In case of crazy weather on our Greenland-to-Alaska cruise (through what used to be called the “Northwest Passage” and is now the “Trump Global Warming (TM) Passage”), I decided to fortify myself with some scopolamine patches. A physician friend wrote me a prescription for 8 patches, each of which can last for three days, but sometimes they come off in the shower, etc.
Wikipedia dates the medication to 1881. The brand name patches were about $340. Thanks to the patent (presumably on the delivery mechanism) having expired, the generics are available for only… $275.
We pay the big $$ for Blue Cross/Blue Shield coverage, so I had the pharmacy run my card. Coverage was denied due to a mismatch in name/gender/relationship that could not be further explained. It was a Saturday, so calling Member Services was unsuccessful.
On Monday, I invested some time in calling Blue Cross, which invested some money in paying a woman to deal with me. She explained that the pharmacy had “rung me in” with two Ls in my first name and with a gender of “female” (of course I asked how many additional gender options there were and she was familiar with only “male” and “female”; where is the LGBTQIA enthusiasm?) It should be a $10 co-pay for a 30-day supply.
After visiting four different pharmacies, I found one that had two packages of the patches in stock. They said that the insurance company would pay them $154, which means that the total price would be $165 (a 40% discount off the $275 that would have been charged to the struggling uninsured person!).
To me this is a great example of how the 18 percent of GDP that is purportedly for “health care” is illusory in terms of benefits to Americans. Absent FDA regulation, the generic patches would have cost $20-40 (8 cost about $60 in the Canadian regulatory environment). It took a week and the efforts of multiple people to get this organized. As soon as the doc wrote the prescription, why didn’t the patches show up a few days later via a standard ecommerce retail process?