Joe Biden’s administration has made reforming drug pricing a signature policy goal. His Inflation Reduction Act’s Medicare drug price negotiations will bring $7.5 billion in savings for seniors beginning in 2026. He has not stopped there.

Last Friday, the U.S. Federal Trade Commission, led by Lina Kahn, whom 60 Minutes profiled this past Sunday, sued the country’s three largest Pharmacy Benefit Managers (PBMs), accusing them of steering diabetes patients toward higher-priced insulin to reap millions of dollars in rebates from pharmaceutical companies.

The case accuses UnitedHealth Group’s Optum unit, CVS Health’s CVS Caremark, and Cigna’s Express Scripts of unfairly excluding lower-cost insulin products from lists of drugs covered by insurers.

How did we get here? And what are PBMs, anyway?

First, how did we get here?

The PBM industry was born in the late 1960s when Pharmaceutical Card System, Inc., (PCS) invented the plastic benefit card. By the mid-1970s, PCS was serving as a fiscal intermediary by adjudicating drug claims. In other words, it was a prescription Third Party Administrator (TPA). By working for insurers and health plans, PCS (later, AdvancePCS) and others figured out that they could leverage the buying power of their clients to negotiate lower drug prices.  And until around 1992, that’s what they did. During that approximately 20 year period, PBMs saved insurers, health plans and consumers money by driving physicians and patients to use lower cost generic drugs. This was a valuable service for all.

In 1992, however,  PBMs began to change their focus. As noted by the Wall Street Journal in August, 2002, from 1992 through 2002, PBMs had “quietly moved” into marketing expensive brand name drugs, not generics. This has created an incestuous relationship between PBMs and pharmacy companies, which occurred over three periods.

From 1968 through 1994, pharmaceutical companies acquired PBMs. For example, in 1994 Eli Lilly bought PCS for $4 billion and SmithKline Beecham bought Diversified Pharmaceutical Services (from insurer UnitedHealth) for $2.3 billion. But the FTC saw anti- trust implications in these deals and ordered the acquisitions to stop and the pharmaceutical firms to divest the PBMs.

So, Eli Lilly sold PCS Health Systems to Rite Aid for $1.5 billion,  SmithKline Beecham sold Diversified Pharmaceutical Services to Express Scripts for $700 million, and Merck spun off Medco Health Solutions, the PBM for 68 million Americans at the time.

The third PBM evolutionary period, the one we’re now living in, has seen mergers between PBMs and PBMs with pharmacy chains. Those long and winding acquisition roads have resulted in three PBMs — Caremark, Express Scripts and OptumRX — cornering 78% of the nation’s PBM business, serving 266 million Americans.

In 2023, total revenue for these three firms had grown to nearly $400 billion, with CVS Caremark reporting more than $175 billion, Exoress Scripts more than $100 billion and OptumRX slightly more than $116 billion.

Second, what do PBMs really do?

The first thing one has to understand in trying to answer this question is that PBMs quintessentially define the word “opaque.”

PBMs claim they serve consumers by negotiating lower prices with drug manufacturers, which result in rebates and discounts that are applied when a health care consumer pays for prescription medication. Sounds simple, but it’s not. It is ridiculously complicated, as this chart from the Drug Channel Institute’s 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers shows.

Let’s see if we can simplify the obscura using this scenario.

Imagine for a moment you are a pharmaceutical company CEO. You produce drugs that help sick people be healthy. Trouble is, the great big US healthcare system in which you operate is a labyrinthian rabbit warren. And in the center of your part of it sit PBMs.

Here’s your issue as a drug company CEO: You know, regardless of what price you set for your super-duper drug, you’re going to have to give a lot of it back as a discount to the PBM so it can give rebates to its clients. What’s a busy CEO to do?

Well, one answer is to set the price, the list price, so high that you’ll be able to provide a generous discount and still make what your finance folks say you must have for a profit.

In a weird sort of way, this works most of the time for patients, but only if they have health insurance. What happens if they don’t? This is where things get sticky. Uninsured people, who mostly don’t have enough money to afford insurance, even the Affordable Care Act variety, get stuck paying the full list price, the one you inflated in order to provide the discount that allows you to make a profit and PBMs to (kind of) save money for their customers. And let’s not forget that even people who have insurance will pay full price until they get past their deductibles. This has been especially difficult for some uninsured Type 1 diabetics, who, as I have written previously (here and here), have had great difficulty paying for the insulin they need to take every day ─  just to stay alive.

And that is why Lina Kahn’s Federal Trade Commission has sued the big-three PBMs, accusing them of steering diabetes patients toward higher-priced insulin to reap millions of dollars in rebates from pharmaceutical companies. In its lawsuit, the FTC contends this conduct hurts patients, such as those with no insurance, as well as those with coinsurance and deductibles, who were not eligible for the rebated price.

Kaiser Family Foundation health policy expert Larry Levitt described the FTC action as a “shot across the bow.”

“Insulin is an extreme case of PBMs extracting bigger and bigger rebates from drug manufacturers and driving list prices up at the pharmacy counter, but this is a dynamic that plays out with many medications,” he said.

As you would expect, the three Pharmacy Benefit Managers have criticized the FTC’s approach to the industry, accusing it of bias. Early last week, Express Scripts sued the FTC seeking to force it to withdraw a report that said PBMs enrich themselves at the expense of smaller pharmacies.

The Drug Channel Institute’s Adam Fein, Ph.D., has measured total rebates and discounts paid by drug manufacturers in 2023 as $334 billion. He calls it the “gross-to-net bubble.” One way of looking at that is to say Doctor Fein’s figure is the amount drugs were overpriced in 2023.

Of course, the Occam’s Razor solution here is for drug companies to set prices precisely at the point they end up at after discounts and rebates are applied, thereby establishing a realistic list price and eliminating the middleman.

In our Rube Goldberg health care world, that has as much chance of happening as rain has of suddenly beginning to fall up, instead of down.

In March of 1772, Doctor Joseph Warren, a Revolutionary hero who fought at Lexington and Concord and would later die on Bunker Hill, delivered an oration at Boston’s Old South Meeting House commemorating the second anniversary of what came to be known as the Boston Massacre, where five colonists were killed and six wounded. Crispus Attucks, a whaler, sailor, and dockworker was the first to die. He was also the first person of African and Native American descent killed in the fight for American freedom. He would not be the last.

When Joseph Warren delivered his oration, he was serving as President of the revolutionary Massachusetts Provincial Congress and was highly respected in the colonies.

Like most upper-class, educated colonists (Harvard, 1759), he looked to ancient Rome’s Republic for  guidance in attaining freedom. By some accounts, he delivered his oration that day in a flowing white Roman toga that would have made Cicero proud.

It was an attachment to freedom, he said,

which raised ancient Rome from the smallest beginnings, to that bright summit of happiness and glory to which she arrived; and it was the loss of this which plunged her from that summit, into the black gulf of infamy and slavery. It was this attachment which inspired her senators with wisdom;…it was this which guarded her liberties, and extended her dominions, gave peace at home, and commanded respect abroad…

Warren warned that Rome lost her Republic over time as her leaders “forgot their dignity and virtue” and “committed the most flagrant enormities,…whereby the streets of imperial Rome were drenched with her noblest blood.”

Seeing into the future, Warren knew that one day America would be free of British rule, so he urged his listeners to study what happened in Rome. If they did, and learned the lesson, he predicted America would be “a land of liberty” and “the seat of virtue.”

And that is precisely what happened following the successful American revolution. When asked by Elizabeth Powel, “Well, Doctor, what have we got, a republic or a monarchy?” Benjamin Franklin replied, “A republic, if you can keep it.”

It’s been a struggle ever since.

We were all reminded of this on Saturday when the Secret Service foiled another assassination attempt on the life of Donald Trump that unfolded as he was playing golf at a country club of his in Florida.

The suspect had an AK-47-style rifle with a scope attached. Authorities also found a GoPro digital camera at the place in the bushes where he’d been hiding for 12 hours, which suggests he appears to have been planning to broadcast his attempt to kill Trump. If it weren’t for an eagle-eyed Secret Service agent, who noticed the rifle barrel sticking out slightly from the bushes, the attempt may have succeeded.

The suspect, Ryan Wesley Routh, has a long criminal record and has been active on social media. He once wrote a self-published book in which he urged Iran to assassinate Trump.

Routh had backed candidate Trump in the 2016 election, but grew disillusioned with him during his first term. In June of 2020, Routh wrote on social media, “While you were my choice in 2106, I and the world hoped that president Trump would be different and better than the candidate, but we all were greatly disappointment and it seems you are getting worse and devolving … I will be glad when you gone.”

Court documents released yesterday detail Routh’s past run-ins with the law, including felony convictions in North Carolina. He was convicted in 2002 for “possession of a weapon of mass death and destruction” and in 2010 for “multiple counts of possession of stolen goods.”

Federal law prohibits individuals convicted of a felony from possessing firearms, let alone assault rifles like the AK-47. That didn’t seem to stop Mr. Routh.

This sordid event is another spoke in the wheel of approaching political anarchy. Think what would have happened throughout the nation if Routh had succeeded. Although officials pointed out he never had “line of sight” on Trump, that was only because Trump hadn’t yet reached  the golf hole where Routh had set up his ambush. But the target was on its way.

There are now 48 days until the election. I’m less worried about those 48 days than I am about the 48 that follow — the ones between the election and the inauguration.

Regardless of whether you vote for Donald Trump or Kamala Harris on 5 November, it’s likely those 48 days will be fraught with tension. If a peaceful transfer of power occurs, the nation will have shown its best side to the world. But if not, we will be dragged “into the black gulf of infamy” Joseph Warren warned us of and toward which the fringe elements of society seem intent on pulling us.

If that happens, we will be looking back on January 6th, 2021, as nothing more than a warm-up, opening act.

That is a distinct possibility, which is a terribly scary thought.

Regarding the debate where cats and dogs were on the menu

The 2024 election is now 52 days away. Post debate polls are about to be released. Most people paying attention expect a small bump for Kamala Harris. We’ll see.

Donald Trump’s approach to the debate seems to have been to see how many weird and crazy things he could shoehorn into 90 minutes, and to do it all with ever increasing  hyperventilating anger.

The highlight for me, and I suspect a lot of people, was his assertion that in Springfield, Ohio, illegal Haitian migrants, the ones he insists are murderers and rapists, were stealing and eating their neighbors’ cats and dogs.  When ABC Moderator David Muir told him ABC had verified with Springfield’s City Manager that no such stealing and eating had happened, Trump said he “saw it on TV.”

The origin of this lunacy was one Springfield woman, Erica Lee, who posted the bizarre anecdote in a local Facebook group. Then, on 5 September, a screenshot of the post was shared on X, which went viral. It’s now been viewed by almost one million people.

Fox News picked up the story and reported it. Then, when it became clear the story was totally made up, Fox reported it wasn’t true. Mr. Trump, Fox’s most devoted viewer, must have missed that second report.

Shortly after the debate, Ms Lee revealed her source for the baseless story, saying she heard it from a neighbor, who heard it from a friend, who heard it from the friend’s daughter. She also admitted that she doesn’t even know the daughter who started the whole thing.

Adding some fuel to that claim was a graphic video, viewable on YouTube, which shows the 16 August arrest of Allexis Telia Ferrell, who allegedly killed and ate a cat in Canton, Ohio. Stark County Court records for Ferrell, a non-Haitian American citizen, show she was charged with cruelty to companion animals.

Finally, JD Vance circulated the “story” on X, but did say it was “possible the rumors would not prove to be true.”

And that’s all the “evidence” there was for this brushfire of calumny.

Over the past couple of days, Haley Byrd Wilt, of Notus, tried to ask as many Senate and Congressional Republicans as she could get to stand in one place long enough what they thought of the migrant stealing and eating episode. You’d think she had thrown them into a pizza oven given the speed at which they tried to escape.

Only Senator Marco Rubio, of Florida, a state chock-full of Haitian migrants who vote, and are therefore important to him, offered any kind of rational reply. Of Haitians eating cats, he said, “We’ve never had a problem with that in Florida.” And Rubio wasn’t worried that Trump’s claims would affect the considerable Haitian population in his state.

“The Haitian community in South Florida, in particular, is well-ingrained in the fabric of our community,” he said. “We all know each other. It’s not going to be an issue in Florida.”

But he was careful not to criticize Trump.

Meanwhile, back in Springfield, Ohio, population about 58,000, bomb threats forced the closing of City Hall and a couple of schools on Thursday. There were no bombs, but the citizenry is decidedly on edge and upset about its new undeserved fame as the cute little pet stealing and eating capital of the country.

For the record, in May 2021, the U.S. expanded Haitian eligibility for a humanitarian program granting deportation relief and work permits to an estimated 150,000 Haitians already living in the U.S. who cannot safely return to their home, Reuters reported.

Want to join Mar-a-Lago?

In 2015, before Donald Trump announced his candidacy, the cost of a membership at Mar-a-Lago was $100,000. After he won the election, he raised the price to $200,000. Today, it is $700,000.

In November, shortly after the election, four slots are coming open, and the price to buy in?

One million dollars. And all of it goes to Donald Trump. Maybe six bankruptcies helped him become a better businessman.

Enough said.

False equivalence at the New York Times – a continuing embarrassment

Margaret Sullivan is a journalist who was the first New York Times public editor, or ombudsman. Now, she writes for The Guardian and publishes a Substack column, called American Crisis. Her most recent entry is highly critical of her former bosses at the Times. While Sullivan asserts that, with its enormous resources, the Times does a lot of great work, she bemoans its coverage of the 2024 presidential election.

As an example, she wrote that she had been discussing this with her former colleague, the Pulitzer Prize winning investigative reporter James Risen, who was deeply disturbed by what he was seeing.

She wrote:

“At first, I thought this was a parody,” Risen told me. Unfortunately, it wasn’t. Even more unfortunately, the lack of judgment it displays is all too common in the Times and throughout Big Journalism as mainstream media covers Donald Trump’s campaign for president.

“Harris and Trump Have Housing Ideas. Economists Have Doubts,” is the headline of the story he was angered by. If you pay attention to the epidemic of “false equivalence” in the media — equalizing the unequal for the sake of looking fair — you might have had a sense of what was coming.

The story takes seriously Trump’s plan for the mass deportation of immigrants as part of his supposed “affordable housing” agenda.

Here’s some both-sidesing for you, as the paper of record describes Harris’s tax cuts to spur construction and grants to first-time home buyers, and Trump’s deportation scheme.

“Their two visions of how to solve America’s affordable housing shortage have little in common …But they do share one quality: Both have drawn skepticism from outside economists.” The story notes that experts are particularly skeptical about Trump’s idea, but the story’s framing and its headline certainly equate the two.

This is a small example of how mainstream media, and particularly America’s “paper of record,” is covering this election. In a committed effort to be seen as fair and balanced, it is being anything but.

The nation deserves better.

Cartoonists do it better.

For hundreds of years, political cartoonists have afflicted the comfortable as no other group has. You won’t find much false equivalence coming out of this crowd.

I end this weekend read with a perfect example.

When Donald Trump desecrated Section 60 at Arlington National Cemetery, I wrote about it. However, I could never capture the callow disregard for the cemetery’s hallowed ground as well as Pulitzer Prize winner Darrin Bell did last week.

See what you think.

Today, we leave the hot jungles of  the Vietnam of my youth where, in the late 60s and early 70s hundreds of thousands of soldiers from opposing sides tried to kill each other and where more than 50,000 Americans died, making the ultimate sacrifice.

We arrive 50 some odd years later in the charming and hallowed ground of Arlington National Cemetery, just outside Washington DC, where so many of the dead from Vietnam have found their final resting place, joining other fallen from our wars.

On 26 August, the cemetery and all its dead were pulled into the political knife fight that is the 2024 presidential election. Once again, as he always seems to do, morally corrupt and remorseless Donald Trump, empty of mercy, pity, empathy, conscience, and guilt, decided that what was in his interest was ever so much more important than any moral considerations for the dead and their loved ones.

As NPR originally reported, on that day Trump visited Arlington Cemetery at the invitation of some Gold Star families whose loved ones were killed at the Abbey Gate of Kabul International Airport while U.S. forces were evacuating Afghan allies three years ago. Thirteen service members were killed after an Islamic State fighter detonated a bomb that also killed more than 170 Afghan civilians.

Trump laid a wreath at the Tomb of the Unknown. Fine, so far. But that’s not all he and his campaign aides did.

Those service members he was invited to mourn are now buried in Section 60, which is the resting place for those killed in the Afghanistan and Iraq wars. The Armed Forces considers Section 60 sacred ground, as do the families of the dead who are entombed there.

I’ve been there, and, when I was, I had the feeling of being in church.

On that day, after laying the wreath, Trump and his campaign team cavalierly invaded Section 60, Arlington’s sanctum sanctorum, for a political photo op and video. Members of Trump’s entourage pushed aside an Army employee who was trying to enforce the rules — and federal law — which forbid photos, videos, and anything else that smacks of political campaigning within the gravesites.

Trump got his pictures.

After the incident became public, Trump’s Representative Steven Cheung, said, “This individual was the one who initiated physical contact and verbal harassment that was unwarranted and unnecessary,” As if that wasn’t enough, he added that the employee obviously “had a mental problem.”

The Army said the employee who’d been tossed aside declined to press charges, allegedly because of fear that Trump and his MAGA minions might retaliate against the employee or her family. For the record, the Army said she was only doing her job.

At a campaign rally the next day, Trump blamed the whole thing on Joe Biden and Kamala Harris. Then he said it didn’t happen. It was a “made up story.” Makes your head spin. But what else would one expect?

Representative Jamie Raskin, ranking Democrat on the House Committee on Oversight and Accountability, and Senator Tim Kaine, a Virginia Democrat, wrote to Army Secretary Christine Wormuth, asking for the incident report from Arlington, which the Army has not yet made public, as well as a briefing.

With Donald Trump, this stuff is routine transactional business. Incidents like this come fast, so fast they seem like a many-headed-hydra, mythology’s version of whack-a-mole. The result is the nation has become desensitized to their rapid fire and depraved nature. And our mainstream media — I’m talking to you, New York Times — treats them as if they’re nothing more than a little dirty politics, which happens in every campaign, doesn’t it?

An existential crisis for American democracy? Many scholars seem to think so, but you’d never know it from America’s “paper of record.”

Yesterday morning, writing in the Washington Post, former Chairman of the Joint Chiefs, Admiral Mike Mullen, giving Trump the Voldemort treatment, never saying his name, scathingly rebuked those who had used Arlington National Cemetery for “a political event.”

Admiral Mullen wrote:

But no part of Arlington — or any veterans’ cemetery for that matter — should ever play host to partisan activity. These cemeteries are sacred ground. They represent the final resting places of our best, our brightest, our most unselfish citizens.

Our fallen and departed veterans did not serve, fight or die for party. They fought and died for country, for each other, for their families and for us. They served in a military that defends all Americans — regardless of creed, color, race and, yes, voting habits.

On a hot and humid August day in 1970, a MedEvac helicopter landed on a dusty, wind-swept pad on the western edge of Camp Eagle in northern South Vietnam. Camp Eagle was the base camp for the Army’s 101st Airborne Division, of which I was a fully paid up member in good standing.

Eagle, about the size of a small city, was roughly seven kilometers south of the city of Hue where the heaviest fighting of the Tet offensive had happened a little more than two years earlier. America won the battle of Tet on the ground, but lost it in the press. Although the war went on for another six years, Tet was the turning point where we lost the support of the American public, if we ever had any to begin with.

When the chopper landed, I was sitting in the door beside the door gunner with my legs hanging out. Both legs hurt — a lot. With the blades still whirling, a couple of medics lifted me out and carried me to a nearby truck with a red cross on the side of it. They maneuvered me inside the back end of the truck and onto a seat on the side, and off we went to a medical unit somewhere on the base.

This was not my first time making this kind of trip. A couple of months earlier, during a brief encounter with some of our friends from the north, a tiny piece of shrapnel had navigated its way into a fleshy spot just above my right knee. For a little thing, it hurt a lot. So, I’d taken a chopper ride back to Eagle where a medic had frozen the spot, made a small cut, dug out the miniscule metal, bandaged me up, and sent me back to my men who did their best not to laugh about it in front of me.

This latest trip to the rear had nothing to do with shrapnel.

Regular readers may recall the 15-mile march to the sea my men and I made on a hot and rainy summer night, the sand-filled bread we pigged out on, the crammed-in Sampan ferry ride up the South China Seacoast, during which Rusty the Scout Dog crapped voluminously smack dab in the middle of us, all of which preceded our launching what was likely the only amphibious beachhead assault of the entire war, only to be met, not by North Vietnamese regulars with murderous intent, but by Red Cross Donut Dollies with Coca Cola.

All of this so my Commander, call-sign Bobcat, could win his silver star.

I don’t know which was more humiliating, getting hit in the knee with shrapnel so small you could hardly see it, or being the butt of merciless “amphibious assault” jokes from fellow officers I used to think were friends.

But following the battle that wasn’t, the military gods smiled, and my men and I were allowed to hang around for nearly three weeks on the beach we had recently “captured.” It was too bad the Donut Dollies couldn’t hang around with us, but they had Cokes to deliver elsewhere. C’est las vie.

During our nearly three weeks of semi-vacation, we routinely patrolled the lowland area, encountering nothing but a few water buffalo and some rice paddy farmers who would have slit our throats if they thought they could have gotten away with it.

When not patrolling, most of our time by the sea was spent in it, swimming and surfing when the tide came in. It wasn’t until I saw Apocalypse Now nearly ten years later and watched Robert Duvall’s fake troops doing the same thing that I realized we might not have been unique, after all. But there was one stark difference between us and Francis Ford Coppola’s movie — we never had to endure the “smell of napalm in the morning.”

That was no small blessing. Standing on a ridgeline looking across a valley toward the end of my time in Vietnam, I saw what a napalm strike could do as two jets streaked in to release their grisly cargo on the forest below. It looked as if the earth had opened up to have fiery hell rise and devour everything it touched. Made me realize just how right Sherman had been about war being hell.

About a week into our time on the beach, we were resupplied, and some kind soul included a couple cases of beer. Shortly after that, I stepped on a small, pull tab that once sat on top of  a can of Bud. It cut my foot, and I thought nothing more about it, except to order the guys to police the area so it wouldn’t happen again to someone else.

Two days later, the foot began to hurt. A couple of days after that, my right calf started to ache and swell. Over the next several days, what was obviously an infection made its way all the way up my right leg and down my left. The pain was exquisite. I couldn’t stand, let alone walk, and it was at this point that our medic, Corporal Gary Porzinski, said he’d done everything he could, which wasn’t much, and I needed to get back to Camp Eagle to get more sophisticated help before things became serious.

And that was how I found myself on the Huey MedEvac chopper winging my way back to Eagle, then to the ambulance with the Red Cross on the side of it, and finally to a light hospital unit where, along with about twenty other medical inmates also suffering from different kinds of infections, I was told to bend over for a shot of penicillin in the ass twice a day for the next ten days.

We were all officers in the medical unit, which was in a large tent, and I remain convinced to this day that the army nurse with the big grin and the giant hypodermic needle derived great joy in slamming it home with vigor.

But what do you do in the middle of a war in the middle of a large army base in the middle of a medical unit tent? Answer: not much.

Which the guys who ran the medical unit realized. One of them was our Battalion Surgeon, Major Skip Davies — a man  I counted as one of my best friends in Vietnam. We had known each other back on Fort Benning before getting the orders everyone knew would one day arrive. Our wives were friends and kept each other company all the time we were gone. Each of us had baby girls we were hoping to get to know.

After I’d been in the medical unit for about a week, he came to see me while I was in between shots in the ass. I told him it would be nice if the guys recovering in the tent could have a little entertainment of some sort. He thought that was a good idea, so good he told me he’d already arranged for us to have a movie night. “What movie,” I asked him. “Nope,” he said, “It’s a surprise. But you’re going to like it.”

And so it was that the following day a few soldiers rigged up a large screen outside the tent and put about 25 dilapidated, rickety chairs in front of it. As darkness began to fall, we all made our way to the chairs in our hospital johnnies with the slits up the rear to make it easier for Sgt. Caligula, or whatever his name was, to get at us. We settled ourselves in, someone turned on a big projector, and the movie began.

It was Mash, which had come out earlier that year. I have no idea how the army not only got it, but got it to Camp Eagle in Vietnam. Regardless, there it was in living color right in front of us. Directed by Robert Altman, with Donald Sutherland as Hawkeye, Elliot Gould as Trapper John, and Sally Kellerman as Hot Lips Houlihan, it was stingingly hilarious.

We had just gotten to the truly ironic part. Hawkeye, Trapper John, and their ghoulish pals had assembled, just as we had, in chairs in front of a tent within which Hot Lips was showering. They sat waiting, as did we. We knew something huge was about to happen.

And it did. At that very moment Camp Eagle came under rocket attack. Regardless of our infectious states, or whatever Hot Lips was doing, once we heard the first explosion we all unassed the area and ran for the nearest bunker into which we dove, some headfirst.

About ten rockets hit Camp Eagle that night, none of them remotely near us, but movie night was ruined.

The next day, cured, I jumped a chopper, flew back to the beach that began it all, and rejoined my men, who hadn’t missed me in the least. We were only at the beach another day or two. After that we said goodbye to water and sand and choppered north deep into the jungle where the war came back to meet us with a vengeance.

It wasn’t for another ten years that I was able to see the nearly two hour, full movie of Mash. With my wife Marilyn, I finally saw Sally Kellerman’s shower screen drop to the ground to reveal her standing humiliated, naked, and covered with soap to the applause and guffaws of Hawkeye and all his friends assembled in front.

Somehow, it didn’t pack quite the punch I thought it would.

Epilogue

Between the Vietnam war and now, Camp Eagle slowly disappeared. Nature reclaimed its own and erased our presence. If you looked for signs of it now, you wouldn’t find any. It’s as if we were never there. That’s  good.