A very good healthcare system

Actual phone call:

Them: “Hello, Shitty Insurance Company,(not the companies real name) how may I help you?”

Me: “Yes, I am calling about a prescription I recently brought to the Pharmacy to have filled. Apparently it was refused by you, my insurance company.”

Them: “I can look into that for you, what is your plan number. (I give him the number) I see it was for a non-generic drug that you have not used before, is that correct?”

“Me: “I think so, I am not sure what this drug is.”

Them: “Do you know why is was prescribed?”

Me: “Not really, I am not a doctor.”

Them: “Well, then, maybe it’s not really necessary if you can’t even tell me why it’s was prescribed in the first place.”

Me: “Are you a doctor?”

Them: “No, why do you ask?”

Me: “Well, how could you make any decision on whether it is necessary if you are not a medical professional?”

Them: “I am not making a decision sir, I am just saying, if you can’t even justify the use of this new, non-generic drug, then how can you expect us to pay for it?”

Me: “Because my doctor, who is a certified medical professional, prescribed it, because she thought it was necessary for my long term health.”

Them: “Do you have any idea how much this particular drug costs?”

Me: “I do not.”

Them: “It’s quite expensive sir. Did you know your doctor could have prescribed a generic drug that is in the same category as this drug, that would be much less expensive.”

Me: “Again, I am not the person doing the prescribing. I just go to my doctor when I am ailing and I hope and pray she does the magic doctor dance that doctors do, and then I get better and I can ride my bike again.”

Them: “Yes sir, I understand, but you must understand that we, as a company, can not just pay for every expensive medicine that is on the market when there are plenty of other options available that do pretty much what the more expensive medicines do, for a lot less money.”

Me: “So now you are a drug interaction expert?”

Them: “Not at all, I am just saying, it has been my experience that a lot of doctors get caught up in using the latest medicines when they could just as easily rely on a trusted medicine that is available in generic form, at a much more discounted price.”

Me: “But that is not the case this time.”

Them: “According to your doctor it is not, but in our opinion, she could have used a generic.”

Me: “I thought we already decided that your opinion was one that is not a medical professional opinion.”

Them: “That is true, but that is not to say we do not have trained doctors on staff to make decisions on prescription drugs and what is being prescribed to patients.”

Me: “Oh, then could you put one of those medical experts on the phone so I could hear how he or she decided that this prescription my doctor wrote for me is not the one I really need.”

Them: “Those people are not in the same building as us.”

Me: “Convenient how that works.”

Them: “I’m sorry?”

Me: “Of course. So when this medical prescription expert turned my doctors recommendation down, you realize that your brilliant expert did not recommend anything else, right? That while I have been waiting for a few days for you, my insurance company, to decide that this prescription was unworthy, and then you don’t leave me with any other options, I am just left hanging. This expert on your end just decides that because there is no generic drug that matches my prescription, I am undeserving of this drug at all, do I have that right.”

Them: “I did not say that.”

Me: “You did not have to. So what am I supposed to do at this point?”

Them: “Have you contacted your doctor?”

Me: “Yes.”

Them: “What did she say?”

Me: “I believe she said you people are all shallow, greedy assholes.”

Them: “Of course sir, and did she write a different prescription?”

Me: “No, she actually had me come in and she gave me samples from the drug company, because she thinks it’s important that I use the drug that she prescribed, weird how that works.”

Them: “Is there anything else I can help you with today sir?”

Me: “Doubtful.”