Same medicine. But since generics do not spend on marketing etc, their price is not inflated. E.g.
Instead of
Crestor — Roauvastatin
Lyrica — Pregabalin
Suboxone — bupenornorphine
Proair — Salbutamol
Etc.
Edit: Thanks everyone for your comments. This has been a very educational thread for me.

My mother is 50 year old. And she have no health issues other than cholesterol. She don't smoke or drink. Her weight is 72kg and height is 5"3
Lipid result is as below
Sample fasting
Serum clear
Serum cholesterol 140.42 mg/dl
Serum triglycerides 99.07 mg/dl
Hdl cholesterol 35.69 mg/dl
Ldl cholesterol 84.92 mg/dl
VLDL Cholesterol 19.81 mg/dl
LDL / HDL Ratio 2.38
Total chlo./ HDL Chole. Ratio 3.93 mg/dl
Fasting glucose is 111mg /dl
Fasting urine glucose nil
Urine albumin nil
Post prandial glucose is 143mg /dl
Post prandial urine glucose trace
Urine albumin nil

 Fatty liver detected three years ago. Doctor told her to loose Weight. She used to take medicine for blood pressure which was also mild but she lost weight and after reports doctor told her to not continue that blood pressure medicine. 

Doctor have given her 10mg table for diabetis in the night and Crestor 10mg for cholesterol everyday.

 My uncle who is pharmacist told me that he takes Rosuson 10mg for his cholesterol which is less costly than creator. I want to know if crestor and rosuson is same? I'm from India. 

Crestor 10mg 510rs 30 tablets
Rosuson 10mg 30rs 10 tablets this is the price difference. And do my mother need medicine for diabetis If it's 111mg and 143mg. She hv same result everytime for diabetes. She does yoga everyday and take very good care of herself. She is very perticular with her medicines. 10mg is the mildest dose right she Take medicine for diabetes at night which is 10mg and she says she feels hungry in the morning She needs to eat first. Feeling hungry has anything to do with her medicine at night??

Where can I get my jersey customized?

Cal-Crests
Cal-Crests Ltd. is one of Calgary’s longest-running suppliers of custom embroidery and cresting. Family-owned and operated since its inception, we have a team dedicated to providing Calgary and the surrounding area with quality products at competitive pricing.
Great Plains Cresting
Great Plains Cresting began operations in 1975 in Calgary, Alberta. We were the first NHL licensed crestor in Canada and are currently the only one in Calgary.
As of 2007 we officially become an officially licensed crestor for Hockey Canada.

Where can I buy or sell Flames tickets?

Ticketmaster
Stubhub
Gametime
Seatgeek
TickPick
FanFirst
Any attempted ticket sale posted on /CalgaryFlames will result in removal and ban as per rule #1.

Where should I sit in the dome?

There are no bad seats in the Saddledome. This ultimately boils down to preference, budget, and experience you wish to have.
The Press Level (PL) offers an unobstructed view of the full ice surface, affordable tickets, access to concessions, bathrooms, and the 200-level bar.
200s level is arguably the best view in the Saddledome if you are sitting at center ice. As a result, this drives up the value of the tickets.
100 level is the closest to the ice surface and arguably the best way to get immersed in the game as you are right in the thick of it. These are typically the most expensive seats in the Saddledome.

When should I arrive at the dome before a game?

From 5:30 to 6:30 p.m., there are food, drink, and merchandise specials. You can get a 14 oz. domestic draught, 1 oz. highball, 6 oz. house wine, a cheeseburger, or a pizza slice for just $5 each. As well, take an additional 10% off all regular-priced FanAttic merchandise." Happy hour lasts until 30 minutes before puck drop.
If pre-game specials do not tickle your fancy, doors open 90 minutes before puck drop. Arrive at whichever time suits your schedule.
Entry for games remains open until the start of the 3rd period. From that point, they will no longer allow entry.

Where should I park for Flames games?

If you have a Lot A or Parkade parking permit, you can access your lots from 5th Street SE, on the North East side of the building. There is public parking available in the Stampede lots, located both North, North West, West, and South West of the Scotiabank Saddledome. Parking is available two hours before the event, and there is a $15 parking fee. There is also public transit available and accessible to the building. The Victoria Park/Erlton stations are both closely located to the Scotiabank Saddledome.

Where is the Ticket Office/Will Call?

The ticket office is located in the NE corner of the Saddledome. Inside the TELUS Club entrance.

Anything else I should know before going to a game?

Concessions are open.
Starting this season the Saddledome no longer accepts cash, bring your debit or credit card, or use your phone to pay.
There is no re-entry for smoking.

Related FAQ

Tourism Calgary FAQ
Saddledome A-Z Guide

Dear MetaVerse Creators/Investors and Brainchild projects
I am a Consumer and I want something to excite me and I have found nothing so. The tone on the hype of the Metaverse was NFTs and then Facebook but that's it.
I am sure a lot of Creation is on its way, but I have an amazing Oculus Quest 2 Head set (firstly great price) but I find nothing to sink my teeth into.
Its boring. No1 seems to be asking what would we like to do into the Metaverse rather there are gimics of MonkeySeeMonkeyDo. I refer the first Monkey as Enternet and the second as mEta.
Dear game creators, do you want EA sports to be ruling this planet too ? cauz there is 0 launches, 0 free lunches, 0 collaborations.
Everyone is trying to make a Million Dollars but not a Billion MetaUnits.
Can the environment be created for us and not for you The Investor .
We will give you a chance to make a more than fair share Mr.Investor, but can you list down the things we do in real life and create a gaming navigation .
Mr.Game Crestors the fingers behind the clicks and keystrokes can you fasten up your ****ing seat belts and concentrate on asking your grandmother what would they like to experience.
In any case you have a responsibility to turn around before the my Oculus busts and the VR bust.
Bootstrap your time guys ask us what we need, we are consumers we will tell you and we will help you make your Billion MetaUnits.
In the coming days I shall want to post some places in the Metaverse that I want to experience, Dear makers of the MetaGalactic listen to us.
Yours boring consumer who feels utterly used and underpaid in the real world ,
BroCreate

Due to the current situation and lack of medications within pharmacies or even the extortionate prices they're asking for, I've decided to compile a simple list of the most common medications that are currently missing.
I've separated them into categories while including doses, the brand name and generic (generics work just as well as the brand name and are usually cheaper), along with their indication and if they're OTC (over the counter) or may need a prescription.I will not be adding insulin to the list nor children vaccines (both of these require prescriptions and are difficult to transport).
For children:

• Panadol - Adol - Tylenol both Syrup and suppository form, for fever mainly the under 1 year doses are missing (Panadol pink, Panadol Blue etc...). (OTC)
• Profinal - Brufen Syrup, also for fever. (OTC)
• Motilium Syrup, for nausea and vomiting. (OTC)
• Prospan syrup and suppositories, for coughs and sore throats can be used by both kids and adults. (OTC)
• Augmentin - Amoclan Syrup, most common antibiotic used dose is adjusted based on weight.
• Klacid syrup, also a very common antibiotic.

Pain relief:

• Panadol - Panamax - Paracetamol - Tylenol pills, the most basic medication we all know it and have it. (OTC)
• Advil - Profinal - Ibuprofen, also basic. (OTC)
• Ponstan Forte, all the ladies will appreciate this I personally can't live without it. (OTC)
• Buscopan - Scopinal, for abdominal cramps also appreciated. (OTC)
• Muscerol, muscular pain. (OTC)
• Voltaren gel, muscular pain. (OTC)

Supplements/Other: (Mainly OTC)

• Magnesium 250mg, helps with stress and cramps.
• Vitamin C 500mg-1000mg, helps with immunity support and the flue.
• Vitamin D (10 000 IU capsules or 100 000IU monthly ampoule).
• Iron supplements.
• Zinc (25mg or 50mg), many are taking Zinc for immunity support.
• Vit B12 in any dose, especially important for the older population.
• Calcium supplement.
• Gravol, for nausea and car sickness.
• Motilium pill form, for nausea and vomiting.

Note for the following categories: although a lot of people are struggling to find these, it's best to check if there are people you know in need of them. I've omitted many more medications that are missing and kept it short.
Asthma/Allergies:

• Butalin - Ventolin - Atrovent inhalers, can be a life saver in case of an asthma attack.
• Singulair - Montelukast (4mg, 5mg,10mg), chronic asthma medications.
• Aerus - Telfast - Histamed, antihistamines. (OTC)

Blood thinners: (Majority require prescriptions depending on the country)

• Aspirin - Aspicot - Aspicor, most commonly used but it's disappeared. (OTC)
• Plavix - Clopidogrel, difficult to find and many people can't be off them.

Blood pressure/Diuretics: (Majority require prescriptions depending on the country)

• Concor - Bisocor - Bisoprolol, for irregular heart rate and high blood pressure. Available as 2.5 mg, 5mg and 10mg.
• Lasix 40mg - Diuresal - Furosemide, diuretic that can help with high blood pressure.

Cholesterol: (Majority require prescriptions depending on the country)

• Crestor 10mg 20mg 40mg - Lotevan - Atorvastatin - Lipitor, most commonly needed for cholesterol.
• Lipanthyl 160mg 200mg - Fenogal , for triglyceride.
• Zemil - Ezetralex, also very common for cholesterol.

Diabetes: (Majority require prescriptions depending on the country)

• Metformin - Glucophage, available in many doses most commonly used is 1000mg.
• Galvus Met 50/1000, very commonly used.
• Diamicron.

Note: Despite there being a shortage in many more medications when it comes to the prescription medications these are the ones I most commonly see my patients take, I work in healthcare and it is currently a living nightmare.
If you are to bring medications with you, be sure to check with the airline what you can and cannot bring since you may not be allowed to bring syrups on the airplane.
I would recommend just bringing general pain relief meds and supplements since anyone would be able to use them.
Thanks to the comments for bringing this to my attention, please be careful not to bring too many items with you as some may be confiscated. Stick to 1-2 boxes of items you know somebody needs, or general pain meds / vitamins.
Thank you to everyone who is asking on how they can help, and to those offering support.

Happy Tuesday, Barkada --

The PSE gained 79 points to 6914 ▲1.2%

Thank you to Persistent_Papaya for the commentary appreciation, and to @springrolls and @TagaUPFight for the kind words on the Discord chat.
Thanks also to MooseFandango for pointing out an error in my post yesterday about Emperador's plan to offer shares on the Singapore Exchange. I said that a secondary offering is where a company lists shares on a different exchange, but that's actually just called a "dual listing". Technically, a secondary offering is just one where the company plans to sell additional shares after already gone through an IPO (whether that's a FOO, SRO, or dual listing in a foreign exchange). Sorry for the confusion, but thanks to MooseFandango for pointing that out!
Shout-outs to InfoBlaze Philippines, Let's Talk Singapore, Stephen Chiong, Corgi Buttowski, N, Lance Nazal, Joe Latham, Chip Sillesa, and Jing for the retweets, and to Froilan Ramos and Mike Ting for the FB shares.

▌In today's MB:

• Sta. Lucia Land: dusts off old FOO plan from 2018, ready to try again
• The Keepers: board approves FOO plan to cure non-compliance with minimum public ownership rule
• MerryMart: buys Carlos SuperDrug, Quezon province’s largest pharmacy chain

Read below for more detail and analysis!

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▌Top 3 MB indices:

 Fast Food ▲3.13% Logistics ▲2.22% D30 Targets ▲2.04% 

▌Bottom 3 MB indices:

 Cement ▼0.25% POGO Gaming ▼0.01% #COVID-19 ▲0.05% 

▌Main stories covered:

• [NEWS] Sta. Lucia Land [SLI 3.05 ▲2.35%] dusts off old FOO plan from 2018, ready to try again... the property developer, headed and owned by Exequiel Robles and the Robles family, has re-filed its old FOO plan (first approved in 2013) with the SEC, seeking to sell 3 billion common shares (2.5 billion firm offer, plus 500 million over-allotment) at a maximum price of ₱3.29 per share. That would raise about ₱9.8 billion in equity for SLI, assuming that the over-allotment shares are sold by SLI (and not some private shareholder, like Mr. Robles), and that all of the shares are sold at the maximum offer price. That is the absolute limit of what we know as this point, but SLI does have a long history of teasing this particular FOO transaction, so we do have some additional information from that earlier attempt that we might be able to use today. While the original FOO plan was first approved in 2013, SLI didn’t seriously attempt to execute its FOO plan until 2019, just after the Kepwealth [KPPI 5.17 ▲1.37%] IPO exploded and the exchange was gripped with IPO fever. SLI was one of several firms that rushed to get various equity raise processes rolling. In its prospectus, SLI said that the primary purpose of the FOO was to raise money for “strategic landbanking”, which as I noted at the time sounded a whole lot more like a “nice to have” than a “need to have” kind of thing. But then Axelum Resources [AXLM 2.89 ▲0.70%], the first IPO after the KPPI phenomenon, fell flat on its face and the AllHome [HOME 8.06 ▼1.10%] IPO raised money but didn’t pop, and it just felt like those two disappointments just let all of the air out of the “IPO ALL THE THINGS” balloon all at once. SLI announced that it planned to shelve its FOO due to “market conditions”, and I said that SLI would probably be back with its FOO plan in 2020.
  
  • MB: Well, here we are! I missed by a year in my prediction, but then, I feel like most plans that were scheduled to happen in 2020 were probably kicked down the road a bit. I’m very curious to get a look at SLI’s prospectus for this iteration of the FOO to see if its primary purpose is still just landbanking, and whether or not the company will provide a better breakdown of its plans for the money. Timing wise, it’s hard to argue with the management team here; the stock is trading at/near an all-time high, and it’s up around 65% in the past year. But what are we supposed to make of this? From a signal perspective, perhaps SLI’s initial approach to the market is a sign that we could be at a crossroads. The last time SLI approached the PSE in 2019, the broader market was rising with some momentum, but after SLI’s October cancellation of its FOO, the market briefly breached 8,000, and then began to melt away. The quick flash crashes in early 2020 put the market down in 7,200 territory, and then we all know what happened when the realities of COVID started to become more clear. I’m not suggesting SLI as a serious, tried-and-true signal, but I’ll be watching to see if they get nervous again and shelve the FOO once more. There are two IPOs coming up over the next couple of months (Filinvest REIT [FILRT] and Megaworld REIT [MREIT]) that could embolden SLI or cause the company to lose its nerve (once again) as it did after AXLM and HOME in 2019. I mean, REITs are not really IPO moon rockets anyway, so... maybe the cards are stacked against SLI actually going through with it. We’ll just have to read the prospectus and watch!
• [NEWS] MerryMart [MM 4.14 ▲4.02%] buys Carlos SuperDrug, Quezon province’s largest pharmacy chain... the signed agreement for MM to acquire 67% of Carlos SuperDrug did not mention the price or any other terms and conditions of the deal. Representatives for MM said that the acquisition of Carlos SuperDrug was meant to “enhance MERRYMART’s range of pharmacy offerings”, “strengthen its supply chain”, and add “Pharmacy DNA to the MERRYMART ecosystem”. Carlos SuperDrug has 27 locations that will continue to be operated by the Carlos SuperDrug team, “in tandem with the MerryMart team”. MM also said that it is interested in additional mergers and acquisitions for its grocery business and pharmacy business. MM is owned by Injap Sia, co-owner of DoubleDragon [DD 11.80 ▼2.32%] and DDMP REIT [DDMPR 2.00 ▲0.50%].
  
  • MB: MM is just one component of Injap’s 2030 vision, which seems founded in making MM (and other Injap interests) a central part of our everyday lives. Pharmacies bring a great deal of foot traffic on a daily basis, both from walk-bys (“Need some biogesic to make it through this day”) and repeat customers (“Filling my prescription of Crestor for the 30th time”), but they’re specialized. It’s easier for a pharmacy to grow its product offering to look more like a convenience store than it is for a convenience store to just casually add some pharma capabilities. Pharmacies require domain knowledge, special employees, and demand a higher degree of cold chain and logistics care than do convenience stores, but their products are high-value, and their customers are (similarly) high-value. Someone who can afford to fill their Crestor prescription for the 30th time might also be interested in some high-margin snacks, groceries, or other conveniences. Not to mention the growing popularity of prescription deliveries; MM might be able to build a delivery business with a reliable schedule of repeated prescription orders as the foundation. I want to see how much MM paid, and I want to know MM’s plans for the SuperDrug name. I’m also curious to see how aggressive MM will be in incorporating this “pharmacy DNA” into MM branches. Like a lot of Injap moves, there are lots of interesting opportunities, but we’ll have to see where they take this.
• [UPDATE] The Keepers [DAVIN 2.95 0.00%] board approves FOO plan to cure non-compliance with PSE’s minimum public ownership rule... the plan calls for the sale of 3 billion common shares, at between ₱2.00 and ₱2.50 per share. DAVIN’s shareholders already approved the use of a FOO to correct the minimum public ownership problem that was created by the Cosco Capital [COSCO 5.20 ▲0.39%] property-for-share swap with DAVIN, so there really isn’t much new here except for the price range and the update that the board is, in fact, moving forward with attempts to fix the situation that’s left DAVIN untradeable for four trading days and counting.
  
  • MB: The 3 billion shares to be sold in the FOO are about 24% of DAVIN’s outstanding shares (post-transaction, after COSCO gets 11.5 billion in return for its three subsidiaries), but only about 19.5% of DAVIN when the shares from the FOO are added to the post-transaction outstanding shares. I feel like I basically nailed it when I predicted the size of the FOO back in May (“<20% of listed shares”), but I can’t take too much credit for my prediction because it’s the least that Lucio Co would have to sell to scrape himself just barely over the line required to lift the trading suspension. The spirits market is booming; why sell more of a quality asset than is required?

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TLDR at bottom. On mobile so please excuse formatting.
So this interaction happened 2 days ago and it was such an obvious attempt to get cheaper meds I just had to share. For context I live and work in Australia, so laws and drug pricing (thanks to Medicare) are different to places like the US.
We had a guy come in and I took in the script initially. He had a script for two different antibiotics and a script with cholesterol and blood pressure medication. When I took them he said he only wanted the brand written on the script (mostly original brands, except for 1) and that he got his normal medication here last month and he wants the same prices. He said he didn’t care about the prices of the antibiotics.
All of this was fine until the pharmacist looked him up and found he had only had one regular medication here before, not all 3, so she asked my coworker to check what he thought the prices of the other two were. He told us he normally pays $7 for the Crestor and $5 for the other one.
The pharmacist checks this against what we normally charge and what the huge discount chemist chain here charges. She told him that she could match the discount chemist at $10 for the Crestor which is the cheapest she can do it to get the original brand. I even checked if he had a concession card which may reduce the price a bit (not much due to the brand premium).
He was not happy with that, and told us that no he would take that script elsewhere, just fill the antibiotics. So, we did. When my coworker was checking him out he told her in quite a nasty tone that we were very expensive and that he was taking his script to the chemist upstairs because they “always” give him the cheaper price.
Once he left we all had a good laugh because the chemist upstairs is owned by the same person as ours and our prices and matching policies are the same. The only way we could figure he was getting those prices was if they were giving him generic brands and not telling him.
TLDR: guy wants scripts for cheaper than the discount chemist price, decides to take them upstairs when we couldn’t, but upstairs is owned by the same person so same prices.

Honorable Attorney General, Kathy Jennings, in God’s name I pray you’ll have every success. I come before you on bended knee and pray you will grant me an extension so that I can prove my innocence. I can appreciate that this is been handed off to you to resolve, I only pray on the ability to confront my accuser. I pray you will be a hero, uphold the oath of office for each and every citizen of Delaware. This is limited to the very specific area of “lying to police” and “falsely reporting a crime”. This is a black and white provable issue that is so completely obvious for the very reason that the report to the police does not match my medical report of the accusation in question. What I have included later in this letter is just more evidence to support my accusation. I pray the media will stay aware of my message, for I have honored the contract in word, deed, spirit and I am signed up for the mission. I am only seeking to confront my accuser and refuse to be treated in any other way than uniform and consistent with all the rights and privileges each citizen of the United States of America is born with. I want “due process” and all the integrity that a court case offers, in addition to the transparency and fairness to all that this type of process ensures, considering this is about a nationwide epidemic.
Honorable Attorney General, Kathy Jennings, I have been in contact with the Atty. Gen.’s office for approximately 2 years and without their help I would not of been able to have access to my medical records so that I may support the most damaging part of my argument. It is my firm belief and I have provided to your office and others, evidence to support “intent” and an “established history of defamation of others” and that Dr. Semaan Abbound, M.D. maintained an office setting that was reckless, careless, derelict, without morals or ethics, as an example, I requested prior to my last scheduled appointment so that I may meet him for the very first time considering I’ve been going to his office for three years. In addition, according to records that I have he received payment on 7/6/16 and the very next day on 7/7/16 records show that nurse practitioner Cheryl Lyn Zdana also received payment, I believe there double dipping, including the multiple HIPAA violations are overwhelming, and this needs looking into. I have asked your office repeatedly for the full name of the “new guy” that is working with nurse practitioner Cheryl Lyn Zdana, and I am still in need of this information. I believe the citizens of Long Neck Strong (a group of citizens demanding police protection), as well as the rest of the taxpaying citizens of Delaware deserve to understand that Delaware State Police were required to respond, to a practice that was closed, doors were locked, I had no warning I would be arrested that morning if I did not leave. I was there to collect my medical records, which I had requested in certified letter. It is this very specific part when the police involvement began, when it went from a medical issue to something more and that is why I require this information. The State of Delaware Division of Professional Regulation Investigative Unit is not responsible for criminal prosecution, and if they had administered any disciplinary action at all, maybe we would not be having this conversation. The State of Delaware Division of Professional Regulation Investigative Unit has a 6 month “magical window” that they would accept any type a complaint, I barely met this requirement, struggled to produce an extremely detailed examination and response to my medical records just to have this very same regulatory agency toss out one half of the records at their whim. Justice delayed is justice denied.
I respectfully demand in the strongest possible way, the following be prosecuted for lying to the police and falsely reporting a crime: Dr. Semaan Abbound, M.D. Of Lewis Surgical and Medical Associates and nurse practitioner Cheryl Lyn Zdana, MSN FNP – BC of Lewis Surgical and Medical Associates, PA or Cedar Tree Surgical Medical Center at 32711 Long Neck Rd., Millsboro, DE 19966. In addition to ”the new guy ”.
Statements from The Medicaid Summary Notice show 6 lab test dates (from 8/2014 to 12/2015 1 every 3 months) ranging in price from $97.87 to $323.01 (the amount Medicaid paid), I am currently paying $60.00 for a “5 panel” drug screening test out-of-pocket. Why is there such a difference between the price that I pay and the price that Medicare pays? Statements from the lab test company show I had a total of 10 lab test dates (from 8/2014 to 3/2017 one every 3 months) without any record of those procedures after 12/2015 in The Medicaid Summary Notice. How could that be? It could be that Medicaid saw the error in the billing and made Dr. Semaan Abbound, M.D. Of Lewis Surgical and Medical Associates and nurse practitioner Cheryl Lyn Zdana, MSN FNP – BC of Lewis Surgical and Medical Associates, PA or Cedar Tree Surgical Medical Center at 32711 Long Neck Rd., Millsboro, DE 19966 do without payment for these other lab test results as a way to balance the books. But considering how complex Medicare is it is very possible that there is a legitimate reason for not having these other procedures listed, that may not be so obvious. It also may be possible that I have lost some of my statements. But I also believe it’s possible that this is an actual case of “up coding” where physicians require tests that are not necessary.
Considering, Dr. Semaan Abbound, M.D. has received payments from drug companies and previously been disciplined by The State of Delaware Division of Professional Regulation Investigative Unit, in addition to the no fewer than 20 HIPAA violations that I have reported, I believe this is additional proof for why those need to be held accountable for their actions.
I would like to say to all citizens I have come forward at great personal risk to myself in addition to the suffering from a medical condition that is chronic, this may not read as well as I would like and I apologize for that, I look forward to my day in court. The following area describes the things that I have discovered or witnessed. Please make sure you focus on the message and not the messenger, I have found myself in this situation by no fault of my own, at the age of 15 and a few months, took the same job of one of the “migrant help” that came up from Mexico in the mid-1970s, co - opt throughout high school, with the majority of my career in metalworking or construction industries. This exposure to people who work so very hard, left me with a work ethic that was admired by my future employers but after a flawed surgery I have found myself in this situation. To my fellow Americans, whether you are an immigrant or not, let it be clear; you will be encouraged by every means possible to work harder than the day before but if you develop a health issue you may find yourself in the very same shoes as me. There is not one physician you’ll ever meet that will not claim to be able to help you, but you are the sole person that has to make a decision whether the physician is competent or not. The hallmark of a sound mind is when a person’s words and deeds are one and the same.
This is a real life example of what you get in exchange for a retainer fee at the firm, Baird Mandalas Brockstedt LLC (www.bmbde.com). I came to the firm with a contract (one side of one sheet of paper) stating that I believe I have met my obligations to the contract in word, deed and spirit, but if I have not, and have made an error in judgment, I still need to fix the issue. Completely transparent on the way in, describing what I expect to find when I was able to read my medical records, upon receiving the biggest part the records that showed what I said was true, I was “baited and switched” and found myself without any representation. During this time that the firm worked with my retainer fee, a phone call was made, that discovered that there was an additional medical record out there. This additional medical record has information on who is allowed into pain management. Because my attorney failed to take any notes of the phone call, about medical records, I do not know the official name (so when I asked officials I don’t know the proper name of the record to request a copy) of that medical record. I have contacted the attorney in question and offered money to make the simple phone call, to either get a copy of the medical record or the actual name of the medical record so that I can search it out myself. I pray the attorney in question will decide to be a hero and make the call, so that I may say kind things about the firm.
I would suggest part of the solution be that a camera with sound be mandatory for all surgical and other medical visits as to ensure all procedures are review-able, so words and deeds are documented and the medical community is held accountable vs. “we are just practicing medicine” (aka “fake it until you make it”). Why are we not allowing the free market to work as it has done for so many years? Allow physicians do what they do best educate and treat the public. This would allow for a check and balance in the system so that the lab testing company was completely independent that enables it to do what it does the best and is most cost efficient at. In addition this medical condition would be treated consistent and uniform just exactly like any other chronic medical issue people would have in their entire life, one could go to a testing facility of their choice. If there is such a fear that there is a chance that the person’s lab test sample was somehow manipulated, how is that possible with the blood test? Who should have to endure the humiliation of a female medical technician standing within arm length of you as you’re trying to fill a sample, in the urinal, for this is exactly what happened at Sussex Pain Relief Center (Dr. Antony, Manonmani) on 4/29/2013 (this resulted in a blood sample taken (a 10 screen panel), a simple example of up coding). If you come in to the office and are so full of liquid that you really need to submit a sample at that very moment you’re looked at like you have the problem.
One would think by the manner that treatment has been administered to this condition, that this is a highly contagious epidemic or that there was some new peer reviewed research describing the treatment being administered. I believe the last time that healthcare experts were required to lie to their patients was doing the Tuskegee Syphilis Experiment (ended in 1972), when they recruited African-American nurses to deceive the African-American patient’s about syphilis treatment. I was led to believe by nurse practitioner Cheryl Lyn Zdana that there had been a law passed that mandated the treatment I was receiving. I received this same pitch from the other pain management physicians named here, if such a “mandate” or “peer-reviewed research” exists, please provide a link. Has there ever been a time or a disease that required treatment equal to a quarantine of sorts, to control the epidemic in the America? If you read an article published by; Partnership For Public Health Law (this is part of the network for public health law a national initiative of the Robert Wood Johnson foundation) it states: “that there to be no interference with the individual’s ability to move about freely”. This is simply part of due process afforded to the citizens by the Fifth Amendment.
These are the pain management companies that when out of business, are closed up and left this part of the state:
Gabriel Somori: https://projects.propublica.org/docdollars/doctors/pid/238 (disciplined Jun –2014) Coastal Pain Care Physicians 1606 Savannah Road; Closed the doors and left the state.
I do not remember the physician but this is the earliest time of meeting, nurse practitioner Cheryl Lyn Zdana!! Compassion Pain Center (or something like that) located at: 33672 Bayview Medical Center Lewis, Delaware; Tried to get my next appointment, the phone would just ring, so I went to the location, the door was locked and the lights were out no sign of what happened and the only option was to go to Dover and I was already driving around 20 miles. Does anybody know what happened here?
Is the additional paperwork so complex or otherwise above and beyond the normal scope of paperwork that your primary care physician provides? What is so special, cumbersome or difficult about it? After reviewing my records I see nothing there.
I would like to send this short comment out to the Hon. Congresswoman Lisa Blunt Rochester. Why doesn’t the 14th amendment (equal protection) apply to those who have a legitimate prescription for controlled substance so they are not targeted by these people who have a criminal mindset as to monitor the people as they go to their vehicles outside the Pain Management Center and simply follow them home knowing with nearly 100% accuracy that there will be narcotics at that residence every 30 days? Considering this will be a larger risk in the future than it is now.
These are links about pain management or other topics that I have found that support my argument:
Physicians in Delaware that provide pain management (this is a very long list); https://projects.propublica.org/checkup/drugs/2954/states/delaware?by=asc&sort=drug_claims
Payments from drug companies can be viewed at the following links:
Antony Manonmani:https://projects.propublica.org/docdollars/doctors/pid/824446
Gala Nihar: https://projects.propublica.org/docdollars/doctors/pid/1347713
Semaan Abboud: https://projects.propublica.org/docdollars/doctors/pid/1219151
Partnership for Public Health Law (5th amendment), search this pdf: Due_Process_and_Public_Health_factsheet.pdf
The Milgram experiment 1962 link; https://www.youtube.com/watch?v=wdUu3u9Web4
The Stanford Prison experiment 1971 link; https://www.youtube.com/watch?v=760lwYmpXbc
The Belmont Report, describes the ethics of healthcare: https://en.wikipedia.org/wiki/Belmont_Report
See earlier post for links to Title 16 & 21; Chapter 17 & 22, for this is the mandate that all physicians in Delaware are required to honor: https://old.reddit.com/Delaware/comments/9mh0xhonorable_governor_carney_i_need_your_help/
This link shows the cost and name of medications prescribed in various searchable ways:
https://projects.propublica.org/checkup/states/delaware
The Washington Post had a recent article dated around 3/11/19 about 300 physicians all signing a petition to the CDC protesting the way pain management is being enforced, please read at washingtonpost.com-by Lenny Bernstein titled: Healthcare Providers say CDC’s Opioid Guidelines are Harming Pain Patients.
Article read at ondelawareonline.com- dated 6/16/16 by Rod Smolla titled: An Unfortunate Omission: Delaware’s Lack of Equal Protection. If this is true this would explain in great deal about this topic but would be a sad day if Delaware citizens are not afforded the same protection as others American citizens by design.
Or article read at huffingtonpost.com- dated 7/31/18 by Art Levine titled: The Government’s Solution to the Opioid Crisis is Feeling Like a War to Pain Patients
In God’s name I pray I will not be penalized for someone else’s actions. I can appreciate that there was a time when some physicians prescribed more pain medicine than was required and that the system that regulated healthcare was inadequate, but that time has passed. The vast majority of deaths to this epidemic are a result of Fentanyl coming through “ports of entry” into the United States. China has only recently made Fentanyl a controlled substance and has promised to control export. Ports of entry include the United States Post Office, considering how potent a small amount is, in addition to currency like ”BitCoin” that can be used for payment on the “Dark Web” or “the Silk Road” I would think that would be the place to scrutinize. There are 15 other medications where a great deal of more money is spent; #1 Harvoni $17.2K; #2 Crestor $11.6K; #3 Xarelto $8.9K at #16th Oxycontin $5K, according to www.propublica.org. Purdue-Pharma that produces Oxycontin is considering going “bankrupt” if there was ever a time for government to privatize just one of the big pharmaceutical companies now is the time the “price is right” and then reach out to the owners of Purdue-Pharma and claw back some of that profit. Leave all the employees in place at that facility and just funnel the profits back into the government versus adding on taxes to the end-user. Historians have a saying “how do you know where you’re going unless you know where you have been”. Considering that the origins of this medication go back thousands of years I cannot imagine how it could be protected by some kind of patent or other document in addition to how could it possibly not be known that this medication may be addictive like many other medications. I do not believe the answer to “addiction” should involve law enforcement unless some laws have been broken, but in my case where somebody just did not want to do their job and they can lie to law enforcement to make sure they can get away with it. After careful review of my records I would suggest whatever additional training pain management providers have that the primary care physicians be trained the same way so they will feel confident in their position. I have never objected to providing a lab sample any time, as often as required, unlimited as to duration, just let the free market work and be treated uniformly and consistent with all other citizens no matter what the medical condition is. If health officials really want to protect the future generations of citizens it would seem to me testing should start at the age of 13 for all citizens, this would give absolute certainty the areas that need attention and may give insight as to why some of these school shootings occur.

"The combined profits for the ten drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together ($33.7 billion) [in 2002]. Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself."

Every day Americans are subjected to a barrage of advertising by the pharmaceutical industry. Mixed in with the pitches for a particular drug—usually featuring beautiful people enjoying themselves in the great outdoors—is a more general message.
Boiled down to its essentials, it is this: "Yes, prescription drugs are expensive, but that shows how valuable they are. Besides, our research and development costs are enormous, and we need to cover them. As 'research-based' companies, we turn out a steady stream of innovative medicines that lengthen life, enhance its quality, and avert more expensive medical care. You are the beneficiaries of this ongoing achievement of the American free enterprise system, so be grateful, quit whining, and pay up." More prosaically, what the industry is saying is that you get what you pay for.
Is any of this true? Well, the first part certainly is. Prescription drug costs are indeed high—and rising fast. Americans now spend a staggering $200 billion a year on prescription drugs, and that figure is growing at a rate of about 12 percent a year. [1] Drugs are the fastest-growing part of the health care bill—which itself is rising at an alarming rate. The increase in drug spending reflects, in almost equal parts, the facts that people are taking a lot more drugs than they used to, that those drugs are more likely to be expensive new ones instead of older, cheaper ones, and that the prices of the most heavily prescribed drugs are routinely jacked up, sometimes several times a year.
Before its patent ran out, for example, the price of Schering-Plough's top-selling allergy pill, Claritin, was raised thirteen times over five years, for a cumulative increase of more than 50 percent—over four times the rate of general inflation. [2] As a spokeswoman for one company explained, "Price increases are not uncommon in the industry and this allows us to be able to invest in R&D." [3] In 2002, the average price of the fifty drugs most used by senior citizens was nearly $1,500 per drug for a year's supply. (Pricing varies greatly, but this refers to what the companies call the average wholesale price, which is usually pretty close to what an individual without insurance pays at the pharmacy.)
Paying for prescription drugs is no longer a problem just for poor people. As the economy continues to struggle ... employers are requiring workers to pay more of the costs themselves. Since prescription drug costs are rising so fast, payers are particularly eager to get out from under them by shifting costs to individuals. The result is that more people have to pay a greater fraction of their drug bills out of pocket. And that packs a wallop.
Many of them simply can't do it. They trade off drugs against home heating or food. Some people try to string out their drugs by taking them less often than prescribed, or sharing them with a spouse. Others, too embarrassed to admit that they can't afford to pay for drugs, leave their doctors' offices with prescriptions in hand but don't have them filled. Not only do these patients go without needed treatment but their doctors sometimes wrongly conclude that the drugs they prescribed haven't worked and prescribe yet others—thus compounding the problem.
The people hurting most are the elderly. When Medicare was enacted in 1965, people took far fewer prescription drugs and they were cheap. For that reason, no one thought it necessary to include an outpatient prescription drug benefit in the program. In those days, senior citizens could generally afford to buy whatever drugs they needed out of pocket. Approximately half to two thirds of the elderly have supplementary insurance that partly covers prescription drugs, but that percentage is dropping as employers and insurers decide it is a losing proposition for them.
For obvious reasons, the elderly tend to need more prescription drugs than younger people—mainly for chronic conditions like arthritis, diabetes, high blood pressure, and elevated cholesterol. In 2001, nearly one in four seniors reported that they skipped doses or did not fill prescriptions because of the cost. (That fraction is almost certainly higher now.) Sadly, the frailest are the least likely to have supplementary insurance.
At an average cost of $1,500 a year for each drug, someone without supplementary insurance who takes six different prescription drugs—and this is not rare—would have to spend $9,000 out of pocket. Not many among the old and frail have such deep pockets.
Furthermore, in one of the more perverse of the pharmaceutical industry's practices, prices are much higher for precisely the people who most need the drugs and can least afford them. The industry charges Medicare recipients without supplementary insurance much more than it does favored customers, such as large HMOs or the Veterans Affairs (VA) system. Because the latter buy in bulk, they can bargain for steep discounts or rebates. People without insurance have no bargaining power; and so they pay the highest prices.
In the past two years, we have started to see, for the first time, the beginnings of public resistance to rapacious pricing and other dubious practices of the pharmaceutical industry. It is mainly because of this resistance that drug companies are now blanketing us with public relations messages. And the magic words, repeated over and over like an incantation, are research, innovation, and American. Research. Innovation. American. It makes a great story.
But while the rhetoric is stirring, it has very little to do with reality. First, research and development (R&D) is a relatively small part of the budgets of the big drug companies—dwarfed by their vast expenditures on marketing and administration, and smaller even than profits. In fact, year after year, for over two decades, this industry has been far and away the most profitable in the United States. (In 2003, for the first time, the industry lost its first-place position, coming in third, behind "mining, crude oil production," and "commercial banks.") The prices drug companies charge have little relationship to the costs of making the drugs and could be cut dramatically without coming anywhere close to threatening R&D.
Second, the pharmaceutical industry is not especially innovative. As hard as it is to believe, only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH).
The great majority of "new" drugs are not new at all but merely variations of older drugs already on the market. These are called "me-too" drugs. The idea is to grab a share of an established, lucrative market by producing something very similar to a top-selling drug. For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first. As Dr. Sharon Levine, associate executive director of the Kaiser Permanente Medical Group, put it:
"If I'm a manufacturer and I can change one molecule and get another twenty years of patent rights, and convince physicians to prescribe and consumers to demand the next form of Prilosec, or weekly Prozac instead of daily Prozac, just as my patent expires, then why would I be spending money on a lot less certain endeavor, which is looking for brand-new drugs?" [4]
Third, the industry is hardly a model of American free enterprise. To be sure, it is free to decide which drugs to develop (me-too drugs instead of innovative ones, for instance), and it is free to price them as high as the traffic will bear, but it is utterly dependent on government-granted monopolies—in the form of patents and Food and Drug Administration (FDA)-approved exclusive marketing rights. If it is not particularly innovative in discovering new drugs, it is highly innovative—and aggressive—in dreaming up ways to extend its monopoly rights.
And there is nothing peculiarly American about this industry. It is the very essence of a global enterprise. Roughly half of the largest drug companies are based in Europe. (The exact count shifts because of mergers.) In 2002, the top ten were the American companies Pfizer, Merck, Johnson & Johnson, Bristol-Myers Squibb, and Wyeth (formerly American Home Products); the British companies GlaxoSmithKline and AstraZeneca; the Swiss companies Novartis and Roche; and the French company Aventis (which in 2004 merged with another French company, Sanafi Synthelabo, putting it in third place). [5] All are much alike in their operations. All price their drugs much higher here than in other markets.
Since the United States is the major profit center, it is simply good public relations for drug companies to pass themselves off as American, whether they are or not. It is true, however, that some of the European companies are now locating their R&D operations in the United States. They claim the reason for this is that we don't regulate prices, as does much of the rest of the world. But more likely it is that they want to feed on the unparalleled research output of American universities and the NIH. In other words, it's not private enterprise that draws them here but the very opposite—our publicly sponsored research enterprise.
Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself. (Most of its marketing efforts are focused on influencing doctors, since they must write the prescriptions.)
If prescription drugs were like ordinary consumer goods, all this might not matter very much. But drugs are different. People depend on them for their health and even their lives. In the words of Senator Debbie Stabenow (D-Mich.), "It's not like buying a car or tennis shoes or peanut butter." People need to know that there are some checks and balances on this industry, so that its quest for profits doesn't push every other consideration aside. But there aren't such checks and balances.
[1] There are several sources of statistics on the size and growth of the industry. One is IMS Health, a company that collects and sells information on the global pharmaceutical industry. See this link for the $200 billion figure. For further sources on this and other matters, see my book The Truth About the Drug Companies: How They Deceive Us and What to Do About It, from which this article is drawn.
[2] For a full picture of the special burden of rising drug prices on senior citizens, see Families USA, "Out-of-Bounds: Rising Prescription Drug Prices for Seniors" at this link.
[3] Sarah Lueck, "Drug Prices Far Outpace Inflation," Wall Street Journal, July 10, 2003, p. D2.
[4] On ABC Special with Peter Jennings, "Bitter Medicine: Pills, Profit, and the Public Health," May 29, 2002.
[5] For the top ten companies and their recent mergers as of 2003, see this link.
[6] These figures come from the US Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, Baltimore, Maryland. They were summarized in Cynthia Smith, "Retail Prescription Drug Spending in the National Health Accounts," Health Affairs, January/February 2004, p. 160.

VANGUARD -- Fidson Healthcare to Begin Manufacturing Rosuvastatin

[May/June 2029]
(ABUJA) One of Nigeria's premier pharmaceutical companies, Fidson Healthcare has announced that it will begin mass producing the statin Rosuvastatin in 2030.
Operating out of a high-tech facility in Sango-Ota, the firm plans to cover Nigeria's need for the cholesterol-reducing drug and have enough left over for export.
Rosuvastatin, also known by the brand-name Crestor, by one metric ranked as the fourth best selling drug in the world. It became available as a generic drug in 2016.
Though the Nigerian economy appears to be contracting at first glance due to the drop in oil prices, the industrial and service sectors are indeed quite healthy. From automotive manufacturing, to electronics, and aerospace, steady monetary policy and a well-handled financial crisis have kept credit conditions manageable for the private sector.
Many developing countries import a large amount of medical supplies and pharmaceuticals. Rumors within the industry indicate that the Nigerian government is pondering a subsidy package for the domestic industry in order to promote exports and reduce the cost of medicine in West Africa.

TL;DR: I became FI on 3/1/2017 with 1.001M in investments and 1.401M net worth. 38 years old, married, 99% single income, no kids, self-discovered FIRE in 2004, began career as a retail pharmacist on 8/15/2005, loathed my job but stuck with it, income 125k-150k, 75% savings rate, had opportunities that many did not but took good advantage of those opportunities, many things worked in my favor while some things did not, made a lot of good decisions and a few bad ones, did not buy stupid things. I will likely RE on 3/30/2017 with SWR of 2.99% (30k/yr) with forty different hobbies and interests to pursue (including a sub three-hour marathon, currently in 3:04 condition) stuff . AA: 60% VSCIX, 20% VFWAX, 20% VWLUX. What follows is targeted toward the general population and might seem a bit elementary at times to FI. Ask away…
~~
How and Why I Retired at 38 without Couponing: A Waldenesque Account 11.5 Years in the Making
When I wrote the following pages, or rather the bulk of them, I lived alone with my wife, in the woods, a quarter mile from any neighbor, in a house which I had built to a certain extent by myself, in the proximity of a nameless pond, in Readyville, Tennessee, and earned my living by the labor of my hands counting pills for revoltingly irresponsible and unappreciative individuals. I have lived there 5 years and 11 months. At present I aspire to be a sojourner in civilized life again.
It has been said that retirement is merely a decision to stop trading time for money. Since I no longer need more of the latter to sustain my standard of living, and since I do not enjoy and never have enjoyed the primary method at my disposal to acquire the latter, I have decided that the former is of more value to me going forward in life. I will say little about my 11.5 years of experience as a retail pharmacist, other than to confirm what I already knew from the beginning to a much lesser extent: people are stupid, ignorant, obese, hateful, difficult, obnoxious, bigoted, misinformed, irresponsible, and intellectually lazy. Instead of dwelling on that horrible industry any longer, it is my hope that the following financial information might be of some use to members of a younger generation who are planning their own future independence. Be forewarned however that early retirement might also be a financial bubble in its own right. I discovered and strived on this principle beginning in 2005, but it seems to have exploded in popularity around the time of the market rebound of 2013-2014. The philosophy of financial independence only provides practical outcomes for the potential retiree as long as there are others who will keep obliviously running on their self-imposed treadmills. Productivity must be high (Americans work themselves too death), and the cost of goods must be low (Americans exploit slave labor overseas). This would not have been possible fifty years ago, and it may very well end up impossible fifty years from now. If you believe that our parents and grandparents had an easier financial adventure to navigate than the one we currently have, you seriously need to take a step back and compare what each generation would consider a decent standard of living.
Throughout my life, there have been a variety of circumstances that have aided me in my goal to retire before the age of forty as well as a few unforeseen (and perhaps, unforeseeable) obstacles that have set me back. I will now share several instances of both, including how much each has saved or cost me (including opportunity costs of subsequent investments). I would be wise to begin with the favorable circumstances that were primed before my life even began. I was born a healthy white male in the United States during the 20th Century. Essentially, I won at life on easy mode. Few other countries and time periods would allow a set of financial rules in which a person could become so financially solvent by doing so little, and I can think of no other country in which so many people have self-imposed financial treadmills that will keep raking income for me long after I decide to step off of my own. Granted that being a white male in this country does not provide the full array of unfair advantages that it once did, I can still say with little doubt that there were countless unknown instances in which my identity made my pursuit of early financial independence much more attainable.
I was also born intelligent. It is nothing to brag about. I say it merely because it is relevant, and because it is true. I did nothing to deserve or acquire this quality. In fact, I could have very easily squandered what advantages my genetic makeup provided me. Despite having an IQ that places me in the top two percent of the population, I scarcely managed to graduate in the top fifteen percent of my high school. I satisfied only the bare minimums for a full scholarship to MTSU. I freely admit that I completely mailed it in on my education from seventh through twelfth grade. I rarely took a book home. I did not try. Video games, music, and the opposite sex were far more important to me than keeping a 4.0. I was, however, responsible enough to know what I had to do to when the time arrived. I knew when I had to cease goofing off and become a more responsible individual. The complete independence of college made me try once more. With high school behind me, my analytical mind was awoken. I started seeing many aspects of life in a different way. Most importantly, I remember the need to craft a long-term plan. In short, my current state of financial independence would be impossible if I lacked the mental capacity to obtain it.
Bipartisan political rant redacted At the time of writing this announcement, I have benefited from $20 Trillion in national debt that I will likely never have to pay back. I was essentially gifted my share of trillions of dollars in services at no cost. Rates of taxation are currently way too low to sustain the country’s bloated standard of living. The bill will doubtlessly be passed onto future generations. But not my future generations. I have no future generations. (Savings: $60,000). This is my fair share of the national debt.
As I previously stated, I did only what was necessary to earn a full ride to MTSU (Savings: $13,000). I was also granted a second scholarship during my sophomore year just by taking the time to complete a two-page form (Savings: $2,000). My parents also allowed me live at home while attending college (Savings: $20,000), bought me a car in high school that lasted throughout college (Savings: $20,000), bought me another car for graduating college, which I drove until it died fourteen years later (Savings: $30,000). My parents also provided me with enough money to get our initial home repairs started (Savings: $10,000) and assumed the debt of the majority of my pharmacy school education and living expenses out of a sense of parental obligation (Savings: $100,000). My parents are also financially responsible people who emerged from dirt-floor shotgun shacks in rural Tennessee before amassing a net worth of $500,000 that will one day be an inheritance for my sister and me (Savings: $250,000). I truly had not realized how much my parents helped me financially until I typed this paragraph. I also fully appreciate now why it has been said with much despondency that inheritance is the true way of earning money in America.
The story of how I ended up as a highly compensated pharmacist is not an exciting one, but it is a necessary detail of how I arrived at my current state. I think it is fair to say that I was semi-indoctrinated as a child with the notion that I was smart enough to go to college and become a physician one day. American parents in the late 20th century had an unhealthy obsession that doctors and lawyers were what all intelligent children should become. So that is the path I obliviously started pursuing, and two years into college, I was dreading where was I headed. Since I wanted out of medicine but didn’t want to waste all of my science credits, I had to choose between optometry, which required Calculus III, or pharmacy. Fortunately, the contemporaneous job market was working strongly to the advantage of my decision to avoid Calculus III. At the time I had switched my career plans, pharmacists were making $50,000 yearly and were projected to be making $75,000 by the time that I would be graduating in six more years. Due to additional unforeseen shortages, that figure ended up exploding to over $125,000 (growing to $150,000 by the time of my retirement). Upon graduating, we all had dozens of job offers due to those shortages. A six-figure job fell right into my lap. I even negotiated a rate $3.50/hr higher than their opening offer (Savings: $125,000). That pharmacy window is now closed due the eminent bubble burst from an abundance of graduates marching out of the abundance of recently opened schools.
This brings me to an important point: I did not pick the career that I wanted to pursue. Reflecting back, I would much rather have tried astronomy, cartography, paleontology, cryptography, or meteorology. I picked what the market demanded. I will leave it to the philosophers to debate if this is truly what one should do in practice, but it benefited me greatly in financial matters. Over the past 11.5 years, I merely had to show up, look semi-presentable, count pills, answer questions that could have easily been Googled, listen to left wing complaints that big pharmaceutical companies are robbing the consumers yet never hear anyone consider other avenues to resolve their health problems, and listen to right wing complaints about how Obama is trying to kill them by raising the copay of their $500 morbid-obesity-fighting Crestor prescriptions from $20 to $30. Ironic rants coming from intellectually and physically lazy individuals belonging to the party of so-called personal responsibility were as common as any other aspect of the job. But I digress.
Nothing could have been more important than my having stumbled into this single epiphany early in life: Happiness does not come from material possessions. Americans tend to buy things that they don’t need to impress people that they don’t like with money that they don’t have. I do not buy things just because I can. I have lived well below my means by saving 70-75% of every paycheck. I have made investments early in life and witnessed the miracle of compounded interest. As far as my investments choices are concerned, I went with small-cap indexed mutual funds with a low expense ratio (VSCIX). The single mistake of choosing an actively-managed fund over an indexed fund would have cost me $100,000 or more over the past 11.5 years alone. What benefit would I have received to beat the market by 1% if the person actively managing my finances was charging me 3%? For the love of all that is holy, avoid financial advisors, particularly those without legal fiduciary responsibilities to their clients! And those doomsday warnings from conservatives about how the market will soon and inevitably collapse? Nothing but sour grapes from those who missed the bullish bandwagons, opting instead for the illusory security of gold and bonds. In fact, I could have very easily reaped even bigger rewards by treading on the riskier grounds of buying individual company stocks, but Warren Buffet, I am not.
So upon graduating, I accepted the overnight position at CVS in Ohio from 2005-2010 for two reasons: it minimized interaction with the intolerable general public, and it paid 5-10% more than the dayshift (Savings: $60,000). I could scarcely let this point pass without mentioning that one-third of that additional income was entirely unearned or unwarranted. I say this because it was company policy that an overnight pharmacist be paid the bonus differential only from midnight to 8am (not from 8pm to 8am as they were doing in Ohio). I neglected to ever point out the mistake to my supervisor. I also received a $1/hr raise in 2013 for taking over as pharmacy manager for six months. The raise was intended to be temporary, but someone forgot to take it away once I reverted back to my regular staff position. I neglected to draw attention to this little tidbit as well (Savings: $10,000).
No purchase regularly has a larger financial impact than a primary dwelling, and I say with much pride that our first home was a very simple one. There is much debate among investing communities whether a house should be considered an investment or an expense, but I tend to agree with the latter camp. I cannot claim that I have a Waldenesque receipt of every expense that went into the process, but I bought what we needed. I did not buy what we could afford. Lenders will tirelessly provide calculations of how much house a person can afford; how much house a person actually needs does not make its way into the equation. These quotes are based on mortgages that financially enslave a person to the bank for 15-30 years. Typically, this means working until very late in life, especially if homeowners elect for refinancing at some point down the road. The purchase price for our house in 2005 was $120,000, but I also invested $40,000 in rehabilitation to bring the total cost to $160,000. Bear in mind that I made this sensible purchase during a troublesome era in which financial institutions were carelessly pawning off McMansions onto people scarcely earning minimum wages. Such individuals who would have acquired a house priced similarly to ours via the 30-year mortgage plan would have ended up paying in excess of $400,000 for that house, including $250,000 in interest alone. I paid ours off in less than three years, including about $10,000 in interest.
Our next house was even more sensible than the first. I exercised great patience and found a 28-acre tract currently worth $150,000 for only $85,000 (Savings: $65,000). I also contracted the house myself with the help of my father. Members of the family did what we could to keep costs down (design, permits, clearing, site prep, outdoor utilities, roofing, flooring, trim, cabinetry installation, painting, and cleanup). Subcontractors were hired for the balance. A well-insulated, energy efficient $200,000 house ended up costing only $120,000. It should be of note that the final cost was artificially low due in part to cheaper labor from the contemporaneous weak construction market of 2010-2011 (Savings: $80,000). The most important savings on the house came from the purchase of the Japanese roofing tiles. A domestic company acting as a middleman quoted me $30,000 as the cost to import the roofing material. For some inexplicable reason, they opted to include the Japanese business card of their supplier in the information packet that they sent. Taking just two minutes of my time, I emailed the contact myself and asked if I could purchase from them directly. The price she quoted me was $15,000 (Savings: $15,000). It never hurts to try.
We decided to build our home in the income-tax-free State of Tennessee. Conservatives here are too dense to appreciate that a shift from consumption-based taxes to income-based taxes would benefit the overwhelming majority of them immensely. I profit from their stupidity (Savings: $50,000). On a related note, knowing the tax code makes an enormous financial difference. Among other shady decisions in the legal gray area, I have turned hobbies into small businesses, taken vacations in the interests of running those businesses, and even claimed a single $7,000 reforestation credit for simply improving and planting on my property (Savings: $20,000). In the 1% chance that I get audited, I can reasonably defend every deduction I have ever made because the tax code is needlessly complicated and nuanced. In essence, it is designed to benefit only the rich and knowledgeable. “I don’t understand all of that tax stuff” is not a good reason for any taxpayer to remain ignorant about it. One can spend a single weekend learning the system like I did and easily save $20,000 over the course of a lifetime. I know most people have wasted far more time than that by binge watching something irrelevant on television. I will leave it for the reader to compare the potential savings versus the time spent. My advice is to relocate as much of your spending to the before-tax column as is legally permissible. I should also say that relying solely on those tax preparation programs to maximize your savings is not a wise move. They do not teach a person how to think critically. Such a quality is not innate; it must be learned and practiced.
Timing has played an indispensable role as well, but it has been far from perfect. I consolidated my federal student loans for my parents in 2005 at a ridiculously low interest rate (2.3%). Interest rates on student loans are currently north of 6% (Savings: $125,000). The financial crashes of 2008 and 2011 happened when I had little invested in the markets, but I kept investing and soaking up index funds at artificially deflated prices. Then came the inevitable rebound of 2013-2014, thanks largely to partisan politics and the Republican gift of corporate corruption that allowed no real regulations against Wall Street in the wake of the recent financial crisis. I was also fortunate that I was born heterosexual. Why? For the first eight years of my marriage (2007-2015), I would have paid 5% more in income taxes if I felt biologically compelled to share my life with someone who had matching genitals (Savings: $50,000). Somehow that would not have seemed fair. And while I am on the subject of marriage, allow me to proudly declare that I married a great woman who is neither shallow nor materialistic. Two months salary on a diamond ring? Not trying to impress anyone. She much preferred an antique birthstone that defies conventional customs and looks way more spectacular (Savings: $20,000). $15,000 Wedding? No inadequacies in need of compensation. Got married, honeymooned in Vegas, and loved it (Savings: $14,000). Will I ever buy a fancy $10,000 box to bury someone in the ground? I am not an idiot, nor do I want anyone in my family to be buried in an idiot box. Life is not a competition to acquire status symbols. Break out of this mentality of doing things that you think you are supposed to do! The primary reason a person cannot retire early is because that person spends far too much. The open secret to creating wealth is to spend less, be content with less, and worry less about financial matters that you cannot control. Adapting is easy; complaining wears you down. But if you remain determined to compete with your coworkers, go ahead and do so while I apoplectically rue the times when I had some.
I lead a simple life and maintain no expensive hobbies. A lot of men in this region look forward to the point in their lives where they can become overweight so that they look proper while fishing in a $20,000 boat. More power to them. Each person has a right to carry his existence how he chooses, but the worst I have ever done with my hobbies is to drop $2,000 on a bicycle that loses barely 5% of its value on an annual basis. But even this decision was much later in my career, and the hobby has the benefit of helping me keep healthy. Staying healthy also keeps doctor bills lower and/or nonexistent. There are no outrageously expensive professionals to allow me access to outrageously priced prescriptions to control my health. There is no need to purchase material things to compensate for the depression of not being healthy and feeling good about oneself. Even being able to keep the thermostat higher in the summer is a benefit. One can easily add more clothes in the winter, but one cannot easily remove insulating adipose in more temperate conditions.
Every purchase I make is on credit card, which earns 1-5% in amazon credit (Savings: $20,000). I then purchase the things that I need on amazon via my own 5% off click-thru links (Savings: $5,000). The savings were even greater before amazon started collecting sales tax. I may have neglected to report all of those purchases in years prior, just as all of the readers may have made similar mistakes. We dropped the worthless cable television subscription in 2013 (Savings: $5,000). We dropped our cell phone plans in 2006 (Savings: $15,000). We dropped the services of the home telephone company and purchased a $200 ooma in 2008 (Savings: $6,000). We maintain smaller wardrobes. We rarely purchase alcohol. We never buy tobacco or other drugs. We make smaller charitable contributions in life and are smart enough not to belong to a religion that often suggests you consistently contribute to their maintenance. Tithing would have yielded a potential loss of $250,000, and I am enlightened enough to know that religion does more harm than good to humanity. Instead, we will be leaving everything to worthy charities when it is our time. While there is no real sacrifice or benevolence on our part, I doubt that it will make any difference to the people who will be receiving it. And then there are the smaller things in life: stretching oil changes to 7500 miles, avoiding a daily coffee habit, rarely paying $1-$2 for bottled water and sodas, leaning toward the dollar menus at fast food restaurants, reflecting before purchasing, making good use of the library, etc. It all adds up.
Perhaps the greatest savings arrives from fighting the indoctrinated societal pressures of having children. Let’s be honest: everyone loves their children but very few people are truly happier by having them. I need not argue my point. Studies show support for my position. I would go so far as to suggest that people simply have them out of ritual or expectation, only to wish later that they had waited until further down the road, had fewer children, or had never reproduced at all. Of course no one is going to wish his children away once they have become attached to them, but it is my position that most people would be happier without an enormous responsibility that they have never known. No one seems to appreciate the true opportunity cost of children: $250,000 each not including college. I will be just fine with our dog.
With all of these benefits, you might be wondering what circumstances did not work in my favor. To start, I will have to return oddly to the summer of 1992 when my father was religiously engaged in raising cattle for show competitions. In an attempt to engage me in his interests, I was given one of his prized heifers in exchange for grooming and showing her at county fairs. She sold several months later for $1,700, which was an abundance of wealth for an eighth grader to come into. I was very much into collecting comic books at that point and tried to convince my dad to co-invest with me in a copy of Actions Comics #1 in Good condition for $4,000. (For you non-collectors, Good condition is an evaluation to conclude that a book is sufficiently damaged enough to be worth only 10% of its Mint condition price). My father wasn’t going for my idea. Today, that book would be worth around $250,000. I should have tried harder. Deliberate understatement.
I also failed to gain admission into the pharmacy school at UT Memphis. At the time, it was the only program in the State; now there are six (part of that pharmacy school bubble that I mentioned earlier). So why did I fail to gain admission? First, I did not focus on the interview as much as I should have because I had already been granted acceptance to the school that I ideally preferred (but which was way more expensive due to being privately funded). I did not hit a home-run like I did with the first interview, but I am certain that I performed well enough to be offered a position. Second, I feel that I was passed over for being a white male. UT Memphis made it a point to advertise that they had the largest female and minority body of any pharmacy school in the country. I do not point this out to cry discrimination or to argue points against diversification. I do not even wish to dispute its fairness. I have already stated that my gender and race have served me in ways I cannot begin to appreciate, but after learning of the qualifications with which some of my classmates were accepted, I can safely say that this was one instance in which who I am did not serve me well (Cost: $40,000). I should have tried harder. Deliberate understatement.
While I am on the topic of education, allow me strongly emphasize that private schools are no better than public schools merely because they are privately funded. Most people do not realize that the cost difference is purely the amount of the bill that the taxpayers carry; it is not due to the quality of education. Private schools might seem like better atmospheres to certain types of people, but I strongly urge the reader to not be a fool. Attend public university.
If I were to define insurance, I would say that it is a form of quasi-voluntary socialism in which the healthy give to the unhealthy, the responsible give to the irresponsible, the careful give to the careless, and the lucky give to the unlucky. My employer has spent $70,000 on my medical policy over the past 11.5 years. I have personally spent $30,000 on my part of that policy. I have used no more than $5,000 (Cost: $25,000; or $95,000 if CVS had just given the money directly to me instead). It is simply not fair that I do what I can to stay healthy and save money, only to have the vast majority of my premiums given to people who do not take care of themselves physically and mentally. Yet I must recognize my inability to do anything constructive about it. I must maintain a policy to protect against disaster, especially with the ACA now mandating it. Without a medical insurance policy, I could easily be hit by a bus and get wiped out financially (and perhaps literally) in the blink of an eye. Or I could get cancer. Or I could lose an arm. I even purchased life insurance, as well as accidental death and dismemberment insurance, because my duty to protect the narcotic supply was not without its hazards (Cost: $10,000). I also carried homeowners insurance and full vehicle coverage for far too long (Cost: $10,000). This is a game we all play, and we tend to play it with a surplus of caution. But I must be mindful that in a parallel universe, I could have very easily lost everything. This brings me to the worst insurance policy that I bought, which I call Ted Cruz insurance. It appeared to me that his influence was going to drive the country to default on its loans and crash the financial markets in 2014. I moved my money into safer investments for a short period and missed out on a small portion of the surging market (Cost: $25,000). Cruz either blinked, or he is not as stupid as his political positions indicate. Lessons learned. Do not try to time the market.
I paid off our mortgage way too early. This looked like a smart move in 2008 when the financial markets were crashing and burning around us, but that perspective was based on a short term view. The $120,000 loan offered at 5% annual interest now seems reasonable compared to the 10% annual interest that the market has earned since 2005. The smart move would have been to carry the loan and invest my extra finances in the market (Cost: $100,000). Lesson learned, but I could have just as easily been wrong. We also bought our first house at the height of the housing bubble. I watched enough house flipping shows on television to know something suspicious was upon us, but the timing of my graduation ensured that I could do nothing about it. We only received $125,000 back out of the house in which we had invested $160,000, but these losses were carried back over into gains by building during the weak construction market that I mentioned earlier. However, my hatred of humanity also drove me to acquire more land than was necessary for our second house. Twenty-eight acres of privacy in this area cost $85,000. We are almost ten minutes from civilization. Granted that this real estate purchase could be considered an investment, and quite an intelligent one as I mentioned earlier, but we do not plan on ever selling the property. Improper exterior construction planning on my part also led to more backfill, fencing, replanting, and yard maintenance (Cost: $10,000). I do not wish to delve further into that. There is also the matter of additional fuel costs from being so far removed from civilization, and I drove a very fuel-unfriendly car for fourteen years that I chose when I was only twenty-three and not thinking of such matters (Cost: $5,000). But as it was, we spent too much time in the high income-tax State of Ohio and paid greatly for the decision (Cost: $30,000). Relocating back to Tennessee was the smart move financially.
I should have accepted more of the overtime offered to me when I was much younger and the job was much easier. The earnings from each shift would have been worth double what each shift would be worth now if the money were properly invested. I should have accepted the $2/hr raise offer to make the move to dayshift six months earlier than when I did, at which point the offer had passed (Cost: $30,000). I also held too much emergency savings in municipal bonds from 2012-2016. Municipal bonds are terrific at avoiding federal taxes, but there were many better investments to be made in a surging market. Put simply, I was not sure how much longer I would be able to survive my job when it started becoming very difficult from 2011-2013. I felt that I had to keep a certain amount of liquidity, and I let those investments sit around for far too long. Such a decision is easy to second-guess but difficult on which to place a cost. Social security will likely be only 75% solvent when I elect to receive it, but the lost earning potential from the tax-free loan that I have paid into the system will end up being the far greater blow (Cost: $100,000). If only people were responsible enough to save on their own instead of the government doing it for them.
There were also the two big vacations that we took to Japan and Europe (Cost: $10,000). We waited until later in my career to visit these wonderful places, a decision which helped prevent greater opportunity costs, but I would have held no regrets either way. They were worth every dime. Eating out at casual dining restaurants is a killer for me. It is my weakness. I love food. We do not often dine at expensive places, but paying $25-$30 three or four times per week certainly adds up (Cost: $100,000). I also tip 22% on average because I find it distasteful and highly unethical to be frugal at the cost of others.
While I can never be entirely certain of future outcomes, conservative retirement models based on historical market performance suggest that a 38-year-old individual with an asset allocation of 80% in equities and 20% in bonds should be able to earn an average annual return of 6% after-inflation and safely execute an annual withdrawal of 3% from said portfolio with far less than a 1% chance of market volatility causing him to go broke before dying. In terms of real numbers, I will begin my first year of retirement with $1.001M, should on average earn $60,000 in interest, withdraw on average $30,000 in living costs (with subsequent increases for inflation), and end my first year of retirement on average with $1.031M. Simulations suggest that the average principle balance should be around $10M after sixty years if spending an inflation-adjusted $30,000 per year. If one analyzes the simulations from the perspective of maximizing spending, a withdrawal of $34,000/yr would still have failed to deplete the portfolio over any sixty-year span.
The seemingly large discrepancy between the 6% return and 3% withdrawal is not to ensure a growing principle, but rather it is an implemented failsafe that has been designed to offset the costly effects of potential downturns in the volatile market during the critical early phases of retirement (known as sequence risk), as well as the known hidden costs of inflation. In the overwhelming majority of scenarios, however, the principle amount remains untouched and does indeed grow exponentially. The ultraconservative model I have followed also makes a few catastrophic assumptions: no social security income, no supplemental income, no inheritances, no national healthcare plan, no disability payments, no spending adjustments for recessions, no spending reallocation for hyperinflating sectors, no observance of the known reduction in spending with age, no liquidation of our excess land, and no ability to downsize or tap into home equity. The only risky assumption I have provided the model is that the ACA subsidies (or some form of them), which I will cover shortly, remain intact until Medicare eligibility. In other words, the likelihood of me ever having to earn another dime for as long as I live is still substantially lower than the likelihood of an event catastrophic enough to reshape the global financial culture beyond the point of recognition.
Pre-retirement annual expenses for my wife and I were $38,000 and can be broken down in the following manner: Food $10,000 (Grocery $5,000 / Dining $5,000), Medical $4,000 (Insurance $3,000 / Costs $1,000), Transportation $5,000 (Vehicles $2,000 / Gasoline $2,000 / Insurance $1,000), House $5,000 (Utilities $1,000 / Internet $1,000 / Taxes $1,000 / Insurance $1,000 / Maintenance $1,000), Other $14,000 (Supplies $4,000 / Vacations $3,000 / Entertainment $3,000 / Miscellaneous $4,000). I have assumed the following cost adjustments to our expenses going forward: an increase of $1,000 to fight the inevitable fits of boredom with more complex entertainment, a decrease of $2,000 for having more time to prepare food at home, a decrease of $2,000 for lower fuel consumption, a decrease of $1,000 from dropping the homeowners insurance policy, a decrease of $1,000 to due to increased flexibility in scheduling vacations, and a decrease of $3,000 due to gaming a quasi-loophole in Affordable Care Act tax credit policy. Allow me to elaborate on that last point.
Citizens with incomes below the Federal Poverty Level are ineligible for these Federal credits because these individuals are supposed to be covered under State (not Federal) Medicaid programs. However, State Medicaid programs disqualify people who have a high net worth through means testing. An individual claiming an income just above the Federal Poverty Line, whether the income is real or not (e.g. Roth conversions), qualifies for ACA credits because the determination process for ACA credits does not take net worth into consideration. ACA credits for individuals just above the Federal Poverty Line pay for the monthly premiums in their entirety, or about $6,000 per year. Furthermore, there is no increase in income taxation for claiming an annual income of $16,000 because the income on which this credit qualification is based is calculated prior to deductions and exemptions that would convert a Gross Income of $16,000 into a Taxable Income of $0. In other words, an individual with an annual income of $0 has the same tax burden as an individual with an annual income of $16,000 (due to standard deductions and exemptions), but a high net worth individual with an income of $16,000 qualifies for a $6,000 tax credit while a high net worth individual with an income of $0 qualifies for nothing. Due in large part to the questionable structure of the process for determining ACA subsidies (and tax policies in general), our annual expenses post-retirement will decrease from $38,000 to $30,000 (adjusted annually for inflation). I have even budgeted conservatively and expect our living expenses to be closer to $27,000 for the first year. This gives us a higher standard of living than 99% of human beings who have ever existed. Let it be known that any similar couple who cannot live on $30,000 per year has serious emotional issues in need of resolution. I must also say that I do not feel the least bit guilty for taking free healthcare coverage. I have paid far more into the system than I will ever get out, and I actually take care of myself unlike the majority of Americans.
So what am I going to do with myself going forward? Instead of waking up and going to a job every day that I loathe, I will spend time doing things that will better serve myself and humanity as a whole: cycling, running, swimming, exercising, weightlifting, bowling, golfing, kayaking, collecting things, socializing, visiting my parents, spending more time with my own family, mentoring students, volunteering, deconverting religious adherents, learning Rubik’s cube algorithms, writing, painting, warning anyone who will listen about the danger of pain clinics, reading, studying, listening to music, watching movies and television, playing video games, housekeeping, organizing, cooking, picking up litter, looking at the stars, metal detecting, going to yard sales, improving my Spanish and Japanese, monitoring investments, building a treehouse and a cabin, traveling, retreating into nature, sleeping, and relaxing. I might even try my hand at opening a business, writing a novel, making a movie, or recording an album. I can finally do whatever I want, whenever I want, wherever I want. Life is an opportunity to navigate existence in the most meaningful way possible. In the end, I may not have chosen the safest and smartest path at each fork in the road, but I fully intend on being content with the decisions I have made. I will also come to appreciate fully that financial stability is not the sole measure of my worth.

Aetna's medicare plans have lowered their reimbursements to an insanely low level. We were willing to fill the prescriptions when we were making little, we were willing to fill them when we were breaking even, but we can't do it anymore when we're losing 10-20% on every generic prescription. Seriously, 90% of the prescriptions are a loss now. And we negotiate our generic prices with six different wholesalers. Just as an example, for generic Crestor they're paying under $4 for a 30 tablet Rx.

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What do my fellow retail pharmacists think of discount cards people bring in day after day? Do your pharmacies ever get reimbursed for people using them, like with insurance or with company sponsored cards (androgel, crestor, etc).
Not sure where people find these things, but everyday I see them and people get caught up in the "you can save 70% on up to 50,000 drugs!"****
I've seen some cases where it priced their meds below our cost and we lost money without knowing it. I'd hate to stop using them because some people need it and I feel like a jerk, but I'm not in the money losing business either