Dealing with Drugs (not to be confused with drug dealing)

This is not a joke. But it is testament to the stunning inefficiency of our "state-of-the-art" healthcare system.

Background:

One day a friendly drug rep walked into my doctor's office.

"Hear ye! Hear ye!" the swankily-dressed drug rep proclaimed, "The FDA has approved a new and remarkable drug for your patients suffering from Megalufidum!"

(Disease name has been changed in accordance with the Patient Privacy Act of 1612).

"You'll be thrilled to know that instead of a 10-inch horse needle, this magical serum can be administered with a teeny tiny needle that does not inflict pain, but provides the patient with the sensation that he or she is sipping lemonade on a beach in Honolulu."

She goes on to explain how this new drug, Lemonada, has been clinically proven to be as effective as the old drug, Maximus.

"Furthermore," she says, "we are sensitive to the insurance travails you regularly experience trying to get Megalufidum drugs approved and paid for. Thus, as part of our welcome package, Lemonada customer service agents will do all the work for you to make this transition as smooth as possible. And if there are any insurance troubles, we'll provide Lemonada free of charge to your patients diagnosed with Megalufidum. You can rest assured: We CARE about your patients' health!"

My doctor is not one to fall for the antics of every drug rep who walks through the door, but he is sympathetic to the horse needle required to inject Maximus. He responsibly reads the research on Lemonada and is convinced of the drug's efficacy.

So at my next appointment, the nurse cheerfully tells me about Lemonada. It sounds good.

"I'll try it," I say.

I fill out a form that she will fax to the Lemonada folks.

"They'll take care of the rest," she assures me with a smile.

What Happened

After spending nearly 7 hours on the phone over four days that involved 2 doctors in two states, 3 clinic receptionists, 2 registered nurses, 2 pharmacists, 1 persistent drug rep, 1 patient training representative, 1 home health nurse, and approximately 9 customer "service" agents from my insurance company . . . .

I decided NOT to switch to Limonada for the following reasons:

a) The insurance would only cover a dosage lower than was not what my doctor recommended. The dosage I needed was going to cost $7000 (I'm not kidding.)

b) The "too good to be true" salespitch from the Limonada folks turned out to be, in fact, too good to be true.

c) My insurance went ahead and delivered Maximus to the doctor's office even though I had canceled the order and had verified that cancellation with at least three insurance reps.

Meanwhile . . .

The whole process had serious consequences on my mental and spiritual well-being since it a) drove me to the verge of a nervous breakdown and b) left me with such un-Christian feelings towards the insurance folks and drug marketers that I've probably lost any hope of a place in heaven.


P.S. I actually do not blame the insurance reps I spent hours on the phone with -- they are merely pawns in the hands of a broken, dysfunctional, self-serving system established by someone else.