The Angry Pharmacist Socalized Health Plan Solution

Here is my outline as to what could be the perfect socalized will-fail-less government subsidized medicine plan.  Since obviously this is going to be passed riding on the coattails of the H1N1 fear and panic machine, I could at least throw in my $0.02 as to how this is to be laid out.

Now before you read this, remember years past when WalMart came into town?  How they used their huge might to pretty much crush any competition in the area with “low low prices” all while shitting on their employees and being an all-around shitty store with poor service.  Now considering this government plan has the financial backing of every taxpaying man and woman in the nation (regardless if they want to or not); think of Walmart as your cushy retirement insurance plan goes bankrupt and you’re forced to enroll into a government ran plan.

The Angry Pharmacist Socialized Health Plan Solution

By: The Angry Pharmacist

Here are some nice and easy (and unrealistic) points that this new government funded (with freshly printed money/stolen from the working class) health plan should have:

  • No trade name drugs are covered.  No exceptions.  Prilosec/Protonix doesn’t work for you? Tough shit.  Cough with ARB? Too bad.  None of the trade name medications would be covered.  The government needs to eat its own dogfood (or practice what it preaches) and only does business with companies that drive down the cost of medication (ie: generic companies).  That expensive chemo drug not covered? Then let the government use taxpayer dollars to buy out Amgen so they can give it out for free (why not, everyone else got bailed out).
  • The plan is voluntary.  If you wish to be a part of Obamacare, then you get the premiums deducted out of your gross-pay.  If you wish to have private health care, then you won’t be dinged a dime for Obamacare.  I’m not paying for all of your PacifiCare and Blue Cross plans (and your insurance premium dollars dont pay for my private insurance) so why should I have to pay for someones Obamacare?  The chances of this happening are as likely as you buying the nice bridge I have for sale.
  • You get 4 doctors visits a year with no/low copay (say, $10).  Every doctors visit after that has a $25-50 copay.  Yeah, it sucks for the people with chronic conditions like diabetes and stuff, but its better than nothing.  Don’t get the unlimited text messaging plan and you can afford your doctors visits.  Don’t order a large pizza and you can afford another doctors visit.  Wait, actually becoming an active part in my health? What is this witchcraft you speak of!
  • You get 1 $0 copay ER room a year.  Every ER visit after that is $100 minimum.  I’d like to see this figure raised to $250 or higher since ER is for……. EMERGENCIES!  You know why the ER rooms are so packed? People view them as “Free”.
  • Since all Rx’s will be billed to the government, if you are on a maintenance medication and you are non-compliant, guess what, your premiums just went up unless YOU (not your doctor, not your pharmacy) can submit documentation showing that you were taken off of that drug, or switched to another one due to intolerance.  Whats the point of the government dumping all this cash into your doctors visits and medications if YOU are TOO LAZY to do anything about YOUR CONDITION.  Not taking your medication is just pissing away money.  No matter how many times I bitch, your doctor bitches if you don’t want to take your medicine then you can get dinged in the pocketbook.  True this can be thwarted by people just picking up their regular drugs and not taking them, but it might make a few people think twice before asking for medication they have no intention of taking.  Cue the “Waah, we don’t want the government poking its nose into our lives” as they happily promote Obamacare.  Wait, are you confused?
  • If your doctor kept up to the standard of care, then unless his peers can show an act of negligence, you cannot sue him/her for 1.4 zillion dollars in a huge malpractice suit.  Lets face it, without your doctors care, you would have died a long time ago.  We don’t need your doctor running up the bill with 400 lab tests every damn office visit out of fear of getting sued if he/she happened to miss something weird.

Now on the surface, this plan looks pretty damn shitty.  However we have a fundamental problem in this country where we want privatized health-care at socialized prices (ie: Free).  Not going to happen, actually it can’t happen!  Look at MediCare and how broke it’s becoming!  No seniors bitch about Medicare (doughnut hole), because they are so (doughnut hole) happy about the coverage (doughnut hole) that it provides (doughnut hole).  Did I mention that the government had to implement the doughnut hole to keep the Medicare system from going completely broke?  Did I also mention that we just slapped Rx drug benefits on top of an already stressed system like an idiot taking a 4th mortgage out on his house to buy a boat then wondering why he can’t make the payments.  Should I just ignore the point that before Medicare part D came out, seniors on MediCare were paying cash-money for ALL of their medications and were doing just fine on all generics?  It wasn’t until the government decided to “feel sorry for them” and slap on a part-D plan that they became greedy and wanted trade name shit (all for no copays).

If health plans were cars, this would be the basement model with no A/C, manual transmission, manual windows/door locks, and it pretty much just gets you where you need to go.  This would be the ideal solution.  It gives people the basic care they need, and to be honest if they wished for a plan with more bells and whistles then some most-costly private plans could do them well.

Oh, but wait, we all want our cake and eat it too.  Mark my words, this plan will give people an inch when they want a mile, and short of the entire collapse of the healthcare system, the public will just want MORE for LESS.

I’d like my bailout in 20’s please.

What comes out of patients mouths starts with B and ends in T

Sometimes I wonder why we even listen to what patients have to say.

How many times a day are you lied to by a patient.  A patient who on the phone will tell you they “lost” their medication, but when they magically show up at the store they say they are going to Mexico for 2 months. A patient who cried how his pain pills were stolen 2 days ago, yet is in the paper today for selling his prescriptions to an undercover officer.

Heres a colorful metaphor.  You have two sparkling clean containers (the doctor and the pharmacist).  One is filled with clean pure drinking water (the message) and must be moved to the other container.  How we join them? A piece of uncleaned retired sewage pipe (the patient).  Sure, water is going to get from one container to the other, but its going to pick up a whole lot of shit along the way.  However heres the kicker, some doctors listen to what these patients have to say as the absolute truth.

Example:  Doctor calls up the pharmacy pissed as hell because the patient said that the “bad pharmacist wouldn’t fill my pain pills”.  Doctor gives the pharmacist both barrels before being fed some humble pie by learning that his beloved patient got a month supply a week ago from another doctor.

Patients are horrible translators, historians, and message carriers.  How many times has a patient told you a message they recieved from the doctor (like to stop a medication), only to have it be horribly wrong?  How many times have you had patients spout medical jargon they learned from their doctor about their condition only to have it be sorta right in a ignore-the-big-picture sort of way?  Yet doctors and pharmacists use the patient to carry messages to each other.

“Contact myself or your doctor if your lisinopril gives you a bothersome cough” turns into “My pharmacist told me to stop my lisinopril because I coughed” and “Maybe you should ask your doctor about a pain management referral” turns into  “My pharmacist said that you should send me to a pain management doctor because you don’t know what you are doing”.  The shit that patients twist and fabricate with a single grain of truth just boggles my mind, and just makes bad blood between the doctors and the pharmacists.

What kills my soul (which a lot of things do, this being one of them), is when patients have a tiny-yet-dangerous bit of medical knowledge gained through the internet or one nursing class 15 years ago.  Then the bullshit they spout actually sounds like it really did come from the doctor or pharmacist even though its completely wrong.

So how to handle this?  Easy, treat the child like he’s a fucking 5 year old, and pin a note to his/her shirt to give to the doctor/pharmacist.