Last week I went to the dermatologist for one of those full body scans for skin cancer. I was given a clean bill of health and a prescription for something to clear up a condition I’ve had for years but only bothers me occasionally. This also required a blood test that I took and passed. Wanting to be a good, knowledgeable patient I looked up the drug in the formulary my insurance company sent me and it said I needed pre-approval. I called them; they gave me an 800 number to give to the doctor to call. I called the Dr’s office this morning and was told I should go ahead and submit the prescription to the pharmacy where it would be denied, and then the doctor could go ahead and fight the insurance company. This could take two or three days and I should call the office again if I don’t hear from them in that time. I’m glad this isn’t an emergency, but what if it was?
This is the kind of thing that makes me wonder how our healthcare system functions, at all. My time making all those calls doesn’t count, after all, I’m retired. But what about the pharmacist, the doctor’s office, and the insurance company? Surely this cannot be cost effective. This is why doctors need such large support staffs. They aren’t there for you; they are there to deal with the nonsensical rules set up by the insurance companies.
This is a nasty game that puts your life in the control of an insurance clerk following rules set up by a high priced accountant.
I began working on this post on July 10, inspired by a post on Wintersong, written more beautifully and coherently than anything I produce. Today is July 16 and I haven’t heard from either the doctor or the pharmacy. I’m certainly glad my life doesn’t depend on this medication.
Critics of single-payer universal healthcare call it socialism and say it is not compatible with the capitalist system. I think the system we have in place now is a form of totalitarianism. I have no control over my healthcare, and worse yet, my doctor seems to have little or no control over my healthcare. Someone is certainly making money out of all of this, but I’m sure it’s not my doctor or any other health provider.