The bureaucracy again
John E. Peterson
Thursday, February 22, 2007
A COUPLE of columns back, I wrote about the bureaucratic confusion we face these days. The bureaucracy I wrote about had to do with health care and, in particular, prescription drugs. But we have lots of other wild bureaucracies, too.
That column brought many favorable comments. A good many other people apparently have similar problems with our system. It brought so many comments — and so much more has happened to us in that same area since I wrote about it — that I would tell you about it again, if I had my way.
First, permit me to tell you what I think I have learned about this bureaucracy. I am not totally confident that I know what I am talking about, however. The Kansas Insurance Office handles insurance for state employees. They use Blue Cross, but they have a company called Conexis, in Dallas, Texas, do many things. Then, SilverScript, in Nashville, Tenn., and Caremark, in Palatine, Ill., are involved in the prescription aspects. And, of course, for we oldsters, there is Medicare and all the complications it adds.
Letters and instructions — most of which I cannot understand — come from them all. For example, huge instruction pages and a new prescription card came for me from Caremark. Another came for Merle. A bit later another mass of information and another card came for Merle from SilverScript. A bit later, the same came for me. The cards from both companies are identical. Why would we possibly each need two of them?
Before the arrival of those new cards, I had gone into Graves Drugs to pick up a prescription, just as I have done for our 36 years in Emporia. One of the fine young women behind the counter told me that I was no longer covered by my former records. After all of these years? She did get on the computer, however, and found my new identity after about 20 minutes. That was marvelous! She unraveled the bureaucracy and I got my prescription.
Some days later, I received a letter from SilverScript which said that the Celebrex, which I have been taking for four or five years for a back problem, would not be covered any longer. I had to get something called “prior authorization” from my doctor or a change in the prescription or do other things.
Celebrex had cost me some $30 for every 60 tablets, but I knew my insurance had covered a big share of it. So I called Graves and talked with one of those fine young ladies in the pharmacy section, to find out the total cost. She told me it was about $90. She also said that she would call Dr. Glenn and get the necessary authorization. She was great! I am hoping it will work.
I have been taking Oxazepam for over 10 years. It is a tranquilizer which reduces stress and anxiety. I often say that I have been through a war, been a head coach and been in federal court for a month when the university was being sued. Such things and the people problems of being a dean for 12 years never stressed me. But the coming of age did and Oxazepam helps much.
Over those years, each batch of Oxazepam cost me less than $5. The last time I went in for it, after all these changes, it cost me $22. At this moment, I do not know whether that change can be resolved or whether I shall just have to pay the full amount.
For all these years I thought Blue Cross covered our prescription drugs. Now, I am not sure how it works. I have just received a big package from SilverScript. On the big, beautiful 56-page booklet was “2007 Evidence of Coverage. Your Medicare prescription drug coverage as a member of SilverScript. Brought to you by the State of Kansas.” That sounds like Medicare now covers the prescriptions. How did it happen that I just got into a Medicare program?
Not only did I get that handsome, costly 56-page booklet, but Merle got one, too. Now, why do a husband and wife each need one of those costly, impossible-to-understand publications? That just costs extra money for us all somehow. Also, in each packet with the big booklet was a big, white page of nice paper. On it was printed “This page left intentionally blank.” Please explain to me how such a waste of paper makes any sense.
One final thought, not really part of the bureaucracy thinking, but related to some of the things I have said above. We have used Graves Drugs as our drugstore for the 36 years we have been in Emporia. The service has always been marvelous. And the treatment of customers special, as I have indicated above in relating some of the things done for me.
I wonder how the coming of the big Walgreens out on 15th and Industrial will affect Graves Drugs and the Medicine Shoppe? I suspect it is a plus for Emporia to be getting a Walgreen store, as it usually is to get big, new businesses, but I do hope that it does not affect our local businesses too much. We need to keep Graves downtown on our main street. I do not want us to ever lose it. Nor the Medicine Shoppe, either.
I have rambled enough about the bureaucratic mess our prescription drugs and health care system seems to be in. I would have a much simpler, more easy to understand system, if I had my way. Do not hold your breath until I get my way in this area, however. I suspect it will only get worse as time goes on.