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Rx Express -- Barbara Turner -- Lafayette, CA
At 77, Barbara Turner takes a slew of medications: for high cholesterol, acid reflux, diuretics. A Kaiser member, she is able to get most of them with a reasonably low co-pay. But only because they are generic drugs.

The problem comes with brand-name medications. Kaiser is no help there; there is no cap on how much patients pay for these medications, and in recent years, Barbara says, the costs have gone "up, up, up."

Barbara takes two such medications, for C.O.P.D. - Compromised Oxygen Pulmonary Disease, which is similar to emphysema. She spends $120 a month for one of them, screzen diskus, and $98 for another Flovent. So Barbara, a senior citizen, is paying $218 of her scant income just for these medications, which she must have.

She can't afford it, and she knows many others can't either. She is going on the Rx express "as a backup for all those people who can't afford these expensive drugs."

Barbara figures she will survive; she has after all, been taking care of her and her family's health for decades. Born in Oakland in 1926, she worked as a dental assistant and a Juvenile Hall counselor, among other jobs, and eventually landed a position as an employment specialist for special education in Contra Costa County.

She worked with youngsters 18 to 22 who had problems like spinabifada, cerebral palsy, and autism "I tied to make them self-sufficient," she says, "so they wouldn't be on the dole." She succeeded, placing many of the youngsters in jobs, and even seeing a few get married. "It's amazing what they can do," she says. "it was the best job I ever had in my life."

While she was doing that, she and her husband were raising seven children.

Barbara "retired," sort of, 20 years ago, but in fact kept working until 1998. When she left the job that time, she received dental coverage, but couldn't get COBRA because of her age. That's when she went to Kaiser's Senior Advantage plan. She is currently working on a temporary contract for the county, to help out, but that ends in December.

Barbara has always been able to navigate her way through the health care delivery maze. When her husband was downsized at the age of 57, for example, and they lost their coverage, Barbara was able to find a 20-hour a week job as an aide that provided it.

"I know how to work the system," she says. But the cost increases anger her. She thinks it's time for changes in the system, especially regarding the availability of non- brand name prescription medications.

"It's unfair that we can't get them at the least expensive price," she says. The Rx Express, she hopes, will lead to changes that will help California's health care consumers.