September 12, 2008

Third Time, Hold the Charm

There will be NO frustrated sarcasm in this post at all, Honest! (Well maybe that was some right there, a little... OK it will get thick.)

Caremark managed to get insulin to us. 3rd delivery wasn't cooked. yeah!

Even delivered it over night. Just like they said they would. They just didn't say over what night.

They gave us a tracking number. It didn't show up in UPS's system. That was because the number is assigned when they pack it. They packed it held it a day and then shipped it over night. They claim they have cold storage at shipping.

Forgive me if I am a wee bit concerned. They have not been real credible.

So when they gave me a tracking number, it didn't track because UPS hadn't scanned it in. Sure that just peachy with me. When the tracking number did work, it showed it wasn't on the truck for delivery. But it was.

That all works out in their minds. Somehow.

It came. While the ice was almost totally melted but this time it was still cold. And it was packed tight. I was impressed, well no I wasn't. I was sceptical and put my insta-read thermometer on it.

So the third batch came, a day late. $4,000 give or take worth of insulin cooked to get it here.

Apparently others have had the same problem. At least that is what they said when I talked with them, but this has only been like 5 people and only recently since they stopped shipping over night.

Lets see 5 people time 4k each is 20 grand. I was an executive complaint guy for a while. (Job sucked.) My experience was that only a small number of people really speak up. In fact we counted on it. Well less than 10% have the nerve work through the concentric rings of telephone protection to get to a supervisor let a lone the complaint department. Let say it is 10% then that $20 grand is really $200,000.00. Oh and it is a quarterly shipment... so they could easily be running at a burn rate of $800,000 of cooked insulin on an annual basis.

I wouldn't really care if it were a free market. Caremark could go out of business, I'm good. If my pharmacy screws up I can go to the one across the street.

BUT Caremark is not in the free market business. They are in the business of being a monopolist. I don't have the choice across the street or down the internet. I am locked into them as the provider under my insurance plan. A plan that I have no say in choosing. (Maybe they take the insurance guy golfing... in the Bahamas... for most of February.)

There is a very vocal voice that rail against 'limiting the free market' in our medical care system. Where is there a free market? Show it to me. We have 'Managed Care' a phrase that means a group of businesses that work together to limit the fundamental market forces of consumers selecting service providers based on service and value.

Caremark wanted me to know it is their cost to eat the 4k. Sure it is. Their cost go up, they pass the cost on to the insurance company and my share of the insurance costs go up.

The office of the Caremark President called. They said the presidents name was Tom Ryan. In July's earnings report Tom said, "We delivered solid improvement in sales and gross margins and continued to exercise disciplined expense control."

Sure thing there Tommy, Can you explain how pissing away 4 grand worth of insulin constitutes disciplined expense control? Yeah your shipping cost went down a few bucks. BUT You increased your return costs significantly and it not a isolated case. One middle level complaint person has seen a number of cases. Extrapolate that (Tip: use the same math you use to figure out your pay package.)

Have fun golfing in the Bahamas, we'll be here trying to manage our kids blood glucose. We don't mind that you wasted more than the cost of CGMs for our kids. Honest we don't. Pay no attention to the voodoo doll that looks like you we are using old syringes on. It mean nothing... Honest.

I am all for free markets. Health care in the US is not one.

I don't expect the service providers to work at their jobs as hard as families with Type 1 work at diabetes care. We are on 24 7 365.25. It is only a job for them, an honest 40 hours a week would be great. Real market forces would be good too.


  1. When our insurance provider switched to MedCo, I breathed a sigh of relief. Maybe it would be more worth it to talk to your insurance company as to this sort of behavior so that they, at least, know that they're getting screwed when it comes to getting their customers what they need. (And may I say, MedCo isn't too bad - they've overnighted stuff to me pretty effectively since we've used them).

  2. Talk to the person that runs benefits at your work. They'll be able to put more pressure on Caremark than you will.

  3. You know what would drive health-care and prescription drug costs down faster than anything? Eliminate insurance and Medicare immediately. People won't buy what they can't afford, and that would drive the prices down on everything exponentially. Doctors and hospitals price their services based on what insurance will pay, not what the market bears.