Too many choices, high costs and bureaucracy: British expats grade American healthcare system 'a pain in the arse' | Money | The Guardian

Warning: Whinge fest alert.

So I had a letter from our insurance company saying a particular drug I have needs re-authorizing, and this must be done after January 1st, "because of the ACA", despite the prescription only being renewed in December. My doctor went on holiday immediately after Christmas. I ran out of said drug 8 days ago, went to CVS and obviously it was declined so they faxed the doctor, and though I was finally able to get through to the office on Wednesday last week they said they never received a fax from CVS, so I sent a copy to them from home by fax (and confirmed as sent). Two days later, still no authorization according to CVS so they send them another fax. I follow up by phoning them again. And again. And again. Repeat ad nauseum - phone either goes to answerphone or just rings and rings. Finally at 4pm it's switched off with a message "closed at 4". That's the weekend gone then. Come Monday, numerous calls unanswered. Tuesday (today), calling every 10 minutes after they open, same result. Get in car, wife starts driving to the doctor's office, finally they answer: "Oh yes, we received a request yesterday but your insurance doesn't carry that any more" (they didn't receive anything on Monday - more like they decided to do something on Monday). An hour later, they call ME for once, "yes, we've phoned your insurance and it's been approved". Sheesh.

In the meantime, I had phoned the family doctor but she said she can't do anything as I'm with that particular doctor for that specialty. Urgent Care would have been another possibility but (a) IMHO it's not urgent, just annoying; (b) I'm not sure they could prescribe this drug as it's controlled.

They can prescribe stuff at the ER, had that done in the past. At least in Canada.

but for controlled drugs ER doctors along with Walk in Docs are not always willing to write a prescription if they don't have an existing relationship with the patient.

Hell one of my past meds wasn't even controlled, but the doctors refused to write refills as it has a high level of abuse on the street.

At the end of the day its completely up to the doctor on duty.

Any doctor in the US could probably legally write the script for the OP, but if it's controlled and the OP has never met the doctor before, chances are the doctor will refuse.

Hence the purpose of IT - gave the ER doc my AHCIP#, he could look up my medical records electronically (at least to some extent, there is some sort of basic reference about the account holder) and confirm the need for the prescription.

This. At least if you're in ER they can watch over you if they prescribe something nasty. Even looking up your records isn't much good because there may be a good reason why a drug hasn't been re-prescribed.

That's an awfully long wait.

I don't know why, but independent doctors offices NEVER fax back those authorization scripts in a timely fashion. I don't understand it. It's as if their fax machines feed directly int a waste paper basket. When our hospice calls and asks the MD office they always deny receipt of the fax. So we send it again. Then we get sick and tired of the wait, because hospice patients are normally in pain and really do need their CII drugs so we have one of our doctors write the script.

ER doctors are normally pretty worried about drug seekers. It's a well known game to get a script from a family doctor, use them all before the allotted time and then go to the ER for more.

They can look up what you have been prescribed and filled in BC via pharma net or whatever it's called, but I don't think they can access your records from outside the hospital such as from your GP or walk in clinic. If they can I'd be surprised since the clinic's I have gone to don't even use electronic record keeping yet.

The ER here has a sign clearing stating they won't prescribe controlled substances if you don't have an existing relationship with the doctor on duty.

Interesting that the story links right at the top to an inaccurate and outdated story claiming that a UK couple are being charged $200k for their baby's birth and care. The Grauniad has a more up to date story they could have linked to saying the cost of the birth is covered by insurance but that wouldnt really fit so well would it?

This article defines cherry picking, anecdotal evidence and http://en.wikipedia.org/wiki/Texas_sharpshooter_fallacy In other words it's a typical clickbait Grauniad article about the US written for the faithful.

"Written for the faithful" may be part of the motivation, but I also think that pieces like this are published for the entertainment value of reading the Readers' Comments that are generated. There's plenty of red meat in this article that is guaranteed to bring the low information rabid big-government haters out into the open.

"An informal survey of a dozen or so educated and successful Brits living and working in the United States found different levels of bamboozlement, resentment and grim acceptance of the American healthcare system."

Take in informal survey of a dozen or so Brits and ask them about the NHS....

Has the Guardian been obtained by Fox News?

That sentence jumped out when I read it, too. What's an informal survey? Over drinks in a bar? And who is defining "educated and successful"?? I could describe myself as "educated and successful", but others may disagree..

I'm not sure what they're using, it looked like a very old VT-100 terminal, but I gave the nurse (or whatever she was) in the ER my AHCIP# and she got a doctor to write out the prescription. My GP was on vacation and the clinic was rammed so I had no choice but to go to the ER.

They do have some sort of central system in Alberta but I'm not clear on how clever it is.

Nah, Fox "News" wouldn't have included the word "informal".

Lazy journalism, but the article's point is pretty consistent with what is posted on here about US healthcare.