Extreme Healthcare: Erectile Dysfunction

In response to the various anti-contraception bills circulating across the land, a state senator in Ohio has proposed legislation that would require men desiring a prescription for ED drugs to undergo a series of extreme and potentially embarrassing steps before being allowed to purchase the drug.  Essentially, the bill would require men to ‘take their medicine’ before they could take their medicine.  

Here are the proposed requirements:  an affidavit signed by at least one sexual partner certifying the erectile dysfunction; an assessment by an approved sex therapist to determine that the dysfunction is truly erectile, not psychological; a stress test ensuring the patient is healthy enough for sexual activity;a signature certifying the patient was informed of the risks of the medicine; awritten statement from the doctor on the necessity and reason for the drug; a repeat stress test every 90 days to ensure continued good cardiac health; outpatient counseling sessions within 90 days of the initial prescription ; and maintenance of all written documentation in the patient’s medical records for not less than seven years.

I appreciate that there is no requirement to pay for erectile dysfunction drugs in group health insurance benefit packages, as was the plan for contraceptives.  But since most plans do cover these drugs, I’m concerned that the Ohio approach doesn’t go far enough.  

It may address the medical issues, but it doesn’t get to the heart of the moral issues which are apparently integral to health care decision-making.  I would make the following suggestions:

·         The signed documents in the initial requirements must be kept on file with the state government for at least seven years, not just held in the patient's medical record.

·         A photo of the men receiving the prescription must be updated and filed with the state each time the prescription is refilled.

·         ED drugs would only be available to men who are married to women of child-bearing age with no reproductive health issues.

·         The women would not be allowed to use any medical or barrier method of birth control during the man’s course of treatment with the drug.  An attestation to this effect would need to be signed by both the husband and the wife, under penalty of perjury.

·         An attestation of reproductive health from the wife’s gynecologist must be signed and kept on file by the state. This document would require renewal each time the prescription was refilled. Should the woman's health change such that she was no longer able to conceive a child, the ED prescription would immediately be voided and any unused medication returned for disposal.

·         The wives of the men seeking the prescription must also sign a document, with renewal every refill, indicating continued consent to their husband receiving the ED prescription.

·         The men must only use the drug when contemplating sexual intercourse with their wives.  Any other use of the drug would be subject to criminal penalties. A signed notice of understanding of this requirement must also be kept on file.

·         Physicians must maintain and file with the state, at least quarterly, a list of all patients receiving ED medications.

Oh, one more thing.  The couples have to video themselves, and we get to watch.

Distractions of Dad

Since my Dad died in January 2007, I’ve gone through what I figure are normal cycles of remembering him and missing him. Not that I don’t always remember and miss him – of course I do.  Most of the time, he’s tucked safely away in my heart; but occasionally I feel he’s sitting right next to me, walking along side of me, or looking over my shoulder. It’s happened twice in the last week, and both times it’s been the most marvelous experience.

The first time was Saturday at the grocery store.  I had left My Sweet Baboo in the cat food aisle and headed off in another direction, and stopped short when I saw a man start to toss something across a low display case to his wife, who was on the other side with their cart. He was gesturing with his hands, making a tossing motion, and she was gesturing right back at him, clearly indicating with both her facial expression and her hands that she wanted no part of his pitch and catch game. He kept trying, she kept saying no, and eventually he gave in and walked over to her, handed her the item, and went off to get something else.

I stood there giggling, and the woman looked at me as if I was nuts; after all, she clearly communicated that she thought her husband had been acting like a child. I apologized to her for laughing and told her it could be worse: when I was a kid, my Dad would roll cat food cans, paper towels, and whatever else he could get moving down the aisle, and my job was to scoop everything up and put it in the cart. Sometimes I missed; things would slide by, and Dad and I would laugh, go pick up the cans, and move on to the next aisle. I thanked her for reminding me of that fun; she smiled and walked away, and secretly I wished her husband would try my Dad’s favorite trick – tossing something across the top of the shelves, from one aisle to another! He didn’t try it often, but it was fun when he did.  (Note that we lived in a small town, with a small family-owned grocery store; I don’t think our behavior would be as well received in a larger store like Wegmans.)

Today it was snickerdoodles. One of my co-workers stopped by this afternoon with a container full of them. They were my Dad’s favorite cookies, mostly because every year at Christmas his sister would make some for him. She’d pack them in a coffee can, put on a pretty bow, and put them under the tree. At some point, we kids would sneak the cookies out from under the tree (preferably while everyone was in the room), and hide them. Even though everyone knew the drill, it was still fun to go through the process, coming up with more creative ways to steal, hide and then rediscover the cookies. One year my aunt made two containers, one for stealing, and one which she triumphantly handed to my Dad, a huge ‘so there, kids!’ moment. In the silliness that followed, my brother stole the second batch and hid that one too.  Another year, we actually left the cookies behind; I remember there was much feigned indignance for a couple of days after Christmas, which ended when the cookies were safely delivered.

Two wonderful memories, completely unexpected, and made that much more enjoyable as a result.  Thanks Dad, for the distractions.