Corporate psychopathy pharmacy edition

Obama was a restrained, smart, charming, president, and a sell-out, the dictionary definition of a neoliberal [1].   His great legacy is a first, conservative step toward ensuring affordable healthcare (private health insurance, actually) for millions more Americans than had access before his Romneycare revolution took place.   Many millions of Americans are still not covered by Obama’s embattled Patient Protection and Affordable Care Act, but record profits for the health insurance, hospital and pharmaceutical industries continue to be raked in.  

There’s always a trade-off, in democracy, as President Obama reminded us, between the Good and the Perfect.   The ACA is, we’ll agree, good, if graded on the curve in a nation whose laws are written by corporations, living people just like you and me.

Because my healthcare plan level is chosen for me, based on my fixed income 167% the poverty rate (I have a choice of private insurance company only, not plan), I receive my prescription drugs from a gigantic nationwide corporation called CVS Caremark.   The drugs are mailed to me from out of state, most recently from San Antonio, Texas.   I got an email recently telling me that my blood pressure medication, Irbesartan 75mg, was on its way to me by USPS.   The package arrived a week later.  It contained a ninety day supply of Losartan Potassium 100 mg.

I never heard of the drug.  Never ordered it.  Never received any notification about it.  The bottle of pills appeared to have been sent to me in error.

So I called CVS, the corporate person who sent me the drugs.   There was the ordinary hold time during which I was informed how important my business was and that all of their representatives were busy helping other customers and that my patience was appreciated.  About ten minutes in I got to tell my story to a human rep for the first time.  She offered to file an internal grievance against my insurance company, Healthfirst.  I declined her kind offer, explaining that Healthfirst had nothing to do with this CVS cockup.

She asked me to hold a few times, and each time I heard a loop of schlocky jazz blues in G, about six bars, over and over.   The first receptionist, who, obviously, couldn’t help me, asked if I’d please hold to speak to the pharmacy directly about my pharmaceutical question.   That hold was about fifteen minutes.  The rep checked in with me every two minutes, as she said she was required to do.  We became almost friendly after the first four or five times, she was always a welcome relief from the endless loop of shit muzak.   I eventually got a laugh out of her with a dry comment about groovin’ to the muzak loop.

I eventually get to tell the story a second time to someone named Joe at the pharmacy.   At this point I am about thirty-five minutes into the call and almost done.  Or so I fondly believed.  I tell Joe the story again, ask him why I’d been sent Losartan Potassium 100mg instead of Irbesartran 75mg.  He asks me to please hold for a moment and then gets more information, as the loop plays again, over and over.  

Joe informs me there has been a recall on Irbesartan and they tried to get the pills in a higher dose, which I could have cut in half, but that dosage too was out of stock. He wasn’t sure why the Losartan Potassium 100 mg. got mailed to me, could I please hold?

The muzak loop in G turned out to be impossible to override, so I put the phone on speaker.  On this higher level of customer care there was apparently no rule that the reps had to check in every two minutes.  Ten minutes passed grooving to the idiotic loop.  

Joe eventually came back on to tell me that my doctor, whose name was on the paperwork from CVS, had prescribed Losartan, five days ago.   I asked if the 100 mg. of Losartan was equivalent to 75 mg. of Irbesartan, the dose I have been taking for several years.   He told me my dose of Irbesartan is 150 mg.   I told him I was reading from the label of the current bottle of Irbesartan 75 mg., and the bottle before that one.   He asked me to hold while he got the pharmacist on the line.

“They told me you were the pharmacist,” I said.

“I am the pharmacy tech,” Joe explained.   Any questions related to pharmaceuticals could only be answered by the pharmacist, would I please hold.

Now I was an hour into the call and starting to be affected violently by the loop of muzak, those cliched jazzy licks being played over and over and over.   Ten minutes later the pharmacist, who almost immediately revealed herself to be an actual imbecile, picked up the phone.  Blessedly the muzak loop stopped, but I was entering an even worse loop.

I told the story for the third time, asking why I had not been notified about this new medication.   She asked me to hold, and a few minutes later, when she picked up, told me I should take the new pills my doctor had prescribed.  She claimed to have all the paperwork in front of her, told me she would send me a copy.   She told me, again, that my dose of Irbesartan was 150 mg. (twice what I take) and that the new drug is very similar to the one I was taking and the dose was equivalent.  I explained to her again that my dose is 75 mg.  She told me that she was looking at the paper, that she would send me a copy.   

My phone is smart, if annoying.  It was counting the minutes.  I was now up to 70 minutes.  She told me that she was sorry for my confusion, and how long I’d been on the phone and that if I could hold for just one second, she’d get her “leader”, who’d be able to help me.

That one second hold lasted exactly ten minutes.   Her leader had told her that the problem was my doctor, not CVS.   While on hold I’d read the paperwork, six pages, arranged helter-skelter, the “cover letter” was the last page, tucked behind the Mail Service Invoice/Receipt with the credit card charge, page two of the personalized medical warnings for Losartan, followed by page one, which brought up numerous concerns about Losartan for me individually, followed by a generic sheet about setting up automatic refills and a generic Mail Service Order Form.   The last page was the cover letter which stated:

YOUR MEDICATION ISN’T AVAILABLE AT THIS TIME  

We can’t send your prescription for IRBESARTAN TAB 150MG because it’s not available at this time  

WE CONTACTED YOUR DOCTOR  

Your doctor told us to change your prescription to LOSARTAN TAB 100MG.

The pharmacist argued again about my dosage.  I asked her what 100 MG of Losartan was equivalent to in Irbesartan.   She told me Losartan comes in three strengths, 25 MG (equal to 75 MG Irbesartan)  50 MG (150 MG Irbesartan) and 100 MG (300 MG Irbesartan).   

I was only ninety minutes into this conversation and already starting to lose my patience.  I asked her to explain how a pharmacist can send a patient a pill that is four times the therapeutic dose he is taking.   She seemed insulted by the question, like she felt unfairly blamed for the corporation’s error.    She was oddly noncommittal, barely communicative.  

I began to raise my voice, telling her what would likely happen if I took a quadruple dose of a blood pressure lowering pill.   I would probably pass out, as I had once while briefly taking a double dose of irbesartan as part of my treatment for kidney disease.   She told me to stop yelling at her, she’d already apologized, and besides, it was my doctor’s fault, not CVS’s.  Then she asked me to hold for a second, she would get somebody who could help.

The second one second hold went on for almost fifteen minutes.  Someone named Irina picked up the phone.  I told Irina that CVS had negligently and without notification dispensed me a pill four times the dose of my prescription.   I informed her I’d already been on the phone for an hour and forty-five minutes.  I said I needed to get her assurance that CVS would get the correct prescription from my doctor tomorrow, overnight the pills to me and reverse the charges on my credit card.  We talked about this for a few moments, she told me she understood and then asked me if I wouldn’t mind, please, if she placed me on hold for just a moment while she spoke to her supervisor.

It was going on two hours, the timer on my phone read 1:59.  I told her it was not reasonable to ask me to hold again, when she was the fourth person I’d been forced to hold for in an already two hour phone call to resolve their error.  I gave her the thirty second version of why the corporate personality is psychopathic; interested only in gain to itself and deniability of all responsibility.  I told her I needed her assurance that CVS would honor my reasonable request to have the correct drug expedited to me and that I’d be on my way.  She told me unfortunately that she’d need to get her supervisor on the line, it would only take a few moments.  I convinced her to have this wizard call me back.  She promised I’d have a call within a very short time.  

Naturally, there was no call from anybody.   Good thing I’m getting medication for my slightly elevated blood pressure, eh?

 

[1] a neoliberal is a wealthy politician or donor who supports all socially liberal causes: nondiscrimination, a woman’s right to an abortion, sensible gun control, environmental regulations (within reason), equal pay for women, homosexual and transexual rights, the right to a public education, a social safety net, a merciful immigration policy, particularly for refugees fleeing violence, even affordable health care.   At the same time, neoliberals are financially conservative, corporatist, committed to preserving a lucrative, if unfair, status quo  protective of the financial services industry and the stockmarket-based casino of the “free market” economic structure as it exists.  

The road to hell is paved with the bones of these benevolent motherfuckers, since all of their good intentions are negated by their continual justification of war (very profitable, apparently)  and the brutal poverty that results from an economic order protective, above all else, of the liberties of the super-wealthy, the chosen elite who, in most cases, were the shrewd inheritors of vast fortunes.

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