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When they retired a few years back, Gene and Betty Greenspan didn't worry excessively about medications. "It was a concern," says Gene, "but the issue of prescription drugs wasn't that paramount."

But as they grew older, they found, as most seniors do, that they needed more medications. Gene developed hypertension, and the various other ailments that come with age began to assail them. Today they are taking some half a dozen medications between them at a cost of roughly $3,000 a year. Betty is on Zocor, Synthroid and Maxzide, and Gene takes Slomax, Glucophage and Cartazen.

They have no prescription drug coverage. When they climb down from the Rx Express in Toronto, they will be looking to pick up some of those medications.

The Greenspans have been in Miami for 30 years. Gene was an executive at the not-for-profit Jewish Vocational Service. Betty was a clinical social worker. He retired 13 years ago, Betty five years ago. Gene had coverage through his agency, then they moved to COBRA, spent a couple of years with an HMO and then went to Medicare.

Unlike many other seniors, the Greenspans have not been forced into drastic choices between paying for their medications and food and rent. They have had to "cut back on movies, trips and things of that sort," Gene says, they "are fortunate."

Nevertheless, they are working for health care reform in the United States. "We feel very strongly," Gene says, "that there should be no prohibition against the re-importation of drugs at that the U.S. should negotiate bulk discounts on behalf of all patients like other countries already do." The larger thrust, the Greenspans say, "is to lower the cost of medication generally."

Betty adds that Medicare "reform" needs to be fixed. "The program is so confusing to so many people. I've seen people throwing up their hands and saying, 'who can understand this?'"