Making rounds this morning, we went to see a patient who had a stent placed yesterday (right circumflex). I sat down to discuss the implications of a diagnosis of coronary artery disease. I started with the statement that she would be talking 4 drug classes – aspirin, ACE inhibitor, beta blocker and statins. As I finished she turned to me teary eyed and asked if she would be able to get her drugs for $4 at WalMart (or other similar store). When I said yes, she smiled and cried.

I wish I had a video to place on YouTube. The entire team had the same reaction. We took a situation that had her worried about money, and because of low cost generics she had great relief. We felt great that money would not interfere with her secondary prevention.

We know that secondary prevention helps and decreases subsequent hospitalizations. I know that those who want the status quo label a public option as government run health care. I still favor (with important caveats) creating a public option for the patients who fall between the cracks. While some will not take advantage of a public option (like many patients do not take advantage of the VA benefit), many will. We have poor citizens who cannot afford basic health care. We should develop a reasonable way to help them avoid the emergency department and hospitalization. I think it makes economic sense.