Pharmaceuticals in America

I have no intention of researching and writing a piece about the folks who sell us legally prescribed drugs.   For a small, bitter taste, you can read this short bit about the wealthy family who helped bring us the Opioid Crisis.  Pharmaceuticals is a fantastically lucrative American industry up there with fossil fuels and munitions as far as the vastness of its profits.  I have to make a few calls today to line up a new drug dealer for my irbestartan and atorvostatin, as well as the weekly megadose Vitamin D, $2.50 a pill, that I’ve been prescribed.   The first two are generic versions of two famous patent drugs, Avapro and Lipitor.   Of Lipitor my mother used to say “I luhhhhhv Lipitor!”.   It seems to be lowering my cholesterol nicely, and not giving me any noticeable side effects, though I’m not sure I have the same passion for the little pill that my mother did.

Right after Obamacare, the Patient Protection and Affordable Care Act, became the law of the land I had a long chat with my local pharmacist, a sympathetic man named Bahdri.  He was lamenting what he expected of the new law.  He predicted that within five years all small pharmacies like his would be out of business.  The turf was being handed over to huge pharmaceutical distribution companies that were set up to deliver prescription drugs to millions of Americans under the PPACA.  It was the pharmaceutical version of Amazon.  No need to walk into your local brick and mortar store to get the shit you needed, just order it and pick it out of your mailbox a couple of days later.   Bahdri was gloomy about his prospects.

I liked my little local pharmacy.   I’d been having one of the drugs delivered to my home by an outfit called CVS Caremark, it was done automatically when the new drug was prescribed.   They’d send a ninety day supply of irbesartan.  I’d save five or ten dollars over the copay at the pharmacy.  I didn’t care about the few dollars, and arranged to have the prescription filled at Bahdri’s.  I preferred helping to keep a small neighborhood store in business.  As it turned out, I needn’t have been so solicitous.

Bahdri explained recently that the thirty day supply of one of the drugs cost the pharmacy $9 and my insurance reimbursed them a mere $1.37.   This did not seem fair to me either.  My new plan, a sort of pay as you go Medicaid, has no copay for drugs under a certain price (I paid a $10 or $15 drug copay on last year’s plan), and so Bahdri’s small store was getting screwed every time I walked in.  Bahdri informed me that the large chain pharmacy across the street would also not fill my prescription, certainly not the ninety day version.  He advised me to have the prescription sent back over to CVS Caremark.  I told him I would, and I will.

Yesterday, being out of one of the drugs,  I went to Bahdri’s to get four more 50,000 unit Vitamin D pills for the weeks going forward.   I take these because, after numerous skin cancers have been removed from my nose (and one from my arm) I avoid the fucking sun as much as I can.   The sun helps the body produce its own Vitamin D, or something like that.  The sun is very good in many ways, no doubt, but I avoid it.  This is no great sacrifice for me, as I stay up late, sleep late, spend my first few waking hours writing, wait for late afternoon most days to venture out.  I take most of my exercise around sunset or after dark.

Anyway I ran into Bahdri’s yesterday early evening to get the Vitamin D and his assistant (Bahdri wasn’t there) told me they no longer accepted my insurance and that Bahdri had told me as much the last time I was in.  I begged to differ, but my begging was not the kind of humble begging one usually associates with beggars.  I told him exactly what Bahdri had said and stated, with a lawyerly flourish, that Bahdri had never told me “your business is not wanted here any more.”  I suggested there was probably a law against a pharmacy denying a customer a prescription refill without some kind of prior notice giving the patient enough time to make other arrangements  (I doubt there is, of course, Big Pharma was in on writing the law).  I was beginning to get pissed off but reined myself in.  The pharmacist did his best to counter each of these points, but he was overmatched.

I demanded to know the price of the Vitamin D.  He hemmed and hawed.  I told him a few more times to tell me the price.  He consulted his computer.  The four pills were $9.95.  I tossed a ten dollar bill on the counter.  He told me he could not take my money, it was against the law, since I have insurance.   It was, he suggested humbly, sub silentio and without judgment, the kind of insurance only a homeless leper in his home country, an untouchable, might have.   Leper was my word, actually.  He was hurt that I had thrown the ten dollar bill at him.  He couldn’t understand it, as he assured me it was nothing personal, they just do not sell drugs at a loss to contemptible paupers like me.

I appealed to basic fairness, made another idle threat about using a law that almost certainly doesn’t exist.  He hemmed a bit, and then hawed some more.  I told him to save his breath.  He did. I was done strong arming him.  One of the kids who worked there handed me the four pills, I signed for them, and left, holding up poor Bahdri and his store once again.  Banned for life, like Pete Rose, from a store I have patronized for the last fifteen years or so.  

So today, as on so many days, I have to make some long, trying calls, try to navigate the hideous compromise with decent health care for all (except for at least 27 million or so odd Americans [1]) that President Hope and Change was able to negotiate with the health care free marketeers who wrote the law, folks who graciously agreed not to string him up as long as he didn’t try to fuck with their bottom line.

 Supreme Court justice Potter Stewart once said “Fairness is what Justice basically is”.  I’m not sure of the context of his remark, but I’m pretty sure they nailed that commie motherfucker to a cross and then burned the cross.   You can’t say stupid shit  like that here, not HERE, it’s just WRONG!  SAD!  Thankfully the guy we have now doesn’t need to be told any of this, or anything, really.

 

[1] This number went up somewhat dramatically in 2018 under President Highness’s rule, as he continues his tireless campaign to make America great again. As for the number of uninsured Americans cited above, it is based on the 2016 number, here is the  source

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