I’ve done everything I’m supposed to do. I’ve had the same job for five years now, and I’ve had the ridiculously expensive health insurance with the ridiculously expensive prescription drug benefit. I’m not He-Man, Master of the Universe, but I am in what I thought was reasonably good health. I eat more-or-less right, and I exercise regularly. I’m almost never sick, and I’ve never used the prescription benefit. Never needed to. Until now.

A couple of weeks ago, I began having digestive-tract problems. The symptoms are quite painful, and also, some are quite embarrassing. The pain part makes me think of what I imagine it might be like to subsist on a diet of razor blades. They wouldn’t digest very well, and they’d cause problems all the way through the digestive system. I called my doctor to make an appointment—only had to wait about a week and a half to get in, then wait for two hours after my scheduled appointment to see him—and he was very reassuring. “It’s probably only acute gastritis. Very acute.” He told me he’d write me a prescription that should clear everything up, and we’d follow up in a week or so.

So, I went directly to Walgreen’s, where my wife always takes her prescriptions. My wife and I are on separate insurance, so I had to start from scratch, and needed my prescription insurance card. Which I didn’t have. I returned home to retrieve it. When I returned, the pharmacist told me there’d be a 45-minute wait. Since it was already late, I told him I’d come back the next morning—this morning—to pick up my prescription.

When I got back to the store this morning, the clerk told me there was a “problem” with my prescription. The insurance company had denied payment. The drug cost 200 bucks, and they thought that was “too expensive.” They didn’t say that I had a pre-existing condition. It wasn’t an “experimental drug.” No, it was too expensive. I needed to get my doctor to prescribe something else. On Saturday. I was incensed. “You’re telling me…,” I began, but the clerk cut me off. “It’s not us. It’s the insurance company.”

So, my insurance company will pay for any prescription I need—as long as it’s cheap.

For all you folks who think that our health care system is fine just as it is—you’re just about as insane as stupid can be. Treatment for my illness is not being decided by me, or by my doctor, but by some lower-level drone at PharmaCare. I'm not looking for your sympathy, or for your advice about what to do about my innards, or for a donation to pay for my prescription. But I want you to think about what happens to you tomorrow, when that blob of cholesterol lets go of the wall of your coronary artery, and starts causing a bit of difficulty with your cardiac circulation. Are you sure that some 22-year-old business-school dropout at your insurance company won't decide that you're "too expensive?"

Male, in good health, and yet you did not Join the United States Military?..... even for One Enlistment?

And yet you feel that you did everything you were supposed to do, and now I have to pay for your Medical?

Fucking Slackers.

nobody says that it's fine...unless they are stupid and we do seem to have a fair number of people who are. I say that mimicking the system is no way to fix it...and so now we have the Baucus debacle designed to bend you over the desk while Aetna rams you till you bleed. That's what you wanted? In the mean time all of the fringe nutcases jumped into the public arena wearing their UFO hats to advance their own particular agendas up to and including the ' Nigger nigger nigger " crowd and the Jacksonian Jingoist Quartet who obfuscate the anger of the common man weary of another huge Insurance company that does everything the old ones did with the exception that it is immune from prosecution.

jo

I didn't see him ask you to pay for anything. I see a guy who's paid for his own insurance and is now expecting that the coverage he's paid for will, you know, COVER him when he needs it.

I don't think the health care system is fine. I think it needs to be reformed/fixed. The government should regulate the insurance companies, limit malpractice suits and therefore the cost of malpractice insurance. I wouldn't mind if the government actually handled any malpractice business directly.

I could see the government helping pay insurance premiums for those who cannot afford insurance.

An insurance company should not be able to refuse your medication just because it is too expensive. I know the stuff does not cost that much. I found out when I started getting my medication from the VA. Meds that were costing $300 a month suddenly started costing me $24 for a three-month supply. That savings should be available to all Americans.

What we don't need is Obama's bullshit health care bill that will bankrupt the country.

Jack

you added this senseless baseless FOX brain rapee phrase in the end:

What we don't need is Obama's bullshit health care bill that will bankrupt the country.

Otherwise people would have thought that you posted something reasonable for a change .

and his Wife has her own Insurance.

That 2 whole Insurance Polices for one Married Couple, yet your kind seems to think Insurance is hard to come by in the United States of America.

What I found funny is I know why the Pills were 200 a Scrip, and he may not.

What I found funny is he took the time to Post here yet did not take the time to look at his Policy, and call a Lawyer if he thought he was wronged.

I know that Prescription Medicine is more Expensive in the United States of America because the Companies that make such things have to sell it at a Discount to Poorer Nations in the World, the American Consumer has been tagged to make up the difference.

I also know that the Company that makes the Prescription Medicine has to put Money aside, in the event of Consumers in the United States of America having an adverse side effect, and then suing the Company for Billions, even after the Company spent Money on Testing, and then to have the FDA approve the Medicine in the first place.

I know that the Company that makes the Prescription Medicine has a set time to get as much Money as they can for a Prescription Medicine, before a Generic comes out, so the Company is always spending on thinking up something new, paying people a lot of Money to come up with the next big Pill.

I do not like Medical Insurance Companies as a rule, that is all Medical Insurance Companies, just so you know. But, I know at least I know why they do what they do to the American Consumers.

I know that the Department of Veterans Affairs gets a good discount on Prescription Medicine, and his Insurance Company is most likely pissed off that the pharmaceutical company has to charge so much to try and make up the difference.

I also know how to fix the Healthcare problem in the United States of America, it is not that hard to take care of.

Cost is and always been the issue not the coverage. The insurance companies are scum but so are the Hospitals and Clinics...the real battle is betwen those two and they don't give two shits if we, the consumer public gets crushed in the stampede.

Yea, he's got insurance...if you can pay for it, it's not hard to come by at all. But his insurance isn't INSURING him! Written into his policy is the right of the "insurance" company to deny claims for whatever cockamamie reason it sees fit. So, they collect premiums from him for years, and then kiss him off when he files a claim.

Lawyer? You're joking, right?

You're right, fixing the system isn't that hard. Except when anybody actually tries to do it.

eam

is about is health care...it is far more related to a permanent revenue stream for Leviathan..but you are quite handy to those who want every last vestige of money dust left in your wallet when you invoke the racism voodoo spell.

He is a fucking scumbag, he is Anti-Ameican, he has his fucking hand-out, he is, in short a Democrat.

He is Crying about having the Taxpayer take over his Medical Plan, and Pay for All His Shit, even though he has never done anything at all for the Nation.

Do you feel better now?

I forgot that you couldn't read.

Carry on, then.

This talks about NET PROFIT of pharmaceutical companies. I'll assume that means they've figured in whatever it is they have to charge extra to make up for charging reasonable prices to those who can negotiate for lower prices.

<link>

Now, as for having two separate insurance policies for two people, I can completely understand that. My husband has his policy, 100 percent paid by the company since he's a member of management. To add me to that policy would cost about $400 or more a month. My own policy, with my own company, runs me $150/month. I'd call that a no brainer.

No again and as usual you are wrong, Arch. You should have simply listened to your pharmacist and called your MD and he would have immediately faxed the Pharmacy with a comparable drug for your acute gastritis (there are MANY of them on the market just as good as the pricey one your MD mistakenly ordered that your health insurance plan didn't cover).

Problem solved.

No wonder you have gastritis, making such a whiney mountain out of a molehill here, and trying to dovetail this, easily solved problem, into a big problem with Health Care.

There are many drugs for your condition that your and any health care coverage will pay for and they are just as good, as the one your MD, mistakenly or ineptly failed to realize your Health Care wouldn't cover.

It's a doctors job to know what drugs are covered by what plans today.

All you had to do, as your pharmacist told you to do, was give your doc a call and he would have faxed the Pharmacy with a new drug order and substitute drug, just as good as the pricey one, for you that your insurance would pay for.

The reason some drugs today are so pricely and some not so much, all has to do with the overall value of the current stock of the various phramaceutical companies at any place in time.

At any rate..you are making a mountain out of a molehill here.

You could have saved yourself a ton of aggravation by,1.) having your insurance card handy the first time you went to the pharmacy(saving yourself your initial aggravation with getting your prescription filled in a timely manner.

And 2.): just following your pharmacist's correct instructions to notify your MD, that he made a mistake when he ordered a drug not paid for by your insurance.

Again, he then, would have ordered you one just as good that your insurance does pay for.

This happens occasionally when an MD fails to note the Health Insurance his patient has, before checking to see if the drug he prescribes is covered by the patient's plan.

In short. It's no big deal at all and you could easily get a drug for your needs that your insurance pays for by following what the pharmacist told you to do.

Instead ..you try to twist that incident into some problem that was only a prescribing error part of your MD.

~LAM