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| "The Gates of Hell," Auguste Rodin (Rodin Museum, Philadelphia) |
Last Wednesday, the same day UnitedHealthcare CEO Brian Thompson was gunned down in New York, an assistant pharmacist at Walgreens phoned me.
The prescription for needles that fit my insulin pen, she said, can no longer be filled, because my insurance company, Aetna, is now insisting it must be done through the mail, in 90-day batches. I might be able to get an exception, but should call Aetna.
No problem! Calling people is what I do for a living. I phoned the number on the back of my insurance card, jumping online — multi-tasking! — during the long delay to try their website.
Online, a form to fill out and mail to Texas, along with my credit card number. I gazed at the form and tried to imagine it resulting in boxes of BD Nano 2nd Gen 4 mm Pen Needles showing up on my doorstep. Unlikely.
Meanwhile, on the phone, I was passed along to several people whose mastery of English was sub-ideal. My suggestion of an exception meant nothing. Negotiations for obtaining the needles via the mail went nowhere. Eventually, what we worked out was that I should have my doctor call in a 90-day prescription to CVS — did I mention that CVS owns Aetna? It's true. My cost for three boxes — a 90-day supply — would be $78.
Now I've liked CVS ever since Nicholson Baker published "The Mezzanine," a lapidary little novel about a man who breaks his shoelace and goes to CVS to buy a new one. Excellent, but not enough to snatch brand loyalty away from Walgreens, a venerable Chicago company that invented the malted milkshake. I can ride my bike to Walgreens. Plus I know people there, thanks to routine visits to secure the seven prescriptions I need every day so as not to die from diabetes.
Social media exploded with joy at the slaying of Thompson. Many Americans are denied medical care, either because they can't navigate the insurance labyrinth or because companies say no to necessary treatment in some arbitrary fashion. Countless people have endured the agony of watching loved ones suffer and die because an unseen bean counter wouldn't check a box.
Let me be clear. All killing is bad, but Thompson's slaying is especially bad because it was a targeted assassination. There are many countries in the world where helmeted assassins on mopeds routinely gun down executives on crowded city streets then roar away. We don't want to live in one of those countries — well, we already do, given last week's slaying. We don't want it to get worse.
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I don’t see the connection between the need for universal healthcare which I am 100 percent in favor of and the issues raised by the terrifying assassination of this man. Didnt one of the issues often raised about UH relate to its denial of claims by those using Medicare, our countries one… limited by age…universal healthcare system that I and many others would like to apply to all demographics. Do you really believe that if government were in charge of all healthcare you’d be less likely to be dealing with bureaucracy or less likely to be asked to deal with things like being required to order through the mail? I assume we’d still be dealing with those thing. This seems like it is standard among friends of mine who live in the UK and use it’s excellent system which is still pretty bureaucratic in terms of getting coverage though very inexpensive individually out of pocket.
ReplyDeleteA government controlled healthcare system will certainly be a bureaucracy, but it will pale in comparison to the multi-level multi-faceted bureaucracy in use here. Most importantly it will be a powerful control on costs. Hundreds of thousands (380,000 is the figure I saw) go into bankruptcy in the US every year due to medical bills, compared to zero in every other developed nation with nationalized healthcare. Providers charge exorbitant prices for simple procedures and devices because they can. The salaries of hospital administrators, insurance company executives, big pharma managers are all also part of the problem. I'll take a central nationalized bureaucracy any day.
DeleteI have original Medicare and a medigap plan. Problems are extremely rare and always have been fixed quickly. Much better than even the high end union policy I had for decades. The medical folks dont like them because they pay slowly and no where near as much as they want. I see people with Medicare Adavantage plans doing no better than people with regular policies..
Delete1. Even I, a hater of the health insurance companies was shocked by the murder of that exec. But it sure freaked out the insurance companies so much, that they removed their execs photos from their website, but I'm sure the Internet Archive can still get them.
ReplyDelete2. I'm not a fan of CVS & I dumped them for my prescriptions because of they're not following my instructions the never put any prescription on auto-refill! In fact, the feds fined them several hundred million for that, because people were being charged for unnecessary prescriptions they no longer needed.
So I transferred everything to Walgreens, except a couple in short supply that I get from the hospital pharmacy my doctor is affiliated with & they ship them to me, overnight via FedEx. No extra cost for that either.
3. One solution is to raise the President's salary to $1 million a year & then put an absolute limit of the salary of anyone at a publicly traded company to that limit, including any bonuses & stock option!
Thank you for using your platform to highlight the absurdity of our healthcare system. It is completely insane that a developed, ostensibly civilized nation uses a for-profit industry to care for the sick. It is simply blackmail - your money or your life. "- How much does it cost to keep me alive? - How much ya got?"
ReplyDeleteThe UHC CEO was a 20 year veteran of the company, he knew exactly the amount of suffering they were causing. The specific last straw seems to have been the use of AI to automatically deny supplemental coverage for Medicare patients in rehab following a hospital stay (Medicare covers 80% of a 3-week stay, a supplemental coverage from UHC is supposed to cover the missing 20%).
While it's shocking to see an assassination like that, I'll admit to a certain level of schadenfreude ("zloradstvo" in Russian, "gladness at evil"). This guy was responsible for far more pain and suffering than many mafia bosses and terrorist leaders combined and not a lot of tears would be shed at their demise.
The best outcome, as you mention, is that it raised the volume of the complaints of people dealing with the absolutely evil consequences of simply getting sick in this country, bringing the issue back to the forefront. Anthem has already backed away from a draconian plan to limit anesthesia coverage. I hope the furor does not quickly die down and more insurance companies and providers realize how far they are pushing people that have the misfortune of needing their services.
And Mark, what happens when you give all your money to the insurance company to save your life. Then later you get sick again. Your money is gone. Now what?
DeleteAmerica has become the land of me.
ReplyDeleteNothing matters, but my own success, power, health, rights, etc.
When altruism returns, things will get better. Until then... not sure we're at the bottom yet.
Mr. B
The ridiculous thing about those needles are that they are charging for them at all! You cannot use the insulin pens without the damn needles!! They should be given for free along with the insulin pens when that prescription is filled. My husband is diabetic and I have gone round and round with the insurance company about this until they finally were able to figure out how to put through with 'no charge'- that is, until we went on Medicare. Forget it - back to hell again when we fell in to 'THE DONUT HOLE'! It's hopeless....
ReplyDeleteIt's like Razors and their blades. Its almost like unchecked capitalism might not be a good thing.
DeleteMr. B
We will soon have bigger problems when the wheels begin to rip away the ACA on 1/21. AI will reduce jobs with good health insurance, which was used as an incentive to woo employees to corporate jobs before it became a given, but perks have become too top heavy when CEOs and board members expect exponential returns on their stock value.
ReplyDeleteMight be a good time to invest in the funeral industry and pitchfork manufacturing.
I like that you think the funeral industry will be paid or that people will pay for their pitchforks.
DeleteFor-profit private health insurance is not cost-effective because its... for profit! Private insurance companies serve as middle-men and make their dollars (billions) by AI-generated denial of claims, hideous customer service, delays, etc. Instead of containing cost, expanding coverage or expediting care, it makes every one of those aspects worse.
ReplyDeleteI still shudder to remember when IL went without a budget for 2+ years (2015-2017: Thank you Bruce Rauner). I was blessed with a health insurance through the state of IL. It was good when it worked, but bad when the state wasn't paying its bills. State employees were sent to collections over unpaid labwork and routine mammograms. We were told to mail in a few dollars at each notice, to keep the hounds at bay. I couldnt stand the harassment and paid one bill in full. I foolishly thought everything would eventually be sorted out and I'd receive a credit for my payment, applicable on the next year's labs. That isn't how it worked out, however. I was charged a higher fee than the insurance-negotiated fee, and never saw the money again. Even worse, insider-politicians in IL set up "middle-men" shops where they were legally authorized to pay the overdue state of Illinois medical bills on behalf of the state employees, and then they would receive reimbursement from the state of IL WITH INTEREST once the budget matter was resolved. No state of IL employees were authorized to pay in advance like this, the only option we had was to pay the uninsured billing rate. Yet our IL political middle-men and women made fortunes from the "budget crisis", which is disgusting. Health care is no longer about health or care, its about money.
Neil, I'm wondering if Mark Cuban's Cost Plus Drugs program is an option for you? He seems to be the only person even attempting to change our healthcare system which is so broken. You probably saw in today's Daily Beast that CEO Andrew Witty of UnitedHealthcare's parent company, UnitedHealth, sent staff a video message last week condemning the "vitriolic" commentary on social media following Thompson's death. Talk about being tone deaf to what your customers are experiencing and feeling! I had an interesting conversation over the weekend with someone who emigrated here from Ukraine 10 years ago who suggested one of the key contributing factors to our current healthcare debacle is the lobbying that goes on in Washington by "Big Pharma," and that lobbying should be outlawed. Would love to know your thoughts on that. I so admire your ability and stamina to deal with and write about complex problems that seem so unsolvable in the current state of our country. Have increased admiration for Bernie Sanders' tireless campaign for "Health Care as a Human Right - Medicare For All." He states on his website, "All Americans are entitled to go to the doctor when they're sick and not go bankrupt after staying in the hospital." He describes a healthcare reality that provides "everyone in America with comprehensive health care coverage, free at the point of service. No networks, no premiums, no deductibles, no copays, no surprise bills."
ReplyDeletei 2nd on the cuban statement. he runs a pretty honest shop and it might be worth a look. might not work for you, but...
DeleteJack Benny's "I'm thinking about it" reply to "Your money or your life" is no long side splittingly hilarious, but deadly serious for many being offered such a choice by rapacious drug manufacturers and insurance companies. If in order to stave off some lethal disease or bodily defect for a few months or years, I have to pay some outrageous budget destroying sum, "thinking about it" is a cruel punishment for people whose only sin is growing old.
ReplyDeletejohn
I mostly love Medicare for its simplicity, except for Part D which requires me to search and hoop-jump every year to find a provider who hasn’t taken my meds out of its formulary. I love the idea of universal health care to provide basic services to everyone, but I keep hearing stories from my friends in Canada of months-long, sometimes years-long waits for things like cataract surgery and hip replacements. I worry about medicine becoming like Soviet grocery stores: cheap prices, but nothing on the shelves.
ReplyDeleteI was in the hospital because of brand new heart problem Nov. 4-6. Once they diagnosed the issue, I was told to make an appointment with a cardiologist as soon as possible. I literally called from my hospital bed. My appointment is Jan. 24. My primary care physician is a remarkable doctor, the best care I have ever received. I don't recommend her to anyone though. New patients wait a full YEAR to get an appointment now. When I moved to her practice, my wait was only four months. It takes at least six months to get into my endocrinologist. I'm not special here. We already wait for months and years for car and as a bonus, we get stuck with a gigantic bill after the appointment and have to hope that our physicians are still in network by the time our appointments come to pass. If not, we're doubly slammed.
DeletePerhaps we can't kill our way out of our healthcare woes? The health insurance industry certainly thinks it can. Health Insurance is like casinos: their whole business model is based on making sure we lose. With a few winners to keep the rest of the chumps in the game. For profit health care has to go.
ReplyDeleteI am also one who is worried about ACA being ripped apart. I had an emergency hospitalization last month that ended up lasting nine days, three in ICU. Of course I signed the waiver that I would pay if insurance would not. I had no choice. Now I am nervously awaiting the numerous bills that will be heading my way.
ReplyDeleteWhen talking to my Podiatrist a few months ago the topic of insurance companies came up. Our conclusion was that the insurance companies would like you to pay your premiums every year not making any claims and when you get to a ripe old age, to sneeze one time and die, at home.
ReplyDeleteHave a number of Aetna stories to share, Mr. S, but time and space preclude their telling. Saw a chart on Saturday, with bar graphs indicating the percentage of claims denied by the major health insurers of Americans. The industry-wide average is around 10%. Kaiser is the best, at 7%. Aetna is far closer to the worst than the best, at 20%. Rock bottom? United Health Care. Thirty-two percent. Think about that. One-third of all claims...routinely denied. JFC, are you kidding me? But figures don't lie.
ReplyDeleteSo this assassination, in this angry and violent Trump Era, was probably inevitable... simply an event waiting to happen. Waiting for one man to snap, and to do what used to be the unthinkable. The only question was where...and when. Brian Thompson's cohorts should be down on their knees, and thanking their Sky Daddy that they were spared. it could easily have been another Oklahoma City...or maybe worse. Hey, it's America. People get mad. And then a few get even.
Stalin was allegedly the one who said it: “A single death is a tragedy; a million deaths is a statistic.” And it's also the health insurance industry. Yes, it's sad for his wife and his family, and for those who cared about him. But this meeting wasn't his first rodeo. He had been with UHC for two decades. He may not have been directly responsible for the final solution (see what I did there?) that ultimately decided the fates of countless sick and suffering (and insured) human beings. But just like Adolf's minions, (Look up Reinhard Heydrich--the "man with the iron heart"), he had to know what was going on, year after year, while he lived the high life in his Minnesota mansion.
Therefore, I have but three little words regarding the demise of this CEO: Boo f'king hoo. (Eventually, in 1942, the monstrous Heydrich bought it, too). Like it or not, hits on the rich may become a trend. Joe and Jane Average are fed up with being screwed over. It's the Roaring 2020s...the Orange Decade...and all bets are off. Nothing surprises me anymore. Do I get saddened? Yes, certainly. Shocked? Sure. Surprised? Hell, no. And like Jolson said: "You ain't heard nothin' yet."
About 30 years ago, before I became a heavy user of the medical industry, United Health Care canceled my policy, ostensibly because they were no longer insuring people in my zip code, but they had the effrontery to send me an advertisement the very next day touting their services.
ReplyDeleteBut to switch sides: I can understand how someone can be in a job making and enforcing decisions that exclude large numbers of people from affording the care that might save their lives...without realizing that they were in effect condemning these people to death. I would venture to say that capitalism demands such hard-heartedness, whereas socialism, even half assed socialism like Medicare, hasn't got a chance to be implemented for all Americans as a right.
However, if assassinations of high level execs continues, the honchos will get the message ... and go nowhere without heavily armed bodyguards. Then the wackos will be killing receptionists and nurses and doctors. And blowing up hospitals and ambulances, expressing their ire against the truly innocent.
john
Can't kill our healthcare woes? The insurers and medical bureaucracy are doint yheir damndest to prove otherwise,
ReplyDelete