Green Acres Mobius Strip

Yesterday I became lost in the morass of the Smallish State bureaucracy which tries to reduce Medicare medication expenditures by limiting doctors’ prescriptions to certain drugs, and requiring “prior authorization” for alternatives. The patient involved was just discharged after being hospitalized more than a year. The medication involved costs about 25 cents a day (retail). I have spent over an hour and a half calling 800 numbers, filling in forms, faxing, receiving faxes, reading replies, looking for allegedly faxed forms that did not arrive in my mailbox, re-filling in other forms, and re-faxing them. So far, I estimate that the Smallish State has spent enough paying me to do this to purchase roughly two to four years of the medication—which may be longer the patient’s life expectancy. Meanwhile, he still does not have the medication, which helps him sleep. If he’s not sleeping—and I bet he isn’t—he’ll probably be back at Green Acres in a week or two. Where he will cost the State upwards of $800 a day.

And the greatest irony is, the person trying to prescribe this medication, and the people in charge of trying to deny it, work for the same state agency. Your (my) tax dollars at work.