This op-ed first appeared in The Gettysburg Times, September 10, 2021

I never thought I would describe Washington Dulles International Airport as a relaxing place to be. I have other associations with travel and the iconic design of Eeuro Saarinen’s main terminal. Navigating traffic on the way down, making sure my passport is not just valid but valid for long enough to satisfy entry requirements of other countries, not knowing how crowded the parking lots would be, and the extra airline fees for things that used to be included (like a suitcase) add to the whirlwind of stress.
 
And yet, walking toward my gate I experienced a sense of freedom that had nothing to do with post-check-in relief. No one argued about wearing masks. It was uncomplicated. People wanted to go places. That was the priority. The mask was just a matter-of-fact part of being in the shared space, a detail no more irritating than taking off our shoes and lifting our carry-on items into the bins for security. 

Public health, at its essence, is about getting everyone to the point where we can relax. To function and live our lives requires basic health and safety. 

We are individuals within communities. Like everyone I move through different spaces and contexts. Waiting to board the plane I was in the context of my fellow passengers and the crew and airport employees. Wearing a mask allowed me to get where I needed to go without endangering or inconveniencing others. 

This isn’t partisan. It’s practical. Whatever context we find ourselves in, we share susceptibility to the aging process, to diseases and viruses, to bullets and the need for air and water. If you require an essential medicine to live you can’t relax without it because you literally cannot live without it.

Insulin is just one example. 2021 happens to be the 100th anniversary year of the invention of insulin in Canada. The patent was sold for $1.00 because the priority was getting it to patients as quickly as possible. Price gouging, easily manipulated patent laws and the power of PBMS are public health issues because we all pay for inflated pricing – directly or indirectly. It’s a public health issue because no one knows, from one day to the next when any of us will need an essential medicine. I’s a public health issue because many legislators – public-elected, public-serving citizens, are likely to take money from major pharmaceutical companies. 

A post-election poll by the Harvard T.H. Chan School of Public Health and Politico asked how important 23 potential priorities mentioned in the media should be for Congress and President Biden. The results appear in Politico’s January 2021 report “The American Public’s Priorities for the New President and Congress.” Issues are ranked according to Republicans, Independents and Democrats. When it comes to points of concern widely agreed upon, “taking federal government action to lower prescription drug prices” was second only to the need for a COVID relief bill. We want the same thing. 

Patients for Affordable Drugs has a useful graphic to show drug price hikes. More than 1,000 price hikes have taken place in 2021. The illustration points to the fact that 53 drug companies increased the price of 75 drugs in the first week in July – and that’s only halfway through the year. 
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We can do better. State and federal lawmakers can do better. Public health is not abstract. Think of ourselves and our health in the next largest context. An international airport is a great reminder that there are many ways to be. Strangers with a heck of a lot in common, we look and speak differently, yet we move through shared spaces – physically and virtually. 
What can we do right now? One feature of the 2022 Budget Resolution and Reconciliation announced in August is giving Medicare the ability to negotiate lower prices for prescription drugs. Give it a chance. Express your support. This is long overdue. Sign the PHAN petition to lower prescription drug prices. Learn about one organization’s approach to the 100-year mark of the discovery of insulin at t1international.com/100years/. Consider stories and solutions offered at patientsforaffordabledrugs.org/solutions/. Get inspired by fabulous visual art responses to public health and the COVID-19 vaccine at Amplifier. 

Katy Giebenhain is on the Gettysburg Area DFA Healthcare Task Force

​A work from Amplifier's #Vaccinated campaign that I especially like is "Vaccines for All" by Macedonian graphic designer Zoran Kardula. Amplifier partnered with the Vaccine Confidence Project for the campaign to "create symbols that build trust in the safety and efficacy of vaccines, advocate for vaccine equity, and help combat vaccine disinformation." See more at Amplifier. 

I appreciate that each year Treatment Action Group (TAG) offers a limited edition artwork donated by a visual artist for purchase. Proceeds support the organization’s advocacy work. The New York-based TAG is an independent research and policy think tank fighting for better treatment, prevention, a vaccine and a cure for HIV, tuberculosis and hepatitis C. 

At the 2018 International Aids Conference in Amsterdam, TAG and the Center for Artistic Activism (C4AA) came up with some brilliant art-infused interventions to show the out-of-proportion power pharmaceutical companies exert. One of these was a registration desk set up outside the official entrance to the conference. Pharmaceutical companies were invited to register in countries where their hepatitis C cure is not produced. Passing out lanyards with “Pharma Laziness Kills” underscored choices at all stages of drug development. Learn more here. 

Visit TAG to see donated works of art. The image is from the TAG site.    

A cartoon pulls off what a really great poem, folksong, or poster design can do, but even faster. Cartoonist Jen Sorensen’s website contains consistently intelligent, witty, crushingly-accurate observations about daily life in the United States. I look forward to her blog entries almost as much as her cartoons. I highly recommend one of Sorensen’s longform cartoons published by Kaiser Health News called “Open Letter to the Supreme Court.” It is a fine example of healthcare truth-telling and lived experience. Here is one of hers from 2017. “Repeal and Destroy” continues to be pertinent. 
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Visit her site or follow her at https://twitter.com/JenSorensen. And, Ms. Sorensen, thank you. Thank you for your service to this country. 

T1International launched a year-long global insulin campaign this week. Physician and scientist Frederick Banting, physiology professor J.R.R. McLeod, medical student Charles Best and chemist James Collip were key figures in the discovery. May 17, 1921 experiments began at the University of Toronto. See a timeline and learn about it here. On July 27, to honor the day insulin was successfully isolated, T1International and the artist Miss Diabetes will release an animated video. 

Insulin came into the world in a spirit of desperate focus and collaboration. Their goal was to figure out the mystery, and to get the results into the bodies of type 1 diabetics as soon as possible. The early story of insulin is a story of access. Today, the story of insulin is a story of profit. The nonprofit T1International advocates for communities around the world to ensure the availability of insulin and supplies. 

A great perspective on early collage in the context of contemporary life and art is Jason Farago's New York Times article from this January "An Art Revolution, Made With Scissors and Glue." I appreciate, among other things, the title. These days we are obsessed with digital presentation. I'm posting a couple of pieces from my current series.  

Formulary Marginalia. Mixed Media, 2021.

Senate Office Building Rotunda. Mixed Media, 2021.

The Kalamazoo Book Arts Center (KBAC) opened its annual exhibit featuring accordion books on Friday, April 9. Visit the gallery or the website to see 90 works from five countries. The materials, themes, shapes and sizes vary, but each one shares that classic back-and-forth fold. It is a pleasure to see these takes on the form. Staff members at the Center are incredibly patient. Unpacking, photographing, wrangling and displaying this many works is no easy feat. 

"Big Pharma and the Barkeep" is included in the open exhibit. The sectioned poem appears in a six-panel accordion book. Each panel measures 10 inches high x 20 inches wide. See the February 13, 2021 post here for the text. Those are glass ice cubes at the base of the open book. The photo is from KBAC. 

Truth well-told is an art in any media. Tradeoffs: Healthcare, Policy, People is a podcast series addressing crucial topics. It manages to be concise and informative, yet stamped with personality. The team takes turns reporting and providing research updates along with cultural observations and recommendations at at the end as “staff picks.” 

Tradeoffs was launched by journalist Dan Gorenstein and University of Pennsylvania community health expert Courtney Summers in the fall of 2019. The first podcast compared health plan proposals of the then-Democratic presidential candidates. I, of course, especially appreciate the podcasts that address drug pricing and choice. We can’t underestimate how useful a series like this is that makes policy understandable. It reminds me of what advocates at the Maryland Health Care for All! Coalition say about access to medicines: “Drugs don’t work if people can’t afford them.” Information doesn’t matter if it is not understandable. 

In their January 15, 2020 post from the HealthAffairs blog “You’ve Got To Hear This: Funding A New Health Policy Podcast” Steven Birenbaum and Jordan Reese wrote “…the most captivating podcasts employ a combination of journalism, classic character-driven storytelling, and a heaping teaspoon of entertainment.” Exactly. It takes work to make something feel effortless. The effortless feel to Tradeoffs’ podcast and weekly newsletter is the result of much work and thoughtfulness. May it continue. We need artful podcasts on essential healthcare topics right now.


​Visit Tradeoffs

Excerpted notes for cocktail recipes 
 
                                         
Lobbyist Lemon Drop                    

Tart. In taste and character. 
Sunny –  
by all appearances safe and refreshing. 
This cocktail
has something slipped into it.
This one will take you 
from Kansas to Oz and back.
You just don’t know it.

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The Good Journalist 

A call drink with your favorite brand 
of gin, Diet Coke, lime, 
is on the house, every time.
We need Clark Kent more than Superman. 
Listen. 
We need reporters who know
the way to save the world
is to inform it.



F.T.C. Fizz 

This one takes a swizzle stick 
with a tiny plastic crane.
Use cracked ice
before the grapefruit juice, before
the Prosecco. 
The Federal Trade Commission prevents 
anticompetitive or
deceptive business practices. 
Except when they don’t.  
Except when they won’t.
This one has a lonnnng, aftertaste.



The Formulary

A daily special, 
its price changes any time. 
Its availability changes 
any time.
The barkeep gets a phone call
and goes back 
to erasing and hand-lettering 
the chalkboard.
This drink is named 
for contemporary 
pharmacy benefit managers,
the post-merger Goliaths.
You must repeatedly show ID to prove 
you deserve 
the chance to be served.



The Prayer 

Serve The Prayer in ceramic steins 
hand-thrown 
by Benedictine monks.                                                                       
Serve it hot 
like Glühwein. 
Spicy, comforting, sharp. 
Drink it with your eyes closed 
(obviously).


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