Thursday, October 13, 2005

Before I start in on people I would like to kill today, here is an interesting experiment that was done by MIT students. The story behind the experiment is that in 212 BC, Archimedes was able to set fire to enemy ships a bow shot away from shore with a "burning glass." It has been assumed that he used some sort of parabolic mirror. It has also been further assumed that it was impossible for a mirror large enough to be constructed with the correct shape to raise wood to the burning point (approximately 1100 degrees F) in 212 BC. The students went a different direction: using 127 1-foot-square mirror tiles, they were able to set oak on fire from 100 feet away. That isn't much of a "bow shot," but it is proof of the feasibility of the concept. It is also important to realize that there are materials that would likely be part of a sailing ship from 212 BC that would ignite much easier than oak. As well, the temperature of surfaces being exposed to the concentrated sunlight would be unbearable for the crew long before ignition, not to mention that anyone that looked in the direction of the mirrors would be blinded.

Now on to the main point of my post. I have Priority Health insurance. They are idiots. That is not surprising; after all we are talking about a "health" insurance company. I have been disgusted on a number of occasions when they refuse to fill a prescription because they don't feel I need it, or something else (usually over-the-counter) would work just as well. Of course we all know this has nothing to do with the money, they're just concerned for my health. It says so right in their corporate mission statement, so it must be true.

More disturbing, at least to me, is the policy they have that triples the cost of a prescription unless I buy it mail-order from Walgreen. Now I learned in school that this sort of differential pricing was illegal under anti-trust law, but I'm sure that, as usual, there is a loophole for the medical industry to slither through. Until recently, I just paid the extra, preferring to deal with an actual pharmacist, until the co-pay was increased to such an extent that I simply could no longer afford to. So I have been using Walgreen for pills, but not for my insulin. There have been problems, most notably that we are not told when there is trouble with a prescription (not available, or rejected by insurance); it just isn't in the box when it shows up. I usually keep extra on hand just for such times.

Well, this last time I took the plunge. My insulin is finally available in a pen injector (supposed to be easier; more on that in a bit) so I had my doctor write up the prescription the way Walgreen wants it and sent it in. The first sign of trouble was a voice mail at work from Walgreen about my "incomplete information." I wasn't sure just what the problem was as the operator was some ebonics-speaking lip-slapper from some place in the third-world like Detroit. I called and was told that they needed to find out what gauge of needle I needed for the pen injector. I've never used a pen injector in my life, so I told the "pharmacist" what I am currently using. It only took me repeating the same thing four times for him to get it.

That was Thursday. Saturday, I had a voice mail on my cell phone (again, in unintelligible ebonics) about my "incomplete order" and a toll-free number. When I called the number, a hyper-active recorded voice announced that I was being given the opportunity of a lifetime to be part of an exiting new business opportunity. Huh. I thought I was calling a pharmacy, not an Amway distributor. I called the toll-free number I had for Walgreen and sure enough, Priority had rejected one of my prescriptions because they felt an over-the-counter drug would work better. Further, my Avandamet was still unavailable. Earlier this year, the feds stop production of a couple GlaxoSmithKline drugs because of "concerns," but supposedly, everything was all better now. Guess not. Great.

The rest of my order had been shipped Thursday and the post office left us the little note in our mailbox to come pick it up at the post office. The problem was that they were closed for the weekend, and wouldn't be open again until Tuesday. Because of these job things we all have combined with a post office that is only open about 6 hours a day, it was Wednesday before I got the package. With a big sticker on top that said "Refrigerate immediately upon receipt." Damn. The insulin. It was packed in an insulated bag with a couple cold packs, but of course by this time it was piss-warm.

Well, it didn't really matter because by last night, I had been out of insulin for five days and my blood sugar was hovering around 600. So I grabbed the pen injector kit, a cartridge of insulin, and the box of needles.

OK, so maybe I'm dense or something, but I can't for the life of me figure out what is supposed to be easier about a pen injector. The "quick-start" guide folds out to a 2-foot by 3-foot poster. I could have loaded up a needle and stuck it in my ass about 20 times in the same amount of time it took me to go through the "Safety Check." (I also wonder about using a medical device that has to be put through a safety check prior to each use, but I digress.) Some of that is surely due to unfamiliarity, but that certainly isn't all of it. But the worst part was when I tried to thread on a needle. They didn't fit.

Walgreen had sent me the wrong damn needles.

So today I was two hours late for work so I could sit in the parking lot outside my real pharmacist waiting for him to open. Luckily I still had a valid script for my insulin. Sixty dollars later, I had an ordinary vial of insulin and some ordinary needles.

So in one drug order, we have (1) perishables shipped so they arrive on a holiday weekend, (2) some pencil-necked MBA who has never laid eyes on me overriding my doctor's prescription, (3) one med that is not available because of the FDA (or maybe it is; no one seems to really know), (4) and the wrong needles for the insulin cartridges that were shipped in the same package.

I've never had much good to say about the medical industry, especially now that I'm part of it. Thanks to all involved in this little fiasco for confirming my worst opinions.

And I'm done. We have early soccer practice followed by a varsity guys game tonight.

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