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Medical Forum / Diseases and Disorders / Prostate Cancer / February 2005

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Medicare and Viagra

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Leonard Evens - 02 Feb 2005 18:11 GMT
Medicare has decided to allow payments for Viagra as part of the
Medicare drug benefit program, but some conservative Congressmen have
objected.  According to today's NY Times, Congressman Steve King of Iowa
doesn't think it should be covered.  According to Cong. King, sex only
has two purposes: reproduction and recreation.  He doesn't think
Medicare should pay for "recreational sex".

I find this a rather strange attitude.  Human being engage in sex for
essentially the same reason they eat and sleep.  We have a hunger or
desire to do these things periodically.  We don't say to ourselves "I
need to eat so I will feed myself", we just get hungry.  The same is
true of sex.  Of course you can say that nature built these desires into
us so that we would accomplish certain goals, but from the point of view
of the individual the purpose of the activity is to satisfy a normal
desire.   These desires: for food, sleep, or sex, can be suppressed for
some periods of time and some people do better at that than others.  But
most normal people, including old male geezers, like the prostate cancer
survivors here, and their not so young spouses, find that sex is a
normal part of a healthy life.

Also, Congressman King's reasoning, if carried to extremes would lead to
not paying for any medical care for old people.  After all, we can no
longer reproduce so we don't serve any biological function, and can be
dispensed with.  Of course, in Congressman King's universe, it is
probably all right to do these things if you can pay for it yourself.
So the upshot is that he is happy if more affluent prostate cancer
patients, like Rudolph Giuliani, use drugs like Viagra, but the poorer
ones should just get by as best they can.

I wonder if Cong. King and his colleagues would change their tune if
they had prostate cancer.
John K. Herreshoff - 02 Feb 2005 20:24 GMT
> Medicare has decided to allow payments for Viagra as part of the
> Medicare drug benefit program, but some conservative Congressmen have
[quoted text clipped - 27 lines]
> I wonder if Cong. King and his colleagues would change their tune if
> they had prostate cancer.

Do you thing he really cares about Viagra?  I'll bet he's just thinking
about the voters and the next election.  Maybe he'll be stricken with some
form of impotence some day, and he'll see the error of his ways.

John.
Steve Kramer - 02 Feb 2005 23:25 GMT
I suspect its a matter of whether the glass is half full or if it is a
bottomless pit.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3bN0M0
Seminal Vesicle involvement, Neg margins
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron (1 mo) 07/21/2003 @ 48
PSA  .07 .05 .06
Lupron (4 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50)
non Illegitimi carborundum

> Medicare has decided to allow payments for Viagra as part of the
> Medicare drug benefit program, but some conservative Congressmen have
[quoted text clipped - 27 lines]
> I wonder if Cong. King and his colleagues would change their tune if
> they had prostate cancer.
c palmer - 03 Feb 2005 01:35 GMT
they could do like tim conway.  after his pca surgery, he said the only
way he could get an erection would be to tie him by his feet and hang
him upside down from a flag pole.

i wonder if you were retired and wanting a script for viagra, would this
would constitute a second opinion?

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc
Beverley - 03 Feb 2005 04:38 GMT
The United States Veterans are only allowed to indulge 2 twice a month.
Which bring up the question - what is considered a normal healthy sex life?
Is it once or twice a month, or once or twice a week or twice a day? And who
has the right to dictate what happens behind closed doors?

We stopped reproducing when I was 23. Does that mean we should have given up
our sexual life too? I don't think so!!!
Bev

> Medicare has decided to allow payments for Viagra as part of the
> Medicare drug benefit program, but some conservative Congressmen have
[quoted text clipped - 27 lines]
> I wonder if Cong. King and his colleagues would change their tune if
> they had prostate cancer.
jhhtexas@ieee.org - 03 Feb 2005 04:41 GMT
I have not been able to get my Medicare Plan B to pay for any drug
benefits, much less Viagra!  My Blue Cross supplement doesn't cover it
either. How do I file?
Leonard Evens - 03 Feb 2005 15:38 GMT
> I have not been able to get my Medicare Plan B to pay for any drug
> benefits, much less Viagra!  My Blue Cross supplement doesn't cover it
> either. How do I file?

It isn't available yet through Medicare.  The Medicare drug benefit plan
is supposed to go into effect next year, I believe, and you will
probably have to sign up for it this year.  Some of the available plans
may cover Viagra and some may not.  I'm not sure whether Medicare
required all of them to do it or just allowed them to do it.  If Cong.
King has his way, none of them will.

These plans will be very confusing, and it is not clear that all people
under Mediare will actually get more out of them than they put in
through premiums, which will be substantial.  One problem is that if
total payments for your drugs exceeds about $3500, then you are
responsible for the rest until some higher sum---I think it is $5000,
but I'm not sure---is reached.  Then catastrophic coverage comes into
effect and pays most of the cost beyond that.   Another gotcha is that
you have to sign up early to be covered later when you may need the
coverage more.  If you wait, the premiums go up rather steeply.  Also,
he private drug plans can drop medications at any time without warning.

Another feature of the bill is that you may get better drug coverage if
you sign up for coverage for all your medical needs through an HMO.  My
experience with a medicare HMO (Humana) would not encourge me to join
such a plan.  For people who stay with traditional Medicare, the drug
coverage won't be as good.

If you have supplementary retiree drug coverage through your employer,
then you may be able to continue with that, and your employer will even
receive payments from the government as an inducement for not dropping
drug coverage.   Only it turns out that in some cases, they will get the
money but not provide coverage equal to what you could get outside their
plan.

This is all going to be very confusing, so you should study it very
carefully before deciding what to do.  And you may find you get the
short end of the stick in any event.
Leonard Evens - 03 Feb 2005 15:25 GMT
> The United States Veterans are only allowed to indulge 2 twice a month.

You can work around that by getting 100 mg pills and cutting them in
half, provided the lower dose works.
> Which bring up the question - what is considered a normal healthy sex life?
> Is it once or twice a month, or once or twice a week or twice a day? And who
> has the right to dictate what happens behind closed doors?

I suspect that the VA is not thinking about such matters, only about how
much it will cost them.  This is obviously a thorny problem.  I think
most medical professionals would agree that a healthy sex life may be
important to maintain overall well being even for people in their 70s or
beyond.  But it would be hard to define what is adequate for this
purpose.  It would clearly vary from person to person.

> We stopped reproducing when I was 23. Does that mean we should have given up
> our sexual life too? I don't think so!!!

I certainly agree with you about that.  I don't think the critics of
such spending would say that; they just don't want medical insurance
schems like Medicare to pay for it.  That means they think that rich
people should have all the sex they want, but poor people are out of luck.

> Bev
Stephen Jordan - 04 Feb 2005 01:21 GMT
On February 3, Leonard Evens wrote,in pertinent part:

> ...........................................  I don't think the critics of
> such spending (Medicare drug coverage of ED medications -- SCJ) would say that;
> they just don't want medical insurance schems (sic) like (sic) Medicare to pay
> for it.  That means they think that rich  people should have all the sex they
> want, but poor people are out of luck.

Hmmm, a bit of political spin, perhaps?

I must admire Len's ability to read the minds of those who oppose that
which
he advocates.

How about reading the minds of those who insist that Lupron and Zoladex
(e.g.) 4-month injections be done on a calendar-month schedule instead
of a (for example) 16-week (112-day) schedule as is called for in the
package inserts? It has to do with saving a couple hundred bucks per
patient per year and to hell with proper medical protocol.

IOW, let's not concern ourselves with sexual slap & tickle but with real
life-affecting matters.

Regards,

Steve J
__
"Men occasionally stumble on the truth, but most of them pick themselves
up and hurry off as if nothing had happened."
-- Sir Winston L. S. Churchill
Danny McCarty - 04 Feb 2005 03:53 GMT
>Subject: Medicare and Viagra
>From: Leonard Evens len@math.northwestern.edu
>Date: 2/2/2005 12:11 PM Central Standard Time
>Message-id: <ptadncECx4hZipzfRVn-2w@comcast.com>

I have been impotent since surgery, 4 years ago, and it doesn't bother me a
bit. If you don't eat, you die.  If you don't sleep you become incompent and
even crazy.  No such result for no sex.  It is pure recreational.

>Medicare has decided to allow payments for Viagra as part of the
>Medicare drug benefit program, but some conservative Congressmen have
[quoted text clipped - 27 lines]
>I wonder if Cong. King and his colleagues would change their tune if
>they had prostate cancer.
Beverley - 04 Feb 2005 06:39 GMT
Our local news has the Viagra listed on their web site as a "recreational"
drug. I didn't like their choice of words as "recreational drugs" imply
something else.

But we are right back to who gets it? The man with a spouse or the man who
wants a hot date? It's so silly. And what about the doctors what want to Rx
it daily after RP's to help get things working again? I think it is a
floodgate and they are afraid to open the gate for fear of what else might
be looming on the horizon.

Thank goodness we are not still in our twenties. LOL Fortunately as we age
our desire drops and the emphasis for most of us is on quality time rather
than animalist pleasure. I have no desire to procreate even if I could. What
I still crave is that wonderful, all encompassing, closeness to the man I
love. (Fortunately he still feels the same way.) As the cartoon character,
Maxine, says "You can have a healthy sex life well into your later
years.Assuming you can stand the sight of people your age naked." LOL
Bev

> >Subject: Medicare and Viagra
> >From: Leonard Evens len@math.northwestern.edu
[quoted text clipped - 36 lines]
> >I wonder if Cong. King and his colleagues would change their tune if
> >they had prostate cancer.
Leonard Evens - 04 Feb 2005 16:39 GMT
> Our local news has the Viagra listed on their web site as a "recreational"
> drug. I didn't like their choice of words as "recreational drugs" imply
[quoted text clipped - 14 lines]
> years.Assuming you can stand the sight of people your age naked." LOL
> Bev

One thing Viagra opponents forget is that usually a couple is involved.
 While it is possible for a couple to have a satisfying sexual
experience without drugs like Viagra, the drug does provide one
important option.  And it is as important for the man's spouse as it iis
for him.

Like any other drug, Viagra and similar drugs can be misued, but they
can be important for maintaining quality of life for older couples.
Quality of life also enters into other medical decisions.   For example,
Medicare happily paid for my cataract surgery.  But since I'm retired,
one could argue that I didn't need it.  After all, why should Medicare
pay for such recreational activities like reading and watching TV.  None
of those are related to procreation, so clearly they are recreational.
Similarly, for hearing aids.

>>>Subject: Medicare and Viagra
>>>From: Leonard Evens len@math.northwestern.edu
[quoted text clipped - 42 lines]
>>>I wonder if Cong. King and his colleagues would change their tune if
>>>they had prostate cancer.
Beverley - 05 Feb 2005 00:51 GMT
It should be interesting to see where this goes and how much will be
allowed. And who makes these decisions? I think so many things should be
left between the doctor and the patient but that is not how things work.

How dare you read!!! (Okay folks, I'm joking. Leonard knows I'm joking.
Leonard has been a major contributor here forever and this group would not
be the same if he were not here. If he could not see well enough to post to
this group we would have lost a very important supporter and source of
information.)
Bev

> > Our local news has the Viagra listed on their web site as a "recreational"
> > drug. I didn't like their choice of words as "recreational drugs" imply
[quoted text clipped - 76 lines]
> >>>I wonder if Cong. King and his colleagues would change their tune if
> >>>they had prostate cancer.
 
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