First of all we have too many for profit entities that are middlemen. It is estimated that the PBM’s net profit of SIX BILLION a yr.. For doing not much more than a VISA or MasterCard function. In fact, that is more net profit than the WORLDWIDE operation of those two charge cards’ net profit.
The insurance industry is one administrative financial black hole.. Skimming off 20%- 30% of every premium dollar for administrative costs and profits.
Then there is war on drugs.. We don’t know how many “health care” dollars or being used by diverters or abusers. Besides all the related dollars spent on law enforcement chasing after legal drugs being diverted or abused.
How can we repurpose all of these dollars to healthcare?
The war on drugs is pretty simple… We quit acting like it is 1970 and use the technology that is available to us.
We are deluding ourselves about the diverter’s access and ability to generate all the fake documents needed. People using fake ID’s and fake rxs is rampant.
This is probably the easiest to solve.. We have PMP but with all the fake ID’s ..they are becoming worthless in catching the serious diverter.
We already have a driver’s license database and a social security database. If the PMP’s had valid information in them they would be extremely useful. What we need is a central database of people with insurance drug coverage.
The process could be very simple from the healthcare provider perspective.
Enter/scan either driver’s license into the website..
The system would bring back the information on the REAL driver’s license… Name- DOB- pic- then the system would cross reference the social security number and cross reference if the person has drug coverage.
The PMP would also be crossed referenced and the PMP would do routine “data crunching” to isolate “persons of interest”
With less than one minute.. It could be determined if the person in front of you who they say they are. If they have drug coverage – when they say they are paying cash – and get a report from the PMP to determine if this pt is an abuse potential.
Prescribers wouldn’t prescribe and Rph could more easily spot a forged Rx ..diversion to the street would dramatically slow down.
I know that this will never happen.. To many entities/people have vested interest in perpetuating the war drug… Power and job security….and they will hide behind “privacy issue”… Like name-DOB-driver’s license & SSN are big privacy issues to those of us who typically have most of their medical history..
Filed under: General dumb-ass problems
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