taken generics my entire adult life and if I were in this position – why change to an expensive brand named drug this one and only time?

There are several drug manufactures who make a generic equivilent of Seconal – why not use one of them? I do not think anyone taking the generic version would be around to experience any side effects.

On your birthday, friends usually spring for the meal, the cake, and the card – so why would your “death day” be any different?

A prisoner on death row is given a free meal of his choosing.

You should be able die on someone else’s nickel – or in this case someone else’s eighty-nine dollars and fifty-two cents.

So, how do you feel about having the option to die with dignity on your own timeframe, peacefully with little or no pain, with people surrounding you who support your choice?

I believe all states should pass legislation like the law in Oregon as long as the person requesting the right to die is of sound mind, has documentation from a physician that he or she is suffering from an incurable disease, that death is imminent, and there is no hope for a reversal of condition.

Comments
sireena	6/4/2011 9:06:57 PM I agree with everything you say here Kevin. In fact, I had this conversation just the other night with a friend. I, personally, could not bear to watch someone that I love suffer indefinitely with no hope of recovery and most likely would assist with this wish in any way possible. Of course, to each his own thoughts and feelings...these are just mine! Interesting topic!
beautifulmind02	6/4/2011 9:22:41 PM To busy trying to live life than to think about dying.....
61falcon	6/4/2011 9:25:14 PM Have you ever heard of Doctors being wrong?????????
trrnnr71	6/4/2011 9:30:04 PM but who are we to make that judgement im thinking. i also would not want to be kevorkian when the judgement comes
moggio	6/4/2011 9:30:05 PM They, obviously, ran that piece because Dr. Jack Kevorkian (Dr. Death) died.
redfaiery	6/4/2011 9:38:17 PM Yes, I have heard of Dr's being wrong. I also have to state the Generally, a patient KNOWS when they have been sick, in pain & have suffered long enough that they want to die. I have witnessed it far too many times to count. A simple one liner & 1500 volumes could not cover this topic. I am grateful for this information & that the choice is out there ~ for any one who seeks to end the agony and suffering. I myself have made that choice already, in the event I should need it. HANDs down. MY CHOICE. Thanks kevin
madamedb	6/4/2011 9:38:26 PM I've been here 3 times Kevin and not sure I have a comment...I'm very conflicted. Suicide is suicide and I hope that when I reach the end I'm not looking for drugs to take me out. There's pain in living and there's pain in death. I can't say any more than that.
kevinbarry	6/4/2011 9:53:14 PM again, it is the patients decision and not the family. also, falcon, that is why people get 2nd and 3rd opinions. the whole process puts the individual who is dying in charge of where and when Thanks redfairy - some individuals have "do not resusitate" on their license and they have instructions for medical professionals to do nothing extraordinary to sustain life - again it is just choices that we are just now getting to have a say in. Everyone does not have to agree - we all have our own minds and opinions and that is what makes each of us different. I am one who would NEVER fault anyone for making this decision - one way or another. I just don't want someone making the decision for me for the wrong reasons - and believe me, there are those who would be looking out for their own personal gain.
kevinbarry	6/4/2011 9:55:14 PM and maggio, the movie was made a while back and was scheduled to be aired over a month ago, well before Dr. Death died. but I am sure the viewership is up because of the timing of his death in the news.
moggio	6/4/2011 9:56:07 PM Understood.
kevinbarry	6/4/2011 10:16:05 PM The movie was well done and very imformative. I would recommend it to anyone who is interested because of a terminally ill family member or even for anyone exploring options. With all states having budget problems and are cancelling many health programs, financial reasons might make some terminal individuals consider options like assisted death. If for nothing else, it gives one insights they did not have before watching it themselves. Madamedb, for some reason I do not think of this as suicide - before I saw the movie I was leaning toward that as a name for it but not after watching the movie. The law in two states is called "The Death with Dignity Act" and even though a person with a terminal illness is speeding up the process somewhat, it is different that a conventional suicide - IMHO.
nickiegirl	6/4/2011 10:36:00 PM Interesting Blog....Where did you come up with the price of this Med. Some Meds do not have a generics and at the cost you stated that sounds like it has no generic if this is the price of the genic I'd hate to see what the real things cost and we do have someone on the selves that would turn you under wear inside out as for the cost...I know some Meds or out of this world in price ...Now as each of the Ins company has a choice of paying for them ....They can or will not pay for all type of drug... They also will tell you if you can have 30 pills or 100 pills...It doesn't matter what the scrip said. Yes maybe your Dr can get the Ins company to do a over ride. meaning that you can get them to pay or give you more pills then the normal 30 days amount. This doesn't happen often and it's a lot of extra work for the Drs office as well as for the Pharmacist....Now you can pay for then out of pocket and then you can get as many pills as the scrip is written for. This is usually not cheap as you stated a price in your blog.... Also with the scrip and you know that it will only take say 6 bills then you'll only have to get 6 pills and again that is what the Ins Company will charge you for...So in the long run it's all up to you and the Ins company and what the scrip is written for....The amount of pills is up to you as long as it is not over them amount of the scrip.......................................................................... Yes I do believe we should have the right do what we think is right at our end times. You blog state many good facts and no one but no one has the right to mess with our life if we so choose to do this in the end....This is between you and your God..... I Think Dr Death as they called him did nothing wrong in his helping someone do what they felt was right for them...may his rest in peace....Yes am Christian and proud to say so...
kevinbarry	6/4/2011 11:23:38 PM Hi Nickie, thanks for the well thought out response. The drug is Seconal and it is a brand named drug. I got the prices at drugstore.com. You can see the detail about 1/3rd into the blog. I read where there is a generic but I could not find pricing. If doctors are prescribing the brand name and in a quantity of 100, people are being taken advantage of on their way out - so to speak. There are many other sites, including Canadian, that have this drug and the price varies significantly. I know you have pharmacy experience and I respect your knowledge and background. But, I still think, it these extreme cases of people deciding to end their life in states like Oregon, Washington, and now Michigan, they should get the meds for free - no copay at all.IMHO
kevinbarry	6/4/2011 11:29:53 PM Another thing Nickie, the rules in states that have passed these "Death with Dignity laws" might have different rules on how these specific meds are prescribed, sold, and shelved. Don't know if you have HBO, but if you do, especially with your knowledge of formularies, HMO's and PPO's, you might find it interesting. I was a mainframe programmer working the United Healthcare years ago and I worked on a pharmacy software package and it was quite interesting. I also worked for a couple of large insurance companies in their Benefits departments which was also interesting. People put pretax money in FLEX SPENDING accounts and lost what they did not use each year so they had to plan carefully.
acutelady	6/5/2011 10:00:23 AM I don't want to "hang on" if I get very ill. I want to die QUICKLY, thank you.
kevinbarry	6/5/2011 11:30:40 AM acutelady - makes sense to me. when the quality of life is gone and all we have in pain and discomfort, there should be an option - now it legally exists in 3 states.
madamedb	6/5/2011 4:39:30 PM Ok Kevin...I'm ready now. First let me say that you can talk about separation of church and state all you want, but the foundation of our country is based on christian people who began creating laws based on biblical tenets. Our money says "in God we trust" and even our pledge of agreement was written "one nation under God". We're a country deeply rooted in our christianity but welcome and accept people of all faiths. The cornerstone of all of man's laws are directly from the 10 commandments...given to Moses by God. One of the strongest commandments is "thou shalt not kill". Now...let me enter a little caveat here because even the bible says that you must obey man's laws and so man made it legal to put other humans to death...for killing other people or even in aiding or abetting the death of another human being. Am I right? Yes! I also maintain that whether you are taking the life of another or taking your own life it is still murder, killing, taking a life. No one wants to see someone they love suffer...it's a horrible thing to have to witness. But who are we to say it's ok to end that life before it's time? Dr. Death followers claim he's an angel of mercy but I think when he tries to get into heaven and knocks on the gate God will open and say "who are you"? He'll say...I'm Kevorkian angel of mercy, don't you know me? God will have to say...I don't know you, my children hear my voice and they follow my word...you have broken a sacred commandment over and over. He'll be cast into the lake of fire. He had no right to hasten another person's life! We don't either. If a person wants to "end their suffering" let them go ahead a do it. But I object to the idea of health insurance or the government being any part of that process. It's wrong on so many levels. Taking a life is taking a life regardless of whether it's merciful or evil and it's wrong. Most people I've heard beg God's forgiveness for what they are about to do but that's knowingly going against what Gods plan is for you. I'll probably get a lot of crap for this but I don't care...it's what I believe. I told my kids if I'm ever in the hospital at death's door they are NOT to pull the plug...God will take me when it's time...just let me go naturally. Lastly...just because it's legal doesn't make it right.
madamedb	6/5/2011 4:40:32 PM oops...pledge of "allegience"...screwed that up. LOL
kevinbarry	6/5/2011 10:02:14 PM The good thing about these "Death with dignity" laws is that it is a person's choice and based on one having an incurable disease. At least in three states people have that choice. ....and I am sure being the person you are, you respect the choice each person makes. Oh, also, I find it interesting that there are Christians who have killed Doctors who work in abortion clinics - if we are not supposed to kill someone or even kill ourselves, how can we condone a Christian killing a Doctor? It is so easy for one to quote scripture when it works out for that person. Also, our government is using unmanned drones and killing innocent people in Afghanistan and Pakistan. They justify the accidental deaths because they are going after the bad guys but missed their target and killed some innocent women, men, and kids in the next house - that is easily discounted by calling them colateral damage. Where are the Christians complaining about those events???
kevinbarry	6/5/2011 10:48:11 PM Oh, one more thing madamedb... Just to make sure I understand. Lets say, for sake of arguement, that you are worth $500,000. and you are on social security, covered by medicare and medicaid.. You are terminally ill and in the hospital because you require constant care with no hope for a cure. After medicare and social security, your medical expenses are $50,000 per month due to chemo and other powerful pain killers. You are in constant pain and wish it were all over but you are in a state that does not allow for "Death by dignity"=and you would not do that because of your religious principals. That said, you would stay ill, spending 50k a month for 10 months down to 0 when you die - The government helped you by paying part of your medical bills, which were paid out of OUR tax dollars - which I am surely not complaining about. 10 months, money all gone, kids get nothing - so I am sure you are okay with that, right? If so, I respect you for that because it is your choice. and if you read where I was suggesting the medical plan paid for the "death pills" because it would also save tax dollars, the government would spend less - and I am sure you would not object to that.....IMHO.
kevinbarry	6/5/2011 10:53:33 PM all I am saying is that it is an individual choice - not the choice of one's kids or a husband or a wife - just the person dying. One last thing - there are many documented examples of soldiers falling on a grenade to save the lives of fellow soldiers - technically, that is suicide - can you accept that? I am not trying to split hairs here - people of all colors, genders, race, creed, and religions do things for honorable reasons. A person choosing to end his/her life a few months early to alleviate pain and to be able to leave something to family is doing something honorable - otherwise, pill companies, doctors, and hospitals make a little more money - Pharmaceudical companies are RAPING people with high priced meds - some elderly people have to decide between electricity, food, or medicines - and where is the outrage.....
nickiegirl	6/6/2011 7:38:27 AM Kevin you last statement in JMOP has hit the nail on the the head....I see this every day I work Meds or bills or even food for the table...One day I'm sure this is going to happen to me as this is life....And God know what I'm going to do. I can not see my kids watch me waste way for what nothing....My Mother wasted away for years at the end the Dr said Julia here is a bottle of pills if you feel like you want to take them it is up to you...Now mind this was in 1977 and you didn't do things like that....But he knew there was no way back to even a remote way of life,,,She didn't take them but lived in a living hell the last few months of her life...Cancer all over her body...Not only did she suffer but we did also and I said if it's up to me I'm not putting my kids though that. They have been told if something happens to have the plug pulled and don't look back as you didn't kill me you only did what you were told to do....
madamedb	6/6/2011 8:33:42 AM So...I should just make the choice to die rather than use up my money on my own healthcare so my kids have an inheritance? If someone wants to die let them die....my objection is in helping them do it. That makes you party to the death. Would you really feel good about yourself if you gave someone the drugs they wanted to end their life? I wouldn't, couldn't do it. Sorry Kevin. When I'm terminal I will request DNR and no extraordinary means to keep me alive. When it's time it's time. As for christians killing doctors at abortion clinics...do you really think they're christian even though they claim to be? I don't think so.
kevinbarry	6/6/2011 10:23:07 AM Madam, I told you several times in the posts that I respect whatever opinion YOU come up with. It is your choice. No Problem with that. ...and as far as me giving someone drugs - that would never happen. Professionals diagnose a persons health and professionals prescribe meds and the individual purchases them. It, again, is clearly their choice. And regarding the Sunday morning church crowd, many profess to be Christians - some are and some are not. But if one who professes to being a Christian, yet kills someone and all the others simply stand by the sidelines - it does not matter how many of them are "really" Christian and how many of them are not.
kevinbarry	6/6/2011 10:46:35 AM Hi again Nickie; Again, well said. I do not know what is happening in this country - when our seniors have to choose between bills, meds, and food on the table, something is wrong. these seniors are not being extravagant - they have their thermostats turned down to almost freezing in the winter, they are taking half their meds OR LESS - which is not good for their health, and they are behind on their bills with no hope in sight. I have also read where some seniors are buying "cat food" Tuna because it is cheaper than "Human" tuna. They do not want to impose on their kids because they are barely making it themselves. I know the economy sucks - unemployment is high but it not through the roof - yet, our government can afford 1. cameras on every street corner to watch us. 2. Not only do we have the older scanners at airports, now we have full body scanners that show EVERYTHING. We also have TSA groping kids and our women - which I find humilating. 3. Our government can afford new Chevy Tahoes that cost $95,000 because they are equipped with the ability to scan thousands of vehicles a minute to determine what plates are "hot" and what vehicles are stolen. 4. We no longer have regular policemen coming to our door - we have several well equipped black Tahoes loaded with special forces type squads of highly armed S.W.A.T. knocking down our doors - many times without warrants. and what do we get in return? States are cancelling clinics that used to provide low cost or free health care. Libraries are either reducing hours or closing. schools are either being consolidated or they are firing teachers and aides. Fire departments are reducing staff. convential police services are being reduced - yet S.W.A.T. is fully staffed. Yet we have money for war, continuous war, elective war.
mkjpol	6/11/2011 5:01:09 PM @madamedb says this, " I told my kids if I'm ever in the hospital at death's door they are NOT to pull the plug...God will take me when it's time...just let me go naturally. " I say....God can not take you if you are pluged in, therefore, if you are pluged in, God can not take you naturally until you are unpluged. Think about it.......If you are at death's door and pluged in you could be keeped alive for 20 years in a vegetable state, and until you are unplugged you will not leave this world.