"Your insurance saved you $260."
My eyes just about popped out of my skull reading that. I'd just picked up a topical foam I'd been prescribed to deal with a skin condition. I'd paid around $30, using my flex spending card. It would have been closer to $50 or $60, but my dermatologist had ever so kindly passed along a prescription discount card (basically a reusable coupon) from the drug company that made the product and that had brought the price down.
Basically, I was fighting a rash with $300 worth of name brand steroid-enhanced hair mousse. Steroid-enhanced hair mousse that left my skin less rashy, but as parched as the Sahara.
Since I was instructed to apply the product twice daily (and my rash pretty much covered my body), I finished off the foam in just over a week. So I called theWalgreen's prescription refill line. The pharmacist called right back: "Your insurance company is only going to pay for this once every 30 days. How is it possible you are done with it already? And how are you using it, exactly?" she asked.
I replied that I was putting the stuff all over, as directed by the doctor. "And are you, um, particularly, um, hairy?" the pharmacist inquired.
Turns out the $300 mousse was a proprietary alcohol-based formula designed specifically for scalp conditions. You know, cause people don't like to put greasy creams on their hair. In fact, the pharmacist told me the exact same active ingredient was available in generic in a cream or liquid formula. Which, aside from being a lot less expensive, would also be less drying to my skin.
Which got me thinking. Why would this dermatologist specifically prescribe a name brand product (instead of the generic) and hand me a coupon for the name brand product? Is his relationship with the pharmaceutical company that cozy? What exactly is the profit margin on a 100 gram can of topical steroid foam?
And what if I didn't have excellent, employer-sponsored health care coverage? Would I have shelled out $300 or just taken my chances? And what if I didn't have $300?
Overhauling our health care system is fraught with challenges, but it's clear to me that what we've got now--a profit-driven system that rewards costly care over quality care and neglects those who can't afford to buy in--is clearly broken.
