How Much Is 13 + 10?

[Gary Sisco]

23, you say?

Wrong. According to the feds, it's 22.

I just went to fill a pain meds script for Bronwyn, made out on the 13th, good for ten days. Pharmacist says it expired yesterday. Why? I asked. Because you forgot to count the 13th. I'm like, Ok, what is 1 + 9? Ten, he says. I say, Wrong, you forgot to count the 1, so the answer is 9. No, no, he says....

So, Bronwyn gets to suffer until Monday.

I'm so tired of morons, folks, including those who write the laws.

[moneyp]

Jesus, what a maroon. I'm going through the same shit with my mom's health problems. I more or less had to physically threaten one guy over the phone for a similar bit of idiocy. I asked him, "why don't I come down and talk to you in person?" and he quickly saw it my way. It was a total bluff, anyway. I'm in Atlanta, he's in Los Angeles. But it worked.

[Gary Sisco]

I did very nearly come to blows with this same clown one day some years back. Apparently his brain turned on enough to read my body language, just in time.

End result is the same, though, moron or not. Bronwyn doesn't have her meds, so she will have to suffer until Monday when we can get it straightened out. Assuming her doctor is "in today." Almost every time I call she's "not in today." The amount of time she's "not in" plus her income is a pretty damned good deal, seems like.

At least it adds up.

Was the feds of course that wrote the 13 + 10 = 22 rule.

So, I ask, How is a normal person to know that 13 + 10 = 22 according to fed regulations?

You can't, he says.

So people have to literally suffer to learn this.

Yes. He tells me, See, you're dealing in logic but I have to deal in law, because of my license.

He did have a point, there, albeit not enough of one to make me stop wanting to stomp on his head ten or eleven times, depending on how you count them.

[Gary Sisco]

Plus, we can't forget that there are an infinite number of points between zero and one. How come they don't factor in?

If shit gets any dumber I'm going to explode.

[Vince Kargatis]

Yeah, that's bogus. 1 day is 24 hours - if it expired in one day, with their logic, it would expire on the day of issue.

[cookie]

Crazy.

And so typical of a health care model that places more value on money than on people. Amerika the cheap and uncompassionate.

[Enforcer]

Originally Posted by moneyp

I more or less had to physically threaten one guy over the phone for a similar bit of idiocy. I asked him, "why don't I come down and talk to you in person?" and he quickly saw it my way. It was a total bluff, anyway. I'm in Atlanta, he's in Los Angeles. But it worked.

Mone getting pissed on the phone.

[Pete C]

Sorry, but I disagree. If it's "good for 10 days," that includes the day it was written plus 9 more. If it were to be valid for the day you thought it was, and it was also valid on the day it was written, then it would have been valid for 11 days. I can understand that you're upset, but in this case the question should be "how much is 13 + 9."

[Pete C]

Originally Posted by cookie

And so typical of a health care model that places more value on money than on people.

What does this case have to do with money? It sounds like it has to do with a bureaucratic regulation.

[Uli]

Originally Posted by Pete C

Sorry, but I disagree. If it's "good for 10 days," that includes the day it was written plus 9 more. If it were to be valid for the day you thought it was, and it was also valid on the day it was written, then it would have been valid for 11 days. I can understand that you're upset, but in this case the question should be "how much is 13 + 9."

yep.

[Vince Kargatis]

Originally Posted by Pete C

Sorry, but I disagree. If it's "good for 10 days," that includes the day it was written plus 9 more. If it were to be valid for the day you thought it was, and it was also valid on the day it was written, then it would have been valid for 11 days.

Simply noting that your interpretation requires that a prescription "good for one day" filled 5 minutes before closing actually expire in 5 minutes shows that it's a plain stupid one that deserves to be decried.

[Uli]

Originally Posted by Vince Kargatis

Simply noting that your interpretation requires that a prescription "good for one day" filled 5 minutes before closing actually expire in 5 minutes shows that it's a plain stupid one that deserves to be decried.

I admit that I can't follow this logic. If the doctor wanted the prescription be valid for the next day as well, he could simply have written "good for two days".

[cookie]

Originally Posted by Pete C

What does this case have to do with money? It sounds like it has to do with a bureaucratic regulation.

To me, they are one and the same. The bureaucratic labyrinth is a result of trying to protect the money because in America, it's *all* about the money 24/7.

[clinthopson]

Is it the Feds fault or is the pharmacist an idiot?

What a wonderful world.

[Gary Sisco]

Federal + regulations = idiocy.

[Daniel]

Originally Posted by Pete C

Sorry, but I disagree. If it's "good for 10 days," that includes the day it was written plus 9 more. If it were to be valid for the day you thought it was, and it was also valid on the day it was written, then it would have been valid for 11 days. I can understand that you're upset, but in this case the question should be "how much is 13 + 9."

yes but if i go rent a movie that's good for 1 day, it's due back the next day, not later that same day.

[Pete C]

Originally Posted by clinthopson

Is it the Feds fault or is the pharmacist an idiot?

The pharmacist wasn't an idiot. If he had put his license in danger by filling the prescription he'd have been an idiot. I know you can read better than that.

[Pete C]

Originally Posted by Daniel

yes but if i go rent a movie that's good for 1 day, it's due back the next day, not later that same day.

By a certain time, yes?

Anyway, there wouldn't be a problem if there had been an expiration date specified instead of the subject-to-interpretation 10 days.

[GoodSpeak]

The specter of the almighty HMO system rears it's ugly head yet again.


Such bullshit.

[moneyp]

Originally Posted by Larry Nagel

Mone getting pissed on the phone.

That's pretty close, but put a little more Harvey Fierstein into it.

[kedoane]

Originally Posted by Gary Sisco

Federal + regulations = idiocy.

I feel that way with Medicare Part D. My mom is in the donut hole now, and has been since April of this year. I have recently spent over $700 on her recent drug order from the on line pharmacy. I will be at least spending $200 more in the next few weeks as I refill one of medications at the local pharmacy (this one drug I don't dare let an on line pharmacy fill since I need to adjust the dosage quickly). I know that I will be spending another $700 towards the end of the year since she will still be in the donut hole by the time that the year is over.

One of the stories of a caregiver daughter.

[Lenny D.Guitarist]

Maybe these gentlemen could teach the bureaucrats something.
http://youtube.com/watch?v=twW_riHWz_4

[Pete C]

Originally Posted by GoodSpeak

The specter of the almighty HMO system rears it's ugly head yet again.


Such bullshit.

A lot of anger about the health care system vented here as if it had anything to do with the particular regulation in question.

This has nothing to do with HMOs, nothing to do with pharmaceutical companies' greed, nothing to do with the pharmacist, simply a specific regulation about an expiration of a prescription. I love America. You don't have to think to have opinions.

Vince or Daniel, if someone gives you a thirty-day pass to a museum, starting today, what's the last day you can use it?

[Vince Kargatis]

Originally Posted by Pete C

Vince or Daniel, if someone gives you a thirty-day pass to a museum, starting today, what's the last day you can use it?

No reason not to just postulate a one-day pass to keep it simple. And yes, the answer is it's good for the day of issue. But that's specific to a business-hour-oriented situation, really not the same functionality as a prescription. Anyway, I'm not denying that your suggested interpretation isn't possible, just that it's stupid for a prescription.

[Gary Sisco]

The guy's been a pain in the ass before, and not just with us, either. First off, they didn't have the stuff when the script was written. Took a few days off there. I asked them to hold the script and fill it when the stuff came in. Nope, not holding any script for narcotics. And so forth. There were several times when they could have explained that ten days isn't really ten days, and so on. Nope, let that wait til a Saturday.

Pete may or may not have a point *depending on how you count.* There was a whole thing over the century change. Did the 21st C start with 2000 or 2001? Most people said 2000. Others didn't. Almost everyone would say that ten days from the 13th is the 23rd.

The real thing is that you don't allow other humans to suffer pain because of such nonsense. We lost most of a working day tracking down a doctor on a Saturday. Bronwyn did it by tracking down their answering service and calling it directly.

This kind of thing in VT until very recent times would have been taken care of with a wink and nod until it could be straightened out paperworkwise on Monday. Small towns, everyone knows everyone. The guy knows Bronwyn requires major pain meds and also knows it's legit and that any problems could be taken care of as soon as the doctor was "in."

He's the kind of guy makes you think you're in the Soviet Union, at desk 9, where you stood line for six hours, but all his job is at desk 9 is to direct you to desk 10 or 11, depending, but desks 10 or 11, depending, are closed, and he knows it. He could help you out, but he won't.

Sandi -- How in the world did you manage to negotiate your way through the incredible bureaucratic maze of Medicare D? We've been trying and trying and neither one of us has been able to yet. Even with the "donut hole," that program could save us an entire month's total expenses or more, but we cannot find a way through all of the obstacles thrown up, so far.

[Richard Pinnell]

I have just left the retail pharmacy industry after 17 years. The UK may not be regulated exactly the same as the US, but over the years I have seen pharmacists severely reprimanded and in one particular case struck off of the pharmaceutical register for exactly this issue.

In this country the prescription would not have been valid on the 23rd so the medication technically couldn't be given. There are ways around this though if it is not possible for the customer to get to the Doctor for a new prescription. If the pharmacist is confident that the person is genuine (i.e he has seen them before and believes that the patient is likely to be prescribed more of the medication) he is allowed to supply a loan of enough medication to last until the customer can see the Doctor and a new prescription can be written to cover the loan and any further supply. The desision to do this rests with the pharmacist who takes professional responisibility.

Whilst not technically legal the pharmaceutical society in the UK consider loans of medication in this manner to be perfectly acceptable if in the patient's best interests, but only for certain classes of drugs. There are a number of painkillers that no pharmacist would ever allow to be loaned in this way and they would expect to be reprimanded if they did so. It really depends on the medication involved.

The prescription certainly isn't valid on the 23rd though.

[Richard Pinnell]

And whilst it all may just seem like red tape, consider that there is more than one reason for these restrictions being in place...

In the UK Harold Shipman, a doctor in this case, (but similar things have taken place with pharmacists) killed patients by giving them overdoses of drugs. Some of the time he covered himself doing this by not actually prescribing the medication officially to them but by handing them the medication from a cupboard in his room. He had to account for the drugs he had given out however, and some of the time he did so by claiming to have given the medication to other patients that genuinely required it, but had run short of supply.

The rules that meant Bronwyn didn't get her medication are also in place to try and ensure pharmacists and dispensers aren't just walking out of the pharmacy with medication. Every drug that is handed out needs to be accounted for for this reason.

[Uli]

Originally Posted by Vince Kargatis

Anyway, I'm not denying that your suggested interpretation isn't possible, just that it's stupid for a prescription.

There you go, Pete.

[Gary Sisco]

Richard -- But still, the point is he was denying pain medications to a quadriplegic woman who he know has serious, chronic pain. He also knows that come Monday morning, the whole business could be straightened out, paperwork-wise. They don't have to make their accounting on Saturday afternoon and come Monday there'd have been no accounting issue at all.

I'd like to know why it is that we have a choice of three veterinarian practices, each with multiple vets, and they are available 24/7 for animal problems. Animals in pain are dealt with promptly. After all, you can't let a poor animal suffer. You can, however, in the US not only let a human suffer but actually cause unnecessary suffering, just by deciding to be a prick.

For example, yesterday he said the script had to be filled exactly as written. The higher dose that was prescribed cost more than twice as much as a lower dose at half strength times two. Nope. Exactly as written or nothing. So, knowing how hard it would be to track down a doctor *again* on a Saturday, we're now twice as light in the wallet as was necessary.

Now, before anyone wants to say anything about the literal correctness of that, try this: It's very often the case that they don't have enough of whatever medication on hand so they will fill a script partially, charge you for the whole, and make up the difference later. But that isn't filling out the script exactly as written, is it? No, it isn't. The difference is that fudging in their direction is common practice. Fudging in a patient's direction verboten (by this one guy -- the others we know and have dealt with for years -- and almost 90k in business with them -- would have worked it out and straightened shit out come Monday). As I've constantly tried to explain, if they do that, they hurts us by removing money that's supposed to be working for Bronwyn but isn't. So we actually end up paying more. It doesn't come out even when they cough up the rest of the script. If you multiply that by many times over nine years, you start talking about significant money, lost by the patient.

So, it isn't really that they will follow a script as written and as written only. It's that he will insist on that when Bronwyn needs some slack but not when the store needs some slack. Thankfully, this jerk is part-time. Unthankfully, he's often the weekend guy. That store takes in more in sales from Bronwyn alone in a year than that guy's salary would amount to. He's just a pain in the ass, pure and simple. That's his rep in the community by the way, not just mine.

Thing is, Vermonters don't govern themselves anymore like used to be the case. We are now ruled by several classes of plutocrats, a large percentage of whom come from other places, mostly suburban, and have brought with them their ways, pushing out the older ways, and turning this place into what amounts to a geographic space called Vermont. The political culture that made and was Vermont is all but nonexistent, now. It's a rural place but not an agricultural one, and it's become a rural place where people work for a living, mostly in shit jobs that don't pay much by standards elsewhere in the US, never mind the NE -- and they do so primarily to pay teachers and state bureaucrats more than they'll ever receive and also for their benefits, which they'll also never see, and which between the two, are by far the largest institutions. No private business comes closer than 10 miles to being of a similar size.

Another place in America now, culturally, but a strange kind of rural zone that isn't agricultural anymore and has no real product but taxes and insurance payments and so forth.

I don't know what to even call a rural place that isn't agricultural anymore.

But yesterday's problem would never have happened two years ago, when the store was privately owned and the man and woman who owned the place worked it themselves. Now, it's owned by a chain -- which unfortunately kept this one guy on -- and the difference is huge, so far as the way people get treated goes.

Fuck 'em.

[Captain Hate]

Originally Posted by Pete C

This has nothing to do with HMOs, nothing to do with pharmaceutical companies' greed, nothing to do with the pharmacist, simply a specific regulation about an expiration of a prescription. I love America. You don't have to think to have opinions.

Pete FTW