Once again, Anthem Blue Cross/Blue Shield has denied me a prescription. It’s like the 4th time in the past couple of years. I spend $10,000/year on all the insurance I can get, while my company pays the other $20K of the mortgage-sized premium. Then I have — whatever it is — $1,500 of deductible, or something. Then I have co-pays. Then I go to the doctor, and he prescribes me something — after looking at their own guidelines, and choosing the worse of two formulations, because they won’t cover “the good stuff” — and then, after ALL OF THAT, Anthem looks over his shoulder, and says, “No, he can’t have it like you prescribed it. You can only prescribe it once a day instead of twice.”
So my doctor submitted a prior authorization, which they also denied. I finally got the letter “explaining” why. Apparently, someone in the bowels of this corporate behemoth went to a government web site which has label information for every drug, and the label for this drug says to take it once a day. Therefore, according to Anthem, a doctor cannot prescribe it twice a day. Period. I’m not sure which is more stupid, this one or their last excuse, which was to steadfastly claim that I have a disease my bloodwork repeatedly shows I do not have.
In the 80’s, when “the bean counters” took over corporations, we made fun of them. We watched as companies who actually built things lost the will to invest in R&D, and abandoned long-term planning for a focus on quarterly returns. It was kind of funny to us at the time, one, because we couldn’t do anything about it, and, two, because the long-term effects wouldn’t be felt for decades.
You don’t have to look too hard to see what it’s done to the American corporate landscape. There’s no heart or soul; there’s only a question of how can they extract another dollar from the operation to return to the shareholders, whether by squeezing the customer or the employees. (I saw a comment the other day that this trend started with Jack Welch of GE fame, and I think that’s probably true.)
When it comes to, oh, I don’t know, making mufflers, this whole attitude and approach is one thing, but when that capitalistic machine gun is aimed — not at health insurance — but actual health care — well, this is what we get.