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).