Fear and loathing of U.S. health care

Rapidly closing in on the Tijuana border, having plowed over the
200-mile stretch of sacred Indian burial ground called Highway 5
from Los Angeles, the knuckles of the passengers whitened with fear
and trembling. They neared the point of no return in their highly
anticipated but grotesque treasure hunt ““ discount
prescription drugs.

My attorney advised that I take a benzodiazepam on the spot for
reasons of patriotic fortitude. The mission could not be
compromised by outbursts of latent teenage hooliganism.

One false move, and instead of a passport to the pharmaceutical
paradise of affordable prices, we would all get a one-way ticket to
the Spanish Inquisition awaiting us inside the fascist dungeons of
the unpopular Mexican prison system.

Somewhere along the mean streets of Revolution Avenue in TJ we
had to find the farmacia where thousands of American retirees and
health care-deprived ““ who make up 45 million of the U.S.
population today ““ forked out $200 million last year for
discounted life-sustaining meds.

Officer Raymond A. Conner of the Los Angeles Field Division of
the Department of Drug Enforcement gave me an authoritative warning
before leaving. “You’re taking a lot of risks when you
go down there.”

It’s a risk a UCLA student, who identified himself as
Jonathan Foxx, felt forced to take. Having been red-taped out of
his inept HMO, and with his UCLA SHIP health care plan yet to kick
in, he was stuck between the Promethean rock of managing severe
chronic pain and the hard place of international trade barriers
preventing access to the affordable medicine he needs to manage
it.

“It’s extremely serious because I require a lot of
medication just to function as a normal human being ““ and
that’s the catch-22 that lies at the heart of the Bush
administration’s philosophy. You have to work to get health
care, but you need health care in order to work,” Foxx said.
“It’ll be “˜good luck’ for me when I
graduate college.”

Under Bush, prescription prices have skyrocketed to colossal
heights, outpacing inflation three times over and pushed beyond the
reach of millions of families by the bottomless greed of investors.
The prices are literally crippling people.

John Kerry said it perfectly during the election: “For the
last four years, one man has stood between America and lower-cost
prescription drugs ““ George Bush.”

And perhaps there’s more than a coincidence between the
fact that “drug prices are the most rapidly increasing cost
of health care today,” according to UCLA Pharmacy Manager
Steven Kozel, and the fact that “half of all U.S.
bankruptcies are caused by soaring medical bills,” according
to a health study published by Reuters this month.

Demonstrated by the fact that the Foxx family’s drug mule
was an American luxury sedan, not a used Festiva, we’re not
just talking about poor people here. “Most people sent into
debt by illness are middle-class workers with health
insurance,” according to the Reuters article. This is one of
the main issues devastating our shrinking middle class.

Along with Valesques Leonardo, our Chicano interpreter at the
wheel, who preferred the name Comandante Aguascaliente, in the car
sat Mrs. Foxx, Jonathan’s mother ““ a former top-flight
manager of a giant HMO she declined to finger.

Appalled by the gross negligence of the family’s HMO,
which she knows first-hand is rooted in the naked greed of
“money-crunchers” ruling the health care industry, Mrs.
Foxx felt compelled to come.

“I’m in the fight,” she said with a militant
defiance rare even among my peers ““ let alone hers.

Mrs. Foxx is currently partaking in the preproduction of Michael
Moore’s upcoming project on our national health care
system.

“It’s a moral issue,” Mrs. Foxx said.
“And this situation forces me to be a little immoral. I
don’t consider it breaking the law. It’s immoral in the
sense that I’m participating in the hypocrisy. I’m
going across the border to get things I think should be affordable
in our country from our health plans without the grief and distress
of going outside the system.”

Outside the system, at the end of San Ysidro Boulevard, we
parked and geared up for the crossover on foot ““ a carton of
cigarettes and a bottle of Stolichnaya from the duty-free shop,
plus a backpack full of prescription bottles.

A fat yet sympathetic taxi driver, “Sami” Rodrigo,
jumped out of a fleet of semi-battered yellow cabs jockeying for
American tourist dollars beyond the border’s rusty metal
turnstiles. “You want women, you want booze, you want a bar?
I’ll take you for cheap,” he said.

“Farmacia,” Jonathan replied.

“No problema,” Sami said, revving the Chevy through
the bumpy chaotic streets of Zona Centro with the adept madness of
a seasoned New York cabby.

As Jonathan and Aguascaliente haggled in Spanglish with the
“generalisimo surgiente” inside the doctor’s
office, two sharp-heeled pharmaceutical company representatives
entered the waiting room where I sat beside Mrs. Foxx.

They carried large black leather satchels, embossed with a
“Pfizer” label, containing the dark secrets of their
trade.

Fearing for their jobs, they disclosed under condition of
anonymity that inside the bags are the free samples they’re
paid to give doctors to prescribe to their patients. They get a
commission off every prescription for that drug filled in the
market zone of the doctor they lobbied.

Like in the States, doctors are generally understaffed and
overworked and don’t actually have time to check the health
benefits or cheaper alternatives for the drug. Due to HMO
cost-cutting, drug lobbyists prey on the ignorance of doctors, who
are unwittingly prescribing useless or overpriced drugs.

For this reason, with our government’s unwillingness to
cap prices, the prescription-drug industry in Mexico is exploding.
The drug reps said that in the last three years alone the number of
pharmacies in TJ has risen 20 percent, to an astounding 5,000.

TJ is fast becoming America’s most popular medicine
cabinet.

Outside, I asked Sami, an 11-year taxi cab vet, who doubtless
was also getting some kind of commission for taking us to that
particular doctor, how often he’s middlemanned for
medicine-hungry Americans.

“A lot,” he said. “Like 10 to 20
(people).”

“A week?” I asked.

“A day.” Poor Mexico ““ so far from God and so
close to the United States.

After many shouts of “Dios mio” and “ay
caramba,” the doctor finally became convinced of
Jonathan’s clinical-level illness and wrote up three scripts
for “controlado” medications.

This should have been the end of the story, but it wasn’t.
Of the thousands of pharmacies populating TJ’s streetscape,
very few were willing to fill the prescriptions, despite their
legitimacy. I would have been suspicious of us too ““ we were
an odd sight indeed.

Nightfall had descended, we were running out of time and
Jonathan’s back was beginning to act up. Going through
legitimate channels had led to a dead end. It was time to go
extralegal.

Aguascaliente called up a taxi driver he met earlier, one of
many running the middleman racket, and who claimed to have a
back-door hookup with a farmacia ““ no prescription necessary.
The myth is true.

“El Bombero” arrived in five minutes and swooped us
up in another yellow Chevy, checked the prescription, made a cell
phone call, asked if we were interested in buying
“pistolas” and rumbled down Revolution Avenue to a
shady alley parking lot off Emilio Zapata Street.

“This feels like a set-up,” Jonathan said, pouring
with sweat. But El Bombero returned with three boxes of unpacked
drugs still in vacuum-sealed plastic. Jonathan paid in pesos, and
our street pharmacists roared the Chevy back onto Revolution
Avenue, saying, “Make it quickly, it’s dangerous. The
policia.”

Following El Bombero’s advice, we started frantically
popping the pills out of the packaging and putting them into the
medicine bottles in case of a police search.

“I feel like a goddamn pusher,” Mrs. Foxx said,
using my notebook as a table to snap the pills flying everywhere in
the back seat of the cab that just then bounced past the flashing
sirens of two police cars parked on the buzzing Mexican
boulevard.

At the customs checkpoint, we saw the officers conducting bag
searches, and we made a quick and highly suspicious retreat to the
nearest bar.

Inside the smoky gambling joint I frantically scanned my brain
for the Daily Bruin attorney’s phone number while telling
Jonathan, even more sweaty now, to relax.

“Let’s get a grip, people,” Jonathan said,
pulling himself off the ground after drunkenly crashing on his butt
trying to sit down. “We have prescriptions, for
Christ’s sake.”

The sweaty bastard was right. They never even checked the bags.
Back in the car on the way home, Mrs. Foxx was happy for the
discounts totaling over $200, but was still disturbed about a
health care system necessitating such a trip.

“The only way to beat the health care system is to have a
lot money. If you’re uninsured, broke and in pain a lot, God
knows what you will do,” Mrs. Foxx said, looking at Jonathan.
“Maybe you’ll be like Hunter S. Thompson and blow your
brains out.”

R.I.P., HST.

Lukacs is a third-year history student. E-mail him at
olukacs@media.ucla.edu. Send general comments to
viewpoint@media.ucla.edu.

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