• Sometimes I despair

    I’m having a week.  Today, someone dared to tell me we have the “best health care system in the world”.  He’s lucky I have restraint.

    This is how good our system is:

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    I have a chronic illness.  I do not have this illness because of anything I did.  There is no way I could have prevented it.  I eat right and I exercise.  I don’t smoke, I don’t do drugs, and I don’t abuse alcohol.

    I work hard; I have health insurance.  I pay for the premiums.  I pay all the co-pays.  I follow the rules.

    For my illness, I take medication.  This medication is serious, with bad potential side effects, and it is not something you would want to take.  But, since I want to be well, I take it.

    This week I was getting to the end of my presctription.  You can’t ask for a refill too early, or the insurance company will deny it.  They know how much you have left.  You can’t ask for it too late, or you will obviously run out.  I’ve found the sweet spot to be about two to three days before you go empty.

    So today, when I looked into the bottle and saw three pills, I immediately ordered more from my local pharmacy.  I expected no problems.  I knew I had one refill left, and I knew I was up to date on my labs.

    At 3:30 PM, my wife called me to tell me there was a message from the pharmacy on our home machine.  I was, of course, not there.  I was at work.  But she gave me the number and I called them.

    It turns out that my insurance (which is really good insurance, by the way) has decided that I can no longer get my medication at the commercial pharmacy.  It’s serious medication, so they want me to get it from their mail-order pharmacy (which I think they own).  So they told the local pharmacy that they won’t pay for it.  I have to go through them.

    Can I transfer the remaining refill from the local pharmacy to the mail order pharmacy? No.  I need a brand new prescription from the doctor.

    Can I get a new prescription from my doctor today? No, it’s 3:30 on a Friday and they’re not answering the phone.

    Can I get you – the mail order pharmacy – to ask my doctor for the prescription directly? Sure!  It will only take up to 2 business days for us to figure out if we can get ahold of her.  And, since it’s a holiday weekend, we should know that by Wednesday of next week.  (Remember, I run out of meds on Sunday)

    Even if I get my doctor to magically get you a prescription today, which is when I first found out about this, can I get meds from you before my prescription runs out? No, no no. It could take up to two weeks for us to fill the first prescription.  We recommend you have a full 30 day supply on hand when you “decide” to transfer your prescription over to us.

    Will you allow me to refill my prescription at the local pharmacy then while I get all this going? No.

    Can I contact you to talk about this? Sure.  Send us an email.  We promise to answer in one business day.  Since it’s a holiday weekend, you should hear from someone by Tuesday.  (Remember, I run out of meds on Sunday)

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    So, people, what am I supposed to do?  Here’s what I have to do.  I have to pay for the meds out of pocket.  They are ridiculously expensive.  But this medication is serious.  I want to be well, so I will do it.

    But I’m lucky.  I’m pissed, but I can afford it.  Lots of people can’t.

    I did nothing wrong.  I follow the rules.  I pay my bills.  I go to my appointments.  I remember to refill on time.  I do everything right.  And I’m absolutely screwed.

    Best health care system in the world my ass.

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