I remembered his words today as i was learning that insurance doesn’t really insure that i would get the care i need (something i knew already, at least theoretically). With a clogged up ear for two days that was starting to hurt again, i saw someone in my doctor’s office. She prescribed three things: eardrops for the pain, a nasal spray to declog me, and antibiotic eardrops to prevent the infection from getting worse. So far so good. She sent the scripts to a pharmacy a few blocks away. I walked there, stood in line for a bit, and then found out that they no longer contract with my insurance company. I wasn’t exactly thrilled by that but thought that i’d rather have the meds and go home for a nap than do anything else. I asked the person helping me how much it would cost me. All three meds would be $300! That was way over my budget, so i asked him to tell me how much each med was. It turned out that the antibiotic was the most expensive. Exactly the med i most needed (assuming this really is a bacterial infection, which is another story…). So, i asked if he could transfer the scripts to a different pharmacy. He could and he did. Except that this other pharmacy was two steep hills away – and i walked there, getting somewhat exhausted on a low-grade fever. Except that this other pharmacy was swamped with transfer prescriptions from that big chain pharmacy that no longer had a contract with a major insurance company. I would get my meds in two days. Not sure if it was my pointing out that i had an acute ear infection or my tears of frustration that convinced the person at the counter that he could expedite the process. He got it down to about an hour and a half. It took longer because they called the insurance company to find out if it indeed was true that they weren’t covering the antibiotic. So, over $150 later, i am hoping that the antibiotic really is necessary – after all this might be a viral infection – and will indeed speed up my healing.
Overall, this was a reminder of why the critique of systems is so necessary while holding the people in them with compassion. At least the two men who had helped me at the pharmacies were tremendously helpful. They were just as frustrated about the system. If insurance would work the way it is supposed to, it would help me care for my health. If there were no profit to be made from people being sick, medications would be affordable even without insurance. And, yes, i could have done my research still in the doctor’s office by calling the insurance company to find out the prices of the meds and then asked my doctor to prescribe something less expensive or something that had been on the market long enough for a generic to be available. Though when i am sick, the last thing i want to do is do research. I just want to get well again. You know, like, healthy.