I apologize to those waiting at Wal-Mart on Wetmore for their prescriptions, while I was on the phone tying up one of the pharmacists.  I know I was inconveniencing you, because she eventually said she had a long line of people waiting, so I got off the phone, in order to give her time.

What happened?  Bad system.

Why?  Good question, and easy to answer, because in large part, nobody in Tucson listened to me when as medical director of a hospital, I said we had to fix bad systems, not punish bad people.  Since then, bad systems helped speed the demise of both my parents and affect every other member of my small family’s medical care. I’ve been through all of that in prior posts: I will stick only to the current problem.

I am on Medicare and needed to sign up for Part D drug benefits. I went online and decided to do it through Humana, which meant Wal-Mart and not CVS.  OK, no problem.  I can drive, rather than walk, to get my medications.

On the Web site where I went, it asked for what year.  I checked 2014, since I wasn’t interested in 2013.  I MADE A MISTAKE.  Or did I?  I was born in December, so I went on Medicare on 1 December.  I needed to sign up for a 2013 plan (December), then sign up for a 2014 plan.  I am quite certain this was not made clear.  The broker whom I used for my supplemental did not make this clear at all.  I am certain of that.  I was told it would be “easy to do”.  What I was not told was, “You have to take care of 2013 before you do 2014.”

Watch what happened.

I signed up for 2014, and I got a lot of paper with an ID card for my 2014 plan.  In the paper, which I try to read,  I learned my drug plan began 1/1/2014, so I said, “Uh oh.  I need coverage for December.”  I could have just paid for it on my own, since I take very few prescription medicines, but that assumes I stay healthy in December and not need a lot of high powered drugs for a ruptured bowel, a traffic accident when I drive to Oregon, or a host of other possibilities.

I called Humana.  I was transferred four times, the fourth back to the original person.  I finally had to explain to them clearly that I was a first time user and not changing my plan.  This is a problem I find far too often in this country.  There is an implicit assumption made, whether it is your car getting fixed or having major surgery, that each person innately understands the key vocabulary.  I did not say the right words, which were, “I am NEW to Medicare.”  That cost me about 20 of the 66 minutes I would spend on the phone.  I explained diagnoses to people.  I explained treatments.  Whether people listened was another matter.  Back then, there were a lot of complaints about how long doctors let patients talk (18 seconds) before interrupting.  I never heard how long patients let ME talk, before interrupting (5-10 seconds).

The next 25 minutes were spent giving out all my personal information, which at least was easy to do.  That led to the last 21 minutes, which was a “phone signature,” which I had never done before.  I have seen 14 total solar eclipses, traveled to 48 countries, published 60 articles, and am well on my way to being bilingual, but I do not know what a phone signature is.  Eventually, that was explained, and I hoped that the telephone system would not crash the whole time I heard a lot of words and had to remember to say “yes” after the prompt.  Starting over was not an option.  I then was accepted, and got the 2013 paperwork, which I added to the 2014 paperwork.

Later, I got another call, this time from Cincinnati, Humana’s headquarters.  Because I had signed up for 2013, now my 2014 plan was invalid, so I had to reapply for 2014.  That was easy, since I had done it before.  The one good thing was that I had a telephone number to call if I had trouble.  I had no trouble.  Why I kept the phone number, I don’t know, but I often save things, although I have trouble finding them later.  Again, I will be sent the same volume of 2014 paper coming, because I originally signed up for it.  This country runs on paper.

On the first of December, I took to the pharmacy the letter that later arrived from Humana, which explicitly stated I had coverage.  The pharmacist at Wal-Mart was efficient, and I inconvenienced virtually nobody.  I was set to get my first Medicare prescription on the sixth.

On the third, I got a call from Wal-Mart, saying my prescription was not ready, for I was not in the system.

I didn’t get incensed.  I was mostly disappointed in that I couldn’t find all the necessary pieces of paper. I thought computerization was going to do away with paper; it has increased it vastly, until recently, when with great fanfare companies send electronic prospectuses and tout how many trees they are saving. I think a prospectus ought to be limited to the following: “we can take all your money, and there is nothing you can do about it.”  But back to Wal-Mart, where I’m keeping people waiting.

I gave all the numbers I needed to, but there was still a problem.  As I saw it, once I cancelled 2014, somewhere in the system 2013 was cancelled, too.  At that point, the pharmacist begged off to serve other people.  I didn’t blame her.  Had I been waiting, I would have been annoyed, too.  Sorry, folks.

Somewhere, in the pile of paper, I got lucky and \found the number in Cincinnati.  I called the woman, told her my problem, and she said I was in the system.  So, I can only think that Wal-Mart hadn’t called.  I can’t think of another reason.  I called Wal-Mart back and gave them the number in Cincinnati.  This at least will save the pharmacist time, since the person (1) will know about me and (2) will assure her that I am in the system.

I have to hope the two of them don’t comment on what a bastard I was to deal with over the phone, a retired physician, whom nobody listened to when he discussed broken systems, a bitter old man, but one who WAS ultimately right, who ONCE again had to find the short term fix.

Welcome to American medicine.  Part D, by the way, is not Mr. Obama’s fault.


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