Ugh. My CGM went down this because of a failure to fill the transmitter. I’m still thinking about these administrative failures that result from doing business in a complex, brittle system so prone to failure. It results in a legal problem for their Duty To Provide Care. Why are we loosing access to care because the insurance company wants to aggressively prevent fraud. Why am I on the hook for that? Because they are bastards.
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Called Minipharmacy to get the rest of my sensors. Hour long phone call, 90% was spent on hold. Lowlights:
- Rep lied claiming the doc wrote a 30 day script.
- Rep eventually said she was transferring me to her manager and I am so messed up after all the mistreatment I start to talk her out of it.
- I ask the manager for a return label to send the order back. She offers to send the other two boxes of sensors. I make her clarify she means send them today, not some “in 30 days” shenanigans.
So maybe that is taken care of but oh my gosh I hate how this process makes me feel.
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Been 30 days and Edgepark didn’t send my pen needle order. I called, the first rep kept claiming pen needles are a pharmacy benefit not a DME benefit so without asking I dialed Anthem and merged the calls. Anthem said they were DME so we get cold transferred to someone with no idea whats going on, puts us on hold for 30 minutes, comes back and asks what she can do for us like we weren’t waiting for her. Finally get a new order placed.
Now I have to file a complaint with the state dept. of pharmacy for failure to dispense and bill edgepark $2500 for having to call them about my order. I wonder if I can talk my county AG into going after edgepark for whatever the real life legal version of attempted murder is. Probably not but I wonder if trying would make me feel better.
My pen needles finally arrived today. I had eleven pen needles remaining. I want to say it’s over but Anthem denied Edgepark’s claim for no PA. I’m not worried because I have a copy of the PA but it still doesn’t feel good.
Oh bleepity bleep bleep!!!
Went to my local independent pharmacy today to pick up a ‘script and found it closed forever.
@mohe0001 I’m gonna write my US and state reps and senators and blame them for failing to regulate, maybe the dept that runs my state health plan, anyone else?
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You gotta write to DOJ. You have about a month.
That sucks, dude.
Let me track you down some resources. I’m on here now snooping around for some links to send to the doctors.
Some of the stuff that I will write about in my letter, include:
1.) The impact of monopolization on labor markets in the Twin Cities
As a really large employer in Minneapolis, UHG pushes wages down. You can see the effects of monopolization in that they are allowed to offer us $100/40-hour work week, plus the guarantee of “LOTS of overtime.”
This is an illegal wage according to Minnesota state law according to the “Minimum for Tech Workers,” law. UHG will burn thru town and hire 40 engineers at this rate (less than $2/hour). They started doing this during covid and never quit. The state has no ability to enforce their own employment law unless we accept the contract, work for some period of time, and then file a formal labor complaint. Its ridiculous.
2.) The impact of monopolization on patient care
When the state tries to fight with the insurers by legislating, the insurers respond by increasing administrative burden. They can do things like this because there is no effective competition.
This bill went into effect Jan 1st.
Prior to Jan 1st, I used to have access to 3 months of supplies at a time.
Thirty insulin pump pods will last approximately three months. Each pod lasts three days, so (30 pods) x (3 days/pod) = 90 days. My most recent refill of my prescription (since the passage of SF2744) supplied only 3 boxes. That is equivalent to 15 pods total because each box contains 5 pods. (15 pods) x 3 days = 45 days, or 6 weeks.
They cut my access to supplies in half.
There is absolutely no medical reason to suddenly change the manner that pump supplies are prescribed and distributed. This is the insurer acting through the doctor to game the system to their advantage after passage of SF2744. This is occurring, not just in pumps, but in every script we fill - they are writing the scripts to allow the smallest quantity of medical equipment possible. This creates the highest possible administrative burden, and the smallest financial benefit possible for patients.
3.) Market consolidation in the form of pharmacy closures
You already know about this and its a sore point today. 
4.) The impact of monopolization on industry incentive to innovate
Why did diabetic patients have to build Loop APS before Medtronic and Omnipod were able to follow suit? Was it that these giant companies couldn’t do it, or were they simply not incentivized to do their jobs?
Your pharmacist is mad at CVS. That’s who has been putting them all out of business. Pharmacies sound alarm for PBM reform – Bedford Times-Press The pharmacists are enraged about CVS (one of the big PBMs called out in this case that is currently stalled). https://www.ftc.gov/news-events/news/press-releases/2024/09/ftc-sues-prescription-drug-middlemen-artificially-inflating-insulin-drug-prices
P.S. if you want to see the new PBM documentary made by the pharmacists, it’s only available on FB. You gotta scroll forward to hour 1, min 16. Modern Medical Mafia Premiere LIVE
Lina Khan on collusion to increase patients and drug prices in medical device: https://www.youtube.com/watch?v=ebQtWZH3TW4
If it’s important to see who you are writing to, this is them:
Previous DOJ guy: https://www.youtube.com/watch?v=shZ2V1fZ4bU
New FTC commissioner & new DOJ guys: Antitrust Under Trump: Keynote
and Antitrust Under Trump: An International Perspective
It’s kinda a relief that the pharmacists are in this with us. We aren’t the only ones in the line of fire anymore. https://www.youtube.com/watch?v=VL6inz4WPhQ