A Special Message For The Profession From George Paz, President, Chairman, And Chief Executive Officer Of Express Scripts Incorporated.

Fellow patient advocates,

As you are probably aware, my company, currently the third largest prescription benefit manager in the country, recently made a bid to acquire MedcoHealth Solutions, the largest company in the field. While we are confident this deal will be in the best interests of each company, plan sponsors, and the people they cover, you may be concerned about what this means to you, our valued retail pharmacy partners. Let me put your mind at ease. You are about to be fucked over. Completely, absolutely and thoroughly fucked like a two dollar whore dropped into a roomfull of prisoners doing life without parole.

Wait. I shouldn't have used the phrase "two dollar whore."  That was wrong. I forgot we only pay you guys a dollar fifty per prescription. Still, I hope you get the idea. What you are in for will be in no way pleasant.

Some of you may be saying to yourselves, "For the love of God, after 30 years of shrinking reimbursements, pointless prior auths, endless waits on hold to contact a "help" desk, and slower and slower payments, short of actually bouncing checks, what more could they do to us?" Well, trust me, we'll find something. Unlocking the synergistic potential of our two companies is the very core of this deal, and while that certainly means things like eliminating duplicate functions and streamlining operations to take advantage of increased economies of scale, rest assured, we will also be working on new and innovative ways for you to take it up the ass with a barbed-wire covered penis of fire. For example, one idea we're batting around is actually charging you a "convenience fee" for the time and trouble it takes for us to send in an auditor to go through your records. After all, I'm sure you'll agree it is far more convenient to have them come to you than it would be for you to gather up all your files and bring them to our headquarters in St. Louis.

And if you don't? Too fucking bad, because we're soon going to control almost 40% of your third party business.

Before you completely panic though, let me assure you we have no intention of actually ending the entire business of retail pharmacy. We have learned over the years that while the process of filling a prescription is a simple one, essentially involving bringing a piece of paper to a store, and refilling a prescription is even easier, there is no small number of people who manage to fuck it up. Sadly, we are required by most plan sponsors to serve not only people with enough brain cells to be able to punch in a refill number, but those unaware of and completely incapable of handling the prescription filling process as well. The person who dumps all their pills into one vial and expects a refill on the one to cleanse their liver? That one's yours. The idiot who's been taking a blood pressure med for years and realizes at 10 o'clock on a Saturday night that they haven't had one for 3 days? Yup. You're on that one. The 86 year old lady who mailed her prescription to Oprah? Time for you to shine.

Not to mention you'll be covering for our fuckups as well. People whose enrollment information we lost, packages that get lost in the mail, prescriptions we just fill wrong. We'll leave you plenty of scraps to fight over, assuring a few of you will continue to be our valued colleagues as we assume leadership of the pharmacy benefits universe.

Just not valued very much. We're thinking 75 cents a prescription starting January 1st. If you beg for it hard enough.

Sincerely,
George Paz.

PS- I said beg for it, bitch.

Disclaimer- While this letter is completely fictional, the future it represents is very real.  

Highlights From My Vacation.

It was 90 degrees in Ohio as I left the delightfully cool San Francisco bay, yet I voluntarily hurled towards the inferno in a metal tube at 600 miles an hour. Like I was in a hurry. Like I really wanted to be there. This makes me question my sanity, as well as the sanity of the first covered-wagon driving pioneer who reached Ohio and decided this would be a good place to stop.

"Well, let's see, it's so hot here that not only have I sweated through my shirt, I'm actually a little dizzy and disoriented. One of my horses looks like it's about ready to die and the Indians tell me that in six months it will be so cold that the snot in my nose will freeze. On the other hand, it makes me feel good that I can be a food source for so many mosquitoes. Yup, this is the place! I'm home!!"

Shortly thereafter I imagine that pioneer started talking about football and making babies, and the people of Ohio have excelled at doing both ever since. I was 16 years old the first time someone in Ohio asked me if I had a kid, and if I know my Ohioans, Jim Tressel's troubles will lead every resident of the state to have major self-esteem issues this fall.

I escaped all this, and I was now headed back.

But not before going through Denver International Airport, which from what I could tell, is nowhere near the actual city of Denver. As we started our descent, I looked out the window and saw absolutely no sign of civilization. This continued all the way to touchdown. I was kinda glad I was just passing through, because I'm pretty sure if I lived in Denver, I would have had to catch another plane from the Denver airport to get home.

By the way, there are splotches on the carpet of the Denver airport that are totally the color of poo. I actually saw one out of the corner of my eye and instinctively avoided stepping in it.

I boarded the plane to Ohio and halfway there I had to pee. There was a lady in the bathroom changing a baby and it honest to God took her more than 10 minutes. The captain of the plane was in line behind me and got very, very, angry. Obviously he didn't realize in Ohio the babies are in charge. We landed and I saw lots of fat people wearing Ohio State t-shirts. I was home. The use of the word "epidemic" to describe the fattening of the country is not an exaggeration. At one point during my vacation I found myself in a gift shop in Ohio's Amish country. The place had two stories and an elevator. I looked around and realized that that elevator was a business necessity, as there was a significant portion of that store's customers that would not have been able to climb one set of stairs. I am not kidding you.

I didn't buy anything.

Gotta hand it to those Amish people though. Balls. Of. Steel. No way in hell you'd ever catch me trying to drive a horse and buggy along a friggin highway. And not one of them is fat, which is probably good news for their horses.

So yeah, I spent the week hot, bored, lonely and miserable. I made fun of the locals in my head and wrote a column for Drug Topics to keep me from going insane. And when I left my Mom cried. Flat out cried. Her tears were disorienting. A reminder that at one time I was one of those babies that run this state, and in her eyes I still am. I boarded another metal tube and headed back to a land of miserable, self-centered, lonely, narcissistic, truly awful people. I went back to California, where I fit in just fine.

I Don't Do This Often, But You Should Check This Blog Out.

Especially if you're in the profession. Most pharmacists write like they expect that people will be forced to read their work. This guy isn't one of them. Go look:

http://lastrefills.com/

It's Not So Much About Sex As It Is Power, They Told The Sheep Later During Counselling.

Do you really think this would be the best choice for a photograph to run on the front page of a newspaper?

Above the fold?

Really?

Actually, I think "Above The Fold" might not be a bad caption for the thing.

Anyway, evidently someone did indeed think this was the kind of thing that should be plastered all over town and delivered to every doorstep in the community.

The other big news story was that in large parts of the country, it is hot during the month of July.

God help us all.

Remember Minnesota, The Only Reason You Have Al Franken As Your US Senator Is Because I Decided You Could Have Him.

It wasn't easy. A part of me still longs for Al Franken's radio show. For the hate mail of the day. All I ever get are emails from some guy who thinks I should be impressed he's figured out my middle name and where I work. He calls me the Drug Commie. Wow. That's great. I wonder if he thought of that all by himself.

Sigh.

Sometimes though, I get a reminder of why I let Al Franken go. That my personal loss was a gain for greater society. Like a message in a bottle that washed up on my own personal beach far from Washington, D.C., a video link showed up in my mailbox today from The Center For American Progress. It shows why anyone who enjoys watching Jesus-freak bigots get bitch slapped, and in particular those on the front lines of the last great civil rights struggle in this country, owes me a bit of gratitude:




Part of me feels like a proud parent who's little boy has all grown up. Part of me still longs for a decent hate mail.

Sigh.

Mary Sammons Given Award For Some Reason.

SCOTTSDALE, Ariz.- The National Association of Chain Drug Stores today presented its Sheldon W. Fantle Lifetime Achievement Award to former Rite Aid CEO Mary Sammons, provoking awkward, polite applause among people with so little to do that they attend chain drug store awards dinners.

Seriously. I know a lot of the quotes and stuff in this post are made up, but they really did give her a lifetime achievement award. I swear.

"Throughout her career, Sammons has never been one to follow conventional wisdom. Her groundbreaking innovations in the world of retail should be a lesson to us all in outside the box thinking, and we at the NACDS are proud to honor tonight her lifetime of dedication, hard work, commitment, and near total lack of real achievement" said president Steve Anderson. "Conventional wisdom says we should be honoring conventional success, but we're proud tonight to break that mold."

During her tenure, Rite Aid's stock price declined almost 80%, wiping out millions of dollars in shareholder equity. Dozens of stores were also closed, and the company was saddled with an almost unmanageable debt burden which drove it to the brink of bankruptcy, all of which evidently is something to be very proud of.

"What the fuck?" said Tom Ryan, former CEO and chairman of CVS, a company that has gone from a regional drugstore player to the nation's largest pharmacy chain, upon hearing that Sammons would be sharing this year's award with him.

"Maybe it's just some sort of trick they're playing on Walgreen's." said a confused audience member, referring to the only one of the three major drug chains not honored with this award. Others theorized that the honor was more for Sammon's previous work with the grocery chain Fred Meyer, which ceased independent operations in 1999 and is now part of the Kroger Corporation.

Wait, no, that can't be it.

A member of NACDS who wished to remain anonymous speculated the award was probably for personal, as opposed to corporate, achievement, as Sammons was able to earn almost 3 million dollars in 2010 for running a company that hasn't turned a profit since 2006. She's also entitled to a base salary of at least $750,000 through 2012, and as much as $9 million if the company is sold. "You gotta admit, cashing in like that by creating a turd and then selling it would be a hell of an achievement" the source said.

At press time, that seems to be the only theory that makes sense. That or she blew someone.

A Groundbreaking Accomplishment By The Hardworking Professionals At Pfizer.

CORPUS CHRISTI,  TX- Surprise was the order of the day at this year's conference of the American Secular Society for the Promotion and Advancement of Disease, as drug manufacturer Pfizer came away with the organization's annual award for excellence in the promotion of ill health in the American populace.

"I understand the award going to an organization that ostensibly dedicates itself to the cure and prevention of disease may at first appear to be quite shocking" said ASSPAD's President Carlos Hickman after the award ceremony, which is held every year in America's fattest city. "But with the publication of a new scientific study indicating that the company's smoking cessation drug, Chantix, may actually increase the risk of heart disease by 72 percent, the true genius of Pfizer becomes clear. Don't you see? People try to quit smoking to lower their risk of disease, and Pfizer has developed a strategy in which these wellness seekers can still end up dropping dead! It's brilliant!"

Hickman added that ASSPAD was particularly impressed by Pfizer's efforts to defend and continue to market Chantix in light of increasing evidence of the medication's link to "loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes."

"They're taking the groundbreaking work done by GSK with Avandia and really building on it" said Hickman, whose organization broke from the North American Disease Society in 1998 in a dispute over NADS' decision to recognize Jehovah Witnesses for their refusal to accept blood transfusions. "So far there is no indication that Chantix will end up in any kind of risk management program the way Avandia did. As a matter of fact, as far as we can tell, Pfizer is going ahead full bore with promotional efforts to sell as much of this med as possible. It's pure genius!!"

"Ask your doctor if Chantix is right for you!" he concluded "You could save up to $30 on your first prescription."

Past recipients of ASSPAD's excellence in disease promotion award have included trans fats, alcohol, Blue Cross and Blue Shield of New Mexico, and Keith Richards. When reached for comment, a spokesman for Pfizer said the award was reflective of the corporation's overall goal of "MONEY!!!!!! GIMMIE GIMMIE GIMMIE MONEY!!!!!!"

Disclaimer- Everything in this post is made up, except for the newly published study linking Chantix to heart disease, even in people with no previous history of cardiovasular problems. And the previous links to loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes. Those weren't made up either.

A Little Thing That Bugs The Hell Out Of Me

You learn to make your way through the small talk when you work behind the pharmacy counter. Tiny talk. Microscopic talk. Talk you will look up and down and over and under with a magnifying glass and still, despite the best of your efforts, find it utterly empty of any meaning. The weather. Christ on a cracker there IS no weather where I live and I still spend at least an hour a day listening to people drone on about it. Sports. Yeah. The quickest way to get me to tune you out is to start talking about the team of large men who don't realize they're gay and their efforts to hit, carry, kick, or throw a ball of some sort over an imaginary line.

For some reason though, I heard the lady say her favorite baseball team was the Brooklyn Dodgers, and I wanted to punch her.

The Brooklyn Dodgers, you see, don't exist. They haven't since 1957. This means they cannot be your favorite team. They might have been your favorite team. Maybe you like the fact that they broke the color barrier when they signed Jackie Robinson ten years earlier, which would be very admirable, but the fact is, if you can remember the day the Brooklyn Dodgers last took the field, you qualify for Social Security. Why the fuck don't you tell me now how your favorite pet is a passenger pigeon, or better yet, buy yourself a goddamn clue with the dollar and twenty five cents you just saved using coupons form the paper and enter the world of reality?  The Dodgers are in fucking Los Angeles and have been since long before your pharmacist whose hair is turning grey was even born. Exactly how long will this take to sink in? The fact you still don't know what to do to operate the credit card reader you've been using at least once a week for five years doesn't give me a lot of hope.

The fact I get so bent out of shape about this makes me even madder at myself.  Sports are stupid, and I shouldn't even care. The fact I do pisses me off. This is usually where I go have a drink to break the hate cycle but it's not even noon. Goddamn it.

Stupid bitch.

A Uniquely American Story.

Who says good old-fashioned Yankee ingenuity is dead? This guy's a goddamn problem solver, that's what he is. To the website of Democracy Now!, which I've told you before you should be reading every day:

A North Carolina man who had no health insurance has admitted to recently robbing a bank of one dollar in order to be sent to jail to get free medical coverage. James Verone, a laid-off employee of Coca Cola, recently noticed a protrusion in his chest and had developed arthritis and carpal tunnel syndrome. Without health insurance or money for private care, Verone concluded his best option would be to go to prison. Verone told a local newspaper, "The pain was beyond the tolerance that I could accept. I kind of hit a brick wall with everything." Since being held in jail he has seen several nurses and has an appointment with a doctor Friday.

I'll also point out that the amount stolen in this case is about $999,999,999 less than the amount looted from the health care system by Florida Governor Rick Scott in his previous gig as CEO of hospital chain Columbia/HCA. Holding down expenses is important in the business world. I bet Coca-Cola wishes they could have this guy back.

Anyway, enjoy your upcoming holiday. That sound you hear in the background will be the Canadians laughing their ass off at us.

I'm Pretty Sure I Used To Date This One.