For anyone who thinks we don’t need health care reform, an object lesson.
I have a prescription for Allegra (Fexofenadine) for my seasonal allergies. My current doctor prescribed it five years ago because when the pollen blows, so does my nose. Didn’t used to, but times change, yadda yadda. My doc is a zealot about it because it helps stave off conditions that traditionally lead me to sinus infections. But it’s seasonal. I churn with the springtime for a few weeks, and then I’m good. Last year, the doc gives me my scrip. Two refills before May 29, 2010. As usually happens, I didn’t finish the bottle last Spring, since Spring passed and the nose dried up and here we are.
So this Spring rolls around, everything blooms, the snot factory kicks it into three-shift operation, and I take as needed my remaining Allegra. As I was coming to the end of the bottle, I proactively called the pharmacist for my refill. All automated – punch in the scrip number, boom bam pow, pick up the scrip.
I did this on the 20th of April – last Tuesday. On Friday – the little automated voice said Wednesday, but I didn’t need to pick it up immediately, so why push? – I go to the pharmacy to pick it up. The doctor, they tell me, hasn’t approved it yet. This is not a happy disclosure on a Friday afternoon at 4:45. The pharmacy suggests I call the doctor to get it approved, since “the doctor is sometimes more responsive to the patient than us.” Well, not after the office is closed on Friday afternoon, they’re not. And I’m pretty sure that follow-up should be part of your job. Can’t the automated voice do that too?
I do over-the-counter over the weekend and get knocked on my ass by it – Allegra is not only effective, but very non-drowsy, so the antihistamine in the O-T-C was brutal – and call the pharmacy on Monday afternoon.
“The doctor has approved the refill,” I’m told, and within my sinuses there is much rejoicing, until the pharmacist adds, “so now all we need is the insurance company to approve it.” Apparently, this process – the Step-Step-Turn of the bureaucratic drug dance – is a daily transmission of outstanding approval items by phone to the insurance company, which then approves or denies the scrip.
Now I won’t [AETNA] name any names [AETNA] but on the part [AETNA] of a major insurance provider [AETNA] I can see where [AETNA] this is a critical [AETNA] process – but it’s a refill, kids. It’s already been to this dance. Multiple times in 60 months.
“How long,” I ask, “does this usually take?”
I can hear the kind pharmacist shrug on the other end of the phone. I might even have been able to see her disinterested gaze. “It could be tomorrow. It could be next week. We couldn’t really say, it’s up to them. You should call us back on Wednesday.”
An aside to those who were worried about Government Death Panels: the fox is already in that hen house. King Kong ain’t got nothin’ on big [AETNA] insurance for cherry-picking who gets what and when. In the meantime, I sniffle and blow and make unsavory sinus sounds when I walk the dog with my cousin. Spitting is also involved. It’s gross, but it’s that or drown. I choose life, no matter how disgusting.
Wednesday? No joy. Much like that poor straw-headed fellow in Emerald City, it’s suggested that I come back tomorrow.
Thursday – today – I call the pharmacist. I’m going out of town, to a place where the pollen count is currently so high (according to the Weather Channel’s pollen advisory) that I’m liable to return on Sunday looking like a bright yellow Cheeto.
“The insurance company,” I am told, “has referred it back to the doctor to verify the medical need for the prescription. We’re waiting on the doctor’s office now.”
I grew up with Pong. Remember that second knob that queered the expected linear movement of the ball? I am Jack’s jaded sense of the second knob. I can only imagine the hell that people with actual life-threatening diseases and disorders go through - the most helpful part of all of this was the cheerful automated voice that started all this nonsense.
I’ve called the doctor’s office, but I expect no additional traction there today. As the insurance company’s bounce-back sounded like a conditional thing, I expect they still need to see their way clear to nodding at my bent-knee supplication. I’ve come to know some of the pharmacists by name.
And my nose? It hasn’t run at all today. Feeling pretty good, even. I wonder if they'll get it when I tell them to send my refill back to April, when I still gave a damn.
