A week and a half ago I went to see my doctor because I've started to develop some indoor allergies. This is a relatively minor ailment, and I had taken some over the counter medicines to provide temporary relief, but I was still moderately uncomfortable on a daily basis. My doctor had a full schedule the day I wanted to see him, but he told me to come in whenever I could and he would fit me in. He took my blood pressure, looked in my ears, mouth, and throat, and listened to my chest. After examining me, he decided to give me a sample of 10 pills. He said, "Take one pill every day, and if they are working, give me a call and I'll call in a full prescription."
No problem, right?
The pills he gave me made me feel a whole lot better. I called him this morning and asked him to phone in a prescription to a nearby Walgreens.
I have just moved, so I hadn't been to this particular Walgreens before. When I walked up to the pharmacy counter, she asked me if I had insurance. I handed her my insurance card and she said, "Good, this medicine is expensive and I wasn't sure you would want it if you didn't have insurance." What an odd thing to say. Of course I want it; my doctor said it would make me feel better.
She ran my insurance card through the machine and said to me, "Your insurance company is denying this request."
I, of course, responded, "Why?"
She explained, "It says that you haven't exhausted the prerequisite treatment. It means that they want you to try over-the-counter medicines or cheaper prescriptions before they approve this."
As infuriated as I was getting, I very calmly stated, "I have tried over-the-counter medicines, and they haven't been working as well as I need, and I have taken samples of what I was prescribed and it worked really well."
The pharmacist explained to me that she will first have to call the insurance company, then she will have to call my doctor to get him to fill out the appropriate forms, and then it will take 24-72 hours for my prescription to get approved by the insurance company.
24-72 hours.
Let's think about that.
I'm one of the lucky ones. I'm just going to be sneezing for 3 extra days.
What if I had diabetes and I had to wait 3 days to get my medication? What if I had heart disease and I have to sit around for 3 days hoping that my heart doesn't fail? What if I was an infant with an infection who had to wait 3 extra days for an anti-biotic? What if I had arthritis and I literally could not bend my arms and legs without excruciating pain.
There has to be a better way. Someone must be able to do this better.
***THE GOVERNMENT CAN DO THIS BETTER***
I spoke to my grandmother the other day. We were talking about healthcare reform. She told me that she was scared that she would lose her healthcare if the legislation was passed. I kindly explained to her that no matter what, if she likes her current healthcare, she can keep it. I asked her how she pays for her healthcare. She told me that it is through the VA. I asked, "how do you like getting your healthcare from the VA?"
She said, "It's just great! I can go to the doctor as many times as I want. I get all the medications and treatments that I want. And they pay for everything very promptly."
That is what everyone should be able to get.
Call your Congressman and Senators and tell them we want a public option that is similar to what is offered through Medicare or by the VA.
http://www.congress.org/...
At that website you can look up who your Representatives are. Click on the "contact" tab above the picture of the person who want to contact. Call their local offices and make sure they know that if they support a public option, they have constituents that will support them.
Nothing this important has ever come easy. We know that we have the American people on our side, let's make sure our Congressmen know it too.