By Allan Detrich
Post-Gazette National Bureau

HELENA, Ohio - It was a cold, snowy day back in January when Larry Nieset and his son Chip left their farm for Windsor, Ontario, about an hour and a half away.

They did not go to play Black Jack in one of Windsor's casinos, strategically placed just across the border from Detroit. They were gambling that Larry could save money on the 17 prescription drugs he needs to stay alive.

The Niesets are barely breaking even on the family farm, and Larry, at age 67, doesn't have health insurance to help him buy drugs for kidney failure, diabetes, heart disease, high blood pressure and the various side effects of all these ailments. So he and his son headed north on what he figured would be the first of many drug runs.

Canadian pharmacies fill prescriptions only if they are written by Canadian doctors, so when Nieset showed up at a Windsor Wal-Mart he had found on the Internet, he was sent to the Roseland After-Hours Medical Clinic two blocks away.

The doctor there briefly went over his health history, laboriously converted his U.S. prescriptions, gave him a lecture about how to stay well, and sent him on his way. It took 45 minutes and cost $20 U.S. "She really wasn't over-enthused and made me sign a waiver saying if anything happened it wasn't her fault," Nieset says. "And I can understand that. She don't know nothing about my health."

Back at Wal-Mart, the pharmacist took nearly an hour to fill the prescriptions and didn't have everything. By this time, Nieset was nervous and upset, having crossed the border and then being bounced back and forth between the Wal-Mart and the clinic, and then finding out he couldn't get all his medications. His heart started racing, so he popped a nitroglycerin pill to settle it down.

Nevertheless, Nieset rated the trip a success. The five-hour venture ended up saving him $450 for a three-month supply of most of his meds. Nieset has been planning to go back for some time now, but he's been too sick.

Last month, he had a heart attack. And three days a week, four hours at a time, he's tethered to a dialysis machine at the Fostoria Community Hospital, about 25 miles away from his farm in Helena. Nieset would like to get back on his tractor and out in his fields. But nowadays he sits a lot, watching with his yellowed, jaundiced eyes, as his sons do the daily chores.