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American Pie: A Message From Limbo

"Bureaucracy isnít the exclusive province of government, as my wife and I found out recently,'' writes John Merchant, who recently became a non-person when his medical insurance provider switched its prescription service to another company.

To read more of John's powerful columns please click on http://www.openwriting.com/cgi-bin/mt-search.cgi?IncludeBlogs=1&search=john+merchant

And do visit his Web site

Among the concerns Americans have about the passage of a bill to create a National Health Care system, is that the service will become a bureaucratic nightmare. There is good reason to fear this, because historically, once government gets its hands on anything, the paperwork multiplies and the jargon convolutes.

A prime example is the US tax system, which is so arcane that only tax lawyers and accountants can interpret it, and often even they are bemused by the ambiguity of some laws. An exception however, is Medicare and Medicaid that run smoothly and efficiently.

Medicare provides coverage for the cost of doctor visits, hospitalization and prescription drugs for people over the age of 65. Medicaid provides similar but more comprehensive coverage for the poor and indigent of any age. So at least there is a history of good administration upon which to base the new scheme if it passes into law.

Having said that, bureaucracy isnít the exclusive province of government, as my wife and I found out recently. We subscribe to a private medical insurance plan that supplements our Medicare coverage. Part of the plan covers a percentage of prescription drug costs, which is an option if you prefer to exclude that from Medicare.

In the past, we obtained our drugs via mail from a company that has performed outstandingly. They emailed us when they received a prescription, told us when it was being processed and when it was mailed. They also reminded us when a new prescription was required. Where applicable, they supplied us with name drugs at generic drug prices. Sounds almost too good to be true doesnít it?

Well it wasnít, until the end of 2009, when, without warning, we were informed by our medical insurance provider that they were switching the prescription service to another company. There was no explanation for the change, and since the original company had performed so well, we could only assume that the new organization must have offered a better deal to the insurance company.

From our point of view, things then only got worse. First we were informed that the cost of filling our prescriptions would increase. On the heels of that announcement came the news that only generic drugs would be provided, where applicable, unless the doctor specified otherwise. If we insisted on the brand name version, the cost would be four times higher.

The changeover was scheduled for January 1, 2010. Unfortunately, as it turned out, we had mailed off a request for a prescription refill about ten days before to the original company.

When we attempted to register with the new prescription provider, as we had been instructed to do, my wife was able to do so on line, without a hitch. When she attempted to repeat the process for me, their system would not accept me as a client.

Her call to the old provider elicited the information that, because they were in the process of filling my prescription during the transition period, my file was not sent to the new provider. Moreover, they could no longer send it because the transition period had now passed. In the blink of an eye I had ceased to exist, consigned to limbo by a paper shredder!

Yet another call to the new provider yielded no solution, other than we would have to solve the problem with the old provider. By this time we were feeling like a couple of ping pong balls. The old provider was unyielding in their position that files could no longer be transferred, and I guess I could understand their dog-in-the-manger attitude since they had lost the business.

Somehow, my wife, who is very good at dealing with intransigent people and organizations, managed to by-pass the pen-pushers at the new provider and reach a supervisor. He quickly resolved the problem by referring to a memo that was addressed to all the parties involved at both providers, but clearly had not been read by some. The memo plainly stated that that there would be in fact three file transfers, starting in December and ending in February 2010.

Hopefully this will return me from limbo, but I wonít hold my breath. Actually, I quite like it here. Anyway, the moral of this story is that it isnít governments that create bureaucracy, itís people.

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