Stupid EPA regulatory nonsense strikes my profession.

[JohnnyGage]

You clearly know nothing about France, because you could see examples similar to what you're complaining about in spades there. Then again, that might threaten your world view.

I like how the guy who is on the side of trying the system that works in every industrialized nation on earth is the guy infected by 'religion', while the guy furiously attempting to stop the implementation of proven, effective methods due to the nebulous concept that our government is bad is the voice of reason in your mind. Physician, heal thyself. (har!)

Or the guy telling the pharmacist that he doesn't know anything about healthcare. Heal thyself indeed.

 

[Hayabusa Rider]

You clearly know nothing about France, because you could see examples similar to what you're complaining about in spades there. Then again, that might threaten your world view.

I like how the guy who is on the side of trying the system that works in every industrialized nation on earth is the guy infected by 'religion', while the guy furiously attempting to stop the implementation of proven, effective methods due to the nebulous concept that our government is bad is the voice of reason in your mind. Physician, heal thyself. (har!)

I'm sorry but I believe evolution is how the various species arose.

 

[woolfe9999]

You really are outside your area of expertise and knowledge. Now explain why an aids patient who has medicaid insurance but who's numbers change can and was denied coverage? Explain the onerous billing requirements? Why I have to say "sorry there was a communications glitch. Call back in a week or two"?

Your hyperbole is nonsense. There are more headaches caused by foolish regs than anything in the private sector, not that things do not need correction. I don't pretend to have knowledge sufficient to reorganize your field, nor do you for mine.

This has nothing to do with "expertise." I can take your word on every single anecdote that you've ever posted about re: government red tape in your field. The trouble is your posts are not constructive. You basically just complain, then make all sorts of generalizations about government being our new "overlords" or thinking they know better, etc. There is no acknowledgement in your posts of the benefits of anything that government does. Apparently the benefits to you are invisible so you simply take them for granted. Take your AIDS case, for example. I asked you once, and you failed to explain, how your AIDS patient would ever have gotten treatment in the first place without Medicaid. Frankly I'm not really sure what you stand for in all of this. You stop short of saying get rid of all government regulations because you're some kind of self styled centrist. Yet you also aren't interested in offering solutions or participating in the process to improve governance because it's easier to get on the bandwagon of complaining about "government red tape."

It's not as if participation can't yield results. Take the very issue you raised in this thread:

http://www.epa.gov/osw/hazard/wastetypes/universal/pharm-rule.htm

From what I can gather, certain pharmaceuticals (31 drugs) and their containers were classified as hazardous waste, I think either in 2008 or 2009. Apparently there were complaints about the compliance measures from pharmacies and hospitals and now the EPA has proposed to reclassify these pharmaceuticals as "universal waste" rather than hazardous waste. I don't know what the more stringent requirements have been, but "universal waste" disposal, from what I have read, requires basically that certain things be deposited in compliant containers and that whoever receives and transports the waste be capable of handling it. Staff training is also required, which consists of telling the employees which substances they have to be put in those containers. There are no records keeping requirements for small businesses. Larger business have to keep rudimentary records of when waste is shipped out and to whom. The estimated cost to small businesses is ZERO.

http://ecfr.gpoaccess.gov/cgi/t/tex...rgn=div5&view=text&node=40:27.0.1.1.7&idno=40

I should also mention that states will be free to adopt more stringent regulations than this so you might want to keep an eye on that if you are truly concerned.

Honestly this sort of mentality is exactly why the global economy was decimated in 2008, and why the lesson people seem to have learned from it is that we need LESS government regulation. I think it's possible that some day the anti-government types may experience their libertarian utopia in this country and then you can find out what life without government regulations and services is really like. Good luck. If I'm alive at the time, I'll be living elsewhere.

- wolf

 

[Darwin333]

On what do you base your learned claims that there are no hazardous substances in certain used Rx bottles? Do you think the EPA just made up this regulation willy nilly without any research? Do you think the industry didn't weigh in and make comments during the public comment period required before a regulation is enacted?

Please cite the regulation that holds a broken bottle of nail polish remover requires hazmat procedures.

Or did you have a fight with your wife last night and this is a convenient outlet to vent?

I would think that acetone should require hazmat long before an empty pill bottle.

 

[Hayabusa Rider]

This has nothing to do with "expertise." I can take your word on every single anecdote that you've ever posted about re: government red tape in your field. The trouble is your posts are not constructive. You basically just complain, then make all sorts of generalizations about government being our new "overlords" or thinking they know better, etc. There is no acknowledgement in your posts of the benefits of anything that government does. Apparently the benefits to you are invisible so you simply take them for granted. Take your AIDS case, for example. I asked you once, and you failed to explain, how your AIDS patient would ever have gotten treatment in the first place without Medicaid. Frankly I'm not really sure what you stand for in all of this. You stop short of saying get rid of all government regulations because you're some kind of self styled centrist. Yet you also aren't interested in offering solutions or participating in the process to improve governance because it's easier to get on the bandwagon of complaining about "government red tape."

It's not as if participation can't yield results. Take the very issue you raised in this thread:

http://www.epa.gov/osw/hazard/wastetypes/universal/pharm-rule.htm

From what I can gather, certain pharmaceuticals (31 drugs) and their containers were classified as hazardous waste, I think either in 2008 or 2009. Apparently there were complaints about the compliance measures from pharmacies and hospitals and now the EPA has proposed to reclassify these pharmaceuticals as "universal waste" rather than hazardous waste. I don't know what the more stringent requirements have been, but "universal waste" disposal, from what I have read, requires basically that certain things be deposited in compliant containers and that whoever receives and transports the waste be capable of handling it. Staff training is also required, which consists of telling the employees which substances they have to be put in those containers. There are no records keeping requirements for small businesses. Larger business have to keep rudimentary records of when waste is shipped out and to whom. The estimated cost to small businesses is ZERO.

http://ecfr.gpoaccess.gov/cgi/t/tex...rgn=div5&view=text&node=40:27.0.1.1.7&idno=40

I should also mention that states will be free to adopt more stringent regulations than this so you might want to keep an eye on that if you are truly concerned.

Honestly this sort of mentality is exactly why the global economy was decimated in 2008, and why the lesson people seem to have learned from it is that we need LESS government regulation. I think it's possible that some day the anti-government types may experience their libertarian utopia in this country and then you can find out what life without government regulations and services are really like. If I'm alive at the time, I'll be living elsewhere.

- wolf

I've stated over and over that there needs to be a reform of healthcare based on improving healthcare outcomes and that government has a role. I also have
repeatedly stated that an assessment of the state of healthcare in advance of legislation by those who have a clue about the subject and that met with "oh everyone already has this figured out. " attitudes. Their reaction? The government can do it all and if you don't
agree you are for the status quo. Wrong. I'm at the level of exasperation you were with the budget, and seeing how screwed up things are on a day to day basis and I'm supposed to embrace medicine by regulation and ignorance? No thank you, and am not inclined to go yet again into how things can be done because my tolerance for foolishness is limited.

 

[Darwin333]

This is most likely the reason.

Water supplies are being contaminated by empty pill bottles??? Really? I can understand requiring some sort of special disposal for drugs themselves but the empty bottles they were in???

A single person flushing a single pill has got to put more drugs in the water supply than 50 pill bottles yet as far as I know that is the recommended disposal method (I might be wrong but it still illustrates a lack of educating a much larger source of contamination). Heck my daughters school even sent something home reminding us to dispose of medication we aren't using anymore because of the increase in prescription drug abuse.



Hayabusa, why don't yall simply give the bottles back to the customer after you scan the barcode? I assume it is perfectly legal for them to deposit the bottle into a trash can that could just happen to be located right next to the pharmacy window.

 

[woolfe9999]

I've stated over and over that there needs to be a reform of healthcare based on improving healthcare outcomes and that government has a role. I also have
repeatedly stated that an assessment of the state of healthcare in advance of legislation by those who have a clue about the subject and that met with "oh everyone already has this figured out. " attitudes. Their reaction? The government can do it all and if you don't
agree you are for the status quo. Wrong. I'm at the level of exasperation you were with the budget, and seeing how screwed up things are on a day to day basis and I'm supposed to embrace medicine by regulation and ignorance? No thank you, and am not inclined to go yet again into how things can be done because my tolerance for foolishness is limited.

I'm curious, were you aware that the EPA is about to streamline these regulations that you are complaining about, and that this was due to complaints from people in your industry? Doesn't seem to fit into the whole "the government thinks they can do it all" and that they never listen to anyone in the industry notions, but then again, like you said, what do I know?

 

[Hayabusa Rider]

I'm curious, were you aware that the EPA is about to streamline these regulations that you are complaining about, and that this was due to complaints from people in your industry? Doesn't seem to fit into the whole "the government thinks they can do it all" and that they never listen to anyone in the industry notions, but then again, like you said, what do I know?

I'd like to see the pharmacist who asked for this so I could throttle them.

This may well be corrected, but how about some thought applied in advance? No doubt this is a case of ignorance instead of malice, but I maintain that as the scope and complexity of the subjects of regulations increase, the poorer the results will be. At heart is how law and regulations are handled. I believe that Congress isn't capable simply because of the sheer volume of work it's asked to do and traditional staffing isn't adequate.

 

[Moonbeam]

This is very bad news for me. I have a perscription bottle of Burrow's tabs on my counter expired 1968 that I found in some of my Mother's things with a friend of hers name on it, perscribed, no less than by Dr. Craig. What the f can I do now, take then and piss whatever down the drain?

 

[Moonbeam]

I'd like to see the pharmacist who asked for this so I could throttle them.

Well you're only commanded to love your neighbor so pray he lives far away.

 

[woolfe9999]

I'd like to see the pharmacist who asked for this so I could throttle them.

This may well be corrected, but how about some thought applied in advance? No doubt this is a case of ignorance instead of malice, but I maintain that as the scope and complexity of the subjects of regulations increase, the poorer the results will be. At heart is how law and regulations are handled. I believe that Congress isn't capable simply because of the sheer volume of work it's asked to do and traditional staffing isn't adequate.

Not sure why you want to throttle the people in your industry who complained that the current regulations are too burdensome which has caused the EPA to propose reclassying pharmaceutical waste so that it falls under a much less burdensome regulatory standard. Seems to me their complaints did you a great deal of service as this is now in the public comments phase so I presume it will be changed fairly soon.

Contrary to popular perception, regulations go up and down, sometimes up then down, sometimes down then up. Increased regulations tend to result in complaints from the industry being regulated and complaints tend to be the only thing we hear about so I guess it isn't a surprise that people don't realize how much DE-regulation there has been both at the federal level and in many states, particularly over the last several decades.

- wolf

 

[Gardener]

You really are outside your area of expertise and knowledge.

That has never stopped you from posting.

 

[darkewaffle]

For just about forever pharmacies have taken old empty prescription bottles for refills. We usually scan the bar code and the computer system brings up the info for processing. We then toss the old bottle and move on. It's a simple efficient system or was. Today I've learned ghats changing. Certain medications like warfarin cannot have their bottles disposed of per the usual and harmless way. In their infinite stupidity the EPA considers it hazmat along with things like paper towels or alcohol swabs used to clean the counter although there is zero evidence that these things are dangerous and the crap just begins there. We now have an expensive service which handles the disposal. So the complexity of the process is increased along with costs for no good reason. The only reason to do it is to avoid punishment. Oh don't drop a bottle of nail polish remover. That's a huge deal now with hazmat protocols out the butt.

I do not welcome our overlords.

Just because there's no proof doesn't mean a lawyer still won't try to prove it to a judge and jury anyway. Cover your ass, every industry puts up with it.

 

[Gardener]

This has nothing to do with "expertise." I can take your word on every single anecdote that you've ever posted about re: government red tape in your field. The trouble is your posts are not constructive. You basically just complain, then make all sorts of generalizations about government being our new "overlords" or thinking they know better, etc. There is no acknowledgement in your posts of the benefits of anything that government does. Apparently the benefits to you are invisible so you simply take them for granted. Take your AIDS case, for example. I asked you once, and you failed to explain, how your AIDS patient would ever have gotten treatment in the first place without Medicaid. Frankly I'm not really sure what you stand for in all of this. You stop short of saying get rid of all government regulations because you're some kind of self styled centrist. Yet you also aren't interested in offering solutions or participating in the process to improve governance because it's easier to get on the bandwagon of complaining about "government red tape."

It's not as if participation can't yield results. Take the very issue you raised in this thread:

http://www.epa.gov/osw/hazard/wastetypes/universal/pharm-rule.htm

From what I can gather, certain pharmaceuticals (31 drugs) and their containers were classified as hazardous waste, I think either in 2008 or 2009. Apparently there were complaints about the compliance measures from pharmacies and hospitals and now the EPA has proposed to reclassify these pharmaceuticals as "universal waste" rather than hazardous waste. I don't know what the more stringent requirements have been, but "universal waste" disposal, from what I have read, requires basically that certain things be deposited in compliant containers and that whoever receives and transports the waste be capable of handling it. Staff training is also required, which consists of telling the employees which substances they have to be put in those containers. There are no records keeping requirements for small businesses. Larger business have to keep rudimentary records of when waste is shipped out and to whom. The estimated cost to small businesses is ZERO.

http://ecfr.gpoaccess.gov/cgi/t/tex...rgn=div5&view=text&node=40:27.0.1.1.7&idno=40

I should also mention that states will be free to adopt more stringent regulations than this so you might want to keep an eye on that if you are truly concerned.

Honestly this sort of mentality is exactly why the global economy was decimated in 2008, and why the lesson people seem to have learned from it is that we need LESS government regulation. I think it's possible that some day the anti-government types may experience their libertarian utopia in this country and then you can find out what life without government regulations and services is really like. Good luck. If I'm alive at the time, I'll be living elsewhere.

- wolf

And this.

 

[Rockinacoustic]

LOL

http://www.fda.gov/drugs/resourcesf...fedisposalofmedicines/ucm186187.htm#MEDICINES

Does flushing the medicines on the list down the toilet or sink drain pose a risk to human health and the environment?

We are aware of recent reports that have noted trace amounts of medicines in the water system. The majority of medicines found in the water system are a result of the body’s natural routes of drug elimination (in urine or feces). Scientists, to date, have found no evidence of harmful effects to human health from medicines in the environment.

So, one branch of the government argues that warfarin dust is hazardous to the environment while the other advocates flushing highly addictive and sedative narcotics because no evidence has been shown of pharmaceutical toxicity in the environment doing damage to humans.

But hey, what the hell we Pharmacists and Pharmacy Students know...

 

[uclaLabrat]

Looks like we need some EPA work by wherever you live, there's definitely something in your water that's affected your brain.

Based on his superb logic, I don't think there's much brain left to affect.

 

[xj0hnx]

You clearly know nothing about France, because you could see examples similar to what you're complaining about in spades there. Then again, that might threaten your world view.

I like how the guy who is on the side of trying the system that works in every industrialized nation on earth is the guy infected by 'religion', while the guy furiously attempting to stop the implementation of proven, effective methods due to the nebulous concept that our government is bad is the voice of reason in your mind. Physician, heal thyself. (har!)

Really? Universal health care is proven to work in the United States at the federal level? Didn't think so.

 

[Hayabusa Rider]

Well you're only commanded to love your neighbor so pray he lives far away.

Well he's safe in any case. I was reading too quickly and misunderstood what Wolffe said.

You and I go back a ways and you pay more attention to what's going on than most and I think you understand what bothers me. Every day I see a system which is increasingly in trouble. Health care isn't about who provides insurance but doing what one can to help another person get and stay better, but it seems only the dollars matter and who wins control. As time goes by I am faced with trivialities which frustrate that, and I'm not alone. I was speaking to a gerontologist who works with may patients in long term facilities. This is where people go to die. She's first rate, a completely impressive practitioner. She and her staff spend a significant amount of time filling out forms as to why not particular medications aren't being prescribed. The answer is that it's not appropriate, but that's not good enough. Less time for giving care.

Over time I've seen a crisis developing in care and it's going to be hell to deal with. Demographics coupled with the wonderful technology that we all want. We can keep people living in spite of their horrible diet, lack of exercise and stress levels off the charts. With our lifestyle we should be dying in greater numbers and we aren't. Then there's an aging population which puts greater demands on the system and that costs a whole lot. The result is a decrease in reimbursements and that leads to staffing cuts. We suffer from them here and frankly I consider it a dangerous and foolish move. If we make a mistake because we can't focus for more than 15 seconds we can kill someone. Less time and quality care for you.

Then we have increasingly complex billing procedures and the worst of those are from the government side. Less time for you again.

The solution? UHC! The Universal Savior of Healthcare. Well it isn't and in fact it addresses nothing that I've said. Someone will pull out another country and say "Look how great this is!" Well that's grand. They are up in shit and they know it too. Well we know how to fix things and so we'll regulate alcohol swab disposal. No it's not directly health related, but it doesn't help anything, but it does add yet another cost and things add up. We'll fix things by regulation. Create a system where someone needs to manually review a computer glitch before reversing the claim to make sure there's no fraud. Have that position poorly staffed so it takes 2 weeks to fix things. Don't worry, people don't need medication that badly. Sure. Then there's the event which brought this to a head a some time back. I don't know if you recall, but I was working at an inner city clinic which had a lot of medicaid patients, many of them homeless. One of them was a very sickly AIDS patient and he was in bad shape, but was doing OK considering he lived in a box. Well the state got religion again and decided that it needed to do something about fraud and it needed to. The plan was to issue new Medicaid cards with pictures and the patient or his/her agent was required to present it before payment came through. The intent was admirable, and the implementation miserable. There was a drop-dead date where this went into effect, and everyone's numbers were changed in the system. Shouldn't have been a problem. What was is that a goodly number of patients didn't get their cards before the regs went into effect. No problem you think. The provider contacts the agency like he would with private insurance and gets the information. Well no. Part of the regs stipulated that under no condition would we be given that information. Potential fraud. OK the guy was here. Give him the numbers. Sorry we can't do that either. WTF? This guy is going to die and they can't help. Further we were warned if we somehow guessed the correct sequence number that we'd be guilty of felony fraud. They kept tabs on the number of trys and if you went past that you got audited. He'll get his card in a couple months.

Bottom line, I'm threatened and the patient dies. That doesn't sit well. Death by regulatory compliance. Yes I called the State House. Yes I call the then Governor. No reply and no remorse. I'm supposed to embrace that mentality?

So there was a comment that in France one could find examples of what I'm concerned about. What the hell kind of justification is that? Why doesn't it outrage people that it happens at all anywhere?

Did the government mean to execute the AIDS patient? Of course not, but once the regs kicked in there is no option for anyone. Now there's mechanisms in place, but how many suffered because they could not use what they had?

We don't need Obamacare, we don't need UHC, at least in it's likely form. What we need are intelligent experienced people guiding legislation for the benefit for the patient without the nonsense that must occur in our system. We need people who understand the looming disaster only partially glimpsed and plan now for it's coming. No amount of insurance restructuring will fix that. Knowledge and insight is needed, not platitudes and diversions. We need enabled providers, not lawyers. We need help to spend our time engaging people like you, not more and more paperwork. We need what can provide good outcomes up front, not trying to figure out how we can spend less time on a person because the latter saves nothing. Only those who know the cost of something, but not the value of it espouse those tactics.

Vox clamantis in deserto.

 

[Gardener]

You had your ass handed to you by wolf.

Anyone with a lick of sense knows your agenda here...you are Professor John, lite.

 

[Hayabusa Rider]

You had your ass handed to you by wolf. Anyone with a lick of sense knows your agenda here...you are Professor John, lite.

You've been here since 1999 and have made 65 posts. Allow me to thank you on behalf of the majority of the forum for not having made more.

Wolfe? I consider him an intellectual equal. We've had discussions in the past where we've agreed and disagreed, sometimes strongly. I fear he's lost this time if for no other reason that he now has a "Buddy" following him around. Dream on Syndrome.

 

[Hayabusa Rider]

Take your AIDS case, for example. I asked you once, and you failed to explain, how your AIDS patient would ever have gotten treatment in the first place without Medicaid.

"Buddy" reminded me to look over your post and I saw this. Where I stand is that people like this should have access to medicaid, and it's for these kinds of situations I believe it should exist. My point is should it exist in a way that causes this problem? Give me a good reason for their denial, not an explanation of the regulatory process. You may accept that. I do not. What we need is to prevent this and when found respond quickly to correct these incidents.

A question for you. The police protect property and person. A new regulation comes in where police cannot respond to a call unless they have prior approval from the district. Your family has is being attacked by a criminal and you see an officer and ask for help. He says that he's sorry but his radio is broken and you are on your own. How would they have gotten aid if the police didn't exist at all? How much comfort would that give you?

 

[woolfe9999]

"Buddy" reminded me to look over your post and I saw this. Where I stand is that people like this should have access to medicaid, and it's for these kinds of situations I believe it should exist. My point is should it exist in a way that causes this problem? Give me a good reason for their denial, not an explanation of the regulatory process. You may accept that. I do not. What we need is to prevent this and when found respond quickly to correct these incidents.

A question for you. The police protect property and person. A new regulation comes in where police cannot respond to a call unless they have prior approval from the district. Your family has is being attacked by a criminal and you see an officer and ask for help. He says that he's sorry but his radio is broken and you are on your own. How would they have gotten aid if the police didn't exist at all? How much comfort would that give you?

That would be an example of government engaged in an activity that they should be engaged in, but doing it incorrectly or inefficiently. It's an example of something that should be changed. Problem is I don't share your overarching negative view of government. I think a lot of agencies are understaffed and hence it can be difficult to deal with them when you have a problem. When working with tax payer money and trying to keep to 2-3% overhead margins, you aren't going to have sterling public relations.

I think much of the justified dissatisfaction with our elected politicians spills over into government agencies and government activities in general. However, much of what government does for us day in day out is unsung and unappreciated. People talk about complaints. It isn't news that, guess what, such and such an agency pretty much does its job properly on a day to day basis. We just take it for granted.

I am reading your ideas about healthcare and I see you are very concerned about patient outcomes. So am I. The trouble, however, isn't poor quality of care. The trouble is that healthcare costs too much and if the current cost curve continues on the same vector, most Americans will have no access to healthcare in 20 years. I haven't heard any solution other than UHC that fixes that. I don't see any suggestions from you about cost cutting other than cutting government red tape. Fine, let's cut the government red tape. How much does that save us? I hate to bottom everything out at economics but that is an unfortunate reality. "Government leave us alone" means you want HC in the US to be a function of the free market, i.e. monetize and commodify healthcare which for the most part is what we've been doing. The end result I guarentee is that you'll have great patient outcomes for the few who can afford care, and the rest will get scraps and handouts.

- wolf

 

[Gardener]

You've been here since 1999 and have made 65 posts. Allow me to thank you on behalf of the majority of the forum for not having made more.

Wolfe? I consider him an intellectual equal. We've had discussions in the past where we've agreed and disagreed, sometimes strongly. I fear he's lost this time if for no other reason that he now has a "Buddy" following him around. Dream on Syndrome.

Then you overestimate your middling intellect.

And Wolf appears far too polite with a hack like you. Pearls cast before swine, I'm sure you know the story.

 

[xj0hnx]

The trouble is that healthcare costs too much and if the current cost curve continues on the same vector, most Americans will have no access to healthcare in 20 years. I haven't heard any solution other than UHC that fixes that.

And how exactly is universal health care going to make medical care cheaper?

 

[xj0hnx]

Then you overestimate your middling intellect.

And Wolf appears far too polite with a hack like you. Pearls cast before swine, I'm sure you know the story.

Dang Wolfee, your nuts must hurt, cuz this dude is swingin' side to side hard on 'em.