Corporate interference in healthcare

I seem to be going through the never-ending medical saga.  For the past few years, our insurance plan has required us to order any long-term prescriptions through a mail-order pharmacy, Medco.  This is supposedly supposed to be an easy way for us to get our prescriptions, and also helps save the insurance company money.  Fine, whatever.

But it's not 'fine, whatever.'  Our family's personal experience with Medco has been mediocre, at best.  Since the beginning, there have been issues of generics being changed, prescriptions not getting refilled on time, and other similar things.  Then for awhile it evened out.  Our doctors' offices and Medco finally seemed to be communicating, and our prescriptions were filled regularly and on-time.

A few months ago, I noticed an odd change when I received my birth control pills in the mail.  After my doctor mailed in a refill, I received pills with a completely different dosage than the one I had been receiving.  I was furious, after having dealt with Medco's errors before.  However, it turns out that one was on my doctor (they had the wrong dosage listed on accident), and my doctor's office offered to change the prescription immediately.  I said I would stay on the new dosage unless I found it to have adverse side effects, in which case I would contact them for a new prescription.

Two months later, the adverse side effects are there in full force.  I call my doctor's office and ask them to change it as soon as possible.  They comply.

The following week, I receive a prescription in the mail and I assume it is the one I had switched with my doctor's office.  Nope.  Not only is it the wrong dosage (1.5/30 instead of the 1/20 I requested), but it is a completely different brand than the pill I've been taking for over 2 years.  Needless to say, after having my generics switched around on a monthly basis about a year in (and having my body protest each time), I refused to take them.  Naturally, I assumed this was an error on Medco's part and called them to sort it out.

After an hour on the phone with 2 customer service reps and a pharmacist (who I forgot to ask if she was even licensed in NYS), I have heard the following things from Medco:

1. The prescription for the 1.5/30 was automatically refilled (note: I do not recall authorizing this)
2. My doctor's office sent a prescription in July for 1.5/30 which was unable to be filled; they sent me notification that they would hold this prescription until it was time to be filled (note: I never received a notice, and also, they received 2 prescriptions on the same day in July for 1.5/30 and 1/20.  Wouldn't you think they would clarify which was the correct one?)
3. The generic for Loestrin has been switched from Microgestin (which I've been on for 2 years) to Gildess due to 'corporate interest'.
4. Even though I cannot and will not use either Gildess prescription mailed to me (both 1.5/30 and 1/20) and offered to mail them back, I am still responsible for the co-pays on both.

The first two had fairly brief rebuttals; the second two are a bit more lengthy.  First, to point #3.

As I was reading Gothamist when I got home from work today, I came across an interesting article about a recall on birth control pills.  My curiosity was highly piqued after my saga of the never-ending birth control pills (my mom actually called me today after finally receiving the correct pills: "Good Lord, how many times are you going to get birth control pills this week?!").  I followed up with that article on Jezebel, which linked to the manufacturer Qualitest's recall list.  Guess what?  Gildess Fe 1.3/30 and Gildess Fe 1/20 (both of which were sent to me) ARE ON THE LIST!

So, let's recap: first, Medco changes my generic prescription due to 'corporate interest.'  Second, the corporation's preferred drug of choice is now *gasp* under recall!  Fan-fucking-tastic job, Medco.  You would think an organization that calls itself a pharmacy would put its patients before its pocketbooks.  But no, silly Kim, we live in an overbloated capitalist society where even those who are supposed to be looking out for our best interests sell us out for a quick buck.

The pharmacist I spoke to at Medco said that even my local pharmacy would do something like that.  Possibly, but my local pharmacist would also work with me to make sure I was getting exactly what I wanted and needed.  I've grown up with my local pharmacist's daughter (kindergarten through high school, and our parents still live down the street from each other), so she knows me and will want to make sure that my health is being taken care of.  While the company may try to cut costs, I know she won't let that happen.

Point #4: in what other place in the United States would you be forced to pay for something you have not used, and also returned back to the place you got it from?  I can understand some issues about things being tampered with before they were sent back, but a) I would assume they would automatically destroy whatever comes back for that exact reason, and b) they're blister packs, which would usually be pretty obvious if someone tampered with them.  Medco's tune was very nice at the beginning, but once I started getting angry and upset (they're screwing with my body, and also keeping me on hold for 5 minutes at a time), they shut down.  Now there's a company that can't take criticism.

And even on top of all this personal stuff (oh BTW, they've also been screwing with my mom's blood pressure medication- something you should never ever mess with, especially if you're not a doctor), I found some other very interesting stuff doing research.

In 2003, Medco was brought to court for a bunch of illegal, unethical, and questionable practices by none other than the United States government (this will open a PDF that I highly suggest you read).  They cite numerous things that Medco has allegedly done wrong, such as having non-pharmacists doing things that should only be done by licensed pharmacists, changing prescriptions, falsifying records, and flat-out lying to patients, among other things.  I found numerous citations in the suit that reflect exactly what Medco has been doing to me, 7 years after the case was settled out of court (with Medco paying a hefty settlement: $29 million to 20 state governments and $115 million to the federal government).

Oh, and one more thing: up until recently (and definitely as recently as that 2003 civil case), Medco was actually Merck Medco Managed Care, L.L.C., which was owned by Merck.  One of the largest drug manufacturers in the world.  Now tell me, how is it ethically or legally possible to have a Prescriptions Benefits Management company owned by a drug company?  The case cited evidence of Medco giving preferential treatment to Merck-manufactured drugs, even in spite of doctors' explicit orders for specific medications.

The case goes on and on, and there has been some recent news from other places in the country about Medco's ongoing unethical practices since that time (including a former Medco pharmacist in Florida undergoing a hunger strike  in 2010 in protest).  My own personal case highlights these ongoing practices.

I plan on contacting Medco again on Monday morning, and taking this further if they refuse to at least eliminate the co-pay for my unwanted medications.  From there, it's the HR staff with our health insurance company, and if needed, the Attorney General's office.  Clearly Medco hasn't changed a bit since 2003.  Maybe if enough people get on board they will finally be forced to change their tune.

What the American media ignored

Al Jazeera English: America's own Taliban

This is a great article outing the Christian extremist right, particularly in light of the recent events in Norway (fueled by a Christian extremist).  With the exception of the Westboro Baptist Church, the American media (left or right) does not do much (or any) criticizing of Christian movements or religious institutions in the country.  Granted, a majority of the country is Christian in some form or another, there are so many different forms that when they're broken down, all the views come out drastically different.  However, it is that idea of Christianity being the status quo that I believe shields it from a lot of necessary criticism.


Bill O'Reilly recently made even more headlines by criticizing the media for calling Anders Behring-Breivik, the admitted killer, a Christian.  O'Reilly claims that because he is a Christian and he believes that no Christian could do this, therefore Breivik cannot be a Christian.  However, this is the same man that equates all Muslims as terrorists, although a vast majority of them could say the same things (and in cases, have) about Osama bin Laden and other extremist Islamic terrorists.  What really gets me is O'Reilly's claim that '"No one believing in Jesus commits mass murder,"' apparently having completely forgotten the Crusades and other so-called 'holy wars' committed in the name of God, the domestic Christian terrorist Timothy McVeigh (of the Oklahoma City bombings), or the massacre in Srebrenica, committed by Orthodox Serbs (who are Christian).

Al Jazeera's article goes beyond all of this, and does an interesting comparison of the American Christian extremists to the Taliban.  The article is well-worth the read, making the main point that like the Taliban, these Christian groups are also highly intolerant of anyone except themselves.  More importantly, it draws our attention to the involvement of many high-name Republican politicians in these groups, and the extent to which their intolerance goes.

The western media tends to ignore much of the well-known politicians' religious idiosyncrasies, except of course when they deviate from the WASP mainstream (i.e., freaking out over JFK's Catholicism, freaking out over thinking that Obama is Muslim, freaking out over Mitt Romney's Mormonism).  Despite what Bill O'Reilly says, Christian extremists exist and can also commit terrorist acts of mass murder.  We must be attentive to sympathetic views in those that seek to lead our country, and curb terrorism in all forms without discrimination.

Citing tweets

CNN: Hugh Hefner: Crystal Harris lied about our sex life

I think this is the first time I've seen an article's citations/links consist mostly of tweets.  I guess this is what we're heading towards...

Our priorities are a bit messed up

Ever since I joined Twitter, I find myself getting more and more news from there.  I subscribe to Al Jazeera, the UN, other political organizations and NGOs, and 'randoms' (i.e. people/organizations not associated with news and/or politics).  Needless to say, information travels fast on there.

I first found out about the attacks in Norway via Twitter, with Neil Gaiman commenting that #Oslo and #Norway seemed to not be news in the US.  Curious, I went to CNN to find out more (and I'm still trying to keep up with all the news there).  Both columns on the front page, which I would conflate to the 'above the fold' section of a broadsheet newspaper, were full of stories on the Oslo attacks, with live feeds, videos, iReports, and staff-produced articles.

Today, also on Twitter (because that's what I find myself doing with my near-unemployed life), I find out that Amy Winehouse died.  For New York at least, the trends are all about her and other celebrities that died young, including the disturbing hashtag #27club (apparently lots of celebrities died at 27).  Norway is still trending, but it's 9th on the list of 10 top trends for the region and the only one about yesterday's tragedy.  CNN also is following this.  Their left-side, smaller column is still full of information about Norway.  The large, front-and-center column, however, is all about Amy Winehouse.  The newspulse, which shows the top stories, lists stories about her as being #1 and #3 (moving up from the #4 spot that it was at no less than 10 minutes ago).  The main article is listed as 'Breaking News.'

Time for me to get a little insensitive here (as some people will think).  Amy Winehouse was a world-famous, talented singer with a loooooooooooooong history of drug problems.  Pretty much every story about her career has always talked about her drug problems, and quite honestly, most stories about her weren't about her career (3 guesses what they were actually about).  It is sad that she died; she held a lot of promise.  But considering her lifestyle, it is not exactly 'breaking news' that she died.  Someone who continues to abuse their body like that for years with no signs of wanting help is going to die much sooner rather than later.  This is like being shocked that Steve Irwin was killed by a dangerous animal (although granted, I was shocked it wasn't by crocodile).  When you live a certain lifestyle, the consequences are pretty much set in stone.  You expect these things to happen.

In contrast, there was a real tragedy in Norway.  The death toll from the two attacks already stands at 92, with 85 of them being from an attack at a youth camp.  While details are still coming in, this already stands as a deeply violent and tragic event that may have implications in the current global culture of terror.  The same article states the suspect may be a right-wing Christian fundamentalist fighting against a multicultural society.  Studying this event can help us rethink the concept of terror and terrorism in an ever-changing world, and also, particularly in the US, think about our own country's right-wing violent fundamentalist groups that could pose a serious threat to the nation in coming years.

But no.  What's more important than shaping the global discourse on terrorism is a dead celebrity whose death was wholly expected.  Sad, yes, but nobody can say they were truly surprised by this.  When will we get out of this sick fascination with the famous and their self-destructive tendencies and start paying attention to the things that can actually have a real impact on our own lives?  We need to get our priorities straight, and also learn to leave people alone (because I'm pretty sure there's a lesson to be learned about paparazzi-hounding in the Winehouse story).  It's all tragic and serious, but it's important.  Americans can't be content to ignore the rest of the world, because whether we like it or not, we've already seen the rest of the world is coming to us.

They mean well, but....

Care2: Bigger AT&T = Less Choice, Higher Prices!

Somehow along the way, I got subscribed to updates from a petition site, Care2.  This latest one is against AT&T's acquisition of T-Mobile, which I find silly for a multitude of reasons.  At the very least, T-Mobile phones are now using AT&T cell phone towers (which explains why when I was camping this week all of us on Verizon had crap service but everyone on AT&T and T-Mobile could actually get reception), which is good news for T-Mobile customers.

While the petition states such issues such as AT&T poised to be the largest cell phone company with this acquisition and forcing higher rates of service on (former) T-Mobile customers, the e-mail sheds a bit of a different light such as less competition (implying that AT&T is heading towards monopoly):

A merger between AT&T and T-Mobile would give AT&T control of more American's cell phones than any other company, allowing them to more easily take out the rest of the competition.

Competition between companies creates innovation in new products, better service and lower rates. Without it, American consumers would be at the whim of the corporation in charge.

As consumers, we have to stand up to giants like AT&T. T-Mobile already charges less than AT&T and T-Mobile customers will see a major hike in prices if the merger is allowed to go through.

Yes, these are valid issues in some respect.  However, let me outline the reasons why I don't think there needs to be a petition at all.

1.  "...The FCC is seriously considering allowing AT&T to swallow competitor T-Mobile, and control more Americans' cell phones than any other company."
   Yes, AT&T will most likely gain the largest market share with the acquisition, according to 2010 data.  For the first 3 months of 2010, Verizon held 31.1%, AT&T had 25.2%, and T-Mobile held around 12% of the market share.*  Combining AT&T and T-Mobile with these numbers gives them 37.2% of the market share, a 6% increase over Verizon.
   
   However, a lot has happened in the cell phone world since 2010.  One of the main things that can potentially have an impact on AT&T's market share is the recent (February 10, 2011) release of the iPhone on Verizon.**  Considering AT&T's notoriously horrible service that even this petition cites, this has the great potential to cause many people to migrate services, as many iPhone supporters signed AT&T contracts simply because they were the only carrier that the iPhone was available on.  Soon after the iPhone came out on Verizon, some friends ran a small test of the carriers, looking at 3G and call connection speed.  Verizon won both times.
   
   I feel that The Oatmeal best summed up this in his 'State of the Web' comic from Winter 2010.  (Seriously, go check it out).  With much better service, how many iPhone devotees will continue to stay with AT&T?***
   
2. "A merger between AT&T and T-Mobile would give AT&T control of more American's [sic] cell phones than any other company, allowing them to more easily take out the rest of the competition."
   
   Citing the percentages above, when the next largest company after the merger only controls 6% less of the market share than you do, not including the fact that neither control over (or even close to) 50% of the market share, I think this is a bit of a scare tactic.  After the merger, there will be AT&T, but there will also still be Verizon, Sprint, Boost Mobile, Virgin Mobile, Metro PCS, and a number of other companies that still have a solid number of customers.  If Verizon and AT&T merged, that would be a huge issue as they would control nearly 70% of the market share.  However, as both companies are operating strongly I don't see that as even a remote possibility.  The only thing I think anyone would be in danger of is a two-company system in which Verizon and AT&T buy up all the remaining companies and just compete between themselves.
   
   Even on this, another point has to be taken into consideration.  Both AT&T and Verizon have eliminated their unlimited data plans, along with a host of other carriers.  For people not grandfathered in on their contracts with an unlimited plan, I can foresee them moving to one of the other, smaller carriers that still provides that service.  This has the opportunity to create more diverse competition, not less of it.
   
3.  "T-Mobile already charges less than AT&T and T-Mobile customers will see a major hike in prices if the merger is allowed to go through."
   This has the potential to be a valid point.  AT&T, once the acquisition is finalized, will control all contracts and will most likely do away with any low pricing that T-Mobile currently offers.  However, T-Mobile has already stated that even after the acquisition is finalized, their customers will be allowed to finish out their contracts with no price increases.****  As I have stated before, after that, customers that are unsatisfied have the option to switch carriers.  While T-Mobile is relatively inexpensive compared to AT&T, so are other companies.

Yes, there are some potential negatives to come out of this merger.  T-Mobile customers may have a rate increase after their contracts expire, and AT&T's service in most aspects pretty much sucks.  However, the beauty of the free market (which I think will be one of the few times I use that phrase) is that if customers don't like something, they can make a statement with their money.  Don't like AT&T?  Move to one of the countless other mobile phone carriers in the country, and take your money elsewhere.  It may be a pain to search for that perfect cell phone company, but I seriously doubt that this acquisition is the harbinger of doom that the Care2 people seem to be implying it is.

*PPCGeeks: Wireless Market Share by Carrier & Devices; May 7, 2010.
**Fox News: Verizon Finally Unveils iPhone; January 11, 2011.
***Full disclaimer: I am totally devoted to Verizon, having been a customer since approximately middle school.  I have also heard a lot of AT&T customers complain about their service.  It's kind of how I am with Hewlett-Packard vs. Dell (hint: never buy a Dell!).
****T-Mobile: Q&A: More Information About AT&T Acquisition of T-Mobile USA; March 20, 2011.

Pirates are dumb

CNN: Pirates target the Maersk Alabama again

Really, pirates?  Did you not see that bad-ass sniper action that happened when you guys held the Maersk Alabama's captain hostage a couple of years ago?  Because I'm pretty sure the U.S. government would have no problems doing that again.