Thanks a lot for my Lipitor

More than a few people would not have been surprised had my head been found during the course of my recent colonoscopy. However, the only part of my brain apparently located up the proverbial wazoo is that part responsible for appropriate action to bring down my cholesterol. That explains why I wrote this column with the bottle of my new, cholesterol-lowering Lipitor pills to my left and my coffee with extra cream to my right.

Early this year my total cholesterol was 264. For a man whose father and father’s father died of heart attacks, a cholesterol of 264 is a creamy thread of arterial sludge that leads directly from their demise to his. That thread was easy to ignore when I was 20 and had no children, but cannot be ignored now that I am 45 and one of my children has already asked me if I will live longer than my father did (yes, by six years so far). I vowed a few months (years, really) ago to get off my butt and get my cholesterol down.

Well, I got off one cheek, found a route to work that led through only one fast-food drive-up, and last week my cholesterol was down to 217. The bad cholesterol (LDL cholesterol – the LDL seems to stand for Little Damn Likelihood that you will get this down to your goal on your own) was 146 and the good cholesterol was 59.

After celebrating with a cup of coffee, extra cream (black coffee tastes like liquid duct tape to me), I compared my results with the recent recommendations of the National Cholesterol Education Program (NCEP) Expert Panel for treating high cholesterol in adults. According to the NCEP Panel, I fell into the category of patients who need to get off both cheeks and get their LDL cholesterol levels down under 130 (some experts would say mine should be under 100 because of my family history.)

My doctor does not trust my ability to adequately unburden my posterior on the cholesterol issue, and recently prescribed Lipitor to help. Lipitor seems to work primarily by costing so much (about $3 per pill) that you cannot afford to eat. One month’s supply cost me about $90. Rather, it cost all of you $90, and me a $10 co-pay, because my health insurance paid the rest. This is where you come in, and why I wanted to thank you all for my Lipitor.

The term “My health insurance paid” is really a euphemism for the truth, which is that we all paid for my Lipitor, one way or another, just as we all pay for each other’s medical care one way or another. If you have health care insurance, your premiums helped pay for my Lipitor. If you have no health insurance, the cost of my Lipitor is part of why health insurance premiums are so costly you cannot afford health insurance.

My cholesterol would not be much of a problem for the rest of you if the only Lipitor you were paying for was mine. Many of you reading the newspaper today have sausage on your plate, Lipitor in your medicine cabinet, and Too Much Cholesterol on Board (now there’s a bumper sticker for you). Last year 16 million Americans with high cholesterol levels spent more than $9 billion on cholesterol-lowering drugs, including $4 billion on Lipitor alone.

The new NCEP guidelines, if fully implemented, would add more than 20 million Americans to the cholesterol medication rolls, and the annual costs would top $30 billion. Others estimate that fully implementing the NCEP guidelines could eventually cost this country more than $100 billion annually.

The cost of treating people with LDL cholesterol levels many points higher than their dietary IQs is going to force some ugly national debate about freedom of choice in personal health care. Why should the rest of you be forced to buy pills for those of us with high cholesterol levels who sit with Lipitor on the left and lipid-loaded coffee on the right? Never mind that this country has other needs for your money (space-based missile defense, for example, because I don’t want to get nailed by a nuke from Iran while I am stirring in the cream). The cream that makes my coffee taste so good stands a good chance of leaving a foul economic taste in your mouth.

The real question is, how much freedom should individual Americans have to act unhealthy and then shift the economic cost of the treatments to everyone else? My discretion to eat the way I want is costing you your discretion to spend more of your hard-earned cash the way you want, and a nation being run into the economic ground by growing health care costs is going to find those two freedoms at progressive odds.

In my case, however, you will not have to worry about it; in the future, I will be paying for my own Lipitor. A doctor who can afford to pay for his own Lipitor can use the $90 that goes up in Lipitor smoke every month to light a fire under his butt to drive his cholesterol down by eating smarter. So should anyone else who can afford their own Lipitor and who eats with the dietary smarts of a coon dog.

Boy, that’s good coffee.

Dr. Erik Steele, D.O. is the administrator for emergency services at Eastern Maine Medical Center and is on the staff for emergency department coverage at six hospitals in the Bangor Daily News coverage area.