Express Scripts, Mylan, and the EpiPen

According to CNBC’s article, Mylan can lower EpiPen price today, Express Scripts says, Express Scripts’ Chief Medical Officer, Dr. Steve Miller told CNBC, “"If she [Mylan CEO Heather Bresch] wants to lower the price [of the EpiPen] she can lower the price today…We'd pass the savings that we take from the marketplace back to our plans." That is fine, as far as it goes, however, if Express Scripts really wants to help reign in pharmaceutical prices, they could give consumers more say in their medications.

As an example, I take valsartan to control my hypertension. Every three months, I receive a new supply from Express Scripts. Express Scripts puts on the label who manufactures it. In my case, the aalsartan comes from Mylan. Given the behavior of the current CEO of Mylan, I would prefer that none of my medications come from Mylan. lists a dozen generic manufacturers of V]valsartan.

Likewise, I take fenofibrate for high cholesterol. Like with the valsartan, Express Scripts has sent me fenofibrate manufactured by Mylan. I can’t find the list of other manufactures of fenofibrate, but I’m guessing there are choices there as well.

If Express Scripts would start shipping me medications not manufactured by Mylan, it would be a great start. If lots of patients started requesting the medication not be provided by Mylan, if at all possible, it would help return Adam Smith’s invisible hand to the pharmaceutical marketplace and prevent predatory pricing from companies like Mylan.

An Amazing Day

I rejoiced with those who said to me,
“Let us go to the house of the Lord.”

It has been a pretty amazing weekend. Friday, after work, I went to Dinner for a Dollar at the local church I attend. It is a weekly food ministry, where we serve meals to whomever wants one. People are encouraged to pay a dollar for the meal, more if they can, nothing if money is really tight. It is about so much more than just an inexpensive meal for people down on their luck. It is a chance to eat together.

Friday, it was sandwiches and potato salad. A simple cool meal to serve on a hot Friday night. After I helped serve, I sat down at one table where there was a woman whose mother had recently died. I had gone, expecting to help serve food, but found myself comforting a woman in her grief.

Sometime, most likely late Friday evening or early Saturday morning, someone spray painted graffiti on the front doors and sidewalk of St. Michael's Episcopal Church in Lexington KY.

Saturday, was a quiet day. I stayed home and wrote and rested. In Lexington, members of the community gathered to clean up the spray paint.

This morning, I preached at Grace and St. Peter’s in Hamden. I really enjoyed preaching and several people commented positively on my sermon. At the same time, the people of St. Michael’s in Lexington to the vandalism at their church with words of love.

Kim and Fiona picked up donuts after church and we had a quiet afternoon. I tried to practice what I preached, sharing positive stories, like that of Chierika Ukogu of Nigeria getting the silver medal in rowing. I shared a video from Demos about addressing prejudice.

For dinner, we had a roast, some baked onions with blue cheese, some freshly made refrigerator pickles, and salad. It was a pretty amazing dinner, helping make the whole day feel like a birthday.

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Speaking What The Lord Commands

Last Sunday, Amanda left us with the question: what does Jesus’ challenge to the status quo mean for us today? a status quo where some people do not have the same opportunities to enjoy God’s creation as others do, because of the family they were born into, the job they have, their race, ethnicity, gender, sexual orientation, or many other things that the powers of this world use to disadvantage others.

This week’s lesson provides us an opportunity to explore this more deeply, on a personal level. When we look at systemic racism, sexism, and all the other forms of oppression, it is easy to feel overwhelmed, to feel as if we can’t make a difference, to say with Jeremiah, “Ah, Lord God! Truly I do not know how to speak, for I am only a boy”. Perhaps, to bring this a little closer to our own lives, we can replace the word ‘boy’ with whatever describes our lack of confidence, our feelings of inadequacy or being disempowered.

The Lord doesn’t buy it. The Lord responds,

"Do not say, 'I am only a boy';
for you shall go to all to whom I send you,
and you shall speak whatever I command you,
Do not be afraid of them,
for I am with you to deliver you,

True, we are not called to the same calling as Jeremiah, but we are called to show God’s love to our neighbors. It reminds me of an old quote from Maggie Kuhn, often seen on bumper stickers today, “Speak your mind even if your voice shakes”.

As a writer, how we put words together is very important to me. It is important for me to think about the words we use regularly, words we often don’t think enough about.

How do we communicate that it is time to sit down and listen to the sermon? Amanda uses a simple gesture. Paul talks about seeking to speak now in the name of the Living God. How often do we stop and think about what it means to talk of God as a Living God. God’s not just a concept, or something that created the world and then sat back to see what happens. God is a Living God who can put The Lord’s words in our mouths.

Others like to emphasize the inclusive aspect of God being a Living God, speaking in terms of what God does, creator, redeemer, and sustainer, instead of using words that might make it harder for some of us to relate to God because issues in our own lives, words like Father, Son, or Ghost.

I like to use the words of Psalm 19 like I did this morning. May the words of my mouth and the meditations of our hearts be always acceptable in your sight, o Lord, my strength and my redeemer. I remember when I was running for political office, and that verse came to mind. Would that all politicians would say Psalm 19 verse 14 to themselves before they speak.

Others like to ask for God’s inspiration with the words, “Come Holy Spirit”.

Come, Holy Spirit – What makes you want to speak up? What inspires your words?

It is easy to think that Jeremiah was different. He had a special calling in a special time. He was called to proclaim great words. What does that have to do with us today? In asking this, we are, perhaps being more like Jeremiah than we would like to admit. “Ah, Lord God! Truly I do not know how to speak, for I am not like Jeremiah”, or “I don’t have important things to say.”

We do have important things to say, and today, as much as any day, we need God’s love proclaimed. Before the Gospel, we sang,

Be thou our great deliverer still,
thou Lord of life and death;
restore and quicken, soothe and bless,
with thine almighty breath:

We need God to be our great deliverer still. We also need to let God restore, quicken, soothe and bless through us. Too often, we don’t recognizing the importance of the words we say or hear. “How are you?” “I care”. “You matter”. “Have a nice day”. “You’re beautiful”. “Peace”. “God loves you”. These simple words are key to empowering the disempowered, to helping end the status quo of oppression that Amanda spoke about last week, to restore, quicken, soothe and bless.

Robert Kennedy spoke about a “ripple of hope”

“Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, …:”

and here, I’d add “or simply says a kind word”.

“he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring those ripples build a current which can sweep down the mightiest walls of oppression and resistance.”

With this as a starting point, let us approach the Gospel lesson for today. When I read stories in the Bible, I like to ask myself, who am I in this story. Often, I am simply the observer. I am watching this great preacher whom I’ve heard so much about heal someone and then get drawn into a power struggle with an opponent playing Gotcha politics.

The leader of the synagogue, instead of seeing something wonderful that has happened, accuses Jesus of not playing by the rules. He engages Jesus in Gotcha politics, and we sit back, watch, and look for favorite person to deliver a stunning rebuke. If you’re following any discussions about the U.S. Presidential election this year, and especially if you’ve participated in such discussions on Facebook, this may sound very familiar, but I also suspect that many of these words may not always be acceptable in the Lord’s sight.

If someone were healed from eighteen years of suffering, I suspect most of us would be elated, unless of course, it triggered our own feelings of inadequacy. Why couldn’t I have performed the healing? What was it like for the leader of the synagogue to have this itinerant preacher show up and address an issue that has been there for eighteen years, and probably seemed unsolvable to many?

Perhaps, we are more like the woman getting healed. What did she do? The lesson starts off with

And just then there appeared a woman with a spirit that had crippled her for eighteen years. She was bent over and was quite unable to stand up straight. When Jesus saw her, he called her over and said, "Woman, you are set free from your ailment."

Notice, that unlike a different woman Jesus healed, we don’t find this one saying, “If I just touch his clothes, I will be healed”. This woman just shows up. I wonder if she even thought that healing was possible. She just showed up, day after day, year after year, with perhaps no hope of being healed, and then one day, unexpectedly Jesus came and healed her. Sometimes, just showing up is what we need to do and our ailments will be unexpectedly healed.

Also notice that this woman had a very visible infirmity. “She was bent over and was quite unable to stand up straight. When Jesus saw her, he called her over” In the story of the other woman that Jesus healed, we read “He turned around in the crowd and asked, ‘Who touched my clothes?’… Jesus kept looking around to see who had done it.” Her infirmities were not obvious. The brokenness of those around us are also not often obvious. There are invisible disabilities. We are often unaware of the chronic illness and chronic pain around us. There is mental illness. Nearly one in five people in America suffer from mental illness. This doesn’t even include the daily struggles each of us face, the griefs so many of us carry. The odds are that you, or someone sitting near you right now is struggling. There is a lot of healing to be done.

Perhaps, sometimes, we can even be a little bit like Jesus, bringing unexpected healing. The feast of St. Clare of Assisi was a few weeks ago and various people were sharing a great quote from her,

“We become what we love and who we love shapes what we become. If we love things, we become a thing. If we love nothing, we become nothing. Imitation is not a literal mimicking of Christ, rather it means becoming the image of the beloved, an image disclosed through transformation. This means we are to become vessels of God´s compassionate love for others.”

We are called to become vessels of God’s compassionate love for others, to be more Christ like, to love our neighbors as ourselves, to heal those who have been suffering for a long time, perhaps with very simple words of healing that the Lord gives us, words like, “How are you?” “I care”. “You matter”. “Have a nice day”. “You’re beautiful”. “Peace”. “God loves you”.

The story in the Gospel illustrates that every day is a day to show God’s love, to heal people, to set them free from bondage. It seems like too often in these current times, we only look for healing, or look to heal others on Sunday, one day out of seven, which is probably worse than what the leader of the synagogue was suggesting of looking for healing on six days out of the week.

How do we stand with Jesus challenging a status quo where some people do not have the same opportunities to enjoy God’s creation as others do? We do it by letting God give us words of love to those around us. We do it by letting God give us the courage to speak, even when our voice is shaking.

After the sermon, we will pray for all people, we will confess that we have not loved our neighbors as ourselves, we will share the peace. We will sing about coming in joy to meet our Lord. We will celebrate the Eucharist. At the end of the service, we will sing “O for a thousand tongues to sing”

My gracious Master and my God,
assist me to proclaim
and spread through all the earth abroad
the honors of thy Name.

Let our voices be part of those thousand voices.

He speaks, and listening to his voice,
new life the dead receive;
the mournful broken hearts rejoice,
the humble poor believe.

May our voices be those that the Lord speaks through, bringing words of hope and healing.

We will then be dismissed with the words “Go in peace, to love and serve the Lord”.

These words, like the other words we’ve been talking about, are not just simple words that we say to mark the conclusion the service. These words relate directly back to Jeremiah.

"Do not say, 'I am only a boy';
for you shall go to all to whom I send you,
and you shall speak whatever I command you,
Do not be afraid of them,
for I am with you to deliver you,

As we go in peace to love and serve the Lord, may seek to show God’s love to all around us, every day.

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A Burning Speck of Star Dust

The rain and clouds have dispersed
and the night is noisy.
Cicadas and bullfrogs
fill the soundscape.
In the distance
an owl hoots
and some coyotes respond.

Sixty miles overhead
a speck of star dust
left behind
by some visiting comet
hits the atmosphere
and starts to glow
before becoming
completely vaporized.

It is dark in the neighborhood
most of the humans are sleeping
and no outdoor lights are visible.
On a distant road
a car can be heard
driven somewhere
by someone
not noticing the show
and, oh,
there’s another shooting star.

Unlike on radio
or television
where dead air
is to be avoided
and viewers become
quickly impatient
we wait on the porch
for the next flash.

We count the seconds
one thousand one
one thousand two
as we wait for another;
just one more piece
of celestial candy
before we return
to bed.

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Collective Effervescence and the Cloud of Witnesses

The Epistle reading for Sunday, August 14th included the verse,

Therefore, since we are surrounded by so great a cloud of witnesses, let us also lay aside every weight and the sin that clings so closely, and let us run with perseverance the race that is set before us, looking to Jesus the pioneer and perfecter of our faith, who for the sake of the joy that was set before him endured the cross, disregarding its shame, and has taken his seat at the right hand of the throne of God.

This has always been a favorite verse of mine, and this past week, I’ve been reflecting on the great cloud of witnesses. I am reminded of those who we can learn so much from by looking at the The Lectionary Page’s Lesser Feasts and Fasts, and additions from A Great Cloud of Witnesses.

Monday, August 8th was the feast of St. Dominic and I spent a little time reading about the Order of Preachers, commonly known as the Dominican Order. Tuesday, August 9th was the feast of Herman of Alaska, “a Russian Orthodox monk and missionary to Alaska”. Wikipedia goes on to say “All biographers agree that at Valaam, Herman studied under Abbot Nazarius, previously of Sarov Monastery, who was influenced by the hesychastic tradition of Paisius Velichkovsky.”

This lead me to do a little reading on Hesychasm, or stillness in prayer. As I spent time reading related topics, I found my way to The Ladder of Divine Ascent. I found a translation online, but I haven’t found a recording of the translation I can listen to on my commute.

August 10th was the feast of Lawrence of Rome and August 11th was the feast of Clare, Abbess at Assisi. A quote for St. Clare has been making its way around the Internet recently:

"We become what we love and who we love shapes what we become. If we love things, we become a thing. If we love nothing, we become nothing. Imitation is not a literal mimicking of Christ, rather it means becoming the image of the beloved, an image disclosed through transformation. This means we are to become vessels of God´s compassionate love for others."

This fits nicely with the thoughts about the cloud of witnesses. We become more like what we love as well as like those around us who love the same thing.

August 12th was the feast of Florence Nightingale. Working in health care, I try to observe this health day, as well as get people to recognize other aspects of her life, around statistics, social reform, and theology.

August 13th was the feast of Jeremy Taylor who “is sometimes known as the ‘Shakespeare of Divines’ for his poetic style of expression, and he is frequently cited as one of the greatest prose writers in the English language”. Part of his writing is recorded on Librivox, so I may listen to some of this later on.

August 14th was the feast of Jonathan Myrick Daniels, an Episcopal Seminarian martyred during the civil rights movement. I thought of Daniels as I prayed for Milwaukee.

Another part of the crowd of witnesses can be found, starting off with this article: Science Says If You Go To Music Festivals, You’re Happier Than Most People.

Can partying be spiritual? Maybe.

The fact you can feel more connected to people around you while enjoying good music is a great reason to actually go to festivals

The article puts it into context by bringing in Emile Durkheim

The phenomenon of shared energy at festivals is attributed to what French sociologist Emile Durkheim calls “collective effervescence.” It’s basically what happens when a group of people get involved in something that allows them to communicate the same thought simultaneously while participating in the same action.

Wikipedia talks about Collective effervescence as “the basis for Émile Durkheim's theory of religion as laid out in his 1912 volume Elementary Forms of Religious Life.”

The Elementary Forms of Religious Life is available on Project Gutenberg, but not on Librivox. It goes onto my reading list.

Collective effervescence, the cloud of witnesses, and becoming like that which we love all has implications for churches. It also has implications for each of us in our daily life, and perhaps especially, in our online interactions.

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