Health Care

Filling Prescriptions is Dangerous to Our Wallets

| by Dr Gwenn

Like most Americans, I have a few prescriptions I fill regularly. Seems to come with age, even though I’m not that old! A couple of these prescriptions I’ve had for years – same drug and same dose, and with the same insurance company.

Mid-January, I went to my local CVS to fill one of the prescriptions and the pharmacist who rang up the transaction picked up the bag twice, typed a few things in her computer, then said to me: “Dr. O’Keeffe, I just want to give you a heads up that it appears your insurance company has bumped up your prescription co-pays. This one was $15 and now it’s $20. This other one was $20 and now it’s $30.”

So much for insurance helping out us insured!

The next month I went in to get a refill on one of the same medications and the same pharmacist said to me “Dr. O’Keeffe, your insurance seems to have a new limit on this medication of 90 per year. That’s new for this drug because there is an over the counter equivalent they are trying to get people to use. You can have your PCP write a letter to contest the limit and get an override. That usually works.”

I’ve had this prescription for years, and without issues. The prescription form works much better than the over the counter form because it comes in a higher dose and in a slow-release capsule, not a tablet. And, the prescription is still cheaper with the higher co-pay than the over the counter version. So, you can be assured I’ll be talking with my PCP about that over-ride!

It’s insulting and disappointing that insurance companies would hike rates and play with limitations during a recession and at a time when more people than ever need a break and access to health care. Then again, they are one of the more self-serving groups in all of health care.

These recent health insurance games sell me on the fact that Obama’s plan to overhaul health insurance isn’t a bad one, if done right. Preventing the health insurance company banks from growing will stop our wallets from being leached unnecessarily, which will also give us all more money to use in the economy and for other much needed expenses.

There is still a great deal in health care that needs reforming but it does make sense to curtain the biggest beast in the system first – the health insurance system – because that’s the beast that is preventing all of us from getting the care we need and from having the money in our pockets to live happy and productive lives.

My message to the members attending tomorrow’s health care summit in Washington is simple: cross the aisle. This isn’t about politics but about people. Negotiate as if you are negotiating health insurance for your wife, husband, son, daughter or parents…not for your political party.

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