Monday, November 25, 2013

Pharmacy Phun

I think Obamacare is a disastrously bad solution, but at least it recognizes that there's a real problem: the existing healthcare system was apparently designed by a group of insane comedians on a four-day crack binge.  Let me regale you with an anecdote.

I went to a new doctor here in Schenectady for a regular check-up. He asks me if I'm currently taking any medications, and I say yes, I'm taking a certain medicine that features Larry the Cable Guy in its advertising. [I don't want to say the real name, because Google will send me ads.]

Says he, "Do you want me to write you a script for that?"

Says I, "No, I buy it over-the-counter at Sam's Club. It only costs me about $10 a month."

Says he, "Nah, let me write you a script; insurance will pay for it."

Me: "I think there'll be a co-pay, so I don't want a script."

Doc: "I'll write you one. I'll send it straight to the pharmacy, no trouble at all."

I'm tired of arguing with him, so I decide to let him write the script but plan on just not picking it up. He must be a new doc and really excited about his prescription-writing powers.

Two weeks later, the pharmacy leaves me a voicemail stating that my prescription has been waiting and that if I don't pick it up, it'll be discarded. I wait a few days but then the rule-following instinct in me starts to kick in. I decide to pick up the script. After all, I pass the pharmacy every day between work and home.

I arrive at the pharmacy and go to the pick-up counter. They can't find the prescription. I say, "Maybe it's been discarded. I might have waited too long to pick it up."

The pharmacy tech says, "Yeah, it's been returned to the shelf. [Can't they just go and get it off the shelf? Maybe it was put on a really high shelf and they misplaced their ladder.] Plus, there was a problem with your insurance."

I say, "OK, I'll call the insurance company and straighten it out," intending to just walk out of there and forget about it.

Four days pass. Another voicemail from the pharmacy: my prescription is ready for pickup, and also they need me to bring my insurance card in so they can re-confirm my coverage. I figure they must have called the doc and the insurance company and straightened everything out.

So today I stop by the pharmacy again, go to the pick-up window and give my name. Pharmacy tech can't find the prescription. I recount the history of the prescription to her and she looks something up on her computer. "Yeah, the prescription was rejected by your insurance company because [wait for it... wait for it...] it's available over-the-counter. They won't pay for anything available over the counter. It's $187 if you want to pay out of pocket."

This raises a whole host of questions of which I will only list one: why did they keep asking me to come to the pharmacy? Did they figure I might buy some candy bars and fashion magazines?

Perhaps this explains why a transparently nutty system like Obamacare could ever gain support: the bar set by the existing system is so very, very low.

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