May 27, 2007

Medical Blackmail


It’s a long backstory, but I’ll try to condense it so I can get to the point. A couple years ago, I went to see one of my doctors for a check-up. My internist, specifically. I had insurance at the time, and had chosen him by opening up the big insurance book and finding the internist who was closest to my apartment. This guy was a block away, and figuring I wouldn’t find anybody closer, I called him and made an appointment.

      (I’d chosen my previous doctor that way too—he turned out to be a Chinese man who determined the condition of my internal organs by seeing how far he could bend my leg—but that’s another story.)

      This new guy gave me the works, and all the while I tried to keep ignoring the fact that he looked and sounded exactly like Adam Sandler. In the end, he told me that my blood pressure was “off the charts” and ordered me back for more tests—EKG, ECG, stress tests, a few other things. Then he put me on a blood pressure medication which I had to take twice a day. That in itself was no big deal—I was already on a few other medications, so adding one more to the mix wasn’t too much of a bother. The pills were comparatively cheap, too, which was good.

      Reading through the various warnings and side effects, however, I saw one thing that bothered me. Essentially it said that once I started taking these pills, I couldn’t stop. If I stopped taking them, see, there would be a massive rebound spike in my blood pressure that could cause a heart attack or stroke or something even more heinous. Unfortunately, I had already started taking them at that point.

      Oh. fine then, I thought. I’ll just keep taking them. Wouldn’t want to have a stroke or anything.

      Six months later, I stopped by the pharmacy for my refill. I knew they had to call the doctor to get his okay on the prescription, but that’s never been a problem in the past with any of my myriad doctors. This time, however, as I stood waiting patiently at the pick-up counter, wallet in hand, the pharmacist approached and said, “Yeah, uh, we talked to your doctor, and he said you can’t get another refill until you come in for an appointment.”

      I stared at her for a moment. What in the hell’s that all about? I had two days of pills left, and it would take me at least a week to get an appointment (the doctor only saw patients on Tuesdays and Fridays, and this was a Wednesday.) What the fuck was I supposed to do in the intervening days? Wait for my heart to explode?

      I explained all this to the pharmacist (that’s another story), who gave me enough pills to hold me for a week until I could get that new prescription. I thanked her, and stomped back to my apartment to call my fucking doctor.

      I saw his evil scheme at work. Get you on these pills, tell you you’ll die if you stop taking them, then refuse to prescribe any more until you come in to see him, thus putting a few hundred more bucks in his pocket. It was a form of blackmail, plain and simple.

      Given that I had insurance, all it would really be costing me was some time and a twenty-five dollar co-pay. In reality he was sapping the insurance company, but using me as collateral.

      I went in, got the damn check-up, learned that I was just fine, and was handed a new prescription as a reward.

      Time went on. My heart didn’t explode. I continued taking the pills. Then I lost my insurance. I could continue taking the pills because they were cheap and plentiful. But then it came time to get another refill, and once again they had to call the doctor.

      Oh, here we go again, I thought. Except this time I have no insurance and no money.

      I don’t like thinking in political terms, but it occurred to me that it was almost like the situation in Iraq, but on a much smaller scale. We move the military in, devastate the country, piss off a goodly number of Iraqis, then tell the population back here, “Well, we can’t pull the troops out until the country’s all ship-shape again and the Iraqis can manage themselves. Oh—and if you vote to cut off funding for the troops, you’ll just be putting them in greater danger, and you wouldn’t want that, would you? Nope, we have no choice but to stay there.”

      Okay, maybe that doesn’t make a lot of sense as an analogy, but it did this morning before I had my coffee.

      Before heading out to the drug store, I prepared my little “this is blackmail and I have no insurance so I can’t afford a doctor’s appointment but if I don’t get those pills my head with blow up” speech. Then I put on my shoes and coat and walked the four blocks on what was an awfully chilly morning.

      “Oh,” the pharmacist said when I appeared at the counter (they recognize me these days—which is yet another story), “we haven’t called that in to your doctor yet—did you want to wait?”

      “Sure,” I said, and waited. This was going to be bad, I knew it. I wandered up and down the aisles, looking as well as I could at the various products. It was a very dim store, so I always had to move slowly. I rehearsed my spiel half a dozen times. Then, ten minutes later, I returned to the counter, ready for a confrontation. It wasn’t the pharmacist’s fault, I knew that, but dammit, I wanted somebody in the business to be aware of what sort of chicanery was going on.

      As I approached the counter, the pharmacist held up a bag. “All set,” she said.

      “Oh,” I said, mildly crestfallen. Preparing never works.

      I paid for the pills, took the bag, and went home.

      Funny thing is, the more I think about it, the more it seems obvious that “having a job” was probably behind the high blood pressure in the first place.


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