Paul Ryan's Health Care Bill is a joke not worth laughing at.

President Trump’s Health Care Bill – NOT – It is Paul Ryan’s Health Care Bill!

This is a failure for Speaker Paul Ryan on many levels. Paul Ryan wrote this bill!  As Speaker of the House he is supposed to create legislation that can pass. On this most basic task, Ryan failed, and failed miserably.  He rushed it through because his calendar was more important to him than health care.

I am not convinced that Paul Ryan did not deliberately sabotage the health care bill in order to hurt President Trump.  Never kid yourself Paul Ryan is President in waiting.  President Trump’s successes reflect badly on Paul Ryan because he did everything he could do to guarantee Trump lost the election.

Conservative Republicans will not vote for the bill because it has more bad policy than any bill that has come before the House or Senate before, even ObamaCare. This bill is a political disaster.  That is why I find it hard not to believe that Paul Ryan planned it to be a disaster.

Republicans were glad to see it die.

Ryan spent the latter half of Barack Obama’s presidency promising to repair the Republican Party’s relationship with the poor (remember Ryan’s “poverty tour”?).  He’s spent every day since the passage of Obamacare saying the Republicans could do better. This is what he came up with? The GOP put their greatest policy mind in charge of the House of Representatives and they got ... this?  I did not vote for Mitt Romney because I did not like him anymore than I liked Paul Ryan.  I have always thought Paul Ryan was a snake willing to destroy anyone or anything in order to advance Paul Ryan.  I have heard people commenting about his “beautiful blue eyes”  well I see his eyes differently – “shifty blue eyes”.

The Republican’s made the same mistake that the Democrats made.  They tried to rush a health care bill through and did not give enough time to debate the issues.  Mrs. Pelosi the Democrat genius in speaking about Obamacare said, “We had to pass it in order to know what was in it”.  If that is not totally asinine I do not know what is. 

I get the impression that President Trump is now disgusted with the health care issue and is ready to drop it and move on – a bad mistake!  If he does that he does not have the bal-s I thought he had when he was campaigning.

It is remarkable that after spending seven years establishing repeal and replace as their top priority, Republicans are abandoning the project less than 70 days after taking power. Doing difficult things in the American political system takes patience. 

If what I was told by a member of the House is true Obama threaten the House and Senate in order to get Obamacare passed.  I did  not know anything about this until he told me.  There was a bill that in 2014 would have forced the House, Senate and Federal employees to take the same health care policy the citizens had.  Obama was prepared to allow the legislation go into effect if they did not pass ObamaCare.  Obama in order to get the legislation passed had them declare Washington politicians and Federal workers as SMALL BUSINESS EMPLOYEES.  Small Business exemptions are for employers with 50 or less employees.  The last time I counted there were far more than 50 elected and salaried personnel working for the Federal Government in Washington D.C. 

I believe President Trump could use the threat of rescinding Obama’s ruling if they do not pass a workable health care bill.  He will not in my opinion because he would never get another piece of legislation passed while he is in office.   The elected officials would blackmail the President as they do the American citizens when they do not get what they want.  

The Republican line on the bill’s failure is it’s the Democrats’ fault. President Trump said, “We could have done this, but we couldn’t get one Democrat vote, not one,”. Of course, neither Trump nor Ryan nor anyone else ever tried to get Democrats support. They didn’t meet with Democrats, and from the beginning, they used the reconciliation process precisely because it meant they wouldn’t have to deal with Democrats. Trump is going to have a very difficult time if he does not try to get some Democrats behind him because he will never have the support from the majority of the Republicans in office that did everything to try and keep him from being elected.

I am a staunch REPUBLICAN.  I find nothing redeeming about the Democrat party.  I am even amazed that I feel the way I do about the Republicans and especially Paul Ryan about this health care legislation.

I do agree with President Trump when he says in time ObamaCare will explode.  It is impossible to fulfill all the promises in the bill.  We have already experience difficulty with the bill – higher insurance cost, less doctors involved, less insurance companies involved and higher deductibles.  Regardless of what happens with ObamaCare now President Trump and the Republicans will be blamed for not fixing it as they promised.

I think the first thing that needs to be done is to move health care away from an employer/employee relationship.  Citizens deserve the right to be able to afford and have healthcare regardless of who they work for.  It amazes me that in a Third World Country like the Philippines for $100 a year a citizens can have Phil Health which covers hospital and doctors.  The relationship is between the government and the citizens.  Why is that not possible in the United States?  I am not naïve I do not think it can be done for $100 a year.

Higher cost employer paid health care should be TAXED.  If you are receiving more than others I see that as a salary benefit and it should be taxed. 

I do not believe people that are able to work and choose not to should be covered by government health care.  I am sorry, I am for welfare when deserved, but not welfare give away.

Health care should not come under free market legislation.  Health care is not something you can choose to have or not have like an expensive car, house, boat, clothing, etc.  Everyone needs health care.  The government should regulate health care cost, insurance premiums and pharmaceuticals. 

The exact same medications I purchase monthly in the Philippines from the very same companies would cost me three to four times more in the United States.  I remember when I first came to the Philippines I went to get a heart medication refilled and when told the price it frighten me.  I ask is this the original or a knockoff and was told it was the exact same medication I received in the United States.  I was asked, “Why do you question the medication” and when I said what it cost in the United States the Pharmacist at Mercury Drug said, “Well if it will make you feel better we can charge you the same price as you pay in the United States.”  I was so unsure that I sent the box and bottle to my Cardiologist in the United States to have him inform me it was the EXACT same medication.  I then learned the Pharmaceutical companies have about four pricing tiers and depending on what country you live in determines what you pay.

Paul Ryan would like to eliminate:

Doctor visits - (I would to for those that abuse them, but how would you monitor that – doctors are not going to say a patient did not need to come to the doctor regardless if they did or not. The doctor wants to be paid).

Emergency room visits - (I feel the same about this as I do doctor visits.  If a person goes to an emergency room for something that could be treated by a physician in an office they should be turned away. I know for a fact the poor abuse this at University of Texas Medical Branch, Galveston, Texas.  I have witness it over and over)

Hospital visits - (If a licensed physician says a patient should be in the hospital the government should not be allowed to second guess that.  If they investigate and find the physician abused the system make him or her pay out of pocket or put them in prison for money paid out fraudulently).

Prescription drugs - (There should be a reasonable co-pay based on income)

Pediatric care - (I believe too much medicine is specialized.  Whatever happen to General Practitioners?  Does a child really need a specialist for flu or cold)?

Lab services - (If licensed physicians request it then it should be paid).

Preventive care - (Within reason).

Maternity care - (Depends on circumstances.  I find it difficult to pay for three or four babies from different fathers.  But, I also have a problem not protecting the baby).  As a staunch Catholic I still believe in mandatory tying their tubes).

Mental health care - (It is an illness as real as any physical illness and should be covered).

Rehabilitation services - (If prescribed by licensed physician it should be paid within reason).

These things should be debated not mandated by Paul Ryan.  I am sure many could find reasonable reasons to disagree with me and their concerns should be considered.

33 Congressional Republicans were publicly against Paul Ryan’s bill.  Health care has been an issue of singular importance for the American people for fifty years.  Societies across the world have had the same problems and societies across the world have instituted some variety of public health care, and have not collapsed financially or morally.  There is a solution, but Obamacare and Paul Ryan Care is not the solution. Paul Ryan’s solution is a compromise that nobody seems to want and that nobody can get excited about. 

THE TRUTH IN MY OPINION IS NO ONE REALLY WANTS HEALTH CARE TO WORK EXCEPT PRESIDENT TRUMP!

Expats - Immigration Laws - Senior Citizens

I wonder how many U.S. citizens would become expat's if they could use some form of government medical care abroad?  All the talk about Obama Care and cost of maintaining our senior citizen population and that the system is going bankrupt has any of our intelligent politicians ask this question?

First off the senior protection programs are going broke because our intelligent politicians stole from the fund to finance projects that would get them reelected. They not only mismanaged the fund they ROBBED the fund.

They are robbing the younger generation by borrowing money to finance projects in hopes it will guarantee them a lifetime job in government. Sadly some have even found a way to enrich themselves while service in government - they are corrupt!

I have spend more than a decade in the Philippines and have cost the United States Government NOTHING!  I also have paid on average $2500 a quarter Income Tax in the United States  for NOTHING!

I am now in bad health and not able to return to the United States. I am home-bound and need a caregiver. Thus far, I have been able to manage on my extra income from investments that will end shortly and my only income will be Social Security. What happens after the extra income ceases is a mystery to me.

What would it have cost the United States Government if I would have remained in the United States?  My medicine in a Third World country cost over $900 a month which I pay for.  What would that cost have been to the Social Security System in the United States $10,000 a month or more?  What about the cost of about two hospitalizations a year that run about $1000 each time.  The hospital expenses would be ten thousand plus yearly in the United States.  Again it cost the United States Government NOTHING.

Now I am in a situation since I am not married to a Philippine citizens I must leave the country every three years for twenty-four hours and then return. I am unable to meet those requirements.  I am in the process of trying to get some type of exception and praying it goes through or in two months I face a real problem.

You mean the United States Government could not establish some countries as places where Medicare or OBAMACARE could be used. In the Philippines there could be limited private hospitals and doctors allowed to except United States Government elderly insurance in Cebu, Manila and Davao. It would only take limited personnel in the Embassy to monitor these programs and prevent corruption.  The money saved the United States Government could probably be a billion dollars a year if done around the world.

I ADVISE ANYONE CONSIDERING BECOMING AN EXPAT TO THINK SERIOUSLY ABOUT WHAT WILL HAPPEN WHEN YOU CAN NO LONGER TAKE CARE OF YOURSELF IN A FOREIGN COUNTRY.  THE IMMIGRATION LAWS ARE CRITICAL AND YOU MUST CONSIDER THEM FOR ONE DAY YOU MAY NOT BE ABLE TO LEAVE AND RETURN TO SATISFY IMMIGRATION REQUIREMENTS.

I do not know why countries like the Philippines have actively not pursued these benefits for it would help their government and the United States Government and those that chose to be expat's.

Most American's consider expat's as some kind of traitor or deserve what they get for living abroad without thinking that most chose to live abroad because they can no longer maintain their lifestyle in the United States because of politicians and the laws they pass without considering the repercussions.

Quite frankly, I do not desire to receive handouts from food ministries because I cannot afford medical care, utilities, food, clothing, etc. in the United States. EXPAT'S DO THE UNITED STATES CITIZENS LIVING AT HOME A FAVOR - WE LEAVE MORE HANDOUTS FOR THEM THAT ARE NOT WILLING TO TAKE THE CHANCE ABROAD.

President Duterte says President Elect Trump is his friend.  If that is so why doesn't he approach President Elect Trump with this idea. I bet he would be speaking to the DEAF!

One thing President Duterte could do would be influence the Philippine politicians to change Immigration Laws immediately and not demand people to leave the country as long as they meet all other requirement for Immigration.  NOT EVEN THE UNITED STATES DOES THAT.  President Duterte talks abut fairness in Immigration Laws in the United States then why doesn't he make Philippine Immigration Laws fair to SENIOR CITIZEN EXPAT'S who can no longer travel and do not want to marry a Philippine citizens because they are already married or like me took vows of celibacy. Mr. President Duterte your predecessors and you plus your men and women in Congress and Senate have talked about attracting Medical Tourism and Senior Expats then why don't you do something to really attract them to the Philippines!

For those that believe this is a matter for my Church please keep in mind that I am RETIRED from my Church and do not want them dictating my life any longer nor do I want their handouts. I have always paid my way and have taken care of myself and I want to continue to do so until I die.

****I just learned from Immigration today (3/15/17) if you get dementia or alzheimer's and are not married to a Filipino you can be deported regardless of how much money you have in the bank even if you have a power of attorney designating someone to take care of you and have access to your funds.  You cannot qualify for one of the resident visa regardless of what size bond you put up if you are over 55 and do not have a health insurance policy that is valid in the Philippines and can pass a physical by a doctor they designate.  The doctor has to certify you are in good health and can take care of yourself if not married to a Filipino. I do not want to leave the Philippines, but if I knew what I know now it certainly would have influenced my decision to spend the remainder of my life in the Philippines.    

Climate change is more of a threat than terrorist - really!

Forty thousand delegates from 190 countries, 130 heads of state, were in Paris this week, not to debate the ISIS terror attack that killed 130 people. They were not there to honor the dead, although they did take time to do it. They were there to develop strategies that will defeat the biggest threat the world faces (according to Obama) climate change.

ISIS or Turkey’s shooting down a Russian jet, which puts both the Kremlin and NATO on the road to war are not as important as climate change according to Obama. If we have World War III or cannot contain the terrorist we will not need to worry about climate change. Oh, I know Obama says he has contained the terrorist – I guess he has them contained in Paris, the United States, Somalia, Pakistan, Iraq, Syria, Afghanistan, Palestinian, Columbia, Thailand, Philippines, Yemen, Russia, France, India or Thailand for all those countries have been attack by terrorist and continue to face terrorist attack as all countries in the world do. We should also note Obama’s own military advisor told Congress this week, “U.S. forces have not contained ISIS in Iraq and Syria. The terror threat is growing.

Fighting climate change seems more like a cult to me and President Obama is its Grand Wizard. He has replaced Democrat Al Gore. Obama and others in his administration have said 23 times over the years that climate change is a grave threat to the world.  In July 2008, Al Gore called climate change a more dangerous threat than terrorism. Al Gore said, “I think that the climate crisis is, by far, the most serious threat we have ever faced.”  I have to cut Gore slack that was in 2008, but Obama continues to say it in 2015.

Secretary of State John Kerry said this about the threat of climate change, “If our military vehicles are unable to move anywhere in the region here or elsewhere because they’re up to their axles in water and all the roads leading into and out of the base here are flooded, that affects military readiness.” If the terrorist continue on the path they are on we will not need to worry about flooding, but according to Kerry we have to solve the climate change problem before we address solving the terrorist problem.

I really do not know what part of the world Kerry is talking about when he speaks of flooding. I have visited eleven different countries in the last fifteen years all countries I had visited previously when I was younger and frankly I did not witness any changes in their weather. I certainly did not witness any great floods in the Middle East.

I think the craziest statement made about climate change in the past six months was made by Bernie Sanders an Independent running in the Democratic primary election – he believes climate change CAUSES terrorism! Dear old Bernie agrees with Obama that it is the greatest problem the United States and the world faces. Dear old Bernie even repeated his claim the day after the latest terrorist attack in Paris. I guess Bernie does not know that ISIS killed more in Paris on that day than Hitler’s troops did when they occupied Paris in 1940.

The world temperate has raised about 1 degree and to combat that 1 degree increase Obama has spent 90 billion dollars of tax payer’s money on green jobs and he spent 5 billion dollars on electric cars. The Federal Food Stamp program costs an estimated 75 billion per year that is 15 billion less than Obama has spent on companies that have gone bankrupt trying to encourage green job industries in the United States. That should tell you where Obama and the Democrats priorities really are. They are more interested in their cronies that want to open green job industries than the poor.

No one can deny that Obama knows how to waste tax payer’s money. He is the King of Waste. It is estimated 175 billion dollars a year could end world hunger. Obama has increased our welfare food stamp budget to 75 billion dollars a year and we still have people going hungry in the United States. Just one more failed Obama program.

Do you remember in 2008, Obama Said adding $4 trillion to the National Debt was "Irresponsible" and "Unpatriotic” - shame on you President Bush? Obama had a program to reduce the National Debt, but in 2012, four years, not eight, he had raised the National Debt by 5.4 trillion. In 2009 Obama presented a program that was supposed to, "Cut the Deficit in half by the End of [His] First Term in Office.” I don’t think that happen, but I could be mistaken. Just one more failed Obama program.  Obama presented a plan that would Prevent 7 to 9 million families from foreclosure. Currently 5.6 million residential mortgages are either 30 Days delinquent or in foreclosure. Now I have to admit they claim Obama did help save 2 million from foreclosure. OOPS! Another failed Obama program. I am not going to waste time talking about ObamaCare. That is obviously a failure – you cannot keep your doctor, insurance is not cheaper, you have to pay for service you do not need or want and if you choose to opt out you have to pay nearly $1000 a year in fines and penalties. Obama was going to reduce college cost, but the cost of college is currently at "an all-time high." Nationally, the cost of a full credit load at a state college has passed $8,000. Throw in room and board, and the average cost for a state college now runs more than $17,000 a year. His education programs have failed. President Obama had a program to solve the energy crisis once and for all. His failed plan was to invest in clean energies like solar, wind, and biodiesel. Obama had a plan to restore America's standing in the world. Bowing to the Saudi King did not work! His plan included once again leading the world not just militarily, but diplomatically and economically. Maybe I have missed something, but I do not think any of the three happen. Need I say more?

We can rest easy though because all these failures do not matter much because our only major problem according to Obama is climate change.

I am beginning to wonder if climate change is not being used by some  in powerful places to prevent them from having to address the terrorist problem. It's as if the terrorist problem may be part of their agenda to reach a goal.  What could possibly be their goal  could it be- too weaken the Christian faith, too keep the economy weak, to bring about confusion among the people, to distract the people from what is happening in government, to create an energy problem or too start a major war or is it all of these things or a combination of them.

I have noticed that when the American Stock Market takes a nose dive it is not the upper 1% that gets hurt. It is the middle class that have their pension funds invested in the market. The upper 1% buy depressed stock  and make a hefty profit when stocks go up again.

It just does not make sense to me that powerful nations like the United States, Russia, China, Japan, Germany, England and France cannot wipe out a bunch of thugs in Syria, Iraq, Iran, Africa and Afghanistan. 

 

 

Can the United States survive Obama?

I hope all the Republican candidates realize the importance of closing our borders to illegal aliens. You read my statement correctly ‘ILLEGAL’ aliens. If they are in our country without the proper documentation they have broken our immigration laws and they are ‘ILLEGAL’.

Donald Trump started the conversation on illegal aliens, closing our borders and building a wall. I hope others will pick up the conversation and if elected see his ideas to completion. It would be difficult for me to support Donald Trump regardless of the fact that he supports many of the things I do. I have a difficult time voting for a man or woman whom I do not respect.

I would think because of the events from last week in Paris, immigration and our open border with Mexico should become the No. 1 issue in America. All the presidential candidates if they are smart will adopt Trumps ideas. Trump is now in command of the most important issue facing America.

Trump in my opinion is mean, vicious, combative, offensive, and bombastic, he doesn’t care about political correctness and he doesn’t care whose feelings he hurts. As much as I dislike him I am beginning to think he is the only person for the job.

It may become necessary to have a Trump for four or eight years not only to clean up the terrorist problems, immigration problems and border problems, but to clean up the messes our lame President Obama has made with his Executive Orders and his ignoring the U.S. Constitution.

I don’t think Trump believes he can deport 12 to 15 million illegals, but I do think he is using that as a negotiating tool to get what he will be satisfied with. Trump is not a fool.

What would Trump settle for in my opinion – closing the borders, the wall, no welfare for aliens, and Mexico agreeing to pay the cost of our housing their criminals in our prisons or we will send them back to Mexico immediately.  

You still do not think building a wall and closing our borders will work then tell me why the first thing the Socialist president of France did after a terrorist attack was close the borders. Even a Socialist understood how important it was to control the borders in order to help protect his citizens.

I do not think Donald Trump would allow the Obama-Kerry plan to import tens of thousands of Syrian refugees into America to stand. It’s insane to allow thousands of potential terrorists into America. It’s self-destructive. Everyone should know it is a lame idea if Obama and Kerry proposed it. Everything else they have done or proposed like the Iran agreement, withdrawing the troops, downsizing the military has proven to be lame. If taking in the refugees is such a great idea then Obama should tell us how many of them will be living with him and his family in the White House.

I have one more question for our lame President Obama - if we can afford to take in thousands of refugees, house them, clothe them, feed them and provide medical care for them why do we not have the money to take care of our OWN poor and homeless - why do we have homeless VETERANS?

It is the Muslim nation’s responsibility to take care of the refuges. I do think we should offer help to provide a safe haven for them in Muslim nations.

The day before the attacks in Paris, our lame President told ABC’s George Stephanopoulos that the Islamic State had been “contained”. Barack Obama has been thinking about his legacy from the beginning of his presidency. Obama’s aim to end “Bush’s wars” is in shambles. I think his legacy now is he contributed to the threats from the Islamic State. I think Obama’s legacy will be that he was the worst President since Jimmy Carter.

Obama is a speech maker, but he is not a decision maker. His lack of commitment has set the United States back a decade. Do you remember the “red line threat” he gave Syrian President Bashar Assad.

Obama’s position on Iran is dangerous for the United States. It has nothing to do with America’s security and everything to do with him desperately trying to build a legacy around it. The Nobel Peace Prize went to his head. He thought by being passive on terrorist his legacy would be that of a peace maker – he failed! He thinks his passive (cowardice) attempt to negotiate with Iran regardless of the cost will be the key to a legacy of peace maker – he will fail again.

Let us not forget how lowly Iran regarded Carter’s pathetic groveling, they only released the hostages minutes after Ronald Reagan was sworn-in as president- a man who the Iranians knew would put a stop to the whole embarrassing episode.

Obamacare continues to fail and the worst is yet to come after Obama has vacated the office - his signature domestic achievement that bears his name is likely to be repealed or be shown to be a disastrous piece of legislation. He thought that would add to his legacy – he failed again.

With his foreign policy in shambles and Iraq being conquered by Islamic fanatics, and his economic agenda having damaged the U.S. significantly and Obama’s dealings with Iran guaranteed to fail his only hope may be Cuba for a legacy.

Obama makes Jimmy Carter look like George Patton. Until Obama is out of office we should hang a sign in all U.S. airports “Terrorist Welcome!”

 

 

Do politicians really care about the sick and elderly?

Why does U.S. law require perfectly good medicine that could be given to the poor and elderly be destroyed?

In the eighties and early nineties a group of us violated the law and risk being arrested picking up the medication of people who died of A.I.D.S. and passing it on to those living with A.I.D.S. who could not afford medication. We would have someone stay at the home when we knew the patient was about to die and secure the medicine before public health care workers arrived.

Public health care workers, nursing homes and hospices must destroy medicines of deceased patients according to U.S. law. Nursing homes, public health care workers, and hospices must also destroy unused medicine when doctors prescribe a new medication or stop a medication. Some medications can be sent back to the pharmacy if the facility has an in-house pharmacy, but most medicines (hundreds of pounds daily) are destroyed.

In my opinion this profits no one but the pharmaceutical companies. The government claim they are protecting Americans from outdated medication or possible errors in distribution. Ask someone who cannot afford to purchase their medications because of insurance co-pays or do not have insurance if they would prefer the medicine to be destroyed or distributed by charitable organizations or selected pharmacy’s for free or a low cost. In a free society why don’t the people in need of these medications have a choice?  

There are people who have to choose each month whether they will buy medications or buy groceries. It is estimated 50 million people in the U.S. fail to fill needed prescriptions each year because of the cost.

Some with cardiovascular disease have said they take less medicine than prescribed due to cost and fifty percent of them were more likely to experience angina, strokes or non-fatal heart attacks. For many others, cutting back on medicine led to faster health declines, increased hospitalizations and premature death.

Even Medicare Part D medication is destroyed. Why can’t the government devise a program where the medication is returned to a government pharmacy (Veteran Administration) and be utilized. This would save millions of Medicare Part D funds yearly. Is this because the pharmaceutical companies do not want such programs developed?

Injectable drugs in syringes packed in tamper proof packaging are destroyed. I do not understand why medication in tamper proof packaging must be destroyed. It seems to me to be a total waste. The government claims they do not want these drugs to fall into the hands of the wrong people who may abuse them.

The D.E.A. destroyed 6400 pounds of medication picked up in one week in nursing homes and long care centers in two counties in the state of New York. Nationwide they collected and destroyed 742,497 pounds last year. This does not include medication facilities that were allowed to destroy unused medications in-house. I cannot even make an intelligent guess of what 742,497 pounds of prescription drugs would cost retail, but I am sure it would be in the billions of dollars.

There is a nonprofit organization called Sirum, which was founded by three young Stanford graduates who use the internet to try and match patient and medicine.  Their goal is to save lives by saving unused medications. They are using technology to bridge this gap between surplus and need. The medications are sent to selected clinics to be distributed. They charge 25% of the retail cost for the drugs they recycle.

Forty states have enacted laws authorizing the reuse of medication. The State of Iowa recycled $52 million in unused drugs to the poor last year. These programs are small and are State authorized and not authorized by the Federal government.  Change is coming, but it is slow because people fear recourse from the Federal government.  Few in the medical industry know about these small recycle programs and only about 25 medications are allowed to be recycled.

Previously sold, but unused medication, brought back to special pharmacies for resale or donation could provide a low-cost source for patent protected medicines. Pharmacies in Mexico and Canada are doing brisk business from Americans crossing the borders to buy medicine. Internet pharmacies are also doing a brisk business in the United States selling both reimported American made medications and low-cost foreign-made products. Which do you think is safer foreign made medications without government regulations or recycled American medications with government regulations that are perfectly good? 

Other countries have opted for pharmaceutical price controls and/or curtailing patent protection, but such actions run counter to American free-market ideology and political realities. Plus lobbyist are too strong in the United States to ever allow this to happen. 

Leftover drugs prescribed for American patients with HIV are now being recycled for use overseas. 'Aid for AIDS in Manhattan' — a nonprofit group with branches in Italy, Spain and Switzerland collects drugs after US patients with HIV switch prescriptions, stop medications, or die. The group passes these very expensive retroviral medicines along to more than 500 people with HIV throughout Africa, the Caribbean, and Latin America. American law makes it illegal to redistribute these medications to the poor in the United States, but says nothing about exporting them. If these drugs are not safe for Americans to take then why is our government allowing people in Third World Countries to take them?

Nursing homes and other healthcare facilities are not the only possible sources of recyclable medicines. A more important source may be medication in consumers' homes that is unused. As I said earlier we collected thousands of dollars of medications in homes. 

“Expired medication” also represents a potentially large source of supply of medicine for a recycling program. As things stand now, expiration dates get a lot of emphasis. For instance, there is a campaign, cosponsored by some drug retailers, that urges people to discard tablets or capsules when they reach the date on the label. It turns out that the date on the label is often much earlier than the official expiration date. Pharmaceutical companies admit most drugs would be okay to use 18 to 24 months after the expiration date.  Very expensive medications are being dumped, being wasted.

Obviously, much discussion and planning is needed before medicine recycling could become a reality on a large scale for example new laws, regulations about what might be recycled, individual pill packaging for the selected items, rules about who might be eligible to return medication, who might be able to purchase it, rules for exchanging the old pills for a new prescription and how to pay for the infrastructure support.

It might be wise to concentrate at first on recycling from nursing homes and other facilities where there is an unbroken chain of accountability for the medicine. Such medication has never been out of the hands of accountable healthcare workers, and there is a clear trail of when it was purchased for whom and why it was not used. Recycled medicine would have to be individually packaged or still in its sealed original container.

Federal law could be changed. Individual tablet and capsule tamper-resistant packaging, including bar code identification of manufacturer, date of manufacture, expiration date, medication name, and dosage would bring us close to the possibility of recycling appropriately chosen medications. Such a system, combined with appropriate safeguards to assure product authenticity, is worth discussing.

We will never know if any plan for medicine recycling can be safely done unless we begin the discussion. This means we would have to overcome the greed of pharmaceutical corporations and retailers of medication.