So today’s rant is going to be about other pharmacists and our willingness to stab each other in the back (usually before we throw each other under the bus). Pharmacists tend to be a very caring bunch, myself excluded of course (I’m just an ass, but ya gotta be good at something). We also love stabbing each other in the back in an attempt to make money. For some people you can never have enough. Personally, I realize that I’m pretty well paid. Being a pharmacist is a pretty solid racket one might say, which is why I decided to stop working on oil rigs and furthered my education (although, this nagging back pain makes me wish I had decided that a year or two sooner).
Anyhow, pharmacists are compensated pretty well. In fact, owning a pharmacy is a great idea (or it was at one time) which is why corporations wanted to get in on the racket. Some time ago pharmacists of a generation past decided it would be a great idea to allow corporations to own pharmacies. Great move! Cue the back stabbing. You see, corporate America (in my case Corporate Canada, but I say Corporate America, just rolls of the tongue nicer) could realistically give a shit about my profession. In fact, they could care less about you or me, all they want is money, as much of it as possible as fast as possible, and if you have to screw over the little guy in the process, well, screw ‘em. This is the essence of capitalism.
Cue insurance companies. They too realized there is a butt-load of money to be made on the drug business. Hence the huge number of insurance companies vying for your hard-earned dollar to get you to buy drug insurance. Here’s where the fun begins. You see, some pharmacists of a bygone generation view themselves as businessmen and not health care professionals. I can’t blame them, this seemed to be what you went in to pharmacy for, to be a businessman and earn a living. It came with the bonus of being a “healthcare” professional. Younger pharmacists such as myself (I know, I’m not THAT young) went into pharmacy to be health care professionals first, the earnings are secondary. This has created an issue in the profession with older pharmacists not understanding why younger pharmacists wouldn’t want to work 120 hour weeks to get as much blood out of the stone as possible, and younger pharmacists soon frustrated when they realize they are nothing but corporate whores peddling their wares to make money for large corporations.
In an event, how does this all tie together (I seem to be rambling). Well, a couple of quick points:
1. FYI, much like Dentist’s, Pharmacies are not required to provide direct billing to your insurance company (but they all do). We could, if we so chose, make you pay the full price and then submit your bills to your insurance company to be re-compensated.
2. Pharmacists in each Province negotiate deals with their provincial government as to how much they will be paid for filling prescriptions. This is the dispensing fee. We also get to charge a mark-up on the medications, which is also negotiated by the government (I can’t upcharge more than a pharmacy down the street for example, this upcharge is fixed).
3. Each Province is different as to the amount of medication they will pay for. Here in Saskatchewan we have negotiated dispensing fees for drug lists. There is a 34 day drug list, a two month drug list, and a 100 day drug list. The fee is the same for each drug list. This means some individuals receive some of their medications 34 days at a time, and some for a full 100 days’ worth (confusing, I know). A pharmacy can, if they so choose, fill ALL medications for a 100 day’s supply (which for me, being a small independent pharmacy is the fast track to going out of business).
4. Insurance companies are run by low-life scum. They could care less about these agreements. They want you to get your stuff for as cheap as possible so they save money, fuck the pharmacists and whether or not their pharmacies are profitable (who doesn’t love working for free, and besides, we all know that bills magically pay themselves). This includes, of late, sending letters to individuals recommending that they request a 100 day supply of all of their medications (not just the ones on the 100 day list) as it is cheaper for them. This means I have to argue with the mouth breathers about why I do not do this, even though I can, and about the pharmacy going out of business if I did that for everyone. Of course the typical mouth breather response: “Don’t do it for everyone, just do it for me” which is the typical piece of shit me first attitude I just love (as will be the subject of a future rant).
So some insurance companies have come up with a great idea. In their little letters they tell people that they should transfer their prescriptions to pharmacies that will fill all meds for the 100 days’ supply. Basically, they strong arm the little guy into complying for fear of going out of business. I love corporate greed. Luckily, there are low-life corporate pharmacies out there willing to cater to this type of stuff. Of course, the pharmacists working in these pharmacies know full well that this type of thing is basically like stabbing their colleagues in the back, but I guess as long as the bills are getting paid they are good (which is also very self-serving and very short sighted).
My solution (knowing full well it has a 0% chance of working) is to have all pharmacies in the province of Saskatchewan refuse to bill 3rd party insurance payors, or failing that, have them just abide by the goddam contract. When the insurance companies cut off their coverage to their clients it is then on them to tell the insurance companies they can take their half-assed drug coverage and stick it up their ass.
But who am I kidding, that won’t work. There will always be that segment of corporate pharmacies willing to screw the rest of us over. And the worst part is, they won’t even buy us dinner before they screw us.
J
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