The Raping of Thee and I by the Medical System
When you need a prescription for a maintenance medication, what do you do?
In times past, one calls the physicians’ office, provide the information to the Nurses Assistant or receptionist who looks up your record, cuts the prescription for the Physician’s signature and either electronically passes it on to your pharmacy or drug plan provider. In some cases, you have to drop by the Doctor’s office but most often the prescription is electronically transmitted to the pharmacy for you to pick up in a day or so. For controlled substances (like opioids) you’ll have to drop by the Physician’s office and pick up the script to personally deliver it to the pharmacist.
There are a few restrictions here and there. For example if your medication is a controlled substance like a narcotic such as OxyContin or Lortab you have to physically see the Doc in order to get the prescription a minimum of one out of three times. One appointment where he writes the prescription and then you can get two more prescriptions without having a face to face with him again. But you still have to go to his office to pick it up.
But things they are a-changing both with your appointments and with your prescriptions.
Now, my local GP requires that I come into the office to obtain any prescription at all – like naproxen (an anti-inflammatory and NOT a controlled substance).
Further more, all of a sudden, I must make an appointment strictly to get a prescription refilled. What a rip. You have the sniffles, go see your family GP and have him peer down your throat, listen to your lungs and heart, pronounce you still alive and yet he will not fill a prescription unless you make yet another appointment to do nothing but that.
Also, to kick your wallet farther down the road, you will likely find that he insists that you come in every three months for a “check up” (especially if you are “mature”).. Then to milk it a bit more, he’ll write an order for a blood test to be run prior to the next appointment to justify the appointment further. I no longer see this physician because he is “milking the system” horribly.
Between the medical profession finding holes in medicare regulations to suck more money from that benighted system, they are now being suitably creative to insure that to enable you to order a $10 prescription, medicare must kick in $85 bucks for an appointment to get the script.
I’d be interested to know if any other TBPers are noticing any funny stuff going on with their primary physicians or any of your specialists as far as changing procedures, padding bills with unnecessary charges, including procedures that are not required or otherwise trying to squeeze more $$$$$ from the crooked and ever-so-rich system we call medical care.
What it all boils down to is that, at the present time, the medical profession is in a position being creative here and there and they can play the system to milk an extra 20% to 40% or more out of Medicare by being sneaky in how they charge for a procedure.
My last experience of this sort was in Arizona a few months ago.. I got a case of altitude sickness and labored to get my breath. Emergency room here I come. Got checked out head to toe, was diagnosed with a small touch of altitude sickness and told to rest a few minutes, take deep breaths and it would soon pass. These tests were run by a resident and a nurse.
After they were done, in wanders an ER Physician. He showed my wife and myself his name tag, spelled his name so we’d be sure and know who it was. And then out the door he vanished. My insurance (Medicare) payed the hospital bill, test, et al..
About two months later I get a bill from an Emergency Room Physician Group headquartered in a different town that was for $600 for emergency room services by the Doctor who had been so careful to show off his badge so we knew it was him that dropped in for 30 seconds. His name did not appear on any forms filled out in the emergency room and as far as I could tell, the name card show and tell was the only thing he did. No exam, no review of records, no nothing.
I wrote the Emergency Room physicians group, told them exactly what this “doctor” had done and told them if they wanted to be paid, they’d better furnish written records of exactly what the “Doctor” had done for me.
I haven’t heard from them since.
The monopoly of the medical profession and the lock that the pharmaceutical industry has enmeshed us all in has got to be broken up. Put simply Big Pharma and Medical services have morphed from something that helps make people well to a grasping multi-tentacled monster that is ruining our ability to obtain quality and HONEST medical help.
I’d be very interested in some views from fellow TBP’rs on what can be done to reverse this state of affairs.
End
Been seeing family Doc for 25+ years…..must come in person monthly to get new scrip, cannot send spouse, and now charges $10.00 (cash) to WRITE the prescription. Used to get annual prescription for 90-day supply and filled via mail-order. Now in process of finding new doc.
Muck, I’ve had a very different experience with both my doctor for prescriptions -I just call the pharmacy and they arrange for it to be renewed, the doctor won’t even make an appointment just to renew one- and with the Hospital where there were absolutely no unnecessary charges made and Medicare even tried to call absolutely essential ones non essential and I voluntarily helped the physicians get an appeal approved for payment. (But I admit I have never had a prescription for narcotics in spite of a Dentist trying to insist I have one for a simple root canal.)
Maybe you should look around for different providers, you may be getting screwed by your current ones.
Not going to be a popular comment – oh well.
OPT OUT – you are not forced to participate in that stuff for pete’s sake.
How would you know if popular or not? Can you see/use the little ‘thumb’ thingy here? I can’t so I never know what is ‘popular’ or not. Not sure why it is blocked on this site and seems that nobody else knows (or cares) either.
Some Ad blockers block rating widget which is that thumbs thingy.
Check any ad or script blockers and see if that is blocked and you can exempt it from blocking.
That was the info I needed to find what what causing it not to show. “Blur” was blocking ‘trackers’ on this site. Thanks…a lot !
It’s called “rating widget.com” It is not difficult to unblock it.
I used to be able to get my blood pressure medicine for six months at a Time .Now all I can get is a 90 day supply after a visit to his office .Frustrating to say the least because he does nothing but tell me he is following new regulations from the government. Just more legalized stealing but I need the medicine so I have no choice if I want to stay alive.
BB – giving people with your heart issues long term scripts does not make sense. I mean, you have one foot in the grave and the other on a banana peel. How you doing, anyway?
Muck – in OZ you can get scripts for 6 months, then back in for another visit.
BahJ , you’re not very popular.Now go to your room and be a good boy or else I will take more of your privileges away.
Not my experience at all. My CVS pharmacy is actually annoying when it comes to refilling running prescription. They call the doctor, they call me when it’s ready. I have one that instead of taking every day I only take twice a week. I tell them I don’t need refills and don’t bother me until I ask. They call me anyway. I have another where I’m supposed to take one three times a day but only take one, so it lasts almost a whole year with a 90 day supply. Again I have to ask them not to refill unless I ask for it. They automatically call my doctor when a prescription needs renewal. The only time I’ve had to see a doctor to get a refill was with the Pain institute when I was getting some pain pills for hip pain and back pain. Had the hip replaced and now, no more pain in the hip or back.
As an addendum, maybe it’s the $50 dollar donation I make to my doctors practice when I go for a checkup twice a year, that gets me special treatment.
I do 2 Dr visits per year with the blood tests. Insurance will pay for most of the first on and all of the second one.
Where they get me is changing the “preferred” pharmacy every year. I could get my maintenance meds (all generic) filled at the local grocery store for just under $100 per month. This year I have to use CVS. It is 8 miles further down the road. The first month it was no charge. This past month it was $21 but they also filled my One Touch test strips at 30 days when I got a 50 day supply at the beginning of the year. Insurance would not cover it so it was full price $142. I told them to put that one back on the shelf. I picked it up for free 20 days latter.
Doesn’t CVS have a mail service? And my wife was using the One Touch strips and up until recently, they were $75 for 50 and then jumped to $142. So, she bought the CVS tester and strips for $82 and now the replacement strips cost $38 for 100. Gets the same readings as the One Touch.
When I had good insurance, I had the same thing. Every 3-4 months for an appt, for BP meds to be refilled. Blood test to check kidneys, never had an abnormal one. Even when the Dr. or PA would say next one in 6 months, the office staff would call me for another one 3 months later.
Then I refused to pay 2K / month for insurance and became self pay, and finally a nice PA asks if I’d like to make it a yearly checkup.
With 90 day script with several refills. So far, I’ve either slipped under their radar?..
Its not like I have nothing else to do with my time…and money.
How about money sucking dentists? All I want is to get my teeth cleaned–oh no, must have unneeded X-rays and “dental exam”(a five minute peek) at least once a year. Just got fired by my dentist of several years and several thousand dollars (mostly my wife) after telling them to shove it, I’d know when I needed their other services. Bunch of money whores.
I think that once a year thing may fall under newer Federal regulations about maintaining an ongoing relationship with your Dentist.
Seems like this became a consistent thing with all of them at the same time after those new laws were passed.
Blame it on the lawyers. I started reading the Journal of American Dental Association in 1970. They posted a synopsis of every dental law case once a month. Back then there were maybe 2 or three cases a month. Today they are too numerous to list.
No regular X-rays taken, dentist at fault and libel.
You did not want that deep cleaning or periodontal screening, and dentist did not document with your signed waiver, dentist at fault and libel.
The average cost of a dental malpractice was about $20,000 with many in the 6 figure range last time I checked. I was only sued one time. For absolute bull shit! I was dealing with my ptsd at the time and told the lawyer to not bother me with case. So he settled the total scam claim.
I once dated a woman who offered to set me up with an office and she would pay all the bills and let me do free dental works. NO THANKS.
In 1976 if I did a root canal or crown I might take several X-rays to confirm proper work – and the cost was included in the original procedure fee. Today because insurance pays so little for a crown or root canal the only way to stay profitable is to charge for all the ancillary procedures. For every damned thing you used to give as part of the service. Or skip on supplies and sterilization and hire dirt cheap help. At least I did not charge $25 or more for local anesthetic (novocaine).
I know there are many incompetent operators out there. Their work kept me busy and made me many grateful clients when I redid shoddy work.
I believe I treated over 40,000 people in my day. A handful earned the right to no xrays for 5 years. Thousands made it to 2 year radiographic exams. You qualified when you had no gum problems or carious activity for two consecutive checkups. I loved the clients who would come in after several years and absolutely no cleaning required. They are a VERY small group. And I found a few undiagnosed cancers as well with early detection. Most of them lived to tell about it and not lose their jawbone. And I never charged anyone for a cancer screening, which I did at every exam.
I bet I have answered thousands after hour calls from my answering service, requiring a call to the patient, to pharmacy, and then back to the patient.
four phone calls total and maybe 20 minutes away from my family. NEVER did I charge a penny for it. Should have because people feel entitled to free stuff and do not value something free, as a rule. Yes I did win clients but also dealt with too many drug seeking scammers and PEOPLE WHO LAST WENT TO THE DENTIST IN THE LAST DECADE… Today’s dentists just have a message on their phone that says “Go to emergency room”.
If you use dental insurance, they charge 25% or more to administer the program. That is about what the dentist makes as profit.
If a dentist does not maintain your records for at least 10 years, they are open to a world of hurt when a man in a suit throws a law suit at them.
Sorry you had a bad experience with your dentist. I once had a man cuss me out and walk out because he had to wait 15 minutes. (I was a bit busy when the roots of a maxillary molar broke off and entered the patients sinus).
I have been through a cardiac event, stent placed, abdominal aortic aneurysm with attendant meds in last two years. And prescribed meds for 40 years. I have not noticed any great change.
EXCEPT this opiate thing needs close watching. My ex filled her needs from pill mill doctors (and street dealers).
The State of Florida Department of Professional Regulation has it’s hands full with impaired prescribers that they administer to with dubious persons and procedures, at least in my experience. Though they were a net benefit for me when I went through my PTSD experience, but it was not POST traumatic, it was traumatic the whole dang time. It causes fear in me when I think about the management of the opioid endemic and epidemic crisis by the government.
A pill for every problem leads to invented/imagined problems to get a pill….and a pusher with a pen gives it to them.
Bob-o, your heart health depends a lot on oral hygiene. I have seen a lot of white people with horrible dental care. They end up with pretty looking dentures by age 50.
My ex-boss pooh-poohed my dental appointments, he said he did his own cleaning with a personal pick. Well, he must not have been so diligent; he got dentures at age 55 and then proceded to have a heart attack 3 years later. He survived but it was another life’s lesson for me. Take care of your teeth.
“Every tooth in a man’s head is more valuable than a diamond.”
~Miguel de Cervantes, Don Quixote, 1605
My mom was proud of the fact that she had all of her teeth. She took very good care of them and passed that on to me. I knew the Alzheimer’s had taken it’s toll when she stopped caring about her teeth. Oh and cutting all the legs off her pantyhose, that was another clue. Still, she died with all of her teeth still on good shape, even if her brain was gone.
Some of it is genetic, of course. My dad had terrible teeth. They were so bad he was declared 4F while still in his late 20’s when they were drafting for WWII. By the time I was born, he was 43 and had dentures.
MC, I’m not a dentist. However, I do have a compulsion to look at people’s teeth. I noticed a lot of folks in Honduras had a ‘placa’, false front teeth. Lots of men and women in their 20’s and early 30’s with placas. By age 40, they looked like they were in their 60’s. Dental care has a lot to do with staying young looking longer.
Let me say, my ex-boss is my age but he looks to be 10 or 15 years older. I can’t even blame it on the lack of melanin, the dude is Italian and is only a shade or two lighter than my Indian coloration.
I stopped all “maintenance” prescriptions and stopped going to the Dr 8 years ago. I have all kinds of chronic this and that. Doing better (not good, but some better) with just vitamins, minerals, herbs, and some other supplements than I was on all the prescription crap. Prescriptions are NOT designed to heal you, just treat you and they have innumerable side effects which you have to get treated with other prescriptions… A real racket. They just keep bleeding you until they screw up and push you too far that it kills you.
One problem I had was that the Drs office, with no notice to me whatsoever, mothballed my account so last year when I had vertigo and had to get a Drs slip to prove to my shit-for-brains boss that I was really sick I couldn’t go to my Dr because I wasn’t in their new system. They wouldn’t reinstate me without a new patient (??) visit and I couldn’t get one of those for a couple months. I had to go to the emergency room to get a Drs note stating that I really was sick. $800 for a f*n note to satisfy my shit-for-brains boss. Turns out that the Drs office mothballs an account if you’re not there for 3 years and deletes everything after 7. NO NOTICE TO THE PATIENT WHATSOEVER THAT THEY ARE GOING TO DO THIS. By chance I had just made it in time before they shredded everything. Maybe I would have been better off if they shredded it because there would be no records of preexisting conditions, I dunno. I did the new patient visit but refused to let him touch me or do any tests, so we just talked for a few minutes to re-establish the relationship. I suppose it’s worth the $ to do that every couple years just so they don’t delete my records.
I would just say screw it and let it all lapse, but medical “care” is so screwed up if you end up needing it for some reason (i.e. get hit by a bus) if you don’t have the insurance they’ll just wipe out any assets you have completely and part of the insurance is that for certain things you have to have a primary care Dr. and I’d rather the devil I know to having to find one in a time of crisis.
Any industry, not just the pharma\sickcare (cause it ain’t about health at all) industry, will have this happen when the administration is taken over by accountants and bean counters. Once the people who know the work are no longer making the decisions about the work, you’re done.
I still shudder at one of the graphs that has been posted on TBP before that shows the growth of sickcare administration compared to actual doctors, nurses, and technicians.
Like every other industry or institution infected by sickness of greed, it is not about the service or the product. It’s only about the money.
Muck,
Are you familiar with Karl Denninger (Market-Ticker)?
His rants about the medical/pharma scam are epic.
We are all being hosed continuously by this medical fraud, in one way or another.
No one seems to have the clout, or the balls, to tackle it. I have no idea how it will end.
@NtroP: Yep..I visit his site at least once-a-day.. Karl gets his panties in a know regularly..
muck
In the US, you become a “new patient” after three years of not being seen. That’s just the definition for insurance purposes.
For new prescriptions, a medical record must be formed to document the rationale, and therefore a doctor’s visit is necessary.
You should be able to get 12 months worth of refills for a medication that you have been on, that will not need adjusting. (All prescriptions expire at one year, so you will have to be seen at least once a year to maintain an active prescription.)
If the medication might need adjustment, you may have to go back after 3-6 months for a re-evaluation, to see if the medication needs adjustment before refills are given.
Single payer is the obvious solution, whether we want it or not.
Just put everyone under the VA system, it’s proven to work and at very low comparative costs.
No. The VA is run by the government. Medicare for All would at least have private doctors and hospitals.
Unless you live 10 miles from a major VA hospital. the VA sucks. They make no effort at health care–only symptom response. One hand has no idea what the other is doing–and–never expect ‘best practices’
Best thing is to designate a trusted someone in your family to have power of attorney AND a medical power of attorney and have a POLST (physicians order for life sustaining treatment) on file with the state. Then stop seeing any doctors, enjoy what’s left of your life knowing that when you collapse, the hospital will not be able to extend your life indefinitely while simultaneously draining away your life savings, and/or assigning a state appointed “guardian” who will do the same by taking over your assets and monthly income by charging their “$100 per hour even for a five minute phone call on your behalf” outrageous fees.
National health care. Socialized health care. Medicare for all. Whatever name you use, a national system of publicly funded health care is the only way to reverse the trend.
The reality is that the actual full out of pocket costs for drugs in other countries is smaller than the deductible cost of pharma I’m the US. Ditto for actual health care by a person.
Howdy,
So just to get this straight; you go to your MD for an RX for Naproxen? Er, dude you know that stuff is just Aleve and costs $4 at Walmart for 60 tabs?!!??!
I have been an ER nurse for 16 years. We see that all the time from folks on medicaid; they want an RX for ibuprofen because then “da welfar folks pays fo dit”.
Not to get snippy, seeing as how this is my first time here…….but dude!!!!! Don’t complain about a doc padding his bill when you are getting your insurance to pay for a cheap med.
Steve
I have two different experiences.
First, I have spent a few years in Japan, arguably the best health care system in the world, and on one stint we were on the National Health Plan. Patient pays 30%, plan pays the rest. Period. No pre-existing conditions, no networks, the plan pays 70% for all health care – chiropractors, acupuncture, massage – everything. Great care cheap. I had surgery on my hand – OR team of 5, 7 days in the hospital, total bill – about $8,000. We paid 30%. I had the same surgery in the US several years before – botched job, outpatient surgery in a chair, total cost – $8,000. (And compare that to the story recently of someone that got an $18,000 bill for some baby formula in a US ER.) And my surgeon here was a team doctor for a Japanese pro baseball team, studied in Scotland and Switzerland, speaks English, and joined us for dinner and a few beers one night. The doctors here are humble, give better service than waiters in the US, and the 3 doctors we have dealt with here all have studied overseas and have MDs and PhDs. My present GP here always apologizes for making me wait, and literally runs when he has to leave the room to get something. Two points here. The Japanese are just better people, AND, THEY CONTROL COSTS. The gubment reviews pricing every two years I believe and sets limits. That’s it. No mystery, they just don’t allow gouging. A last note – the antibiotics and antifungals I take for Bartonella and Lyme are 1/3 the price here in Japan.
Secondly, in Oregon I have a naturopathic doctor as my Primary. The only prescriptions involved are for the aforementioned antibiotics and antifungals. No other condition requires prescription drugs. Check the Mayo Clinic’s top ten health problems in the US. The top 7 involve no pathogen, and #s 8 & 10 are easily avoided.
Americans suffer from health problems of their own making. The #1 health problem in the US is malnutrition. They eat lots of calories for sure, but how has following the AMA’s recommendation for a high-carb low-fat diet worked out? No thanks, I’ll stick to my meat, eggs and vegetables routine. #2 is the toxic affect of GMOs and pesticides/herbicides. It is no small coincidence that most of the current health problems started in the late 90s after the introduction of GMOs and glyphosate. It is almost impossible to avoid them in the food chain,
Good luck to us all.
How are you doing, Muck?
I was thinking about this little piece of yours (am myself recovering from an operation and we will soon be gearing up for all the fights over co-pays and deductibles and all that crap that starts raining down on one immediately once released from the hospital) and thought I’d bring it to the forefront and see if you are still on the road to recovery.
I didn’t even ask for a refill of the pain medications. Even though it appears my recovery time will be extended due to wound complications, I’m not going to have some doctor I don’t know lecturing me on addiction to pain meds less than two weeks out of surgery.
I’m praying that Medical Marijuana passes here in November. And, staying in close contact with my old doctor in Oklahoma, where it passed earlier this year.
Out medical care system is almost OVER.
High Muck!
Muck, now I am truly concerned.
I hope you are still in recovery mode, but will whisper that prayer that you are healing or mended and so damn busy as to not have time to respond.
A box about knee-high just arrived, signed for by my husband. This is the wound vac. I am planning to take notes on the journey of the wound vac, which has a value of more than a thousand dollars the agent on the phone said yesterday, should we end up buying it for some reason. I am not sure why she felt she had to tell me that, but she did. One thousand eighty dollars and change. Really.
As is, my insurance company covers 80% of the rental, which comes out to be about $200 monthly. Do the math and realize the company is getting that thousand dollars one way or another.
Today is the last day of the month. Does that mean that tomorrow I owe another $200? I am betting so.
I think I will try to document the pain in the gut (entendre intended) this one piece of equipment ends up being for me. I bet there will be a lot of discussions between the company and our insurance “folks” with Nick the Knife about this and other issues. Since my first face-to- face with death years ago, he has become almost an expert in the laws guiding Tricare (retired military) insurance and more than one collection agent has had his/her self-esteem handed to them on a little tin platter when my no-nonsense Italian stallion informs them they are not dealing with your typical “whatever you say massa” sort of patient. Learn how to read the laws and sometimes you can actually make these bastards follow them.
I’ll let you know as the saga plays out.
Meanwhile, the wound nurse is on her way from St. Louis and will be here within the hour. Squeaky wheels get grease, but some of us require handling with kid gloves to prevent the release of the Knife.
I will be requesting as many drugs to get through this day as possible. Will I get them? Probably not, but I am a tough old broad and, apparently, God isn’t finished with me yet.
It is a little box with a hose that creates a flow of blood across and through the wound to keep it clean and provide fresh oxygen via blood flow. Minor noise but real discomfort, but if it gets me healed faster to fight Simon another day, I will grin, bear it and get right on through.
Last note for a while. The shot is wearing off and it is time to sleep.
Muck? Hoping and praying you are fine.
The journey of the wound vac is paused since the malfunction and removal by the home care nurse. I will resume on another venue at that time, if I feel like it.
However, having discovered Muck is NOT about, I will continue to pray that Muck’s life is just too busy and full right now for Muck to check in.
Hi all,
I am Muck’s grandson and wanted to let the community know that he has passed away. Thank you all for reading his posts, writing was one of his greatest passions.
Thank you Jake. I tried emailing him and when I didn’t get a response I feared the worst. Mike was a great writer and a great man. You should be proud to be his grandson. We’ll miss his wit and wisdom on TBP. I’m sorry for your loss.
Jake
My condolences as well. Mike will be missed.