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I started watching The Americans in 2012 because I like Keri Russell. Besides the great acting, she always made my curly hair feel accepted.

I had forgotten what a great song Tusk was. Fleetwood Mac was played all through my terrible high school physics homework, pretty routinely. Turns out, physics isn’t my thing.?

Spy dramas aren’t my thing, either.?

I didn’t continue watching the believable, solid Americans TV show. Tusk was played while in my new job downtown, almost as much as Pink Floyd and Bon Iver Jagjaguwar.?

I wanted to get to the heart of the matter between haves and have-nots in healthcare. Experience with the have-nots was already plentiful, including managing a program where medicine access was a crucial complaint. So downtown in 2012, with my Youtube on, I quietly observed and asked questions beyond daily tasks. More attention was paid to how the haves systems worked. Me and my Tusk.?

If you’ve followed me or know me for more than a few minutes, you know I dislike elephants in rooms. Actually, they are detested. Getting to the heart of the matter and directly addressing it without delay is valued most.

I’m not sure what the opposite of an elephant in the room is. The opposite does not require getting to the heart of the matter right away. I suppose the opposite?would just be everyone talking to, and at, the elephant.?

This may be almost as inefficient as ignoring the issue. The song Tusk fits so, so well.

Medication cost and access is the opposite. The United States has done a really good job avoiding placing medication costs as the elephant in the public room. However, sometimes it feels as if everyone’s talking to and at the issue.?

It’d be helpful to get to the heart of the pharmaceutical costs and access here, and around the globe. It’d be helpful if the conversations were in sequence, in response, clear and heard.?

So, I’m going to sit alongside the tusk everyone’s talking to and about. I am a patient person. Here are some things I’m going to listen for:

CMS and DHHS responses to studies that demonstrate significant government and patient out-of-pocket savings associated with pharmacy discount programs such as Mark Cuban Cost Plus Drug Company (MCCPDC)?
Incorporation of pharmacy discount programs into PhRMA policy agenda; to date, MCCPDC is not mentioned at PhRMA
Data on patient medication adherence when patients use pharmacy savings interventions such as MCCPDC?
Data on patient health outcomes associated with pharmacy discount programs and savings interventions
International comparison of pharmaceutical pricing transparency, health outcome data alongside medication cost data, and access comparisons across countries
Manufacturer analysis, including projected and actual impacts on research and development, associated with pharmacy programs like MCCPDC. It is important to acknowledge if major cost savings for CMS will not translate to less money for a manufacturer developing Parkinson's treatments, for example. It’s also key to acknowledge any impact on generic manufacturing, so we know ahead of time if a manufacturer may stop making certain generics.
DHHS and CMS plans on where the saved dollars can go
International plans and metrics around fake pharmaceuticals. Our world keeps getting better with illegal trade issues, including ivory. We can keep getting better with the dangers of fake pharmaceuticals as well.?

The issue isn’t exclusive to The Americans, and we needn’t pretend otherwise.?

As I observe and listen, I absolutely want to know the opinions of financial philanthropists. They are the ones likely asked by strangers to help pay medical bills and healthcare, over and over again. To accuse a wealthy person of not understanding the experience of poverty, and then ignore their experiences around sheer volume of financial assistance requests, would be hypocritical. For the empathetic philanthropist, it would be tiring and disheartening to realize just how many people can’t afford healthcare. The constant asks would get one’s wheels spinning. So I definitely want to hear what’s been going on in their mind, what ideas they have.??

It’s not like they are brainless.?

Neither am I.?

Let’s get to the heart of the matter by directly addressing it.

Oh yeah, and just to get to the heart of the spy matter: it would annoy the living daylights out of me if foreign spies sift through my stuff, yet don’t prioritize healthcare access and healthcare improvement in their own countries. If it’s important enough to spy on, it should be important enough to properly mimic. United, or nothing.