Carol H Tucker Passionate about knowledge management and organizational development, expert in loan servicing, virtual world denizen and community facilitator, and a DISNEY fan
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beladona Memorial Be warned:in this very rich environment where you can immerse yourself so completely, your emotions will become engaged -- and not everyone is cognizant of that. Among the many excellent features of SL, there is no auto-return on hearts, so be wary of where your's wanders...
Today is the 5th day of the 15th week, the 13th day of the 4th month, the 103rd day of 2017, and:
Celebrate Teen Literature Day
Make Lunch Count Day
Maundy Thursday
National Peach Cobbler Day
Scrabble Day
Thomas Jefferson Day
One of the things that I resent about the way healthcare is handled in the US for those who are not independently wealthy is how insurance companies interfere with treatment. You see, the insurance company does not care about the insured’s health and well-being, all their focus is on their bottom line and making their investors happy with their profits. Patient costs have to be “managed” – translation: cut consumer costs as low as possible – and the welfare of the patient is not a consideration. This means every single time a doctor prescribes a course of treatment [whether it is testing, therapy or medication], 99% of us have to have a talk about whether or not we can actually afford the recommendation. Doctors are becoming increasingly aware of this limitation and are quite frustrated by it; unfortunately one solution for them is to go “boutique” which means you pay an annual subscription fee [usually around $5K] and all costs then you bill the insurance company for reimbursement.
My plaint this time has to do with prescription drug coverage. The insurance company takes the stand that if there is a generic drug available, then doctors must prescribe that or the insurance will not cover the cost. The problem is that the generic drugs are not just the same drugs with a different label on them, the difference is in the “delivery” to your system and therefore the harsh aftereffects. I wonder if any of those fat cat executives with their huge salaries and bonuses ever tried to take a drug that makes you nauseous day in and day or ever try to get a restful night’s sleep when you wake up every three or so hours and have to head for the bathroom because you feel like you might throw up? Or how about trying to deal with a drug that makes you retain fluid so that your ankles and feet swell up to the point where you cannot put shoes on and all your joints constantly throb with a dull ache? So what happens if the doctor decides that you simply cannot take the generic and specifies which drug you are to use going forward? [1] most insurance companies mandate that the doctors’ office has to reorder refills every thirty days instead of giving you a 90 day supply. [2] they classify the brand name as a “tier 4’ drug which means they only pay 10% of the cost and you have to foot the bill for the rest. The drug that I used to be on was reclassified in this manner and the cost was higher than a car payment! [3] they may refused to permit you to use the mail delivery pharmacy, telling you that you have to go and pick up the pills in person at the counter so you can sign for it – a real hardship for anyone who is disabled Yes you still have access to the brand names, of course you do! But in truth, you only get good healthcare if you have the money to pay for it, which is why the rich live longer.
It’s just not fair and apparently things are only going to get worse.
CEOExpress
