Saturday, October 26, 2013

With Apologies To Bill Maher, New Rule. You're Perfectly Free To Hate Obamacare, But....

....you have to pick a reason that's ACTUALLY TRUE. Because if you hate something for a reason that is false, you look really stupid.

Like when the people at your counter started complaining last year that they weren't getting the yellow Norco anymore and it must be because of Obamacare. Someone who would say something like that is a demonstrable idiot, and you know it wherever you fall on the political  spectrum. I'm trying here to keep you from looking like that guy. Doing you a favor really. You should thank me.

Thank me even though it may seem at first like I'm being a bit condescending. Stick with me though, because the journey to a reality-based reason to hate Obamacare  is fraught with peril. You may be making an effort to educate yourself about the issue by tuning into what passes for TV news in this country these days, and while that effort should be commended, sadly, it is not enough. Watching the shout shows is likely to leave you convinced that Obamacare is a threat to the sacred free enterprise system itself, as it becomes obvious that small business across the nation have been crippled under the weight of onerous regulation. Here's what an actual journalist wrote about the experience:

I happened to turn on the Hannity show on Fox News last Friday evening. “Average Americans are feeling the pain of Obamacare and the healthcare overhaul train wreck,” Hannity announced, “and six of them are here tonight to tell us their stories.” Three married couples were neatly arranged in his studio, the wives seated and the men standing behind them...

For those of you unaware, Hannity is one of the leading current affairs commentators on the television today. His ratings the envy of many an aspiring journalist.

As Hannity called on each of them, the guests recounted their “Obamacare” horror stories: canceled policies, premium hikes, restrictions on the freedom to see a doctor of their choice, financial burdens upon their small businesses and so on. 
“These are the stories that the media refuses to cover,” Hannity interjected.

Well they certainly are covering it now. Hannity is on the Fox News Network, on which millions of Americans depend for their information. He is the very essence of today's mainstream media. Back to the journalist:

I decided to hit the pavement. I tracked down Hannity’s guests, one by one, and did my own telephone interviews with them. 
First I spoke with Paul Cox of Leicester, N.C. He and his wife Michelle had lamented to Hannity that because of Obamacare, they can’t grow their construction business and they have kept their employees below a certain number of hours, so that they are part-timers. 
Obamacare has no effect on businesses with 49 employees or less. But in our brief conversation on the phone, Paul revealed that he has only four employees. Why the cutback on his workforce? “Well,” he said, “I haven’t been forced to do so, it’s just that I’ve chosen to do so. I have to deal with increased costs.” What costs? And how, I asked him, is any of it due to Obamacare? There was a long pause, after which he said he’d call me back. He never did.

Facts. Remember when news outlets valued them?

Next I called Allison Denijs. She’d told Hannity that she pays over $13,000 a year in premiums. Like the other guests, she said she had recently gotten a letter from Blue Cross saying that her policy was being terminated and a new, ACA-compliant policy would take its place. She says this shows that Obama lied when he promised Americans that we could keep our existing policies.
Allison’s husband left his job a few years ago, one with benefits at a big company, to start his own business. Since then they’ve been buying insurance on the open market, and are now paying around $1,100 a month for a policy with a $2,500 deductible per family member, with hefty annual premium hikes. One of their two children is not covered under the policy. She has a preexisting condition that would require purchasing additional coverage for $600 a month, which would bring the family’s grand total to around $20,000 a year.
I asked Allison if she’d shopped on the exchange, to see what a plan might cost under the new law. She said she hadn’t done so because she’d heard the website was not working. Would she try it out when it’s up and running? Perhaps, she said. She told me she has long opposed Obamacare, and that the president should have focused on tort reform as a solution to bringing down the price of healthcare.
I tried an experiment and shopped on the exchange for Allison and Kurt. Assuming they don’t smoke and have a household income too high to be eligible for subsidies, I found that they would be able to get a plan for around $7,600, which would include coverage for their uninsured daughter. This would be about a 60 percent reduction from what they would have to pay on the pre-Obamacare market.

This is what I'm trying to save you from my friends. This person was so convinced by the right wing echo chamber of the evils of Obamacare that she never even bothered to look before shooting off her mouth. She was more willing to go on national TV and spread the bullshit she'd been eating than to put any effort into finding out the truth and saving 60% on her health insurance costs in the process. I bet she wants the yellow Norco because it works better.

Don't be like this person.

But what's a loyal right-wing Obama hater to do when it comes to the challenge of opposing this law using the reality based world? To be honest, I'm not sure how much I'll be able to help you here, but for the sake of a civil debate that may serve the purpose of improving our public policy, let's do a little exploring and see what we can come up with.

I guess you could say the website sucks. That is an undisputed fact. But what you're really saying if you go down that route is that you want Obamacare to work better. So even though that seems to be the only thing Congressional Republicans have left in their arsenal after their delightfully suicidal shut down the government and piss everyone off maneuver, I'm not sure how far that'll get you, even though you will be miles ahead of that Hannity moron.

Here's an idea. You could say that Obamacare was an incredible wasted opportunity to implement the reforms our healthcare system really needed. That by leaving the insurance companies that have earned the hatred of their customers through so many types of abuse in charge of coordinating health care, it is the ultimate corporate welfare law. Forcing us to give our dollars to soulless, for profit entities with no care other than getting an extra nickel per share profit over last year, when we could have used far fewer dollars to create a public, single payer system which would be far more efficient and provide better outcomes than the numbnuts at Humana and the rest of their ilk could ever dream of.

Definitely fact based. Medicare has been shown time and time again to be more efficient with your tax dollars than Humana's ilk ever is with the ones they take from your payroll check. And I don't think even Hannity could come up with a panel willing to sing the praises of their current insurance plan.

So there's your talking point for those of you used to listening to Rush and having them given to you. You hate Obamacare because it is simply corporate welfare for the companies that have been abusing their policyholders for over a generation now. Say that and you'll never look like the yellow Norco guy. Your gratitude is appreciated but not necessary. A smarter public shall be reward enough for me.

Now, go forth and be less stupid.

Monday, October 21, 2013

I Was Fascinated By This Picture For A Long Time. Then I Figured It Out.

Look at it. Seriously, take a good hard look:



What is up with that face? I've...never seen an expression like this. Is it...

Fear? The eyes don't really give off a fearful vibe.

The mouth. It's perfectly straight. Not the slightest hint of smile or frown. I don't think I've ever seen anyone pull this off while showing teeth.

It is fear. Not in him, but in me. The longer I look at this humanesque...creature? The more frightened I become.

I just tried to mimic this expression in front of the mirror for five minutes and couldn't pull it off.

WHAT IS THIS MAN'S STORY?

For awhile I thought it would be the face one might make while undergoing a prostate exam. You don't want it to look like it's painful...but honestly, you really don't want to give the appearance of pleasure either. I've heard prostate massage can be pretty hot but you wouldn't tip the medical staff to that kind of thing I wouldn't think

And, why the suit? Wait. That's my clue. The suit. I was closer when I guessed "zombie" than I realized.

A little closer inspection told me I was looking at Jason Rubin, senior manager of immunization services for Walgreen's Corp. If you're plugging away at the corner of healthy and happy this is the man cracking the whip to make sure you hit that flu shot quota.

And this, I bet, is what he looks like when he is having his metrics read to him by his boss. Right after the soul leaves his body.

The numbed-out from the inside corporate drone. It's been so long I'd almost forgotten. This picture captures it perfectly.

Poor Jason. I fear him no longer.

Monday, October 14, 2013

Holy Crap I've Been So Busy I Forgot It's Been Over A Year Now Since The Fuckers At Rite Aid Have Had Any Power Over Me.

Since they forced me to make the best decision of my life. It's been a year and a couple months actually and what's embarrassing isn't how my time at the chain that keeps it personal ended. What's embarrassing is that I degraded myself by submitting to their power for so long.

Because this is the kind of thing they did with that power. Twisted the arm of educated professionals to fill prescriptions that everyone knew, or should have known, had no business being filled.

Not that Rite Aid had a monopoly on this. Both Walgreen's and CVS have run into far bigger problems for pushing obscene amounts of narcotics in the state of Florida. How embarrassing. For the people there deluding themselves by trying to maintain a veneer of professionalism in those sweatshops.

To those I left behind in the chains and to the person at corporate headquarters who's paid to do a Google search for "Rite Aid" every morning and will come across this post I say... it doesn't have to be like this. You do not have to sell your self respect for a fat paycheck that is destined to get smaller as the pharmacist surplus turns into a glut. You have no idea how good it feels to wake up in the morning and not be beholden to their bullshit. I work harder, and for far longer now than I ever did back then. But I have a bottle of scotch in the cupboard that I haven't felt the need to touch for months. And my self respect. And I haven't slept away a day for over a year now. Because now the days mean something to me.

It is deeply embarrassing it took me so long to stop being a coward.

To those of you left behind, it doesn't have to be like this.

__________________________________________________

Original Blogpost Air Date, January 25, 2009

Updated: I Am Fucking Tired, So The Quality Of This Post Will Suck. But I Feel Bad For Teasing You. My Personal Story Of Trying To Do The Rite Thing.

Because at work I like to keep things personal.

I think most of us in the profession can agree that making an effort to not have our customers become addicted to benzodiazapines would be the Rite thing to do. Our duty as health care professionals even. I think we can all agree on that.

At least I thought we could all agree on that. Evidently there is at least one exception. My Pharmacy District Manager, with whom I really don't have a personal relationship. I've never met him. He was of no Aid to me when I tried to do the Rite thing though. Benzodiazepines are high markup items, so maybe he's thinking the company needs the money. He could be right about that part.

Customer wanted a refill of temazepam that was filled 4 days ago for a 90 day's supply. While the other pharmacy was being contacted to confirm said 90 day supply was indeed picked up, the customer EXPLODES, and contacts the corporate office. She managed to find the Rite number to call without much Aid.

It's taking awhile to confirm the 90 day prescription. It was dispensed from a big mail-order outfit. I don't have to tell you what it's like to navigate through an organization like that to even find a person, much less one whose head is not up their ass.

I should say at this point I am asleep while all this is happening. I usually sleep until around 2 in the afternoon.

I should also say at this point the Pharmacy District Manager ORDERED THE OTHER PHARMACIST TO FILL THE PRESCRIPTION. Ordered the other pharmacist to dispense a 30 day supply of a controlled, habit forming medication when there was reason to believe a 90 day supply may have been dispensed 4 days before. A Pharmacy District Manager ordered this, which makes me think he may not be the Rite man for the job. Or perhaps he needs some Aid in his position.

The other pharmacist buckles. Don't blame her. She's here on an H-1 visa and if she's fired she's deported. She's also a good person and perhaps the best pharmacy manager I've ever worked for.

In stumbles the Drugmonkey in a caffeine-deprived haze. The other pharmacist is upset and doesn't want to talk about it, then leaves. At this point, the refill Rx has been filled, just as the District Manager ordered, and is ready to be picked up. The staff fills me in on the situation.

Step 1) Grab that refill off the shelf and make sure it ain't going nowhere.

Step 2) Sharpen the Drugmonkey claws.

I called the large mail-order operation and found someone with their head nowhere near their ass. There is a person working at a large mail-order operation whom if I ever meet in the real world, I will take out for dinner and as many drinks as they'd like. They were able to confirm delivery of the 90-day package and that it was signed for. As Kramer would say, Giddyup.

Oh, and the two prescriptions were from two different doctors.

I called the customer to tell her we would be unable to fill her 30 day refill request. You know what the customer said? The crazy customer who went ballistic only hours earlier?

"I understand. Thank you for calling."

Do you know what my District Manager said when I told him this? After putting me on hold for half an hour? That we still didn't have the power to deny the customer an early refill. My conversation with the customer was far more rational than the conversation I had with my District Manager. That's the saddest part of this whole episode.

The conversation with the District Manager quickly devolved into a semi-screaming match, at the end of which I reminded my District Manager there was a poster in every pharmacy in the state of California that spells out in clear terms the circumstances under which a pharmacist can refuse to fill a prescription. Preventing harm to the patient is one of them.

"Send me what this poster says in an e-mail" Said The District Manager who has sent out dozens of e-mails to every store he manages telling them the exact place to hang these posters. This was his way of blowing me off and ending the phone conversation.

My first thought was that my District Manager was a rookie under pressure from above to kiss customer ass who had a decision to make and blew it. After this phone conversation however, I realized I was wrong. He is a smug, arrogant, cocky power hungry bastard who has turned this into a pissing contest for no other reason than the need to feel his dick is bigger. He also is not an unintelligent man, which concerns me. I'm used to District Managers being kinda dumb and overwhelmed.

At any rate, I spent Friday in a nasty flame war with my District Manager. If I get fired, maybe I'll publish some of what I wrote here. There's some good stuff in there.

That's where it stands at the moment. A District Manager for a major pharmacy corporation maintains he has the power to order pharmacists to give out early refills of controlled medications.

Again I ask you Dear Readers, who the fuck needs cable? There is drama all around. I'll keep you posted.

Update 1/30- After almost a week, the District Manager decided to say he did not, in fact, order the other pharmacist to fill anything. The other pharmacist had documented in the patent's profile notes, however, that the DM did indeed order her to fill the early 30 day refill. Determined not to let him slip out of this, I sent an e-mail to the DM pointing this out, and thanking him for teaching us the importance of documentation. A meeting was held between myself, the other pharmacist, and the DM. The District Manager claims it was a case of miscommunication. The other pharmacist maintained she most certainly felt as if she was being ordered to fill this prescription. I made the District Manager look me in the eye and say he did not have to power to force a pharmacist to fill a prescription against his or her professional judgement. Outcome acceptable. Situation stable. For now.

Monday, October 07, 2013

The Tyranny Of Obamacare Explained Through My Own Eyes

Today was the day every freedom loving, right thinking, mostly middle age and most likely very white and healthy American has dreaded. I had waited for this moment for nearly two years. Ever since the man who has won two nationwide elections by a combined 14,400,000 votes signed into law The Affordable Care Act.

Obamacare. It was here. Tyranny had come to my own drugstore as my technician approached me with the news that she had just been to Covered California. The tyrannical website set up to trick poor unsuspecting souls who wish to see a doctor into committing treason.

It was worse than I expected. She reported that next year she would be saving over $5,000 in health insurance costs. $5,000 that could have gone to good, honest corporations such as Aetna, United Health Care, or Anthem Blue Cross. Companies that have been such good friends to the pharmacy profession.

I shudder to think what sort of hit Humana might be taking in all this.

Back to my own store though. I immediately ran through the impact of the bombshell my technician had just exploded in my face. With $5,000 extra in her pocket the pressure would be off me to give her a raise anytime soon. I looked down at the pharmacy's carpet as I gathered my thoughts. The money that I otherwise might have spent on a technician raise could now be used to replace the tissue paper thin fiber remnants that continue to cling to the floor. A faint echo of the glory my floor covering knew in the age of Don Draper.

So now my technician will have more money in her pocket and I will hire a local contractor to do something about my disgusting floor. If that isn't tyranny than I, and most tea party members, have no idea what is.

I've saved the worst revelation for last however. My friends I have a confession. I myself have been to Covered California. I could not resist the siren call of socialism and as a result I found out I will be paying 1/3 the price of what I was privileged to hand over for COBRA coverage. It wasn't enough that I was already taking advantage of one federal law that interferes with  free market health insurance companies who only want to do what is best for you. I would soon be paying far less to the corporations who never in their wildest dreams would ever do anything unjust to their customers.

My other technician, firmly in the grip of Medicare, is long lost to the cause of freedom. She is very healthy however, which I'm sure is a small consolation.

So this is the face of tyranny. A pharmacist taking advantage of no longer having a history of hypertension held against him, able to buy health insurance so he can go into business for himself. His employees happy, healthy, and with a significant amount of extra bank in their purse. A carpet layer hired and paid to perform work.

In short, a socialist hell.

And as soon as the parks open back up and the tourists come back....a more profitable one for me as well. I haven't looked up the meaning of the word "tyranny" in awhile, so I'm not quite sure when it started to mean "extra money and profits." One of you teabaggers will have to clue me in on that one.