Wednesday, January 13, 2010

Dirty Little Secret

I don’t normally write about my business dealings, or personal health issues, except maybe to illuminate a particular behavior, or to demonstrate some aspect or another of human nature. But I feel rather compelled to let you in on a situation I encountered yesterday in the course of attending to an illness I’ve been struggling with for the past two weeks. I’ve been laying low with a bronchial infection, which began as a mild cold, progressed to a persistent cough, and ultimately, became the bronchial infection that I ended up seeking treatment for. It’s a serious, but not life threatening condition, unless left untreated, in which case it could develop into pneumonia. I should have obtained a prescription of antibiotics earlier, but like many men do, I put it off until it became very apparent that I better do something about it. I’ve had this condition before, a couple of times over the years. Consequently I knew that I just needed the antibiotics to kill the infection and I’d be fine.

Like many, I belong to an HMO. I have a regular doctor within the company, and the corporation has computer records of all conditions and treatment I’ve received from them over the past many years. I emailed my doctor describing my symptoms, and asked her to write a prescription I could swing by and pick up. In response, she said she wanted me to come in for a visit. Although I knew what I had, and knew what I needed for treatment, she still insisted on scheduling an appointment. I guess she doesn’t want to put herself in jeopardy. OK, understandable. However, this particular HMO prides itself on the millions of dollars it spends on advertising suggesting that people take responsibility for their own health, in partnership with their doctor.

So, I’m paying my monthly premium to belong to the HMO, and now I’m charged a fee to visit the doctor, and when she sends me down to get chest Xrays (even though I knew I didn’t need them), they charge me another fee. I don’t really like that, but I guess I’m OK with it, sort of. However, when I go downstairs to the in-house pharmacy to pick up the medications the doctor ordered for me they want to charge me $120.00 for them. I said, “Excuse me.” The clerk said again, “That’ll be $120.00.” I kind of choked and responded, “Sorry, but I can’t afford that. I think that’s kind of outrageous.” And this is the remarkable part, and the reason for writing this blog. He says to me “OH, WELL, ACTUALLY I DON’T NEED TO CHARGE YOU THAT MUCH.” And then he says, “Let me go make a phone call. I’ll be back in a few minutes.” I’m left thinking, “You don’t need to charge me that much, but you were going to?” I’m beside myself. The pharmacy was full, about 150 people waiting for their prescriptions, so I went out and waited in the hallway. The clerk shuffled around some shelves for about five minutes, obviously just killing time. He didn’t know it, but I was watching him through the glass. He never did make a phone call, but then he called me back to the window and said, “OK, I got it all taken care of, that’ll be $72.00 now.” Just so you, my readers, understand what I’m saying here, they were going to charge me $50 more than they supposedly needed to. Dirty little secret. Of course my mind raced back over the years trying to get a sense of how often I’ve been charged more than I needed to be. Then I say to the clerk, “How much for just the antibiotic?” He says “$11.00,” and I said, “OK, I’ll just take those.”

I had to jump through a lot of hoops yesterday just to get the antibiotics I had initially asked for. It left me wondering, again, about the disingenuous practices of all these HMO’s. And if they were going to knock $50 off of the stated price of those medications, can you even begin to imagine what their profit margin must be? It’s got to be, not only obscene, but unconscionable as well. Reason in it’s self to be skeptical of all the drugs the industry is pushing on us, and doing their best to keep us dependent on.

Give me a break!

Question everything.