Monthly Archives: June 2009

Pharmacies

One pharmacy to rule them all…

69 Comments

Going along with my previous (and popular) socialized medicine post, I have a solution from the pharmacy aspect that I thought of while reading some responses to it.

You see, we shouldn’t have the folks like Walgreens, Rite-Aid (if they are still around), CVS, and the hundreds of independents profiting off of the pain and suffering of our aging and sick population.  We all know that Walgreens charges like cost + $30 on most of their generics, that’s just pure profit and its wrong!  The $4 menu is just suckering you in so they can pass the “savings” off on the bigger ticket items.

The federal government should open its own pharmacy, a huge one, and go 100% mail order for everyone.  They can negotiate directly with the drug manufacturers to drive the cost down, and people will just have one flat copay regardless of drug (the rest will be subsidized by the government).  All citizens will use this pharmacy because it’ll be cheaper than anyone else.  Most insurance plans require mail order anyways, so what would be the big difference doing consultations over the phone (since we do them now anyways).  Sorta like how the VA or Kaiser does it, only on a much larger scale.

Since its the government, it can make its own rules with regard to how many pharmacists/techs it can have.  50 techs to 1 pharmacist?  Sure!  Huge warehouses of nothing by filling machines and techs certified to check off prescriptions? You got it!  You want Cozaar? Too bad you’re getting Diovan and LOVING IT.  Got a complaint? Call this 800 number.  Meds get lost in the mail? Call this 800 number again!

Just think, $5 for Zyvox since the government can tell the manufacturers to either lower their cost or take a hike.  I’m sure they would get a deal also since they run the postal service.

Except… most of you (including myself) would be without jobs because the price would drive down so low that you couldn’t stay in business.  Much like what WalMart did to the local mom-and-pop shops.  At least the cost of drugs (brand name) keeps the chains vs independents in line with each other.  Obviously pharmacists are all about ‘helping the patient’ so our jobs really mean little in the whole grand scheme of things.  Techs on the other hand are set!  You only need a bare staff of pharmacists to just sort through the massive amount of medical data the government would be collecting from filling your prescriptions.

Drug reps would be a thing of the past because doctors wouldn’t have any choice in what they prescribe, it’ll just be what the government approves of.  Hell, maybe they can pay-per-view drug-rep battles to see who’s PPI gets on formulary!

Just a thought you know, because some of you feel that having the government play the healthcare game is a good idea (which I don’t expect you all to agree with me ALL the time, just most of the time when it involves crackheads and Soma).  In fact, the government stepping in is a great idea until they bottom out most of the private insurances (because what private company can compete with the government?  A private company backed by a few billion in shareholder cash that people choose to invest in vs the federal government which is backed by every working citizens taxes that they are forced encouraged to pay.  Lets see who’s going to win!); which turn cause a bunch of layoffs (cue whining), and give them a 4.8 trillion dollar bailout like every other failing corporation gets. But hey! Those laid off people will have AWESOME health benefits regardless if they are contributing taxes or not!

Just a thought I had.  Continue your discussions.

Insurance Companies

The big socialized medicine post

206 Comments

Here I will give my thoughts and viewpoint on the current push to give people socialized medicine in the US.  Feel free to chime in on what you think.

As all of you are quite aware, there is a push in this country to give every man-woman-child government sponsored health-care.  Here I will tell you why this is a horrible idea and is doomed to fail.

Here in the wonderful USA, we already have 2 forms of socialized medicine:

  • MediCare – Given to citizens over the age of 65, or to those under 65 who qualify (renal disease, disability, etc)
  • MediAid – Welfare

Both of these are wholly sponsored and paid-for by Uncle Sam.  Sure Medicare Part D plans have a small premium, but usually those are taken out of your MediCare check (and are no where near the cost of private insurance).

What this socialized medicine bullshit wants to do, is to give “universal health-care” to people who do not fit within those two categories.  Now mind you, that anyone can go to any county hospital (paid for by the taxpaying citizens of that county) and receive medical care without having the ability to pay.  Most private hospital ER rooms will also give you stabilizing treatment without you showing proof of ability to pay.  That seems pretty damn awesome if you ask me, however people want more.

The big idea that some Americans throw around is that access to health-care is a right.  Let me clarify this for everyone who thinks that way:

HEALTH-CARE IS NOT A RIGHT!

Access to a Doctor is as much as right as having access to a Plumber, a Roofer, an Electrician or anyone else in a specialized trade.  Until the government FORCES AND PAYS people to go to medical school, it is not a right. You see us Doctors, Nurses, Pharmacists? We chose to go into this profession, we weren’t forced into doing it.  Do you see an amendment in the Constitution showing the right to see a medical professional? No. Do you know how to re-shingle your roof, install a shower, fix a rotting foundation, lay brick, or do a bunch of other jobs that you have NO PROBLEM hiring someone to do; but the moment you can’t get in to see the doctor RIGHT NOW (because his/her practice revolves around YOU) the “I HAVE A RIGHT” card gets thrown down as you throw a 2 year old tantrum?   Quit fucking whining about your “right” to see a doctor and be thankful there’s more than 1 doctor in 300 square miles like in some 3rd world countries.  Be thankful we even have people who choose to be doctors, pharmacists and nurses after dealing with shit-ass people like you.

Now that we cleared up that “confusion” that some entitlement douches like to throw around, we can move on why socialized medicine will not work here:

IF ITS FREE, USE UNTIL CANNOT USE ANYMORE!

Irresponsible humans have a nasty of habit of seeing “free” and totally abusing the shit out of it thinking it is indeed free when its not.  Its free to them, but costly to someone else.  Let me give you a situation:  You have a sore throat.  You should probably go and see the doctor but you might want to wait another day.  Judging that you can see the doctor “RIGHT NOW”, are you more willing to go if its going to cost you a $100 copay, or $0 copay?  Now imagine EVERYONE doing this to the same doctors office.  Now get really mad when your appointment is 3 years away, and the doctor sees you for 30 seconds.  Now bitch about something that you get for free off of the backs of the working class.

As evidenced by the MediCare system (why do old people need so many fucking lab tests.. OH ITS FREE!) and the welfare system (I need my Nexium, Diovan, but I only really take my VICODIN), if something is perceived as free it will be used, abused, and taken for granted.   Just look at e-mail and the internet for example.  People believe that email is free, so as a result I get thousands of spam messages a day to my inbox.  People believe that its free for me to run this site, so they have scripts setup to check it every 30 seconds for new content (if you’re slow, you wouldn’t realize that I try to post something every SUNDAY).  Humans abuse what is free.

I’m sure the Canadian and the UK readers will share how most of them have PRIVATE insurance because the socialized stuff has a 4 year waiting list for appointments for the socialized docs.  Hate to say it, but copays filter out the “I must see doctor!” from the “Eh, im bored, lets go get drugs”.  If you don’t believe me, go sit in the ER and see what piddly shit comes in to waste our dollars.

THIS COUNTRY IS BROKE

Yeah, we’re broke.  We bailed out every corporation that should of failed (will Obama bail out my pharmacy and the other independents when the insurance companies force us under? No) and have a few trillion dollars of unaccounted free money (our money) floating around.  Now how exactly are we going to pay for this?  I’m paying into a MediCare system that will be long dried up before I ever get to get a lab or appointment covered by it.  Medicare part D has to have the ‘coverage gap’ to keep it from going broke (faster), and now we want to give subsidized health care to everyone?  Reading above how people abuse what is free doesn’t really make much sense that this is going to financially fly.  The government couldn’t throw a 5 year old’s birthday party without tons of red tape and spending 100x what is would normally cost and there is talk about making them have a hand in our health-care?  I think this whole ‘universal healthcare’ is just a government ploy to give new jobs to the idiots who work on the federal dime so they can keep their meaningless pointless jobs.

So I don’t really know what the future holds if we have socialized medicine in this country.  It might look good on paper, but I think its going to flop.  At least I’ll get my opinions in before the government forbids me from giving them (or maybe the’ll just take over this website like they are taking over everything else in this country). 😉

UPDATE: Look, less than 24 hours and already I’m trying to explain what I wrote.  So this post was to clarify on how I think that healthcare is not a right (which it’s not, disagree if you will)  and two huge issues that any government subsudized plan is going to have (which could apply to ANYTHING that ANYONE pays to service that someone else uses)  It wasn’t “YAR YAR NO SOCIALIZED MEDICINE” like the words some of you are putting in my mouth.  Since /any/ plan that is made by our broke government is going to be 1000% funded on the backs of taxpaying citizens (since obviously doctors aren’t going to take a huge pay cut, pharmacies aren’t going to take a huge pay cut, where is the cash going to magically come from?) these are the concerns I have (and rightfully so).  Like one reader said, we can’t take the usual government approach and throw this together, dust off our hands, and pat each other on the back.  You would think that most of you who dealt with the Medicare Part-D bullshit would understand that.  This is huge, and its with our money, so we should demand that it be perfect, well thought out, or we’re just throwing money away.  And to the federal workers to got offended by my joke about the ‘government conspiracy’, get back to work, quit wasting time reading my website, and dont be so easily offended by the unfaulting sweeping brush that I make jokes under.

Insurance Companies, The Wonderful Public

Workmans Comp – The working mans welfare

106 Comments

Every pharmacist has had to deal with Workman’s Compensation prescriptions at some point in their careers.  They usually involve paper billing (although now Express Scripts, RESTAT and others have made them electronic) and a lot of begging/paperwork to get paid.

Pharmacists see this all the time, but its a little known fact that work-comp has become the “richs mans Medicaid”.  It has spiraled so out of control, and gotten so outrageous that now I view it as just another form of welfare.

How its supposed to work:

You get injured on the job via some fault other than you being an idiot.  Equipment fails, your employer had something go wrong, some freak accident happens.  Work comp then pays  for your doctors visit and medications.  If you cannot perform that job any longer, you find another job doing something that doesn’t require a bad back or missing fingers, etc.  You continue to work, your (former) employer’s work comp insurance premiums go up, and life goes on.

How pharmacists see it work (ie: how it really works):

You were at work and get injured because you’re a fucking lazy idiot (with your head firmly planted up ass) and go to the ER for a smashed pinky finger.  They give you an Rx for 40 vicodin and some ibuprofen and keep you off work for 3 weeks.  You (and your work comp lawyer) then sue your former employer giving you full paid time off.  You relax and go on vacation and do other fun stuff with your wife and kids while receiving a fat work-comp check (and free medications).  You OBVIOUSLY cannot work any longer because of the MENTAL ANGUISH of having a mangled up pinky finger.  It is SO HORRIBLE that you then obtain full disability and never have to work again.

Yeah, its really like that.  I’ve seen people get a few medications (like ibuprofen and like 20 vicodin every other month) and continue to work.  All the work comp pays for is just a few doctors visits a year, and 2 measly prescriptions that are filled once every 45 to 50 days (and they are 20 day supplies at that).  I’ve also seen people who have basically nothing happen to them, go off work fully, get medicare prematurely because they are “disabled”, then have me try to get vacation overrides for their cruise to the Bahamas.

It all comes down to how well you can play up your “injury” and how good of a scumbag work-comp lawyer you can hire.  Work comp is raped to the point where the premiums are outrageous for employers, and more and more people (read: police officers; that’s right, I’m calling your ass out) are comping out just before retirement so they can collect their fat retirement check along with their work-comp check.  Their reason? MENTAL ANGUISH.  Yeah, try to work as a pharmacist for 30 years and see what kind of mental anguish you get from dealing with the same ghetto public without a bulletproof vest, a gun, backup, and a radio to call for help.  Another reason why hanging your head in the public trough of state-worker is the way to go.

If dealing with the scamming-free loading work-comp abusers wasn’t enough (as they brag to you about their next vacation, knowing that you’re working hard and they are just freeloading from a system that cant say ‘no’); processing a work-comp prescription is a nightmare all in itself.  Some companies make you call a 800 number EVERY TIME YOU FILL AN RX so the processor can get approval from the comp adjuster (the person who decides if your drugs are needed for your comp condition, a position that is filled by an idiot with zero medical knowledge what so ever).  Now I admit that it was better then the old days where the pharmacist had to track the adjuster down, but you also got paid a whole lot more for those paper billings vs electronic billings.

Personally, if I was king of the work-comp world, unless your injury left you permanently handicapped or mentally disabled (ie: a vegetable), all of you leeching fucks would be at a desk job, a greeter at Walmart, or any of the 100 million jobs out there that does NOT INVOLVE THE PART OF YOU THAT WAS INJURED.  Just because you are a lazy fuck who got hurt because you had your head up your ass, it doesn’t mean that us HARD WORKING PEOPLE (including those who are on comp yet find another job) HAVE TO PAY FOR YOUR FREELOADING LAZY ASS.

Maybe your injury wasn’t your fault, but sure as shit it wasn’t mine, so why should my premiums go up because of your fuckup?  Sounds more and more like the welfare system to me.

Patient Handouts, The Wonderful Public

Cracky McCrackhead Addict

102 Comments

A pharmacy without crackheads would be like a Big-Mac without the secret sauce.  The two go hand-in-hand like fat-chicks and spandex.

Have you ever sit to think about the hard work and dedication to be a tried and true crackhead?  The kind of crackhead that makes pharmacists everywhere sigh and cringe as they hear their name on the phone, or see them walk into the front door?

I believe its time for another patient handout!

Tips and tricks on becoming a successful “crackhead”

By: The Angry Pharmacist, RPh

http://www.theangrypharmacist.com

Becoming a successful “crackhead” and inflicting sadist pain upon your pharmacist is not an easy task.  However with these short yet useful tips you shall have your pharmacist begging you to never return.

  1. To be a successful crackhead, you must reduce your brain-cell count to above invalid, but way less than average.  Blunt instruments, large amounts of alcohol, illegal drugs, huffing paint, drowning, and other similar brain-reducing acts will aid you in your journey.  The goal of this exercise is to develop the skill (either learned or by trauma) of not grasping simple concepts like numbers.  This important skill will aid you in later tips.
  2. Think of a month as not 30 days, but a random number of days between 10 and 25.  Most medications will have warnings that say that it must last one month.  However if YOUR month is only 13 days, it means that obviously you can take more than what is prescribed on the bottle.  This is YOUR medication after all, so it gets to play by YOUR rules and thereby YOUR month.
  3. Reading directions is for chumps and nerds.  You take your medication the way that YOUR body tells you.  YOUR body makes the rules that YOUR drugs have to follow.  If your body needs 10 Soma a day, than so be it!
  4. Who’s in the boss? Not Tony Danza, YOU are the boss!  Who’s in charge? Charles is NOT in charge, YOU are in charge!
  5. Don’t use proper terminology or pronunciation when referring to your drugs.  Everyone says “Soma” or “Vicodin”, but having you refer to your medication as “SOMAS”, “VICO-DANS”, “DAN SOMAS”, or “WATSONS 389” makes you really stand out in the pharmacists eyes.  Nothing says “I know my pain pills” than reciting the NDC number on that bottle of Watson vicodin.
  6. Develop some good stories.  “My medication was lost or stolen” is so 1990’s.  You need to think of some good stories to feed to your doctor and pharmacist so they will feel sad for you.  It helps if you learn to sob on command, or come into the pharmacy loaded so they can really see how much pain you are truly in.
  7. Have a black cloud of bad luck encompass you always.  Be the unluckiest person on the planet.  Have anything and everything happen to your pain-pills (but not your high blood pressure pills!).  Martians came and a meteor hit your vicodin bottle!  Go for the gusto!  If you’re loaded while you mumble this story it makes it more realistic (at least to you) thereby making you tell it better!  Remember, YOUR story plays by YOUR rules, and YOUR pain-pills make YOUR rules!
  8. Only chumps get all 90 Soma at one time.  Split that Rx up!  Even though you have $5 in your pocket, it should get you at least 3 of the 90 soma you are allowed every month.  Dont worry about such trivial things such as money management, saving for the whole 90, or the added work your pharmacist goes through.  Remember, YOUR money plays by YOUR rules and YOUR shitty 4 tablet partial fills make YOUR rules!
  9. Transfer early, transfer often!  Nothing says confusion than getting a partial fill on your pain pills and having 5 fills of 10 tablets splattered across 7 independants and 3 chains!
  10. PAY CASH!  Only chumps use insurance for their pain-pills!
  11. Money management? Throw all that shit out the window.  You need to piss away your welfare check like its burning a hole in your pocket.  In fact, you have to be so bad that you have to prepay for your soma that’s due TOMORROW or you’ll spend that $30 on something else.
  12. Avoid chains!  Their computers are all linked up via magic so they know how much other stores have given you!  Go for the mom-and-pop shops!
  13. Become an active part in your treatment, call the pharmacy every 10 mins to see if the doctor OK’d the early refills.  Nothing says “I take my life seriously” than being on top of your medication refill requests.  It doesn’t matter if you don’t remember calling 10 mins ago because you were loaded, YOU ARE TAKING CHARGE OF YOUR TREAT-.. what was I saying again? Oh, TREATMENT!
  14. Fax machines can break, make sure you call the doctors every 10 mins to see if they received your early fill request from the pharmacy.  Doctors LOVE patients who are active in their treatment.  Remember, YOUR name is on your early-refill call-tag so it plays by YOUR rules!
  15. Catch fibromyalgia!  That shit is the golden ticket to Watson-Wonka’s Narcotic Factory!  If you catch fibromyalgia you can get ANYTHING!  Plus pharmacists and other health care people LOVE IT when you talk about how bad your fibromyalgia is.
  16. Take up acting!  Don’t limit yourself to the “OH JESUS IM IN SO MUCH PAIN” once you hit the pharmacy doors, but also practice it as you walk through the parking lot.  Nothing says that you’re in “OH SWEET JESUS” pain like stumbling and shuffling about in the parking lot AND in the pharmacy.  If you cannot sustain the act for long enough, make sure the sneaky pharmacy doesn’t have cameras outside to record you acting normal only to be hit by the “OH JESUS PAIN” stick once you cross into the store.
  17. Wait until the very last second before bringing in your prescription to your pharmacy.  If the pharmacy closes in less than 2 min, you obviously didn’t wait long enough.  Everyone knows that at the end of the day, when doctors and staff have left, pharmacists cant check on those 5 refills that you circled on that Rx from the ER!  Have a DATE to be LATE!
  18. Invest in a good variety of pens, or look to see what kind your doctor uses.  You can never be too careful when forging that “ES” after the vicodin or the extra “0” after the quanity of “10”.
  19. Be vocal!  The pharmacists obviously have to do what YOU want them to do, and like cheap labor the louder you yell the faster they work!

Following these simple guidelines will secure your spot in the drugbuyers.com community!