Custom Site Search

Sunday, June 22, 2008

Thank God for Insurance...

O the humanity; O the irony. See, we shouldn't be thanking the insurance industry for anything. Nothing. Nada. Zero.

But inevitably someone comes in -- this happens on a daily basis -- thanking God for insurance. Of course, what they really mean to say is I'm so glad I don't have to pay $637.98 for my bottle of pills. (Pills, btw, are different than tablets or capsules: just a nitpick but a nitpick I just had to get out there.)

What these thankful people don't stop and realize is that the person in back of them isn't going to get their bottle of pills. No, the God-given insurance company that they have paid their money to is going to deny them because they need to take two capsules a day and they only allow one.
Doesn't matter if the doctor has already tried the one per day regimen. Doesn't matter that two per day works just fine.

Oh, and the person who was just ahead of that one who was so thankful? She left because she needed an anti-nausea tablet for her kid's chemo. Denied! No tablet for you! Next! Seems the insurance company from heaven felt the drug was too expensive for its stockholders. No soup for you!

So why did the insurance company pay for that other person, you remember, the one who was so thankful? She would have had to pay $637.98. Seems a lot for the company to pay. But what she didn't know was that they made a deal with Manufacturer XYZ, so that they only pay $98.98. Then they slap a high copay on the patient, say $50, thus getting a neat little profit, good product share in their drug class, and a thankful patient, to boot!

This used to be called payola in the music industry (a contraction of "pay" and "Victrola," btw) and bribery elsewhere, but if the government allows it it is called Good Business Practices.

Thank God for government!

No comments: