I'm very happy to see the spring weather finally arrive. It seems Old Man Winter just wouldn't go to bed this year. With changes in the weather, comes my spring chest cold. There isn't anything I can do about it except head to the doctor and ask him to treat the symptoms until it clears. That's the routine. However, I discovered the routine isn't so routine anymore. After entering the exam room, I saw a new computer had been set up in the exam room. Nice LCD monitor, sleek key board on a telescoping arm. I asked the nurse about it as she checked my vital signs. She said it was installed in January, and was part of their office upgrades to allow integration into the new national heath care system - something to do with reporting data, and "stuff like that", to insurance providers. She said some things about the system were irksome, but she thought it was "a good thing". My only thought, at the time was, "Huh." You'd think something more profound would have occurred to me, but hey, I was sick after all.
Ultimately, the doctor showed up, gave me a going over, and decided I needed some meds. Instead of writing it all out on a paper scrip, he did it all on the computer. Pretty nifty. He fired off the prescription to the local drug store, via email I suppose, and told me it would be ready in about fifteen minutes. I thought that was kind of cool.
This is where it gets interesting. I drove to the drug store, allowing for the fifteen minutes suggested by my doctor. I walked up to the pick-up window, and found a woman in a fairly heated discussion with the pharmacist. I tried to be polite, tuned out the conversation best as I could, and occupied myself with a really nice, near-by massage chair. After saying something about making a call to her doctor, the woman turned from the window and stalked off. Seizing the opportunity, I jumped up and asked the pharmacist if he had filled the prescription emailed by my doctor. He said "not yet" and asked me to take a seat. So, I went back to the chair. The woman returned a few minutes later, and took the seat next to mine.
After waiting a good twenty minutes, and a series of ignorant expressions offered by the pharmacy crew (blank looks when I made eye contact with them to remind them I was still waiting), I finally broke and went to the window for a status report. The pharmacist said, "Oh. Your prescription was denied." That surprised me. I've never had that happen before. I asked, "It was only for an antibiotic. What's so difficult about that?" He said,"Your insurance company disagreed with your doctor, and denied the prescription." Again, my thought was "Huh." But this "Huh" was immediately followed by a "That was pretty cheeky of them." In the desire to learn more about this situation I asked, "So, insurance companies can now over-ride my doctor's recommendations, without knowing or examining me?" The response was, "Yes." The pharmacist told me he was in the process of contacting my doctor to have him submit a prescription for a different drug, with different dosages, as suggested by my insurance company. He again asked me to, "Take a seat."
I returned to the massage chair. The woman, from the earlier conversation at the pick-up window, still occupied the adjacent seat. She said, "They did the same thing to me." She went on to say her insurance company was denying her mother's prescriptions. Apparently, the woman's poor mother was dying of stomach cancer, and in the final stages. According to her, their insurance company simply "Didn't want to pay for medication for a woman who was dying anyway." After concluding the brief conversation with the woman, the remaining contents of which I'll keep private, I finally received my updated prescription and left the store. I hoped the circumstances surrounding the woman's mother weren't as dire as she explained them. Since she was still waiting at the pharmacy as I left, the pharmacist was likely working on some sort of resolution for her prescription problem.
I'm just a bloke who writes a blog. I don't know at what stage the implementation of Obamacare is currently. The dems could have gotten some of it in place before they were slapped down last November. I don't know if the federal government now dictates policy to private insurance providers in this country as part of that process. Supposedly, Obamacare is stalled by court rulings, restive republicans in congress, and some Democrat Party concern for public opinion. That may well be the case. From this experience, I can see what awaits if Obamacare becomes fully operational. It was my wake-up call, my peek at the man behind the curtain. The above incident was just a taste of things to come. Perhaps, much worse awaits than dealing with profit oriented insurance providers.
Ultimately, the doctor showed up, gave me a going over, and decided I needed some meds. Instead of writing it all out on a paper scrip, he did it all on the computer. Pretty nifty. He fired off the prescription to the local drug store, via email I suppose, and told me it would be ready in about fifteen minutes. I thought that was kind of cool.
This is where it gets interesting. I drove to the drug store, allowing for the fifteen minutes suggested by my doctor. I walked up to the pick-up window, and found a woman in a fairly heated discussion with the pharmacist. I tried to be polite, tuned out the conversation best as I could, and occupied myself with a really nice, near-by massage chair. After saying something about making a call to her doctor, the woman turned from the window and stalked off. Seizing the opportunity, I jumped up and asked the pharmacist if he had filled the prescription emailed by my doctor. He said "not yet" and asked me to take a seat. So, I went back to the chair. The woman returned a few minutes later, and took the seat next to mine.
After waiting a good twenty minutes, and a series of ignorant expressions offered by the pharmacy crew (blank looks when I made eye contact with them to remind them I was still waiting), I finally broke and went to the window for a status report. The pharmacist said, "Oh. Your prescription was denied." That surprised me. I've never had that happen before. I asked, "It was only for an antibiotic. What's so difficult about that?" He said,"Your insurance company disagreed with your doctor, and denied the prescription." Again, my thought was "Huh." But this "Huh" was immediately followed by a "That was pretty cheeky of them." In the desire to learn more about this situation I asked, "So, insurance companies can now over-ride my doctor's recommendations, without knowing or examining me?" The response was, "Yes." The pharmacist told me he was in the process of contacting my doctor to have him submit a prescription for a different drug, with different dosages, as suggested by my insurance company. He again asked me to, "Take a seat."
I returned to the massage chair. The woman, from the earlier conversation at the pick-up window, still occupied the adjacent seat. She said, "They did the same thing to me." She went on to say her insurance company was denying her mother's prescriptions. Apparently, the woman's poor mother was dying of stomach cancer, and in the final stages. According to her, their insurance company simply "Didn't want to pay for medication for a woman who was dying anyway." After concluding the brief conversation with the woman, the remaining contents of which I'll keep private, I finally received my updated prescription and left the store. I hoped the circumstances surrounding the woman's mother weren't as dire as she explained them. Since she was still waiting at the pharmacy as I left, the pharmacist was likely working on some sort of resolution for her prescription problem.
I'm just a bloke who writes a blog. I don't know at what stage the implementation of Obamacare is currently. The dems could have gotten some of it in place before they were slapped down last November. I don't know if the federal government now dictates policy to private insurance providers in this country as part of that process. Supposedly, Obamacare is stalled by court rulings, restive republicans in congress, and some Democrat Party concern for public opinion. That may well be the case. From this experience, I can see what awaits if Obamacare becomes fully operational. It was my wake-up call, my peek at the man behind the curtain. The above incident was just a taste of things to come. Perhaps, much worse awaits than dealing with profit oriented insurance providers.
