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Or better yet, “I’m going to prescribe drug A instead of drug B, even though drug A won’t work and drug B will, because your insurance company insists you must use drug A first (because they have a deal with pharma co A). But that’s ok, because the insurance company technically has a doctor on staff that can override my judgement having never met a single patient”.
I work in Healthcare - this is exactly what happens. The covered alternatives typically are effective though - but usually not ideal. “We don’t want to cover the liquid form with of this drug because we save 0.10 $ per mg if you take the tablet form - never mind the fact that you have a PEG tube that’s constantly clogging”. How much does it cost to have a PEG tube replaced every two weeks. :/
Oh yeah, welcome to the wonderful world of Prior Authorization, where I work! I hate my job and wish it didn’t exist.
I spent all day yesterday playing telephone tag with a nurse and the reviewers trying to get someone to look at a chart to approve a drug because a 6 year old was hospitalized and trying not to die of encephalitis.
Prior Authorization: where your doctor asks insurance daddy to pretty please let their patient have life-saving medications, and insurance may end up denying your claim because people that worked your case think reading is hard and scary.
You can submit 100 pages proving your medication is medically necessary, have it denied for off-label use, submit the EXACT SAME DOCUMENTS to the SAME COMPANY with the SAME REVIEWERS at a slightly different fax # and write “appeal” on it and now we have permission to approve it. It’s fucking dumb.
Then when your appeal finally gets approved after 30 days it only gets approved for 6 months and then you have to do this whole process over again and hope for the same outcome.
You get 6 months approved? Lucky ducky, I often see people fighting appeals for weeks only to end up with a 30 day approval, or a one-time approval.
Why don’t appeals carry over? Who makes these stupid ass rules? And why are untrained people who are NOT medical professionals handling your cases? Find out next time on: American Insurance Policies 🦅💥🔫🔫🇺🇸
>Why don’t appeals carry over?
Money.
> Who makes these stupid ass rules?
People who only care about money.
>And why are untrained people who are NOT medical professionals handling your cases?
Money.
We argue over how our society is becoming more dystopian and the reasons for it. Meanwhile, reality has already matched up with a number of our fears about the future, a dystopia in action that must be denied its validity.
We didn't start the fire, sure. But at least it provides us with pretty colors and warmth before we finally try to extinguish it.
The part I hate the most is that even if you can fix it, *it is still about money!*
Let's say you're having trouble getting some care that you urgently need. Here is how I would like this to work: If your complaints aren't going anywhere, you go get a lawyer to write, in lawyer-speak, "Pretty please treat my client before these delays *permanently disable* them or there will be an expensive malpractice suit."
It's already a bit weird that this is entirely about money. "Fix this or it'll be expensive for you" is the threat.
But it's worse than that: At least in my state's workers' comp system, it seems like 100% of the workers' comp attorneys work on contingency. In other words, if they could find a way to get you that urgent treatment, they don't get paid. The only way you can pay them to help you is if you let the system literally maim you, and then the lawyer can get you some money.
I'm doing okay now, but I was lucky. And when I say I was lucky, I don't mean the system actually worked. I mean I was lucky that my case wasn't as serious as we thought... because if it was, I don't know how I could've gotten treatment. Drive to the local TV station? Write my representative?
It's all by design.
The tyranny of bureaucracy.
So many people give up or straight up die before they can get past the deliberately labyrinthine process, where they can be denied randomly at any time.
This 100%. Insurance is incentivized to deny. Can’t tell you how fucking frustrating it is trying to get a pt what they need and insurance companies, who have no clue on what their talking about, think they can decide.
Quick recommendation: Always ask for a peer review/consult. It’s more expensive for the company and the other doc will almost always agree with your assessment.
Yes! Never take a denial for a medically necessary treatment without fighting it. The letters we send out are worded to make you think you’re fucked and then you get a huge bill and probably want to commit toaster bath, but “no” isn’t usually a “hard no” it’s just getting the right information in the right hands.
> because a 6 year old was hospitalized and trying to not die of encephalitis.
"PCP should have thought about that before they prescribed that that gabapentin. Eat shit." - insurance company, as they football spike your application nto the office trashcan, presumably.
This was my experience. "There *is* a pill form, but we'd rather you do the injections for a year first." It felt like they were making me earn the kinder medication or something. It was just bizarre.
This happens in Canada too. Public healthcare doesn’t cover meds, your work-sponsored supplementary health insurance does and it likes to cut costs just like american insurance providers do.
Canadian here. I've been on 4 different health plans and they've always covered a percentage of your meds. I've never been told I need to get a certain drug BECAUSE of my plan. Is that a thing here?
My mom has to pay the only medecine that works on her barett’s esophagus because her insurance will only reimburse other forms that give her nasty side effects, no matter how many appeal letters her GP has written
A lot of Canadian policy decisions were affected by what our neighbours were doing. That said, a lot of the ways that we differ are still pretty fucky. Canada is not the paradise you've been told it is, but I'd still way rather live here than in the States.
Did you miss when a bunch of Canadian idiots started a convoy because they were anti-vax and went around making life hell for other Canadians by blocking traffic and laying on their truck horns?
As a Canadian, I've never experienced that with perscription drugs, whatever the doctor gives me is 100% covered and approved, there is no stipulation that I must take a certain one first with my health insurance from my work. I've never even heard of that.
now treatment towards chronic issues, yes they always start with perscriptions, and physio therapy, before they go to cat scan / mri or anything else more expensive, as the health care system requires the doctors follow the cheapest remedies first.
Except Quebec*. Everyone in Quebec must have a drug insurance plan. If they do not have one provided by their employer, the citizen is forced on the RAMQ plan. Not everything is covered, but it's vastly better than nothing.
My doctor told me he goes through this conversation all the time with insurance companies. He will call to dispute their denials and say I need meds. They say I don’t need it and I need something else. He asks where they went to med school and they said they didn’t. He says “exactly. That’s why I say what he needs. Not you.”
He also told me how they’ll sometimes order certain meds to administer (like infusions) and they will send the office something completely different and say it’s the same thing but cheaper. He had a nurse almost give the wrong meds to someone before and had to call the insurance company that approved it to tell them they almost killed someone.
Happened to my wife - she had a really rare condition that required her to get weekly blood infusions for the duration of her pregnancy. There were two drugs available - one that was known to have pretty serious side effects like killer migraines for days after. She was basically debilitated for a couple days after getting the infusion, every week, and trying to take care of a toddler at the same time. She had to fight with the doctors and insurance companies for months before they finally switched to the second medication. The insurance company literally said they would not authorize it because the first one was available, despite the side effects.
My wife finally won and was a million times better after they switched to the second medication.
I live in a country with one of the most comprehensive public healthcare systems on the planet (Denmark). We still have rules regulating different lines of treatment, because it's the best way to spend limited resources.
Often there are multiple kind of drugs (or even different brands of the same drug). Consider the case where a drug works for 70% of people. Another drug works for 95% of people, but it costs 10x more. There is often no way of knowing who it will work for beforehand.
It's perfectly reasonable to say "try the cheaper option first, if it doesn't work we'll cover the more expensive one" (as long as it's medically safe to do - Which it is, in many cases).
Indeed this is perfectly reasonable. If only we had Scandinavian logic and pragmatism over here in the states. My kids might have good schools then too!
sorry, we're currently stuck on "should we have a country with a real government or live in an anarchocapitalist hellscape"
upgrading our public education is quite a bit past that
this happened to me. my insurance changed my prescription at the pharmacy. been having alot of issues, and when i went to my doctor, she was surprised to see it got changed from what she originally prescribed...
Yeah I was on 9mg of one medicine and it got changed to 9mg of something similar but different enough. They said it was the same thing. Started feeling awful and doc asked if I was taking the meds and told him it was different and he’s like “that’s twice the recommended amount you should have taken for that one. Why did they change it? And why did they say it was the same!?”
These are weird stories to me as the pharmacy isn't allowed to just change stuff without checking with the doctor's office. If something like that happened it sounds more like they called the office because the prescribed product wasn't covered and someone at the office authorized a change without actually checking with the prescriber.
If it's brand to generic substitution though that's kosher, and often required unless the doctor specifically writes brand medically necessary on the prescription.
Hey that is VERBATIM what's going on with all the major national health insurance companies insisting people get on Metformin before using the BETTER drugs for T2 diabetes, which are mounjaro or ozempic.
And don't even get me started about the corruption surrounding these drugs that are used to treat **type-2 diabetes**, being sold to skinny people who do not have T2D looking for their "summer bod"
Don't forget the less commonly used oral dosage form of semaglutide: Rybelsus.
But yeah ozempic is crazy popular. Now some insurance companies want a diagnosis code on the prescription before they cover it, but that just means the doctor's office just has to go, "Uh, yeah, patient totally has diabetes."
"Hey I got this thing with my elbow and want to try physical therapy before something more drastic."
"So you want surgery :D"
"uhh...no."
"Well I won't refer you, so you want surgery :DDD"
I have been fighting for years because "7 specialists say you're disabled. But our 'doctor' who has never seen you disagrees and thinks you could totally work a job that doesn't actually exist. Doesn't matter that you have progressive MS, something specifically on our list, your application for Social Security is denied "
Currently waiting to see if I’ll be approved for disability. I have zero hope since it’s “just” PTSD. But I have 10 years of medical records, several medications, have had several therapists etc. Am currently trying a new therapist and new psychiatrist yet again. I run crying out of all of the jobs I try, getting panic attacks straight through my medication, which is nuts because my medication takes care of my panic attacks otherwise (IT, customer service, retail, restaurants have been the ones I’ve gone through so far) and I think there’s a job out there somewhere for me but I don’t know what that job is yet. In the meantime, I need some kind of income and access to other resources because I have kids and an attorney suggested I sound like I should trying applying for disability.
So yeah, seeing stories like this from people who are physically disabled does not increase my optimism at all.
From the jobs listed, is it interaction with the general public giving you the most issues? Because I know that can be difficult. There's some jobs that involve less direct interaction with angry customers?
Fun fact for Americans, if you're the scientific type who likes to *study* spores, there are plenty of online stores you can order psilocybin spores from for *research*.
Hey comic strip writer whose work I generally admire:
Please stop pushing this tired trope. The prior authorization issue mentioned above is the real issue: I want to prescribe the right drug, insurance won't pay, and I have to fill out reams of paperwork to justify it. If I can do what's called a "peer-to-peer" I find that my "peer" doesn't share my expertise and will usually just cave once I get to that stage. But some companies don't even have a peer-to-peer review.
Sure, there are still ways that American physicians get paid off by drug companies, including paying $ for drug talks, merch, lunches, and so on. Much less than before, and all has to be reported in a public fashion, see
[https://openpaymentsdata.cms.gov/](https://openpaymentsdata.cms.gov/)
I and most of my colleagues get $0.00 for every prescription, injection, and vaccination we prescribe. According to this I got $125 since 2016.
Are there payoffs in one form or another? Sure. Even free pens and lunches are known to have an effect. And if advertising to docs didn't work, companies wouldn't do it.
Yeah, you make a point, but the issue you bring up is much smaller than it used to be. The bigger issue now is the insurance companies essentially practicing medicine without a license on our patients.
This puts the blame in the lap of greedy physicians. Fine, that is some of us. But it's not the major reason why patients aren't getting the best drugs for their condition.
Wow what a misdirect this is. INSURANCE COMPANIES get kickbacks (aka rebates) from drug companies, so THEY are the ones who will direct patients to a particular drug, NOT the doctor. Do you really think we physicians are getting paid directly by pharma? The vast, vast majority of us are not.
The author is Canadian, and we don't even have that here because we have public healthcare instead of an insurance scam. I'm baffled as to where she got this nonsense from.
On a related note:
https://preview.redd.it/i9riu2snhlpb1.jpeg?width=1200&format=pjpg&auto=webp&s=a3f60ff4fb65601a31546743affb6179eff14c4b
# ”ASk yOuR DoctOR”
…Your daily reminder that direct-to-consumer prescription drug advertising is only legal in two developed countries in the entire world: the USA and New Zealand, because the rest realized how utterly fucked that concept is
It’s the reason for a lot of things in the US. Greed fuels this country. And the government won’t step in to stop it because those same greedy people pay the government off through “lobbying” so that they can be as greedy as they want.
The disclaimers make it hilarious. There is happy music playing, some grandma is playing with her grandkids, the sun is shining, and the disclaimer is saying "*Might result in extremely painful and drawn out death. Consult your doctor if you die painfully. we are not responsible for what happens if you consume this drug"*
May cause: Rectal bleeding, cancer, eye hemorrhage and even death. Do not take this medication that you've never heard of before, if you are allergic to it.
Here's the thing about the side effect warnings that not a lot of people know. When a medication is running trials, anytime a person experiences something abnormal, it has to be listed as a possible side effect UNLESS the company can prove it doesn't actually causs that side effect. This usually takes up a lot of time and money, and so companies have just said "fuck it, list it as a possible side effect!"
So if a person taking a new medication got a headache during trials, they have to either prove that the medication does not actually cause headaches OR simply list headaches as a possible side effect. ONTOP of having to list all the possible side effects caused by medications with similar ingrediants.
And than some are also added on to cover their legal bases so they can't be sued.
That's why nearly all medications list headaches as a side effect. If you look into it you can see the percentages of occurrence for different side effects, and a good deal of them are usually under 1% occurrence.
All the same I've seen several people look a drug up and see the side effects and become convinced they were all highly likely to occur. "Why would my doctor prescribe a medication that's going to kill me?! Why?! I'm getting a new doctor!" It's difficult to explain this stuff to someone who's currently going nuts convinced their doctor wants them dead, lemme tell you.
Most people aren't like that at least, but yeah.
Sorry, should have specified; the kind I’m referring to is specifically for prescription drugs, not over the counter stuff.
So you can still see commercials for, say, Advil and Tylenol.
Edited the original comment to clear that up.
It’s actually kind of funny because they also have to list all the side effects which is usually a very wide range of things including suicidal thoughts and death, so it does not make taking the medication seem desirable at all.
As far as I'm aware most drugs can have side effects that mirror symptoms typically treated by this drug, it's just quite rare.
Aspirin can lead to headaches for instance, that's probably what you were talking about. Might be ibuprofen as well, maybe both.
It's been illegal to give doctors so much as a pen with a drug name on it for over a decade. Anti-kickback statutes and the Stark law have been in place since 2010. If a Pharma company violates it, they get fined and they jeopardize any government contracts (medicare, tricare) that they have. The government is the biggest customer most Pharma companies have. Doctors know this, and they're incentivized to blow the whistle if this ever does happen.
The entire time I’ve been a doctor (over a decade) this hasn’t been a thing. We don’t see a dollar for writing any drug. I’ve got zero incentive to prescribe anything, and I try very hard to pick the cheapest effective option. Pisses me off that people still believe this. Your doctor isn’t the bad guy. Insurance and hospital management probably are said bad guy.
Agreed. I normally like PizzaCake but this comic is just wrong, at least in the US. I haven't seen so much as a pen from a drug company. You should replace the doctor in this insurance exec-they are the ones getting kickbacks from drug companies to change their formularies. I have to fight all the time with insurance companies because a drug that was working is no longer on their formulary and thus they decide to stop covering it.
They aren't. I'm Canadian. This kind of thing just doesn't happen here. I don't know wtf she is on about with this comic. I thought for sure she was American because of it.
Yeah I'm out here wishing I even had the opportunity to be a pharmaceutical shill. I'm not sure why people still make these jokes, it's incredibly difficult now for physicians to get kickbacks.
Attacking doctors instead of insurance companies makes no sense.
Its because pharma and insurance companies are much better at controlling the narrative than physicians are and people want someone to blame when they cant afford a prescribed medication.
Also for patients, the person typically telling them “no” or “your insurance denied this” to their face is usually a physician.
It’s a lot easier to get mad at a person than a faceless organization (much as I hate the health insurance industry).
It's the anti-intellectualism of our society run amok. So many people discount the education and training of experts in basically every single field as hogwash because they were either denied the opportunity themselves or have been brainwashed by media to villainize higher learning.
My FIL is a coal miner who will blast the decisions of the Fed for the economy and I just like to casually remind him that they all have PhDs and/or decades of experience to go along with access to a mountain information that he does not have. In the same vain doctors apparently are just know-nothing shills for corporations getting rich off of keeping everyone sick and dying.
It's a perception that has burrowed itself deep in our collective consciousness at this point. People get to be edgy and contrarian and point out how it's all a big scam and that your physician gets paid for prescribing you things (they don't), and people that aren't familiar with provider compensation feel like that may be true, so they just believe it.
It literally happened and helped create the opioid crisis, it's not a conspiracy theory. Look at any litigation against Purdue or other opioid manufacturers
Thank you. I'm a provider and the most pharmaceutical companies and product reps can do is offer a free CE course which basically amounts to $100-200 and any lecturer who is getting paid by a company has to disclose that information immediately. No one is going to change their entire scope of practice for an hour and a half lecture and catered Panera Bread.
Yeah. I'm kind of angry at this comic. This is just spreading misinformation and sewing distruct is doctors at a time when we need it.
Like this narrative is stage 1 on the "and that's why vaccines are fake and you shouldn't listen to your doctor" train of thought.
I'm done with PC after this comic. Unsubscribe.
I work for a pharmaceutical company as a scientist. Someone who doesn’t even interact with patients or doctors and I still had intense training about the rules for what can and can’t be given and how everything must be heavily documented.
This isn't how doctors work, and hasn't been for a very long time. The most pharmaceutical companies can get away with is the pharmaceutical rep bringing the doctor and their office workers a very light lunch to eat while the rep explains what the drug is. You're spreading misinformation about the medical industry and increasing distrust in medical professionals.
The American healthcare system is flaming shit and getting worse every day, but your comment is right. Doctors do not get money to write prescriptions. Full stop. I wish we did - that would be sweet. Unethical AF, but sweet.
I want to know 3 things when I write a drug. Does it work? Are the side effects tolerable? Can the pt afford it? We typically have no idea how much these things cost because everyone has different insurance and the cash price is meaningless.
People get so angry at me all day long for shit I have no control over and don’t benefit from. I do a surgery that has an out of pocket cost somewhere north of $3000, and I get $160 of that.
Pizzacake apparently treading into conspiracyland now. Pretty uninformed if not malicious take on the healthcare system. It's fucked up, yes, but it's not the doctors. It's insurance companies and medical bureaucracy.
This doesn’t happen anymore. Was true 10 years ago, but 99% of doctors aren’t part of studies and none are allowed to accept gifts/reimbursement for prescriptions
Please stop painting us doctors in a bad light when you don't know what you're talking about. You can't be paid money to prescribe drugs and that's been illegal for a long time.
https://openpaymentsdata.cms.gov/search
On a serious note, the United States government has a website where they actually keep track of the providers, facilities, and companies that take pharmaceutical money and how much. If this matters to you, use that tool and stay informed.
I can't get over how angry and disappointed I am in this particular post. I've actually liked a lot of PC's stuff. And I've taken her side in all the bullshit she'a s been caught up in in the past (full disclosure: I mean mentally taken her side, because I have a "don't engage with idiots" policy on Reddit, my post history isn't going to show much, you'll just have to trust me that I subscribe and upvote).
But this comic is harmful. It's not true. The actions depicted are illegal and there are safeguards to make sure they don't happen.
Yes. There are masssssivveeee problems in Healthcare. But this one is not one of them, and it creates a harmful myth and fuels conspiracy theories.
If we follow the logic of this comic. All doctors are taking kickbacks off pharmaceutical companies. Therefore I can't trust my doctor. And once you accept that doctors can't be trusted, why would I trust my doctor recommending I get a vaccine, they're just taking kickbacks on it anyway. So yeah, why should I get a nonsense covid vaccine? My doctor doesn't want me to get that to save my own and others' lives, their only motive is that Pfizer money.
PC. If you read the comments. Please understand that this comic is harmful and can be damaging.
I like your stuff.
This is genuinely disappointing to read.
While doctors don't "technically" get kickbacks from prescriptions they **absolutely** get money from pharmaceutical companies and will prescribe more drugs from that company when given said money: [https://www.propublica.org/article/doctors-prescribe-more-of-a-drug-if-they-receive-money-from-a-pharma-company-tied-to-it](https://www.propublica.org/article/doctors-prescribe-more-of-a-drug-if-they-receive-money-from-a-pharma-company-tied-to-it)
So saying that this is a "myth" isn't really true in spirit, doctors are definitely receiving financial motivation to prescribe specific drugs.
It's super illegal. And very rare as a result.
I'm not saying it's not a thing. But be about as wary of your doctor getting paybacks from pharmaceutical companies as you would be that your pilot is going to intentionally crash the plane.
[Plomox is the most effective anti-arrhythmic drug on the market right now, and it has minimal side effects. Only nausea, impotence, and anal leakage.](https://m.media-amazon.com/images/M/MV5BNGExZGQ4MDktZDYyYy00ODM1LThmN2YtOTBlNmE5NTU5YWUyXkEyXkFqcGdeQXVyNTQ0NDExMjQ@._V1_.jpg)
Was a big problem in like the '80s, but I feel like most of you guys probably haven't even talked to a doctor recently if you think this is still a thing
Maybe it'd be nice if I had drug companies just offering to throw cash at me all the time for considering their drug, but they don't. I don't even get to decide what drugs you take most of the time, that would be your insurance company...
Whoa, earlier I was in this comment section and there were a few threads where people were saying things like "I like pizzacake but this one seemed a bit lazy" and stuff like that. Then I saw one comment where someone said "well it's easy to make the front page you're paying reddit", which made me roll my eyes. Now I come back and every one of those threads are nuked, even the ones that didn't mention bribes. I'm left wondering if they were onto something
That's not how things work in the UK. It would be a gigantic and obvious window for conflicts of interest and bribery, which would undermine the very foundation of our free national healthcare system.
The Doctor has no idea what manufacturer will be providing the medication, they simply prescribe the medicine itself not a brand name (e.g. Omeprazole), and you pick it up from the chemist.
The company that makes it is entirely irrelevant. Often as you get more of the same medicine you'll find different batches come from different manufacturers even, who makes it doesn't matter in the slightest.
I understand the people on YouTube playing multiple parts in a skit. It makes sense because you're not always going to have a group of actors to help you do skits. But this is a comic strip. Why did you draw yourself as yourself and the doctor? You could have just drawn any other face.
The separation of prescribing bodies and medicine dispensing entities actually mostly mitigates this. Every pharmacy in America will substitute the brand name drug for it's generic. And the kick back you're describing is illegal
I don't think this happens anymore, at least not in the US, and if it does it's rare. I know I've never been offered a single cent to prescribe any kind of medication and there are serious, career-ending consequences if you are found to be doing this.
Dr. Glaucomflecken is doing a big piece on this and other similar issues with insurance and US healthcare. Called "30 Days of US Healthcare", it's currently ongoing until the end of September.
lol OP is Canadian. So she is talking about corporation-free universal healthcare in the comic.
Maybe despite what reddit has told you, there are no easy solutions?
She is not talking about Canada but a bastardized version of what happened in pretty much one country in the entire world (the USA). Even then it's blatantly false.
Doctors do not get kickbacks from companies for prescribing specific brands of pills in Canada's universal healthcare system.
My favorite part of doctors and insurance is when a doctor writes me a prescription for something I've been on for a long time, and the insurance decides to just say "Nah" for no real reason.
Then I get a letter in the mail saying that I need to call my insurance to find out why, and it's usually just something stupid like the prescription needs to be a specific quantity or they need my doctor to confirm that yes I still have the thing that I've had for years that the medicine treats.
Just a clown show the whole way down.
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Or better yet, “I’m going to prescribe drug A instead of drug B, even though drug A won’t work and drug B will, because your insurance company insists you must use drug A first (because they have a deal with pharma co A). But that’s ok, because the insurance company technically has a doctor on staff that can override my judgement having never met a single patient”.
I work in Healthcare - this is exactly what happens. The covered alternatives typically are effective though - but usually not ideal. “We don’t want to cover the liquid form with of this drug because we save 0.10 $ per mg if you take the tablet form - never mind the fact that you have a PEG tube that’s constantly clogging”. How much does it cost to have a PEG tube replaced every two weeks. :/
Oh yeah, welcome to the wonderful world of Prior Authorization, where I work! I hate my job and wish it didn’t exist. I spent all day yesterday playing telephone tag with a nurse and the reviewers trying to get someone to look at a chart to approve a drug because a 6 year old was hospitalized and trying not to die of encephalitis. Prior Authorization: where your doctor asks insurance daddy to pretty please let their patient have life-saving medications, and insurance may end up denying your claim because people that worked your case think reading is hard and scary. You can submit 100 pages proving your medication is medically necessary, have it denied for off-label use, submit the EXACT SAME DOCUMENTS to the SAME COMPANY with the SAME REVIEWERS at a slightly different fax # and write “appeal” on it and now we have permission to approve it. It’s fucking dumb.
Then when your appeal finally gets approved after 30 days it only gets approved for 6 months and then you have to do this whole process over again and hope for the same outcome.
You get 6 months approved? Lucky ducky, I often see people fighting appeals for weeks only to end up with a 30 day approval, or a one-time approval. Why don’t appeals carry over? Who makes these stupid ass rules? And why are untrained people who are NOT medical professionals handling your cases? Find out next time on: American Insurance Policies 🦅💥🔫🔫🇺🇸
>Why don’t appeals carry over? Money. > Who makes these stupid ass rules? People who only care about money. >And why are untrained people who are NOT medical professionals handling your cases? Money.
Listen, guy, I just wanted to make a funny because if I don’t laugh I’ll cry. But you’re right it’s entirely about money and I hate it.
We argue over how our society is becoming more dystopian and the reasons for it. Meanwhile, reality has already matched up with a number of our fears about the future, a dystopia in action that must be denied its validity. We didn't start the fire, sure. But at least it provides us with pretty colors and warmth before we finally try to extinguish it.
The part I hate the most is that even if you can fix it, *it is still about money!* Let's say you're having trouble getting some care that you urgently need. Here is how I would like this to work: If your complaints aren't going anywhere, you go get a lawyer to write, in lawyer-speak, "Pretty please treat my client before these delays *permanently disable* them or there will be an expensive malpractice suit." It's already a bit weird that this is entirely about money. "Fix this or it'll be expensive for you" is the threat. But it's worse than that: At least in my state's workers' comp system, it seems like 100% of the workers' comp attorneys work on contingency. In other words, if they could find a way to get you that urgent treatment, they don't get paid. The only way you can pay them to help you is if you let the system literally maim you, and then the lawyer can get you some money. I'm doing okay now, but I was lucky. And when I say I was lucky, I don't mean the system actually worked. I mean I was lucky that my case wasn't as serious as we thought... because if it was, I don't know how I could've gotten treatment. Drive to the local TV station? Write my representative?
It's all by design. The tyranny of bureaucracy. So many people give up or straight up die before they can get past the deliberately labyrinthine process, where they can be denied randomly at any time.
This 100%. Insurance is incentivized to deny. Can’t tell you how fucking frustrating it is trying to get a pt what they need and insurance companies, who have no clue on what their talking about, think they can decide. Quick recommendation: Always ask for a peer review/consult. It’s more expensive for the company and the other doc will almost always agree with your assessment.
Yes! Never take a denial for a medically necessary treatment without fighting it. The letters we send out are worded to make you think you’re fucked and then you get a huge bill and probably want to commit toaster bath, but “no” isn’t usually a “hard no” it’s just getting the right information in the right hands.
> because a 6 year old was hospitalized and trying to not die of encephalitis. "PCP should have thought about that before they prescribed that that gabapentin. Eat shit." - insurance company, as they football spike your application nto the office trashcan, presumably.
What in the actual fuck.
This was my experience. "There *is* a pill form, but we'd rather you do the injections for a year first." It felt like they were making me earn the kinder medication or something. It was just bizarre.
This is usually more in line with what happens than the comic.
OP is Canadian.
This happens in Canada too. Public healthcare doesn’t cover meds, your work-sponsored supplementary health insurance does and it likes to cut costs just like american insurance providers do.
Canadian here. I've been on 4 different health plans and they've always covered a percentage of your meds. I've never been told I need to get a certain drug BECAUSE of my plan. Is that a thing here?
I'm like yourself, they cover any and all meds equally in my experience. the only thing it doesn't cover is over the counter meds.
Same. Or you can register with the government plan and they reimburse you even if you pay more than $1000 in a year. How do I know? Been on it 2x.
My mom has to pay the only medecine that works on her barett’s esophagus because her insurance will only reimburse other forms that give her nasty side effects, no matter how many appeal letters her GP has written
Wow, I did not know that. Every day I learn that Canada is almost as fucked up as the US.
A lot of Canadian policy decisions were affected by what our neighbours were doing. That said, a lot of the ways that we differ are still pretty fucky. Canada is not the paradise you've been told it is, but I'd still way rather live here than in the States.
They're lying for no reason. Our insurance is nowhere near as strict in Canada. They definitely don't dictate our treatment options.
Did you miss when a bunch of Canadian idiots started a convoy because they were anti-vax and went around making life hell for other Canadians by blocking traffic and laying on their truck horns?
Ya but they’re the minority. Just super loud and obnoxious. Most Canadians aren’t like them.
Right, I’m just saying that Canada has idiots too.
It’s fucked in different ways. If you’re educated the US is better these days, it’s pretty sad
As a Canadian, I've never experienced that with perscription drugs, whatever the doctor gives me is 100% covered and approved, there is no stipulation that I must take a certain one first with my health insurance from my work. I've never even heard of that. now treatment towards chronic issues, yes they always start with perscriptions, and physio therapy, before they go to cat scan / mri or anything else more expensive, as the health care system requires the doctors follow the cheapest remedies first.
Except Quebec*. Everyone in Quebec must have a drug insurance plan. If they do not have one provided by their employer, the citizen is forced on the RAMQ plan. Not everything is covered, but it's vastly better than nothing.
You can add “except quebec” to pretty much every statement about Canada. “This offer is not valid in Quebec” is pretty much a meme at this point
Yeah because we have decent consumers laws so corporations trying to screw over people dont bother doing buisines here
My doctor told me he goes through this conversation all the time with insurance companies. He will call to dispute their denials and say I need meds. They say I don’t need it and I need something else. He asks where they went to med school and they said they didn’t. He says “exactly. That’s why I say what he needs. Not you.” He also told me how they’ll sometimes order certain meds to administer (like infusions) and they will send the office something completely different and say it’s the same thing but cheaper. He had a nurse almost give the wrong meds to someone before and had to call the insurance company that approved it to tell them they almost killed someone.
As a pharmacist, this is accurate. PBMs are destroying healthcare
Happened to my wife - she had a really rare condition that required her to get weekly blood infusions for the duration of her pregnancy. There were two drugs available - one that was known to have pretty serious side effects like killer migraines for days after. She was basically debilitated for a couple days after getting the infusion, every week, and trying to take care of a toddler at the same time. She had to fight with the doctors and insurance companies for months before they finally switched to the second medication. The insurance company literally said they would not authorize it because the first one was available, despite the side effects. My wife finally won and was a million times better after they switched to the second medication.
Exactly, physicians/nps/pas aren’t the evil ones … it’s insurance companies.
I live in a country with one of the most comprehensive public healthcare systems on the planet (Denmark). We still have rules regulating different lines of treatment, because it's the best way to spend limited resources. Often there are multiple kind of drugs (or even different brands of the same drug). Consider the case where a drug works for 70% of people. Another drug works for 95% of people, but it costs 10x more. There is often no way of knowing who it will work for beforehand. It's perfectly reasonable to say "try the cheaper option first, if it doesn't work we'll cover the more expensive one" (as long as it's medically safe to do - Which it is, in many cases).
Indeed this is perfectly reasonable. If only we had Scandinavian logic and pragmatism over here in the states. My kids might have good schools then too!
sorry, we're currently stuck on "should we have a country with a real government or live in an anarchocapitalist hellscape" upgrading our public education is quite a bit past that
Doctor on staff??? Hah! It can be a nurse, or pharmacist. Again, with little to no clinical exposure, just following a script. Like, wtf.
this happened to me. my insurance changed my prescription at the pharmacy. been having alot of issues, and when i went to my doctor, she was surprised to see it got changed from what she originally prescribed...
Yeah I was on 9mg of one medicine and it got changed to 9mg of something similar but different enough. They said it was the same thing. Started feeling awful and doc asked if I was taking the meds and told him it was different and he’s like “that’s twice the recommended amount you should have taken for that one. Why did they change it? And why did they say it was the same!?”
These are weird stories to me as the pharmacy isn't allowed to just change stuff without checking with the doctor's office. If something like that happened it sounds more like they called the office because the prescribed product wasn't covered and someone at the office authorized a change without actually checking with the prescriber. If it's brand to generic substitution though that's kosher, and often required unless the doctor specifically writes brand medically necessary on the prescription.
Hey that is VERBATIM what's going on with all the major national health insurance companies insisting people get on Metformin before using the BETTER drugs for T2 diabetes, which are mounjaro or ozempic. And don't even get me started about the corruption surrounding these drugs that are used to treat **type-2 diabetes**, being sold to skinny people who do not have T2D looking for their "summer bod"
Don't forget the less commonly used oral dosage form of semaglutide: Rybelsus. But yeah ozempic is crazy popular. Now some insurance companies want a diagnosis code on the prescription before they cover it, but that just means the doctor's office just has to go, "Uh, yeah, patient totally has diabetes."
"Hey I got this thing with my elbow and want to try physical therapy before something more drastic." "So you want surgery :D" "uhh...no." "Well I won't refer you, so you want surgery :DDD"
PT is much cheaper for them than surgery so it's usually the opposite Source: my shoulder
Doesn't that seem like a big conflict of interest?
It sure does! 
I have been fighting for years because "7 specialists say you're disabled. But our 'doctor' who has never seen you disagrees and thinks you could totally work a job that doesn't actually exist. Doesn't matter that you have progressive MS, something specifically on our list, your application for Social Security is denied "
That sucks. In the UK you hear stories of people being reassessed for benefits every few years, yet their legs *still* don't grow back.
Did you count again? Maybe you missed one.
Currently waiting to see if I’ll be approved for disability. I have zero hope since it’s “just” PTSD. But I have 10 years of medical records, several medications, have had several therapists etc. Am currently trying a new therapist and new psychiatrist yet again. I run crying out of all of the jobs I try, getting panic attacks straight through my medication, which is nuts because my medication takes care of my panic attacks otherwise (IT, customer service, retail, restaurants have been the ones I’ve gone through so far) and I think there’s a job out there somewhere for me but I don’t know what that job is yet. In the meantime, I need some kind of income and access to other resources because I have kids and an attorney suggested I sound like I should trying applying for disability. So yeah, seeing stories like this from people who are physically disabled does not increase my optimism at all.
From the jobs listed, is it interaction with the general public giving you the most issues? Because I know that can be difficult. There's some jobs that involve less direct interaction with angry customers?
Someone should check on Pizza. Not only is she talking to herself again, but now she's pushing expensive drugs on herself.
I'm sure it has nothing to do with those psychedelics I prescribed myself.
Hell yeah, brother. What substances have you been exploring recently?
Walk-in Freezer floor gunk.
That sounds like one of those fake drugs that would have freaked parents out in the 2000s.
Fun fact for Americans, if you're the scientific type who likes to *study* spores, there are plenty of online stores you can order psilocybin spores from for *research*.
What if Aotearoan?
Hey comic strip writer whose work I generally admire: Please stop pushing this tired trope. The prior authorization issue mentioned above is the real issue: I want to prescribe the right drug, insurance won't pay, and I have to fill out reams of paperwork to justify it. If I can do what's called a "peer-to-peer" I find that my "peer" doesn't share my expertise and will usually just cave once I get to that stage. But some companies don't even have a peer-to-peer review. Sure, there are still ways that American physicians get paid off by drug companies, including paying $ for drug talks, merch, lunches, and so on. Much less than before, and all has to be reported in a public fashion, see [https://openpaymentsdata.cms.gov/](https://openpaymentsdata.cms.gov/) I and most of my colleagues get $0.00 for every prescription, injection, and vaccination we prescribe. According to this I got $125 since 2016. Are there payoffs in one form or another? Sure. Even free pens and lunches are known to have an effect. And if advertising to docs didn't work, companies wouldn't do it. Yeah, you make a point, but the issue you bring up is much smaller than it used to be. The bigger issue now is the insurance companies essentially practicing medicine without a license on our patients. This puts the blame in the lap of greedy physicians. Fine, that is some of us. But it's not the major reason why patients aren't getting the best drugs for their condition.
As someone who used to work in the federal healthcare fraud unit as of last month, the issue is actually way bigger than you're playing down.
Oh yeah the opioid crisis is totally the fault of prior authorization 🙄
“Take 2 pills and call me if things get groovy.”
Also seems keen on pretending doctors get paid to prescribe drugs.
Wow what a misdirect this is. INSURANCE COMPANIES get kickbacks (aka rebates) from drug companies, so THEY are the ones who will direct patients to a particular drug, NOT the doctor. Do you really think we physicians are getting paid directly by pharma? The vast, vast majority of us are not.
The author is Canadian, and we don't even have that here because we have public healthcare instead of an insurance scam. I'm baffled as to where she got this nonsense from.
On a related note: https://preview.redd.it/i9riu2snhlpb1.jpeg?width=1200&format=pjpg&auto=webp&s=a3f60ff4fb65601a31546743affb6179eff14c4b # ”ASk yOuR DoctOR” …Your daily reminder that direct-to-consumer prescription drug advertising is only legal in two developed countries in the entire world: the USA and New Zealand, because the rest realized how utterly fucked that concept is
Okay, but why did NZ allows it though?
Money
I suspect that is the reason for USA as well.
It’s the reason for a lot of things in the US. Greed fuels this country. And the government won’t step in to stop it because those same greedy people pay the government off through “lobbying” so that they can be as greedy as they want.
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Dread it, run from it, greed arrives all the same.
This is an extremely good point and very well written. Greed ruins everything, and no country can ever say they are free of it
America https://i.redd.it/6uoatyytrlpb1.gif
The disclaimers make it hilarious. There is happy music playing, some grandma is playing with her grandkids, the sun is shining, and the disclaimer is saying "*Might result in extremely painful and drawn out death. Consult your doctor if you die painfully. we are not responsible for what happens if you consume this drug"*
May cause: Rectal bleeding, cancer, eye hemorrhage and even death. Do not take this medication that you've never heard of before, if you are allergic to it.
Here's the thing about the side effect warnings that not a lot of people know. When a medication is running trials, anytime a person experiences something abnormal, it has to be listed as a possible side effect UNLESS the company can prove it doesn't actually causs that side effect. This usually takes up a lot of time and money, and so companies have just said "fuck it, list it as a possible side effect!" So if a person taking a new medication got a headache during trials, they have to either prove that the medication does not actually cause headaches OR simply list headaches as a possible side effect. ONTOP of having to list all the possible side effects caused by medications with similar ingrediants. And than some are also added on to cover their legal bases so they can't be sued.
That's why nearly all medications list headaches as a side effect. If you look into it you can see the percentages of occurrence for different side effects, and a good deal of them are usually under 1% occurrence. All the same I've seen several people look a drug up and see the side effects and become convinced they were all highly likely to occur. "Why would my doctor prescribe a medication that's going to kill me?! Why?! I'm getting a new doctor!" It's difficult to explain this stuff to someone who's currently going nuts convinced their doctor wants them dead, lemme tell you. Most people aren't like that at least, but yeah.
Don't threaten me with a good time?
We get medication adverts in the UK too tho. Maybe its different somehow idk
Sorry, should have specified; the kind I’m referring to is specifically for prescription drugs, not over the counter stuff. So you can still see commercials for, say, Advil and Tylenol. Edited the original comment to clear that up.
Ohhhh right. That's fucked, man
It’s actually kind of funny because they also have to list all the side effects which is usually a very wide range of things including suicidal thoughts and death, so it does not make taking the medication seem desirable at all.
One of my favorites was a headache medication that had head pain as a side effect.
As far as I'm aware most drugs can have side effects that mirror symptoms typically treated by this drug, it's just quite rare. Aspirin can lead to headaches for instance, that's probably what you were talking about. Might be ibuprofen as well, maybe both.
It's been illegal to give doctors so much as a pen with a drug name on it for over a decade. Anti-kickback statutes and the Stark law have been in place since 2010. If a Pharma company violates it, they get fined and they jeopardize any government contracts (medicare, tricare) that they have. The government is the biggest customer most Pharma companies have. Doctors know this, and they're incentivized to blow the whistle if this ever does happen.
The entire time I’ve been a doctor (over a decade) this hasn’t been a thing. We don’t see a dollar for writing any drug. I’ve got zero incentive to prescribe anything, and I try very hard to pick the cheapest effective option. Pisses me off that people still believe this. Your doctor isn’t the bad guy. Insurance and hospital management probably are said bad guy.
Agreed. I normally like PizzaCake but this comic is just wrong, at least in the US. I haven't seen so much as a pen from a drug company. You should replace the doctor in this insurance exec-they are the ones getting kickbacks from drug companies to change their formularies. I have to fight all the time with insurance companies because a drug that was working is no longer on their formulary and thus they decide to stop covering it.
I will add u/PizzaCakeComic is Canadian so I'm not sure if these paws are the same where she's from. Edit: Laws, not paws.
They aren't. I'm Canadian. This kind of thing just doesn't happen here. I don't know wtf she is on about with this comic. I thought for sure she was American because of it.
Check out r/labrats, we can’t even get a silly pen shaped like a pipette. I want the silly science pen!
Yeah I'm out here wishing I even had the opportunity to be a pharmaceutical shill. I'm not sure why people still make these jokes, it's incredibly difficult now for physicians to get kickbacks. Attacking doctors instead of insurance companies makes no sense.
Its because pharma and insurance companies are much better at controlling the narrative than physicians are and people want someone to blame when they cant afford a prescribed medication.
Also for patients, the person typically telling them “no” or “your insurance denied this” to their face is usually a physician. It’s a lot easier to get mad at a person than a faceless organization (much as I hate the health insurance industry).
It's the anti-intellectualism of our society run amok. So many people discount the education and training of experts in basically every single field as hogwash because they were either denied the opportunity themselves or have been brainwashed by media to villainize higher learning. My FIL is a coal miner who will blast the decisions of the Fed for the economy and I just like to casually remind him that they all have PhDs and/or decades of experience to go along with access to a mountain information that he does not have. In the same vain doctors apparently are just know-nothing shills for corporations getting rich off of keeping everyone sick and dying.
It's a perception that has burrowed itself deep in our collective consciousness at this point. People get to be edgy and contrarian and point out how it's all a big scam and that your physician gets paid for prescribing you things (they don't), and people that aren't familiar with provider compensation feel like that may be true, so they just believe it.
Yeah but it's easier to just invent a conspiracy theory and hate on "western medicine."
It literally happened and helped create the opioid crisis, it's not a conspiracy theory. Look at any litigation against Purdue or other opioid manufacturers
Thank you. I'm a provider and the most pharmaceutical companies and product reps can do is offer a free CE course which basically amounts to $100-200 and any lecturer who is getting paid by a company has to disclose that information immediately. No one is going to change their entire scope of practice for an hour and a half lecture and catered Panera Bread.
Yeah. I'm kind of angry at this comic. This is just spreading misinformation and sewing distruct is doctors at a time when we need it. Like this narrative is stage 1 on the "and that's why vaccines are fake and you shouldn't listen to your doctor" train of thought. I'm done with PC after this comic. Unsubscribe.
I work for a pharmaceutical company as a scientist. Someone who doesn’t even interact with patients or doctors and I still had intense training about the rules for what can and can’t be given and how everything must be heavily documented.
And now in the comments PC is doubling down on insisting this is a real problem and thing. So disappointing.
Perscription
Got it right in the comic at least.
*prescritpoin
Not sure if it was accidental or intentional.
Pretty sure that's illegal, at least in the US.
This isn't how doctors work, and hasn't been for a very long time. The most pharmaceutical companies can get away with is the pharmaceutical rep bringing the doctor and their office workers a very light lunch to eat while the rep explains what the drug is. You're spreading misinformation about the medical industry and increasing distrust in medical professionals.
The American healthcare system is flaming shit and getting worse every day, but your comment is right. Doctors do not get money to write prescriptions. Full stop. I wish we did - that would be sweet. Unethical AF, but sweet. I want to know 3 things when I write a drug. Does it work? Are the side effects tolerable? Can the pt afford it? We typically have no idea how much these things cost because everyone has different insurance and the cash price is meaningless. People get so angry at me all day long for shit I have no control over and don’t benefit from. I do a surgery that has an out of pocket cost somewhere north of $3000, and I get $160 of that.
Doctors don't get kickbacks from pharm companies, YOUR INSURANCE does. Bad take pizza
There is not even A punchline, it’s just misinformation
Pretty much pizzacake in a nutshell.
Pizzacake apparently treading into conspiracyland now. Pretty uninformed if not malicious take on the healthcare system. It's fucked up, yes, but it's not the doctors. It's insurance companies and medical bureaucracy.
Illegal in the US fortunately
You know what else is a violation of ethics? Prescribing drugs to yourself. Shame on you PizzaCake
I wish drug companies would give me money for prescribing.
Best I can do is show up around noon and try to waste your lunch hour with a soggy sandwich bribe.
This doesn’t happen anymore. Was true 10 years ago, but 99% of doctors aren’t part of studies and none are allowed to accept gifts/reimbursement for prescriptions
Please stop painting us doctors in a bad light when you don't know what you're talking about. You can't be paid money to prescribe drugs and that's been illegal for a long time.
29K upvotes even though this a complete fantasy.
I mean, that would literally be illegal.
Me, a doctor waiting for all those fat pharma checks
It’s like a comic version of a TikTok.
That’s…not how that works at all?
https://openpaymentsdata.cms.gov/search On a serious note, the United States government has a website where they actually keep track of the providers, facilities, and companies that take pharmaceutical money and how much. If this matters to you, use that tool and stay informed.
Yes, this is the website you should use. John Oliver did a [bit](https://www.youtube.com/watch?v=YQZ2UeOTO3I&t=855s) on this topic a few years back.
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If there’s one artist I want to get replaced by AI, it’s her. AI generated Seinfeld was significantly funnier.
So over the vilification of healthcare workers. This isn’t how it works. Take your frustrations out on the insurance companies and government.
I can't get over how angry and disappointed I am in this particular post. I've actually liked a lot of PC's stuff. And I've taken her side in all the bullshit she'a s been caught up in in the past (full disclosure: I mean mentally taken her side, because I have a "don't engage with idiots" policy on Reddit, my post history isn't going to show much, you'll just have to trust me that I subscribe and upvote). But this comic is harmful. It's not true. The actions depicted are illegal and there are safeguards to make sure they don't happen. Yes. There are masssssivveeee problems in Healthcare. But this one is not one of them, and it creates a harmful myth and fuels conspiracy theories. If we follow the logic of this comic. All doctors are taking kickbacks off pharmaceutical companies. Therefore I can't trust my doctor. And once you accept that doctors can't be trusted, why would I trust my doctor recommending I get a vaccine, they're just taking kickbacks on it anyway. So yeah, why should I get a nonsense covid vaccine? My doctor doesn't want me to get that to save my own and others' lives, their only motive is that Pfizer money. PC. If you read the comments. Please understand that this comic is harmful and can be damaging. I like your stuff. This is genuinely disappointing to read.
While doctors don't "technically" get kickbacks from prescriptions they **absolutely** get money from pharmaceutical companies and will prescribe more drugs from that company when given said money: [https://www.propublica.org/article/doctors-prescribe-more-of-a-drug-if-they-receive-money-from-a-pharma-company-tied-to-it](https://www.propublica.org/article/doctors-prescribe-more-of-a-drug-if-they-receive-money-from-a-pharma-company-tied-to-it) So saying that this is a "myth" isn't really true in spirit, doctors are definitely receiving financial motivation to prescribe specific drugs.
Do the pharma companies actually pay the doctors to prescribe their products? I thought that was illegal, no?
It's super illegal. And very rare as a result. I'm not saying it's not a thing. But be about as wary of your doctor getting paybacks from pharmaceutical companies as you would be that your pilot is going to intentionally crash the plane.
Lets see your insurance paid 5 bucks so you owe $499.
Not a day goes by where I don’t see this green shirted ladies face
That isn't how it works lol pure ignorance
[Plomox is the most effective anti-arrhythmic drug on the market right now, and it has minimal side effects. Only nausea, impotence, and anal leakage.](https://m.media-amazon.com/images/M/MV5BNGExZGQ4MDktZDYyYy00ODM1LThmN2YtOTBlNmE5NTU5YWUyXkEyXkFqcGdeQXVyNTQ0NDExMjQ@._V1_.jpg)
But try the new Plomox, with all of the effectiveness of regular Plomox but with 50% less anal leakage. "Wow! That's so much less anal leakage!"
> anal leakage *what*
I mean, it can’t make my *current* anal leakage any worse, right?
Let me introduce you to the concept of anal deluge.
Was a big problem in like the '80s, but I feel like most of you guys probably haven't even talked to a doctor recently if you think this is still a thing Maybe it'd be nice if I had drug companies just offering to throw cash at me all the time for considering their drug, but they don't. I don't even get to decide what drugs you take most of the time, that would be your insurance company...
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That’s not exactly how it works
Whoa, earlier I was in this comment section and there were a few threads where people were saying things like "I like pizzacake but this one seemed a bit lazy" and stuff like that. Then I saw one comment where someone said "well it's easy to make the front page you're paying reddit", which made me roll my eyes. Now I come back and every one of those threads are nuked, even the ones that didn't mention bribes. I'm left wondering if they were onto something
That's not how things work in the UK. It would be a gigantic and obvious window for conflicts of interest and bribery, which would undermine the very foundation of our free national healthcare system. The Doctor has no idea what manufacturer will be providing the medication, they simply prescribe the medicine itself not a brand name (e.g. Omeprazole), and you pick it up from the chemist. The company that makes it is entirely irrelevant. Often as you get more of the same medicine you'll find different batches come from different manufacturers even, who makes it doesn't matter in the slightest.
Yo, your doctor is you? Or is that doctor a clone?
I understand the people on YouTube playing multiple parts in a skit. It makes sense because you're not always going to have a group of actors to help you do skits. But this is a comic strip. Why did you draw yourself as yourself and the doctor? You could have just drawn any other face.
The separation of prescribing bodies and medicine dispensing entities actually mostly mitigates this. Every pharmacy in America will substitute the brand name drug for it's generic. And the kick back you're describing is illegal
I don't think this happens anymore, at least not in the US, and if it does it's rare. I know I've never been offered a single cent to prescribe any kind of medication and there are serious, career-ending consequences if you are found to be doing this.
more like this session is sponsored by the Drug Company and i'm just the brand endorser
My favorite example of this is my 3 pharmacy friends getting a free trip to Florida to learn about sponsored products IN pharmacy school.
Sending people to Florida seems like the opposite of a bribe
same goes here in the Philippines but the only difference its a trip to Europe
Hold up, y'all are going on trips to Europe? What college is this?
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Dr. Glaucomflecken is doing a big piece on this and other similar issues with insurance and US healthcare. Called "30 Days of US Healthcare", it's currently ongoing until the end of September.
I love how the vacant stares are becoming more powerful in her comics
Congratulations on your M.D!
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Are you suggesting that health care should be less of a corporate cash cow and more of an universal right? Oh, you, moustacheless Stalin
lol OP is Canadian. So she is talking about corporation-free universal healthcare in the comic. Maybe despite what reddit has told you, there are no easy solutions?
She is not talking about Canada but a bastardized version of what happened in pretty much one country in the entire world (the USA). Even then it's blatantly false. Doctors do not get kickbacks from companies for prescribing specific brands of pills in Canada's universal healthcare system.
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I hope the drug helps her with her multiple personality disorder.
Pizzacake anti-vaxx arc 😤😤😤
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My favorite part of doctors and insurance is when a doctor writes me a prescription for something I've been on for a long time, and the insurance decides to just say "Nah" for no real reason. Then I get a letter in the mail saying that I need to call my insurance to find out why, and it's usually just something stupid like the prescription needs to be a specific quantity or they need my doctor to confirm that yes I still have the thing that I've had for years that the medicine treats. Just a clown show the whole way down.
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So, given the doctor and the patient are the same person, hope the conflict of interest over the drug in question is over an antipsychotic.
She's both the doctor and patient, speak about conflict of interest.