#type: article

[tommyactually]

just so everyone's clear. the interview only came out this late because lou's been filming for swat. been seeing a lot of people on here & twitter just skip past that and make assumptions

[endlingmusings]

[ Slender-billed curlew specimens at the Natural History Museum in London, England. ]

"The slender-billed curlew was last officially seen in 1995. Over the past 30 years there have been a trickle of reports of the migratory bird being seen across south and eastern Europe. It now seems likely that these were mistaken identities. Researchers have gone through the account of every specimen, photograph and report for the slender-billed curlew since the late nineteenth century to figure out the probability that the bird survives to the present day. The result is that the curlew is likely extinct, making it the first mainland European bird to go extinct in half a millennium. Dr Alex Bond is the Senior Curator in Charge of Birds at the Natural History Museum. He has been involved in tracing the fate of the curlew. “When the slender-billed curlew stopped returning to their main wintering site at Merja Zerga, Morocco, there was quite a lot of effort put in to try and locate them on breeding grounds,” explains Alex. “Several expeditions, hundreds of thousands of square kilometres searched. And all this has turned up, unfortunately, is nothing.” “They are extinct. And they probably went extinct very close to or very soon after 1995.” The full assessment for the status of the slender-billed curlew has been published in Ibis."

- Excerpt from "The slender-billed curlew is declared extinct" by Josh Davis.

[thoughtportal]

A Libertarian Walks Into a Bear: The Utopian Plot to Liberate an American Town (and Some Bears)

PublicAffairs, 288 pp., $28.00

But don’t worry—it almost never comes to this. As one park service PSA noted this summer, bears “usually just want to be left alone. Don’t we all?” In other words, if you encounter a black bear, try to look big, back slowly away, and trust in the creature’s inner libertarian. Unless, that is, the bear in question hails from certain wilds of western New Hampshire. Because, as Matthew Hongoltz-Hetling’s new book suggests, that unfortunate animal may have a far more aggressive disposition, and relate to libertarianism first and foremost as a flavor of human cuisine.

Hongoltz-Hetling is an accomplished journalist based in Vermont, a Pulitzer nominee and George Polk Award winner. A Libertarian Walks Into a Bear: The Utopian Plot to Liberate an American Town (and Some Bears) sees him traversing rural New England as he reconstructs a remarkable, and remarkably strange, episode in recent history. This is the so-called Free Town Project, a venture wherein a group of libertarian activists attempted to take over a tiny New Hampshire town, Grafton, and transform it into a haven for libertarian ideals—part social experiment, part beacon to the faithful, Galt’s Gulch meets the New Jerusalem. These people had found one another largely over the internet, posting manifestos and engaging in utopian daydreaming on online message boards. While their various platforms and bugbears were inevitably idiosyncratic, certain beliefs united them: that the radical freedom of markets and the marketplace of ideas was an unalloyed good; that “statism” in the form of government interference (above all, taxes) was irredeemably bad. Left alone, they believed, free individuals would thrive and self-regulate, thanks to the sheer force of “logic,” “reason,” and efficiency. For inspirations, they drew upon precedents from fiction (Ayn Rand loomed large) as well as from real life, most notably a series of micro-nation projects ventured in the Pacific and Caribbean during the 1970s and 1980s.

None of those micro-nations, it should be observed, panned out, and things in New Hampshire don’t bode well either—especially when the humans collide with a newly brazen population of bears, themselves just “working to create their own utopia,” property lines and market logic be damned. The resulting narrative is simultaneously hilarious, poignant, and deeply unsettling. Sigmund Freud once described the value of civilization, with all its “discontents,” as a compromise product, the best that can be expected from mitigating human vulnerability to “indifferent nature” on one hand and our vulnerability to one another on the other. Hongoltz-Hetling presents, in microcosm, a case study in how a politics that fetishizes the pursuit of “freedom,” both individual and economic, is in fact a recipe for impoverishment and supercharged vulnerability on both fronts at once. In a United States wracked by virus, mounting climate change, and ruthless corporate pillaging and governmental deregulation, the lessons from one tiny New Hampshire town are stark indeed.

“In a country known for fussy states with streaks of independence,” Hongoltz-Hetling observes, “New Hampshire is among the fussiest and the streakiest.” New Hampshire is, after all, the Live Free or Die state, imposing neither an income nor a sales tax, and boasting, among other things, the highest per capita rate of machine gun ownership. In the case of Grafton, the history of Living Free—so to speak—has deep roots. The town’s Colonial-era settlers started out by ignoring “centuries of traditional Abenaki law by purchasing land from founding father John Hancock and other speculators.” Next, they ran off Royalist law enforcement, come to collect lumber for the king, and soon discovered their most enduring pursuit: the avoidance of taxes. As early as 1777, Grafton’s citizens were asking their government to be spared taxes and, when they were not, just stopped paying them.

Nearly two and a half centuries later, Grafton has become something of a magnet for seekers and quirky types, from adherents of the Unification Church of the Reverend Sun Myung Moon to hippie burnouts and more. Particularly important for the story is one John Babiarz, a software designer with a Krusty the Klown laugh, who decamped from Big-Government-Friendly Connecticut in the 1990s to homestead in New Hampshire with his equally freedom-loving wife, Rosalie. Entering a sylvan world that was, Hongoltz-Hetling writes, “almost as if they had driven through a time warp and into New England’s revolutionary days, when freedom outweighed fealty and trees outnumbered taxes,” the two built a new life for themselves, with John eventually coming to head Grafton’s volunteer fire department (which he describes as a “mutual aid” venture) and running for governor on the libertarian ticket.

Although John’s bids for high office failed, his ambitions remained undimmed, and in 2004 he and Rosalie connected with a small group of libertarian activists. Might not Grafton, with its lack of zoning laws and low levels of civic participation, be the perfect place to create an intentional community based on Logic and Free Market Principles? After all, in a town with fewer than 800 registered voters, and plenty of property for sale, it would not take much for a committed group of transplants to establish a foothold, and then win dominance of municipal governance. And so the Free Town Project began. The libertarians expected to be greeted as liberators, but from the first town meeting, they faced the inconvenient reality that many of Grafton’s presumably freedom-loving citizens saw them as outsiders first, and compatriots second—if at all. Tensions flared further when a little Googling revealed what “freedom” entailed for some of the new colonists. One of the original masterminds of the plan, a certain Larry Pendarvis, had written of his intention to create a space honoring the freedom to “traffic organs, the right to hold duels, and the God-given, underappreciated right to organize so-called bum fights.” He had also bemoaned the persecution of the “victimless crime” that is “consensual cannibalism.” (“Logic is a strange thing,” observes Hongoltz-Hetling.)

While Pendarvis eventually had to take his mail-order Filipina bride business and dreams of municipal takeovers elsewhere (read: Texas), his comrades in the Free Town Project remained undeterred. Soon, they convinced themselves that, evidence and reactions to Pendarvis notwithstanding, the Project must actually enjoy the support of a silent majority of freedom-loving Graftonites. How could it not? This was Freedom, after all. And so the libertarians keep coming, even as Babiarz himself soon came to rue the fact that “the libertarians were operating under vampire rules—the invitation to enter, once offered, could not be rescinded.” The precise numbers are hard to pin down, but ultimately the town’s population of a little more than 1,100 swelled with 200 new residents, overwhelmingly men, with very strong opinions and plenty of guns.

Hongoltz-Hetling profiles many newcomers, all of them larger-than-life, yet quite real. The people who joined the Free Town Project in its first five years were, as he describes, “free radicals”—men with “either too much money or not enough,” with either capital to burn or nothing to lose. There’s John Connell of Massachusetts, who arrived on a mission from God, liquidated his savings, and bought the historic Grafton Center Meetinghouse, transforming it into the “Peaceful Assembly Church,” an endeavor that mixed garish folk art, strange rants from its new pastor (Connell himself), and a quixotic quest to secure tax exemption while refusing to acknowledge the legitimacy of the IRS to grant it. There’s Adam Franz, a self-described anti-capitalist who set up a tent city to serve as “a planned community of survivalists,” even though no one who joined it had any real bushcraft skills. There’s Richard Angell, an anti-circumcision activist known as “Dick Angel.” And so on. As Hongoltz-Hetling makes clear, libertarianism can indeed have a certain big-tent character, especially when the scene is a new landscape of freedom-lovers making “homes out of yurts and RVs, trailers and tents, geodesic domes and shipping containers.”

If the Libertarian vision of Freedom can take many shapes and sizes, one thing is bedrock: “Busybodies” and “statists” need to stay out of the way. And so the Free Towners spent years pursuing an aggressive program of governmental takeover and delegitimation, their appetite for litigation matched only by their enthusiasm for cutting public services. They slashed the town’s already tiny yearly budget of $1 million by 30 percent, obliged the town to fight legal test case after test case, and staged absurd, standoffish encounters with the sheriff to rack up YouTube hits. Grafton was a poor town to begin with, but with tax revenue dropping even as its population expanded, things got steadily worse. Potholes multiplied, domestic disputes proliferated, violent crime spiked, and town workers started going without heat. “Despite several promising efforts,” Hongoltz-Hetling dryly notes, “a robust Randian private sector failed to emerge to replace public services.” Instead, Grafton, “a haven for miserable people,” became a town gone “feral.” Enter the bears, stage right.

Black bears, it should be stressed, are generally a pretty chill bunch. The woods of North America are home to some three-quarters of a million of them; on average, there is at most one human fatality from a black bear attack per year, even as bears and humans increasingly come into contact in expanding suburbs and on hiking trails. But tracking headlines on human-bear encounters in New England in his capacity as a regional journalist in the 2000s, Hongoltz-Hetling noticed something distressing: The black bears in Grafton were not like other black bears. Singularly “bold,” they started hanging out in yards and on patios in broad daylight. Most bears avoid loud noises; these casually ignored the efforts of Graftonites to run them off. Chickens and sheep began to disappear at alarming rates. Household pets went missing, too. One Graftonite was playing with her kittens on her lawn when a bear bounded out of the woods, grabbed two of them, and scarfed them down. Soon enough, the bears were hanging out on porches and trying to enter homes.

Combining wry description with evocative bits of scientific fact, Hongoltz-Hetling’s portrayal of the bears moves from comical if foreboding to downright terrifying. These are animals that can scent food seven times farther than a trained bloodhound, that can flip 300-pound stones with ease, and that can, when necessary, run in bursts of speed rivaling a deer’s. When the bears finally start mauling humans—attacking two women in their homes—Hongoltz-Hetling’s relation of the scenes is nightmarish. “If you look at their eyes, you understand,” one survivor tells him, “that they are completely alien to us.”

What was the deal with Grafton’s bears? Hongoltz-Hetling investigates the question at length, probing numerous hypotheses for why the creatures have become so uncharacteristically aggressive, indifferent, intelligent, and unafraid. Is it the lack of zoning, the resulting incursion into bear habitats, and the reluctance of Graftonites to pay for, let alone mandate, bear-proof garbage bins? Might the bears be deranged somehow, perhaps even disinhibited and emboldened by toxoplasmosis infections, picked up from eating trash and pet waste from said unsecured bins? There can be no definitive answer to these questions, but one thing is clear: The libertarian social experiment underway in Grafton was uniquely incapable of dealing with the problem. “Free Towners were finding that the situations that had been so easy to problem-solve in the abstract medium of message boards were difficult to resolve in person.”

Grappling with what to do about the bears, the Graftonites also wrestled with the arguments of certain libertarians who questioned whether they should do anything at all—especially since several of the town residents had taken to feeding the bears, more or less just because they could. One woman, who prudently chose to remain anonymous save for the sobriquet “Doughnut Lady,” revealed to Hongoltz-Hetling that she had taken to welcoming bears on her property for regular feasts of grain topped with sugared doughnuts. If those same bears showed up on someone else’s lawn expecting similar treatment, that wasn’t her problem. The bears, for their part, were left to navigate the mixed messages sent by humans who alternately threw firecrackers and pastries at them. Such are the paradoxes of Freedom. Some people just “don’t get the responsibility side of being libertarians,” Rosalie Babiarz tells Hongoltz-Hetling, which is certainly one way of framing the problem.

Pressed by bears from without and internecine conflicts from within, the Free Town Project began to come apart. Caught up in “pitched battles over who was living free, but free in the right way,” the libertarians descended into accusing one another of statism, leaving individuals and groups to do the best (or worst) they could. Some kept feeding the bears, some built traps, others holed up in their homes, and still others went everywhere toting increasingly larger-caliber handguns. After one particularly vicious attack, a shadowy posse formed and shot more than a dozen bears in their dens. This effort, which was thoroughly illegal, merely put a dent in the population; soon enough, the bears were back in force.

Meanwhile, the dreams of numerous libertarians came to ends variously dramatic and quiet. A real estate development venture known as Grafton Gulch, in homage to the dissident enclave in Ayn Rand’s Atlas Shrugged, went belly-up. After losing a last-ditch effort to secure tax exemption, a financially ruined Connell found himself unable to keep the heat on at the Meetinghouse; in the midst of a brutal winter, he waxed apocalyptic and then died in a fire. Franz quit his survivalist commune, which soon walled itself off into a prisonlike compound, the better to enjoy freedom. And John Babiarz, the erstwhile inaugurator of the Project, became the target of relentless vilification by his former ideological cohorts, who did not appreciate his refusal to let them enjoy unsecured blazes on high-wildfire–risk afternoons. When another, higher-profile libertarian social engineering enterprise, the Free State Project, received national attention by promoting a mass influx to New Hampshire in general (as opposed to just Grafton), the Free Town Project’s fate was sealed. Grafton became “just another town in a state with many options,” options that did not have the same problem with bears.

Or at least—not yet. Statewide, a perverse synergy between conservationist and austerity impulses in New Hampshire governance has translated into an approach to “bear management” policy that could accurately be described as laissez-faire. When Graftonites sought help from New Hampshire Fish and Game officials, they received little more than reminders that killing bears without a license is illegal, and plenty of highly dubious victim-blaming to boot. Had not the woman savaged by a bear been cooking a pot roast at the time? No? Well, nevertheless. Even when the state has tried to rein in the population with culls, it has been too late. Between 1998 and 2013, the number of bears doubled in the wildlife management region that includes Grafton. “Something’s Bruin in New Hampshire—Learn to Live with Bears,” the state’s literature advises.

The bear problem, in other words, is much bigger than individual libertarian cranks refusing to secure their garbage. It is a problem born of years of neglect and mismanagement by legislators, and, arguably, indifference from New Hampshire taxpayers in general, who have proved reluctant to step up and allocate resources to Fish and Game, even as the agency’s traditional source of funding—income from hunting licenses—has dwindled. Exceptions like Doughnut Lady aside, no one wants bears in their backyard, but apparently no one wants to invest sustainably in institutions doing the unglamorous work to keep them out either. Whether such indifference and complacency gets laundered into rhetoric of fiscal prudence, half-baked environmentalism, or individual responsibility, the end result is the same: The bears abide—and multiply.

Their prosperity also appears to be linked to man-made disasters that have played out on a national and global scale—patterns of unsustainable construction and land use, and the climate crisis. More than once, Hongoltz-Hetling flags the fact that upticks in bear activity unfold alongside apparently ever more frequent droughts. Drier summers may well be robbing bears of traditional plant and animal sources of food, even as hotter winters are disrupting or even ending their capacity to hibernate. Meanwhile, human garbage, replete with high-calorie artificial ingredients, piles up, offering especially enticing treats, even in the dead of winter—particularly in places with zoning and waste management practices as chaotic as those in Grafton, but also in areas where suburban sprawl is reaching farther into the habitats of wild animals. The result may be a new kind of bear, one “torn between the unique dangers and caloric payloads that humans provide—they are more sleep-deprived, more anxious, more desperate, and more twitchy than the bear that nature produced.” Ever-hungry for new frontiers in personal autonomy and market emancipation, human beings have altered the environment with the unintended result of empowering newly ravenous bears to boot.

Ignoring institutional failure and mounting crises does not make them go away. But some may take refuge in confidence that, when the metaphorical chickens (or, rather, bears) finally come home to roost, the effects are never felt equally. When bears show up in higher-income communities like Hanover (home to Dartmouth College), Hongoltz-Hetling notes, they get parody Twitter accounts and are promptly evacuated to wildernesses in the north; poorer rural locales are left to fend for themselves, and the residents blamed for doing what they can. In other words, the “unintended natural selection of the bears that are trying to survive alongside modern humans” is unfolding along with competition among human beings amid failing infrastructure and scarce resources, a struggle with Social Darwinist dynamics of its own.

The distinction between a municipality of eccentric libertarians and a state whose response to crisis is, in so many words, “Learn to Live With It” may well be a matter of degree rather than kind. Whether it be assaults by bears, imperceptible toxoplasmosis parasites, or a way of life where the freedom of markets ultimately trumps individual freedom, even the most cocksure of Grafton’s inhabitants must inevitably face something beyond and bigger than them. In that, they are hardly alone. Clearly, when it comes to certain kinds of problems, the response must be collective, supported by public effort, and dominated by something other than too-tidy-by-half invocations of market rationality and the maximization of individual personal freedom. If not, well, then we had all best get some practice in learning when and how to play dead, and hope for the best.

[lifewithchronicpain]

Many patients have horror stories to share about their experiences in hospital emergency rooms, where they’ve been treated as drug seekers and denied opioid pain medication.

“I had a broken arm and was given nothing for pain when leaving the emergency room,” one patient told us. “They now treat everyone like a drug seeking addict even if you have legitimate pain!”

“My last ER visit has caused me PTSD. It was awful they put me in a room and turned the light off and left me there for hours,” said another.

“The emergency rooms are horrible,” said a patient with a fractured rib. “I wasn’t even asking the ER for meds. I wanted an x-ray or something because I was in excruciating pain.”

A new study found that the risk of developing addiction or opioid use disorder after being treated with intravenous opioids in the ER is quite low – less than one-tenth of one percent (0.002%).

Out of 506 patients treated with IV opioids in two Bronx emergency rooms, only one met the criteria for long-term or persistent opioid use six months later.

“These data suggest that the use of IV opioids for acute pain among opioid-naive patients is extremely unlikely to result in persistent opioid use,” wrote lead author Eddie Irizarry, MD, an emergency medicine physician at Montefiore Medical Center.

I’ve had many an ER visit in the past where I needed an opioid and they kept refusing until eventually they realize that I really do. It was fucking torture and I’m so glad I don’t have those flares anymore that put me in the ER.

[exhaled-spirals]

« Hibernation allows many animals to time-travel from difficult times to plenty […but] it is something that eludes us humans. […] Is there something special about our nature that prevents us from hibernating? Will we ever know what it is like to hibernate? […] Humans have always been remarkably creative and imaginative with respect to changing their state of body and state of mind, for example by taking mind-altering drugs, entering a state of deep meditation, or even willingly changing metabolic rates […]. The lack of scientific theory behind the induction of artificial hibernation, and a poor understanding of the underlying biology, is likely an explanation for the lack of progress in this area. […]

Naturally, we are envious that so many creatures, big and small, around us have mastered and perfected the skill of hibernation, which still escapes our understanding. Is it because we are too obsessed with trying to make sense of what we can see and measure […]? Our efforts to understand hibernation go against its entire idea—to disappear, to disconnect, to stop time, to become one with the world. Is this why understanding hibernation eludes us? »

— "Could humans hibernate?" by Vladyslav Vyazovskiy, professor of sleep physiology at the University of Oxford

[hawleywilby]

The photo's used in that interview / article

[brahmasawakening]

I wanted to share some of these sunsets here as well because aren’t these just drop dead gorgeous? 🌅

[qwuilleran]

There's something to be said for not fearing a future that hasn't been written yet. But not when we have a solid example of how it played out last time. Not when you want the people in charge of writing policies to have in mind the most vulnerable. Not when the system of checks and balances will be dismantled and replaced with people who are loyal to a single person, not The People.

It is not out of our hands, as those cabinet nominations must be [verified] in the Senate. Sure, it is nigh impossible, as Congress is now the full trifecta for Republicans, but to roll over and just let them do it is to obey in advance.

cc: @antimony-ore

RFK Jr. Is Even Crazier Than You Might Think

The full depth of his battiness is getting lost in the political coverage of his presidential bid

[maaarine]

Why are British teenage girls so unhappy? Here’s the answer (Caitlin Moran, The Times, Sep 13 2024)

"The report, by the Children’s Society, found that British 15-year-old girls are the most unhappy in Europe.

British girls aged 10-15 are “significantly less happy” with their life, appearance, family and school than the average boy — and their happiness is still declining.

Boys’ life satisfaction, meanwhile, remains broadly stable. (…)

But I still didn’t have an “aha!” moment about why this so disproportionately affects girls until… I talked to some teenage girls.

It was at a party, and I went to vape with them on the patio. Because I take my nicotine like children do.

“Duh — it’s the boys,” one said when I brought it up, as all the others agreed.

“The boys?” I asked.

My last book, What About Men?, had been all about how much boys struggle these days: their loneliness; their suicide rates. I’d spent the past year feeling very sympathetic towards boys.

“Yeah, well, who do you think they’re taking out their unhappiness on? It’s us,” another girl said.

“One boy at school used to draw a picture every day of how ugly I was,” a third girl said. “Every day for two years.”

“They’ve all got ‘Rate The Girls’ polls on their WhatsApps,” the first said. “They mark you down for weight gain, haircuts, what you say.”

“But then, if you’re hot, it’s just as bad, in a different way, because they’ll be talking about how they want to f*** you.”

The girls discussed coping techniques. Bad news: none of them worked.

“The only way you can stop them is if you become ‘one of the boys’ and hang out with them. But then,” the second girl said with a sigh, “all the other girls call you a slut. Because you’ve gone over to the boys’ side.”

“Surely it’s not all the boys?” I said. “There must be some nice boys?”

“Oh, yeah,” one girl said. “But they keep their heads down. Because… well, look.”

She showed me the Instagram account of her friend. Under every picture she posted of herself — smiling in a new dress; with her dog — dozens of anonymous accounts had replied with the most rank abuse.

“Fat.” “Slut.” “You gonna try and kill yourself again, for attention?”

“They’re all boys from her school,” she said. “And look, this one boy tried to defend her.”

I saw a series of messages from a brave teenage boy, posting things like, “You’re all big men, leaving these replies under anonymous accounts.”

As I could see, this boy immediately became a target too. Mainly accusations that he was “white knighting” this girl: “You wanna f*** her, bro?”

“So,” I asked, “you don’t think it’s social media pressure to be beautiful, or the economy, that’s making girls so sad?”

“Well, yeah, them too,” the first girl said. “But, Monday-Friday, 9-3, I’m not on social media. I’m not… in the economy. I’m just with these boys. And no one talks about how horrible they are.”

I thought about another recent report, showing a 30 per cent ideological gap between Gen Z men, who are increasingly conservative, and Gen Z women, who are increasingly progressive.

I thought about Andrew Tate, who has nine million mostly young male followers — and faces human trafficking charges, which he denies.

And I thought: maybe these girls are on to something. Maybe more people need to vape with teenage girls and ask them for the school gossip."

[schoolhater]

link to the article

siraj's tumblr blog

siraj's gofundme

[charles-breaks-beakers]

HETEROSEXUAL CIS-PEOPLE LOOK HERE

Snaps my fingers at you as you scroll past this post

Look at me. Listen.

I'm not the best at serious posts, but that article up there reminded me of how important it is that people like you stand up for us. So hold on while I try to get this out of my mushy end-of-work-day brain.

We could fight this fight ourselves for decades trying to reach the equal laws, gender affirming trans healthcare that doesn't have a 2-5+ soul-eating years of waiting time, medical care with equal knowledge of lgbtqia+ bodies, and, what is often forgotten, inclusion in the little everyday areas of life like our way of speaking or things being set up or designed with the existence of queer people in mind.

But you joining in could get us there so much faster.

The power you have as a hetero cis person is that you set the standard for what is seen as the average way of treating us among other hetero cis people. You have been given the power of deciding what's "normal" and I'm begging you to use it.

Richard Green is a great example of to what extent your actions can help our situation, and smaller ways of support still add up to a great impact on society, and could make the days of the queer people you interact with.

Educate yourself before you speak up, but don't be silent.

[thecoffeelorian]

The fact that this gets so few notes is concerning to me...so!

If you see this on your page, please reblog it! Thank you!!

Now’s a good time to call your senators, the press will need all the protections it can get for the coming years

[skeith-platinumprincess]

Yuzu Pays $2.4 Million to End Nintendo Lawsuit

[thoughtportal]

Opinion Here’s how to get free Paxlovid as many times as you need it

When the public health emergency around covid-19 ended, vaccines and treatments became commercial products, meaning companies could charge for them as they do other pharmaceuticals. Paxlovid, the highly effective antiviral pill that can prevent covid from becoming severe, now has a list price of nearly $1,400 for a five-day treatment course.

Thanks to an innovative agreement between the Biden administration and the drug’s manufacturer, Pfizer, Americans can still access the medication free or at very low cost through a program called Paxcess. The problem is that too few people — including pharmacists — are aware of it.

I learned of Paxcess only after readers wrote that pharmacies were charging them hundreds of dollars — or even the full list price — to fill their Paxlovid prescription. This shouldn’t be happening. A representative from Pfizer, which runs the program, explained to me that patients on Medicare and Medicaid or who are uninsured should get free Paxlovid. They need to sign up by going to paxlovid.iassist.com or by calling 877-219-7225. “We wanted to make enrollment as easy and as quick as possible,” the representative said.

Indeed, the process is straightforward. I clicked through the web form myself, and there are only three sets of information required. Patients first enter their name, date of birth and address. They then input their prescriber’s name and address and select their insurance type.

All this should take less than five minutes and can be done at home or at the pharmacy. A physician or pharmacist can fill it out on behalf of the patient, too. Importantly, this form does not ask for medical history, proof of a positive coronavirus test, income verification, citizenship status or other potentially sensitive and time-consuming information.

But there is one key requirement people need to be aware of: Patients must have a prescription for Paxlovid to start the enrollment process. It is not possible to pre-enroll. (Though, in a sense, people on Medicare or Medicaid are already pre-enrolled.)

Once the questionnaire is complete, the website generates a voucher within seconds. People can print it or email it themselves, and then they can exchange it for a free course of Paxlovid at most pharmacies.

Pfizer’s representative tells me that more than 57,000 pharmacies are contracted to participate in this program, including major chain drugstores such as CVS and Walgreens and large retail chains such as Walmart, Kroger and Costco. For those unable to go in person, a mail-order option is available, too.

The program works a little differently for patients with commercial insurance. Some insurance plans already cover Paxlovid without a co-pay. Anyone who is told there will be a charge should sign up for Paxcess, which would further bring down their co-pay and might even cover the entire cost.

Several readers have attested that Paxcess’s process was fast and seamless. I was also glad to learn that there is basically no limit to the number of times someone could use it. A person who contracts the coronavirus three times in a year could access Paxlovid free or at low cost each time.

Unfortunately, readers informed me of one major glitch: Though the Paxcess voucher is honored when presented, some pharmacies are not offering the program proactively. As a result, many patients are still being charged high co-pays even if they could have gotten the medication at no cost.

This is incredibly frustrating. However, after interviewing multiple people involved in the process, including representatives of major pharmacy chains and Biden administration officials, I believe everyone is sincere in trying to make things right. As we saw in the early days of the coronavirus vaccine rollout, it’s hard to get a new program off the ground. Policies that look good on paper run into multiple barriers during implementation.

Those involved are actively identifying and addressing these problems. For instance, a Walgreens representative explained to me that in addition to educating pharmacists and pharmacy techs about the program, the company learned it also had to make system changes to account for a different workflow. Normally, when pharmacists process a prescription, they inform patients of the co-pay and dispense the medication. But with Paxlovid, the system needs to stop them if there is a co-pay, so they can prompt patients to sign up for Paxcess.

Here is where patients and consumers must take a proactive role. That might not feel fair; after all, if someone is ill, people expect that the system will work to help them. But that’s not our reality. While pharmacies work to fix their system glitches, patients need to be their own best advocates. That means signing up for Paxcess as soon as they receive a Paxlovid prescription and helping spread the word so that others can get the antiviral at little or no cost, too.

{source}

[serial-unaliver]

That year, a Hoover Institution economist who advised both Nixon and Reagan named Roger Freeman said the quiet part out loud when he told the San Francisco Chronicle, “We are in danger of producing an educated proletariat. That’s dynamite! We have to be selective on who we allow to go through higher education.”