Monday, February 04, 2013

Managing Care

If physicians would manage care, insurance companies wouldn’t have to. 

I’m in the midst of one of the health insurance episodes that drive physicians crazy. The whole thing has been handled in the ham-handed way that is common among large bureaucracies with different parts of the organization telling you different things.   

One of the drugs I’ve been taking for years has recently been identified as being potentially hazardous.  The insurance company’s mail order pharmacy dealt with that by not filling the most recent prescription written by my primary care physician, instead asking her for a justification.  Though annoyed by the request, she responded to it and was then driven into a frenzy when it was rejected.  

The irrationality of the whole procedure was illustrated when I told the mail order pharmacy that my supply was running out.  The person I spoke with suggested that I get a month’s worth at my local drug store. 

One supposes that the pharmacy is concerned that I will get in trouble with the drug and then file a lawsuit claiming that I shouldn’t have been allowed to have it.  If I got it at the local drug store, it took the mail order pharmacy off the hook. 

During all this I saw the physician on a previously scheduled visit and pointed out that since health care providers can’t be counted on to manage such things, insurance companies think they have to. 

It didn’t make her any happier, but she had to agree that I was right.



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