Letters for the week of May 7-13, 2003 

A host of alternative solutions to the "problem" of pill-splitting: high medication costs, high medication prices, chicken politicians.

Billboard

Where are the listings?

We are a group of visual artists in the East Bay. We have been reading the Express collectively for fifteen years. One of our tools as artists is the Gallery Openings and Gallery Listings section of the paper. To our dismay, we have noticed that this section has been missing from the paper for at least the past three weeks. We feel that, heretofore, the Express has done a commendable job of publicizing all the arts.

The elimination of this section will have a negative impact on the galleries, as well as the artists and patrons. We implore you to once again include this section, which represents a very vital part of the community.
Sydney Bell, facilitator, the Lakeside Art Salon (Group members: Nancy Nottage, Becky Lyman, Nan Lim, Joy Sunyata, Nina Lasant)

Editor's note

The Express still features the East Bay's most comprehensive arts and entertainment listings. However, to make way for our newly expanded coverage of upcoming arts and entertainment events, we have moved our listings to our Web site, EastBayExpress.com. In the Billboard section of our home page, select an event category from the pull-down menu and click "Go."

"Cutting Corners," Feature, 4/16

A breach of trust

Thank you for printing the article on pill-splitting. Just by your act of presenting a complete story of the matter, you have probably saved quite a few lives.

The irresponsibility of Kaiser and other HMOs that choose to mimic these cost-saving business tactics will eventually come to fruition. These tactics are not appropriate in the medical world, which is based on absolute trust between doctor and patient. Kaiser has again let its patients down.
Vickie Travis, Palmdale

High medication costs are the real problem

Your article on Kaiser's pill-splitting policy seems to be "much ado about nothing." I have worked as a cardiologist at Kaiser Richmond for 22 years. I am the physician in charge of our cholesterol, heart failure, and coronary artery disease programs in which pill-splitting is commonly done. With the aid of a pill-cutter, our patients routinely cut their pills in half with absolutely no ill effects. The money saved from pill-splitting is reinvested in patient care, allowing us to develop prevention and care programs for patients that we would otherwise not be able to offer. I think the real issue here is the skyrocketing cost of medications and the inability of some patients to afford them.
Jeff Ritterman, MD, Oakland

Stupid pricing policies are the real problem

Your article on Kaiser is grossly misleading. Kaiser is a nonprofit. If Kaiser saves $40-$50 million by having patients divide pills in half because of cockamamie drug industry pricing structures, that money means that we -- Kaiser members and their insured employees -- save that money, resulting in lower premiums.

Reality check: If a few people are not physically able to manage the very simple and easy-to-use device, nor are able to recognize that a pill has not been evenly split, it should not be an insurmountable task to find someone to do it for them.

I find the recurring anti-Kaiser articles annoying. My family and I have used Kaiser for over thirty years. The service we have gotten has been terrific! It is easily and by far the best big health-care system for the money anywhere. If it weren't for Kaiser, we'd be roadkill.
Steve Juniper, Berkeley

Cowardly politicians are the real problem

Despite presenting no real evidence that pill-splitting does anything other than save precious health-care dollars, Goldsmith manages to portray the policy as a dangerous "scheme" where "health-care providers accrue the bulk of the savings ... patients typically save only about $1 a month." What rubbish. Kaiser is a nonprofit healthcare provider. Every dollar they save helps keep premiums affordable and provides needed capital for hospitals and clinics. If they actually do save $40 million with this practice, I say hurrah! The Pacific Business Group on Health stated some time back that for every $1 health insurance premiums go up, 10,000 Californians can no longer afford coverage. How's THAT for bad health care?

Instead, how about doing a story on why no politician in the land will touch the growing health-care delivery system crisis with a ten-foot pole?
Dave Dondero, Lafayette

A choice for the uninsured

Though I initially wondered about the choice of an article on pill-splitting for your cover, I began to realize what an exciting option this practice may present for uninsured folks who are struggling to meet the high cost of their prescription meds. Why not get together a list of those high-priced medications that can be most safely split, putting some energy into researching this well? And we can let everyone know that Kaiser is giving away at no charge those cleverly designed plastic contraptions that can relieve us of the time, waste, and danger of cutting pills apart with knives, teeth, or ice picks!
Vivien Feyer, Berkeley

If not court, where?

Thank you for a very informative article. I had never imagined that such a problem existed, although I've sometimes found it necessary to split pills when my doctor wanted me to gradually increase or decrease the amount of a medication. It's interesting to note that the judge in Alameda County dismissed the case because "the courtroom is not the venue to determine whether or not a business practice is safe." If not the courtroom, then where?
Tom Hamlyn, Katy, Texas

Consider the risks

One of the arguments used by the Pharmaceutical Manufacturers Association against doctors prescribing generic medicines is that the active ingredients in name-brand medication vary by only a few (2-3) percent, whereas the active ingredients in generics routinely vary by more than 10-15 percent. They claim that this variation is harmful to patients.
Osman Vincent, Berkeley

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