Why help those who refuse to help themselves?

There is a common saying that goes “You cannot help someone who will not help themselves”.  Pharmacists deal with patients like these day in and day out.  Patients who get prescriptions from their doctor only to have them sit unused on the shelves to be brought to you for refills months after months.  These are the patients who give you a bottle to refill that has 28 out of 30 tablets left in it (but the vicodin bottle is stone empty).  These are the patients who you see the drug dosages increase and increase then switched to something thats expensive (and not covered) only to sit there and expire on them.  We do the prior auths, we go through the filling procedure to RTS them a month later, we send refill requests to the doctors to have them waste money paying office staff to respond to them.  Its a big waste of time and money for everyone involved EXCEPT the patient.

What does a pharmacist do at this point?  Does he try to have a “Come to Jesus” meeting with someone who obviously has no regard for their health?  After all, healthcare is “free” to them, they can just take an ambulance ride to a cushy ER at some paid-for-by-tax-dollar establishment.  Or does he/she see the writing on the wall and just fill the Rx knowing full well it won’t be taken.  We all know that the moment you refuse to fill that Rx they are going to die and you’re livelihood is in jeopardy in some civil suit.

What does an MD do at this point?  Does he/she shit-can the patient only to have him/her die of some complication and get his life ruined by a suit brought upon by the family?  Does he/she write for more medication just to cover his/her ass knowing full well it won’t be taken?  Does he/she waste his/her time filtering the piss out of the ocean when there are other patients out there who need the help?

What does a healthcare professional do when the patient really doesn’t give two shits about his/her own health?  Tough question, no real cut-and-dry answer.  If the patient dies, someone is getting sued; be it me, the doctor, the hospital, someone.  Even if the patient’s family loses the suit, you still have to deal with the mental/financial bullshit that goes along getting sued.  After all, its everyone’s fault but the patient.

A big contributor to this problem is that the patient really isn’t forced to care about his/her health.  Like I said before, the medication is free, hospital visits are free, and the proverbial “You can’t get blood out of a rock” comes true when the bill arrives for services rendered for their irresponsibility.  These patients have nothing but what the state gives them, and have nothing to lose.  So what if I’m 500 lbs and my HbA1c is around what my IQ is, I know that if the shit hits the fan I can go to the ER and get treated for “free”.  Theres no burden/penality on the patients to take care of themselves, and (much like everything in life) the responsible people end up paying the price.  People in other countries would cut their testicles off for just a smidgen of wasted care that is taken for granted here.

I hate to say it, but I think know the healthcare system is going to implode on itself in the next 15 years (if that).  There are way too many irresponsible people sapping the resources that the responsible people produce.  Nobody cares about their health anymore, and the people that do are the ones paying out the ass for services that cost a truckload to compensate for the loss accrued by the irresponsible.

You may think that I’m blowing smoke out up your ass, but take a look around next time you are in a public place at the amount of morbidly obese people are mouth-breathing around.  Look at their kids and the crap they stuff into their face at an alarming rate.  Its not ignorance thats fueling this, its the simple fact that when push comes to shove they will get treatment without payment.  We are afraid to say “You did this to yourself, you deal with it” because of some bullshit excuse like “its not their fault”.  You may think that sounds uncaring and callous, but take a second out of your candyland outlook and look around you at the people who are pissing their health down the toilet on your dime just because they can.

Healthcare is a business, All of us; doctors, pharmacists, nurses, PAs, NPs, and the staff that help us all have bills to pay and families to provide for.  Charity won’t put food on the table, and the sooner you realize this the better off you are.  If you want charity and “helping those in need” then work for free and see how far that gets you.

I hope you link this jaded-yet-true article on your website/forums/whatever, because I’d really like to know how this problem can be fixed/should be fixed or what we can do short of just making as much money as we can before the entire system explodes and we’re all out of work.