Health concerns (not alarming, just maddening)

First, I received a warning message in a dream last night. Apparently, while I have been launching a near daily seek and destroy mission against post menopausal facial hair in my brow, lip and chin areas, there has been substantial enemy incursion in my cheek areas. In fact, I had an incipient Civil War style beard putting down roots. Happily, like nearly ALL my dire dream accounts, this is not (yet) true.

John alerted me to an OPB account of PBM's with the Orwellian official name of Pharmacy Benefit Manager. It is not really a manager of benefits so much as it is a manager of the profit portion allocated to the players*. Spoiler alert: less and less over the past decades as these entities have consolidated and grown like cancers (my words, OPB is less straightforward). This has become an existential threat to pharmacies across the nation, but especially in Oregon due to an unintended effect of the Corporate Gross Receipts Tax in combination with how PBMs have structured the payment and purchasing schemes for their captives.

After getting a bit into the weeds via that report I think I now understand what is at play in my choice of Medicare Part D plans for 2022. This year my best choice was a mail delivery option via CVS Caremark. I had decided that the grief I got during the later half of 2021 getting two of my quarterly deliveries of prescriptions might require either a change of carrier, or a change to a local pharmacy. I researched this weeks ago and to my surprise, the best plan for me was with the same carrier, but with a local preferred pharmacy (I chose Walgreens). The surprise was how much MORE it would now cost to have a mail service. But based on the info from OPB, all too predictable.

My Mood Today

The financial squeeze put on Pharmacies by the PBMs (more correctly standing for Profits Belong to Me) left them with no financial survival strategy but to cut back personnel. Thousands of pharmacists and assistants were let go, while there was not only no reduction of work (filling, billing, advising, etc.) but an increase as the remaining shops had to absorb the customers whose pharmacy had closed.You can get all the unhappy details in this report if you think I am exaggerating: https://www.opb.org

I expect that the degraded access to pharmacies, and the degraded service at overwhelmed pharmacies will result in lower Rx costs for the Part D provider due to unfilled and unfillable scripts than the costs of the easier to fill delivered Rx. As I have a one month surplus of my regular drugs I am going to take my chances with the likely delays at Walgreens over the predictable annoyance and higher cost of a home delivery plan.

* Named Drug Mfg, Generic Drug Mfg, PBM, Insurer with prescription drug benefit (including govt. insurance), and pharmacy (roughly in order of possible available profit).

Here I am AGAIN

By here, I mean April 28, 2019: my blog post conundrum. Well, not EXACTLY the same, as you will agree (but only if you re-read the related post herein referenced).

Blah Blah Blah.  Here we go.

As of April 2019 I was a fully paid up Register Guard delivered paper subscriber. I once again had financial scruple consonance. This state continued until  March 2021 when I decided that the paper version of the local "rag" was too sad to continue. So I cancelled it and awaited the remaining balance of the year I had paid for.

I then experienced a local news blackout as I haven't sought television news for perhaps a decade. John suggested I go to online local news sites. I didn't. He showed me the online version of the Guard, and I decided to give it a try ($1 a month for six months). So I signed up, but decided that to avoid any confusion at the RG billing dept. (Now Gannett) I created this account under my secondary email address. I believed I had succeeded at this task, as I was charged for my first month: July 2021. I accessed RG on line and kept up on local news, local deaths, and Wed. through Saturday NYT crosswords*. And then, darkness once again descended. About two months later I was suddenly unable to log in. I even tried logging in under my prior email address. And there I was, with a fully paid up account. But I could not get online access. I procrastinated about a month and then called the only phone number I could find. It had a diabolical " customer service" phone tree which prioritized wanting a new subscription (paper or online). There MAY have been a chance to discuss a current account at the end of the Desperate Offers of Free Gifts From A Dying Product options tree, but I only lasted through 1.5 of them before saving myself and hanging up**. 

Somewhere I found a link to send an email inquiry. I bit. It warned it would be a delayed response, and it surely was. In addition it was completely unhelpful, except it gave me the phone number to call for assistance. As per above, I had been there, done that and remained help-free. But I decided to try one more desperate call, and this time I would immediately begin answering "No" to all desperate offers. This time, for unfathomable reasons, my THIRD choice was to connect to a PERSON🎆. He was patient, tried things, stayed on the line while I tried things, and then did something to activate my account. I was back with access! But billing is still not happening. I think I will just let the $5 I owe for 5 months, and whatever they may want after that just go the way of errant electrons. I believe that I have tried to assist their revenue flow to a reasonable, prudent, and sincere standard. I am OK will failing my strict financial honesty standard in this case. I have been beaten, but not broken.

* Mon and Tues not worth printing out and Sunday cannot be printed out.

** First desperate offer for anyone over 65 was a free emergency call button. Second desperate offer for anyone........I no longer recall. But it left me wondering if instead of extreme discounting the cost of a new subscription and offers of a gift they simply made it worth purchasing. They might survive a few more years as the value continues to devalue.