Early demand for Viagra, the new potency pill from Pfizer, has been so enormous that it has caused worries about an unexpected rise in health care expenses. Newspapers have reported the weekly sales of Viagra the way they earlier reported the gross for Titanic. In April one urologist was quoted by the Washington Post as saying, "If we were in the military, I think we would call in and say our position is being overrun."
Unwilling to capitulate, health insurers are insisting on a physician's diagnosis of "erectile dysfunction" ("ED" for short) and setting limits on the number of pills per month. Doctors are available who will obligingly make the diagnosis, but who would have guessed that so many men would rush to be declared impotent? Apparently the temptation of the perfect erection at someone else's expense is too great to resist.
It will be interesting to see what rules the most stringent managed care companies set for covering Viagra. Why just accept a doctor's say-so? Yes, the determination of impotence presents verification problems not seen since negotiations over the disarming of ballistic missiles, a very similar problem. On-site inspections seem unlikely, but patients could be asked to provide testimonials, videos, and other documentation. We've often heard that managed care was a dirty business but someone had to do it. Now we'll see whether the health plans really can control their members.
NEVER SAY WE'RE SORRY
Twice this spring, an American politician who expressed regret over slavery was scorched from the right. When Republican James S. Gilmore, III, became the first white governor of Virginia to include a condemnation of slavery in a proclamation of "Confederate History Month," the president of Virginia's Heritage Preservation Association called it an "insult" and described plantations as places "where master and slave loved and cared for each other and had a genuine family concern." (Gilmore's Republican predecessor, George Allen, never mentioned slavery in his annual proclamations, describing the Civil War only as a "four-year struggle for [southern] independence and sovereign rights.")
Days earlier, President Clinton's statement in Africa that Americans "were wrong" to benefit from the slave trade provoked Pat Buchanan to declare on television: "I can't think of an occasion when I have been more embarrassed for my country than seeing Bill Clinton grovel over there to those people in Africa." Buchanan went on to remark that Africans sold each other into slavery, a point that as a former presidential speechwriter himself, he no doubt would have tactfully inserted. Tom DeLay, the Republican majority whip in the House, said of Clinton: "Here is a flower child with gray hair doing exactly what he did back in the '60s: He is apologizing for the actions of the U.S."
You might have thought that if any controversy were settled, it was slavery. Someone should really remind Buchanan and DeLay about the historical roots of their own party—slavery was what originally embarrassed Republicans for their country. It looks like we do need those history standards for the schools.
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