Getting Medicine from a Bureaucracy

If you put a military bureaucrat and a federal government bureaucrat in a contest, which one would come out ahead in a rules making contest?  Since both are really government bureaucrats and control freaks of the highest order, I would think it would be a pretty even contest.

I have had some experience with rules makers of this order with respect to health care.  When my father died, my mother lost her prescription coverage.  My mother was a hypochondriac without the delusions—she actually had everything in the book except cancer.  When my father retired from teaching, my parents chose the benefits option of “Greater income and benefits until insured dies” over “Lesser income and benefits, but if insured dies first, benefits will extend until spouse’s death.”  It was unimaginable that my mother would outlast my father.  Then the unimaginable was reality.

Mom was on over 20 long term prescription medications, all for different conditions.  The doctors tried to eliminate some on many occasions, but every time they did, something popped up and put her in the hospital.  I had the hospital switchboard on my speed dial for the last 9 years of my mother’s life.

I spent one day a week going to my mother’s and taking her out, or visiting her in the hospital or rehabilitation facility after hospital stays. (I was not allowed to call it a nursing home.)  I took her out when she was home just to get her out of the house once a week.  At least twice a month the outing included some doctor or specialist appointment.  She was on oxygen and needed a wheelchair. For the last 3 years of her life, she was in a motorized wheelchair.

It just so happened that my father had two careers:  He taught for 17 years after spending 27 years in the Air Force and going back to college.  So even though the prescription coverage through the teachers’ retirement was gone when he died, we found out that my mother could get medicine with a minimal copay through a clinic at an Air National Guard Base (ANG Base)  in the area.

Unfortunately, the bureaucrats set up the pharmacy rules.  There was always some problem with the prescriptions that I presented.  Sometimes, I would have 5 prescriptions and leave there with only 2 filled.  There was always some different problem with the way the prescription was written or the medicine being prescribed.

The most frustrating time was when it took me 6 weeks to get one particular prescription filled.

The day I got the prescription from the doctor, I drove to my mother’s house (55 miles), took her to the doctor (32 miles), took her home (32 miles), went to the ANG Base (57 miles) only to find out that the pharmacy closed at 4:00 pm that day and it was 4:05.  The pharmacist was still there, but he was unwilling to acknowledge my frantic dance outside his window.  He pointed to the sign and mouthed the words, “We’re closed.”  So, I went home (26 miles).  There was no pressure—she still had a couple of weeks supply, but I had planned ahead to get the prescription because Mom wasn’t supposed to see the doctor again before then.  So, the first week, I drove around 200 miles, about 32 miles of which were extra to try to get the prescription filled.

The second week I did not try to pick up the prescription.  I don’t recall why.  I knew that I had one more week to get the prescription.

The third week, I drove to my mother’s house (55 miles), took her out for lunch (32 miles), took her home (32 miles), and went to the ANG Base (57 miles).  The pharmacist looked at the prescription.  It was 15 days old, and they could not fill a prescription that was written over 14 days ago.  He could not call the doctor for an updated prescription, he could not take a call from a doctor for an updated prescription, and he could not accept a FAXed prescription.  All of those options were “not allowed by the rules.”

You see, I was not dealing with a pharmacy, who could have done something reasonable.  I was dealing with a dispenser of medicine controlled by government rules. Remember that part.

I went home (26 miles).  So, that second week of trying to get the prescription (the third elapsed week) I drove around 200 miles, about 32 of which were extra miles to try to get the prescription filled.  By now, my mother did need a new prescription before I could get it to her, so the doctor phoned a week’s supply into the local pharmacy in her small town and they delivered it to her house.

The fourth week I drove to my mother’s house (55 miles), took her to the town that her doctor lived in, but to a specialist appointment (32 miles).  That specialist wrote a prescription.  I stopped and picked up a new prescription for the other medication at her regular doctor’s office (8 Miles), took her home (32 miles), and went to the ANG Base (57 miles).  I was going to have to take the prescriptions back to her house that day because she was out of the old medicine and needed the new.

Unfortunately, the prescription that I had been trying to get for 4 weeks was written for 100 mg pills.  The pharmacy only had 50 mg pills.  He could not fill the prescription so that she simply took two 50 mg pills instead of one 100 mg pills.  That was “not allowed by the rules.”  (I told you to remember that.)   He did fill the new medication prescription from the specialist, which I drove back to my mother’s house (57 miles) and then returned home (55 miles).  So, the fourth week I drove 288 miles, 114 of which where to pick up and drop off prescriptions, only one of which I could get filled.  I had my mother’s regular doctor phone in a two week’s supply to my mother’s local pharmacy for her to purchase, just in case.

The fifth week I drove to my mother’s house (55 miles), took her to the town that her doctor lived in.  I stopped and picked up a new prescription for the original medication at her regular doctor’s office.  This time, he wrote out a prescription for a 90 day’s supply to cut down on my travel time.  I took my mother home (32 miles) and then drove home (55 miles).

The sixth week, I drove to the ANG Base (57 miles) before going to my mother’s.  This prescription was for 50 mg pills, less than 14 days old, and I arrived in the morning, well before 4 pm.

Unfortunately, the prescription was written for 90 days.  The pharmacy was “not allowed by the rules” to fill a prescription for that medication for more than a 30 days supply.  However, the rule makers had missed one opportunity.  The pharmacist could give me a 30 days supply—that was allowed.

I took the prescription back to my mother’s house (57 miles).

So, after 6 weeks and almost 1000 miles, I arrived at my mother’s home with a 30 days supply of pills.  Granted, I would have gone out there to spend the day taking my mother out anyway, but I drove 200 extra miles just to get a prescription filled.

If the government is going to operate anything, they have to have rules so that they can employ overseers that breathe down the necks of the workers to be sure that the rules are getting followed.  Overseers can’t subjectively evaluate if the job is getting done, they can only objectively try to ensure that the rules are being followed.

Make no mistake about it, the government rule makers in charge of what happened with prescriptions can come up with just as many rules for government health care options.  How many government rules will it take to implement a government health care option?  I can’t count that big.

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Published in: on August 3, 2009 at 4:40 pm  Leave a Comment  
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