The doctors used this therapy among diabetic patients aged 55 or older and any patients with coronary artery disease.

The blood pressure medications used were either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. The most common set of drugs patients took were lovastatin (40 mg/day), lisinopril (20 mg/day), and a low dose aspirin.  Doctor’s evaluated each patient to make certain that there was no reason they should not be taking any of the prescribed medicines.

Patients taking the “bundle” of cheap meds had a much lower rate of heart attacks and stroke that those who did not.  In their paper, the doctors who did the study argue that these relative cheap old medicines can clearly be extremely effective, and perhaps it’s more important to help patients take their medications regularly, than to try and develop new drugs with slight benefits over the old ones.

We all love the idea of having “wonder drugs” that wipe away our ills, but if we don’t take our medications regularly, how can we expect to get the benefits?

The fact that health care reform has become the topic of the moment, and is clearly a defining issue for the Obama Administration, made it that much more intriguing to participate.

Room with a View

On the morning of July 16,   I joined more than 90 other determined constituents at the Reserve Officers Association on One Constitution Avenue in Washington D.C., which is steps from the Senate and a brief walk to the House offices: You know you’re in the thick of it when you can see the Capitol from the ladies room.

The group first congregated at tables according to our home states to mull the information packets and find out who we’d be meeting that day. I’m currently a registered voter in Massachusetts.  I ended up in a group that was composed mainly of employees from Genzyme Genetics – one of the few drug companies in the world that makes medicines to treat rare diseases.  Our itinerary included visits to the offices of Senator John Kerry, and Representatives Michael Capuano, Bill Delahunt, Edward J. Markey, and Niki Tsongas:  All are Democrats.

After a healthy breakfast, we got our marching orders from Andria Cornell, the Alliance’s uber organized Advocacy and Health Policy Coordinator, and some words of advice from CEO Sharon Terry.

“Share your story,” Terry urged us, “And just make three points in each meeting.”

It’s important to note that the Alliance isn’t asking for specific reforms, rather, they have carefully crafted a set of  “principles” they are asking legislators to “keep in mind” while considering any health care legislation.  Congress likes to write the legislation themselves when it comes to something as huge as health care, and with all the bills floating around it would probably be a waste of time to throw another one out there anyway.

The Genetic Alliance is an unusual type of organization. It is a network of about 10,000 health care groups, about 1,000 of which advocate for patients with specific diseases.  The group has about 150 million members in total, and provides a range of services (e.g. a biobank ) and many information resources on issues like fundraising, building a website, or education about genetics. About 25 million of its members are Americans who have a genetic disease or their family members. They are passionate, deeply invested, and highly opinionated about what kinds of fixing the health care system needs.

To craft their principles, a month earlier the Alliance had joined with several other health care groups and convened an “urgent meeting” on health care reform.  BIO (Biotechnology Industry Organization), the Coalition for Affordable Health Coverage, the Coalition for 21st Century Medicine, FasterCures, Inspire, and Research!America, which co-led the event, were represented.  Ideas generated at the meeting were also widely shared through social networking, including a blog and Twitter @geneticalliance.

That group reached agreement about five major principles for health reform:

• Access: Create universal access to optimal care that provides an established benefit to individuals, families, and communities.
• Economics: Realign financial incentives to center on the health of people.
• Delivery Systems: Coordinate delivery across all spectrums of care.
• Patient Empowerment:  Create an individual sense of ownership and responsibility for health.
• Research to Care Continuum:  Link the research and healthcare systems and increase research focus on quality of life and health outcomes.

They see these principles as interconnected:  One bit of our broken health care system can’t be fixed without addressing the intersecting parts as well. “It is imperative that health reform be comprehensive, actionable, and sustainable; it must look at health as a continuum,” says Terry.  Unfortunately, nothing has yet emerged from Congress that looks like it really fits that bill, even the highly heralded, but widely disappointing, Baucus bill.   Still Terry is optimistic.  “Genetic Alliance is still hopeful that Senator Baucus will craft a bill that gets to the root of health reform, and not simply health insurance reform,” she says.

Glazed Looks and Vigorous Nods

During “Genetics Day on the Hill” the Massachusetts group visited our representatives’ offices, gave our opinions to their often surprisingly young legislative staffers, and then dropped off an information packet that offered many more details. We also invited our representatives to “use us as a resource” as they consider future legislation.

It was a lot of walking, getting lost, getting found, and a little bit of really good ice cream that a member of our group led us to in the basement of one of the Congressional office buildings.  Most of all, it was eye-opening.

One of the most important things I learned from this experience was the power individual stories have for politicians. Terry had repeatedly emphasized the importance of these, and she knew what she was talking about.  Legislators are hungry for true stories about problems their constituents face. When you give their staffers such stories, they usually pay attention and nod vigorously.  Massachusetts is one of the few states that has tried to reform the health care system, and so I talked about my experiences as a taxpayer dealing with that.  It seemed especially pertinent since the Obama administration appears to be copying the Massachusetts plan.

It’s tempting to resort to logical arguments in these brisk sit down sessions, but the staffers have probably listened to and dissected every well worn political argument you can think of, particularly if its about health care reform.  Rehashing well-trodden ground drew glazed looks or polite smiles for them.

They seemed much more interested when I talked about the challenges I face as a Massachusetts resident: We are all obliged to buy health insurance that is some of the most expensive in the country because health care costs have kept rising even after the “reforms” were enacted here.

So, if you decide to do your own lobbying, get your story down first. We’re all voters, after all, and each of our stories has power. That’s why “Joe the plumber” almost became a defining moment of the 2008 election.

If you’re really passionate about health care reform, like most of us who attended “Genetics Day on the Hill,” it’s exhilarating to talk to someone who actually might do something about it.  One family brought their child, a pretty young girl with a rare genetic disease who was obviously facing serious health challenges.  Her parents wheeled her in a stroller through the halls of Congress. At the end of the day, their group reported that they were enthusiastically welcomed.  Those are doors that are now opened, however much, to further discussion.

After a rousing speech on health care reform by Congressman Patrick Kennedy (D-RI), we left clutching the business cards we’d collected during the day with our notes, preparing to follow up with our new contacts on Capitol Hill.

Everyone has a stake in how health care reform turns out, and so everyone really should try to understand the arguments and the proposed bills as well as we can. The Alliance does a great job of explaining what they think are the pivot points. Could you explain your position that well?

The study looked at more than 2000 patient visits from members of a Minnesota health plan that paid for patient visits to such clinics for more than five years.  They analyzed how retail clinic patients were treated for: ear infections, sore throats or urinary tract infections.  That information was then compared to data about patients treated for the same problems, but at doctors’ offices, ERs and urgent care centers.

“The costs of care in retail clinics were 30 to 40 percent lower than in physician offices and urgent care centers and 80 percent lower than in emergency departments,” the study found. Ouch.  That’s a lot of dollars.

Meanwhile, the quality scores retail clinics received: “Were equal to or higher than those of other care settings,” according to the study.

CVS, Walmart, and Walgreens are among the companies now running retail clinics.  These new “convenience” medical clinics have been attacked by medical associations around concerns that they might provide poor care.  Apparently, that worry isn’t supported by the data.

Because they are being watched so closely and judged, the staff at these clinics might even be especially cautious. That’s just a theory.

Having all your care at one spot is usually the best idea, as well as forging a good relationship with your doctor. But retail clinics seem offer a valuable option to people who can’t afford the ideal.

For more, see this Time story.

The site lists the more than 300 drugs, and the dosages, eligible for the “$4 Prescription plan.”  Higher dosages may cost more and prices may vary in some states.  Patients can also order other medications through the free mail order system.  Customers create an online account or drop into the pharmacy at a nearby Walmart to get their prescriptions filled. They can also call 1-800-2REFILL.

In a company press release, Dr. John Agwunobi, president of Walmart’s health and wellness division, is quoted as saying: “With this program, we’re able to provide consumers in every rural town or big city across America with more affordable prescription medicines through a convenient, free mail delivery system.”

This is just the kind of bargain people need more than ever.

Part of the problem is that people tend to touch their faces a lot.  Disease-causing germs can infect people through the moist tissue of the mouth, nose and eyes, as well as through breaks in the skin.

Keeping your hands clean breaks the cycle.  In one study of college students the “risk of getting sick was 20 percent lower in the dorms where hand hygiene was emphasized, and those students missed 43 percent fewer days of school.”

Kids might not like hearing that, but definitely the moms, dads, teachers, and others who come into contact with them will.

CNNhealth.com has a just posted an article on “How to Prevent a Medical Bill Disaster.”

Some tips from that article, and a couple of my own:

• Don’t let your health insurance policy lapse if you can.
• If you are laid off this year, the U.S. government will pay 65% of your insurance tab if you keep the policy your got from your employer. Go here for details.
• Budget for health care.  Figure out what your costs are likely to be, and set that money aside.
• Read your health insurance policy carefully.  For more on that go here.
• Read up on your disability coverage too.
• Try to stay healthy.
• Appeal every claim that is denied by your insurance company.
• Negotiate if you get a huge bill. The article advises you “do this early.” I can’t emphasize that enough.  In fact, the best time to negotiate is before you actually get the service.
• In fact, I’ll add one more “tip” to their list:  Shop around.  Yes, call around and compare prices, you’ll be surprised at the deals you can get. Go to www.healthcarebluebook.com to see what the right price should be.

The U.S. Center’s for Disease Control (CDC) has encouraged people to get their seasonal flu vaccines as soon as possible, although it is possible to get both the H1N1 and seasonal vaccines at the same time.  Possible side effects from both types of flu vaccine are similar, and include: soreness at the injection site, mild fever, body aches, and fatigue. For nasal spray versions of the vaccine, possible side effects include runny nose or nasal congestion, sore throats in adults, and — in children 2 to 6 years old — fever.

According to the FDA release: “As with the seasonal influenza vaccines, the 2009 H1N1 vaccines are being produced in formulations that contain thimerosal, a mercury-containing preservative, and in formulations that do not contain thimerosal.  People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.”

According to a report in The Wall Street Journal today, several challenging varieties of flu could infect people in the coming months.”This season is going to be crazier than ever,” William Schaffner, an infectious-disease expert at Vanderbilt University told the paper.

The H1N1 flu is likely to be the most dominant variety, and it is relatively mild compared to others.  One strain of H1N1 is resistant to the drug Tamiflu, which makes it harder to treat.  Fortunately, that strain has been very rare so far.   Another variety of H3N2 flu is linked to higher rates of hospitalization and death among the elderly.  That strain is also relatively rare.

For more information go to www.flu.gov