When did the Insurance Company become Your Doctor? Wonder if Insurance Companies have any Ethics?

January 18, 2010

You can tell it’s winter when you start to find yourself hanging around people who seem to have the upper respiratory crud.  Unfortunately, both my wife and I have been dealing with it.  You know – coughing and sneezing, etc.  Now, I’m sure you didn’t start to read this to find out our medical condition, but it sets the stage.

My wife, not one who likes to go to the doctor, broke down today and paid the Doc a visit.  Sure enough she had a form of bronchitis for which the Doctor prescribed an antibiotic.  So far so good.  She paid her co-pay and went on to the pharmacy.  Her prescription was filled and all seemed well.

Well…that is…until she checked out the instructions to the antibiotic.  Instructions stated “take one pill each day for five days.”

STOP!

One would assume that there were five pills since the she was to take one each day for five days.  But when she opened the bottle – there were four pills.  “Wal-Mart”, she thought, they shorted her a pill.  So she called them.  The result…no shortage.

Seems that the INSURANCE COMPANY says they will only pay for four pills.  WHAT?  YEP.  They will PAY FOR 4 PILLS.

Now, when my wife told me this, we both shared our disbelief.  A prescription that should be completed – (take 5 pills) – was shorted by 20%.   Maybe it’s a myth, but I was always told that to be effective a prescription should be taken through completion (i.e., all 5 pills).

MY QUESTION:  When did INSURANCE COMPANIES become the DOCTOR?

So, on the way home, I stop to get come cough syrup and ask the pharmacist what the deal with this is.  His response.  “You don’t have a clue how bad it is and it’s getting worse.”  INSURANCE COMPANIES are effectively practicing medicine and we’re letting it happen.

So, as a business ethics speaker and author, I wonder, do you feel that this right?  Are INSURANCE COMPANIES practicing medicine?  And, when did the Doctor lose control of the care of his/her patients?

I bet you have stories too…feel free to share…

YOUR COMMENTS ARE WELCOME!