PHARMACIES, PHYSICANS, AND MONEY

After living Belize for a number of years, that experience has sensitized me to certain aspect of our health care system in the United States that disturbs me. One of them is the way pharmacies in the United States are controlled by the medical profession. In Belize, I could go to the pharmacy and buy whatever I thought I needed; prescriptions were not needed except for narcotics. In addition, the relative lack of physicians, veterinarians, and dentists, the use of the word ‘relative’ applies to the idea that the professionals were often there but family economics prevented their use. Therefore, the people relied on the pharmacist on for advice. Everyone recognizes these people have limited training but they do gain experience by exposure to people who buy drugs; what drugs are used for what diseases, etc.

With that background, after I returned to the United States, I tried to buy blood pressure medication.  The pharmacists would not sell me the drugs I needed and told me that I had to have a prescription. I decided that I would go to a cardiologist because they are the ones who deal with blood pressure problems. If I went to a general practitioner, they would refer me to a cardiologist, I would have to pay the general practitioner and then pay a cardiologist for telling me what I already know.  I saw the current referral scheme as no more they a way of kiting medical fees. I called and made an appointment with a cardiologist to write a prescription for me. I told the woman on the telephone what I needed; she said OK, and made the appointment. When I showed up at the appointed time, I again told the receptionist I was there for a prescription so I could buy the medicine I needed. After half an hour a nurse moved me to an examine room and took my blood pressure. In fifteen minutes or so a cardiologist came into the room and looked at the file, one page with name age and blood pressure, and asked why I was there.  I told him I needed a prescription to buy blood pressure medication and gave him the name of the medicine. His next question was why didn’t I go to a general practitioner. I gave him my reason.  

He wrote the prescription and I left. I went to the pharmacy, bought the medicine, and paid lots of money. The pharmacist told me that I could get it refilled for a year simply by calling the doctor. Several days later, I received a bill from the doctor for $390 but I also received a warning that I had another office visit scheduled for a year later so they would renew my prescription. I traveled to the pharmacy when I need a refill, which was quite soon because they would only sell me so few pills at a time.  The pharmacy called the doctor’s office; they told her it would take 72 hours before they could approve the refill. I had to go home and wait—talk about the medical system milking people for money and wasting their time.

I understand that legislators make the laws following the advice of the drug industry and doctors organization to protect me from myself—they make the laws to protect me. I understand that physicians feel they are the anointed ones.  I understand they have studied a number of years, paid high tuition costs, and have the right to charge patients for their services.  I understand all of this but I also understand why Belizean people seem so happy. The reason is that they are.  

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