The Catastrophe; Jude Law; Saving Big on Dental Care; NTMD September 1, 2005January 17, 2017 THE CATASTROPHE Life is short. We are all in this together. I haven’t written anything, because it’s so numbing. I don’t know what to say. Like so many of you, I have clicked here for the Red Cross. (Also, for those with spare living quarters, this group asks that you ‘Please consider providing any vacant property – homes, preferably – for the use of some needy family. We will work with all necessary agencies to speed things along.’) It’s easy to write about this before the fact – here, from this space, in part, four years ago: It seems, there are a few places you really don’t want to live if a hurricane is headed your way. You think you’re OK living in Manhattan? Read on. But let’s start with New Orleans, the worst of them. New Orleans sits 13 feet below sea level, with a huge levee around it, so that the city is like a dry soup bowl. Dry, that is, until a serious hurricane, driving massive volumes of storm surge over the levee, hits dead on and fills it up. Even after the storm, there’d be the small problem of draining the bowl so those who survived could come down off their roofs and out of the trees. Imagine a night or two spent in complete darkness on top of your roof, with nothing but snakes and insects to keep you company. The city’s massive pumps, if they could all be made to operate, could drain the bowl – more than 13 feet deep, because of course the lip of the bowl, the levee, is purposely built higher than sea level – at the rate of about half an inch an hour. So it would take a mere three weeks or so, in optimal conditions, to get rid of the water . . . beginning, I suppose, only after you dynamited the levee, so that the extra water, now trapped inside the levee, could rush back out to a once-again tranquil sea. And what if everything isn’t working optimally? We are talking about a pretty massive catastrophe. Let’s hope it’s 50 hurricane seasons, rather than this next one, before – as is bound to happen sooner or later – it hits. And now it has. What to write now? Here‘s a piece from The Progress Report that begins: In 2001, the Federal Emergency Management Agency ranked a major hurricane strike on New Orleans as “among the three likeliest, most catastrophic disasters facing this country,” directly behind a terrorist strike on New York City. So what was done after that assessment? Here‘s a piece in Editor & Publisher that details the drastic cuts in New Orleans hurricane protection projects that were made to make room for tax cuts for the rich and the war in Iraq. It was, as so much of government is, a matter of priorities. TEETH Alan Light: ‘I asked my favorite dentist (who is in fact a very smart University professor prosthodontist) over breakfast this morning if he could come up with some answers for you. He rattled off a few thoughts. He recommended a book, DEAD ON ARRIVAL: The Politics Of Health Care in Twentieth-Century America, by Colin Gordon that covers your questions in detail. ‘In response to ‘how is it that teeth somehow got excluded from the body? Health insurance covers organs, limbs, skin – but NOT teeth’ he said it is partly because there is a lingering perception that people can live without their teeth. They may not enjoy a good quality of life, but they can live without them. He said there was a politically driven compromise re: Medicare in 1964/65 which excluded dentistry. Dentists politicked very strongly at the time to be excluded because they did not want cut rates to be dictated to them. They wanted the free market, not some government bureaucrat, to be in control. The doctors, the AMA, also fought national health insurance but eventually compromised. Dentists didn’t. He said if you talk to physicians today many will say the dentists did it right. ‘There is also a basic difference between medical and dental insurance in that with medical insurance, there is the risk of enormous bills to insure against – though you might never have them. Dental insurance, by contrast, is basically pre-paid dentistry, as most people use some part of it. It’s not really ‘insurance,’ it’s pre-paid care. ‘As for why the British have such bad teeth in spite of having universal health care, there are several possible reasons. Historically, there has been a big cultural difference in sugar consumption. Also, the British have traditionally accepted the idea that at some point everyone loses his teeth. ‘The government in the UK, because of the ballooning cost of national health insurance, had to put in very strict quotas in terms of time dentists are allowed to do a particular procedure, and the remuneration is about 10% of what fee-for-service would pay a dentist. So NHS people get a rush job because what with the cost of running an office, overhead, staff, etc., dentists LOSE money on every one of those they see. Dentists would make more money if they didn’t see them. Today, dentists can elect out of the NHS system if they want, so that is just what more and more are doing, which means that those dentists that are left are even more stressed and overworked. More and more dentists are refusing to accept NHS. It’s the same way here with dentists re Medicaid. It’s a real problem to find dentists willing to accept Medicaid. In some states, Medicaid will pay SOME part of dental coverage, especially for kids, but it’s a problem to find dentists who accept these patients.’ Jesse Duvall: ‘In Scotland, I had incompetent emergency dental work for an abcessed tooth. The office waiting room was comfy with dark leather chairs and a fire going in the fireplace. There were several patients; one had his faithful black Lab at his side. If dental care were free for everyone there, they would still have awful teeth because the dentists are awful. They went to British dental schools. This young dentist did not kill the nerve as he was to do, he drilled right out the side of the tooth. It still hurt because the nerve was not killed. I had to fly back to US to get it fixed. Dental care is third world and medical care is not much better. And the indifferent attitude adds to the situation.’ Jack: ‘Jude Law is British.’ ☞ Well, there’s that. SAVE MONEY ON YOUR TEETH – AND MORE Joshua Goodman: ‘After not having a full-time job for a number of years but needing dental insurance, I recently discovered the GE Wellness Plan (which also has a similar type of health coverage). For just over $100, I am able to use any dentist within the plan – and I found many. The dentist is limited to charging pursuant to a fixed fee. For example, a regular cleaning is $48 and x-rays are free. Considering that in NYC, I was paying $250 for a cleaning and checkup, this is a tremendous savings. Plus, there is no waiting period, unlike more traditional dental plans. You can use it right away. I immediately saved $2500.’ ☞ Thanks, Joshua! Information on dental plans can be found at here and on the GE Wellness Plan here. It also provides savings on prescription drugs, eyeglasses, and more. It’s not an insurance plan, so there are no forms to fill out – it’s basically a discount card. NTMD Prescriptions for BiDil are jumping sharply, as one had to assume they would (the company has 200 sales reps out pitching it, after all). As of a couple of days ago, the 7-day rolling average of prescriptions was reported at 76, up from 30 the day before, which if my math is right would suggest 172 prescriptions in the most recent of the 7 days. And that leaves two questions. What proportion of them will be filled at full price versus the generic (bulls on the stock say: most or all of them) and of those, how many will there ultimately be? Ten thousand patients at $1,800 a year ($18 million in sales)? Fifty thousand ($90 million)? Three hundred fifty thousand ($630 million)? If you bought puts with money you could truly afford to lose, sit tight. My very smart friend guesses that the numbers will be nowhere high enough to cover the budgeted $115 million in expenses, let alone justify the current $580 million market cap. But you never know.