House of Cards

The phrase house of cards refers to an institution whose very infrastructure is so fragile and unstable that they are prone to collapse at any moment.

That's not what I'm talking about.

I'm talking about your local drugstore. Walk into any modern drug superstore and you're likely to find at least one or two aisles dedicated to greeting cards. Whether it's American Greetings or Hallmark, or some other offbrand of expensive, colorful cardboard, the greeting card business would appear to be the primary function of your local apothecary.



That's not what I'm talking about either.

Here's a fun little exercise. Walk to the back of your local drugstore, grab a seat in the waiting area, kick up your heels, relax, and enjoy the chaos. What was once a fairly quiet and serene place, the back of the pharmacy counter, is most likely going to be more busy than New York's Grand Central station at rush hour. The pharmacist, who used to work solo, is now swarmed by a flock of minions, who busily rush around, to and fro, processing paperwork.


I think I know why Martin Mull's character, Russell the pharmacist, has a substance abuse problem. I know that I would have one if I had put in long hours in such a crazy environment.



The pharmacy counter changed from its serene origins into a crazy place that it now is when prescription drug coverage came into vogue. Where once the pharmacist only had to concern his or herself without the act of filling prescriptions, they were forced into becoming insurance clerks, checking coverage and formularies for every new prescription. They were forced to take on added help in order for them to complete this grinding task. This mirrored the transformation of the physician's office several decades before when they had to start processing insurance forms along with providing health care for their patients. In case you haven't noticed, the modern medical office no longer resembles the Norman Rockwell ideal.



" You want me to check the heartbeat of your doll, kid? Take a hike!"



Recently, the game behind the pharmacy counter has been turned up to its now frenzied level. This is due entirely to the advanced of the co-pay prescription card. These cards are now gleefully handed out by most major pharmaceutical companies to help combat high co-pays imposed by prescription insurance companies. The problem seems to be that none of these cards actually follow a standard way of processing. Worker bees at the pharmacy must cajole, swipe, and telephone the different entities who process these cards on behalf of of the pharmaceutical company. To add insult to injury, if the patient fails to hand the pharmacy clerk there prescription card upfront (as most of them do), the clerk is then forced to scrap the entire transaction and start all over again. I personally experienced this when I used such a card while filling a recent prescription. And yes, I was the douche bag who forgot to give them the card before they processed my claim. Long story short, it took a over one half an hour for me to pick up my overpriced prescription.

So what does this mean to the healthcare consumer?

Well it should be obvious to anyone that the added people working at the pharmacy counter don't work for free. In addition to their salaries, there are benefits to be paid, 401(k)s to be financed, FICA taxes to be filed, and a whole host of associated expenses. And ultimately, the healthcare consumer will be footing the bill for these added employees.

After witnessing the chaos at my local CVS firsthand, I realized what a tenuous state that my local pharmacy was in. The anarchy behind the pharmacy counter made it appear that the whole shebang was about to collapse.

So maybe your local pharmacy does follow the true definition of " House of Cards" after all.

So, what's the solution to this impending disaster? I, for one, believe in" out-of-the-box thinking" in order to solve these new world problems. Now is not the time to be coloring inside the lines.

So, I would propose that we start staffing our pharmacies with cheap labor. And in the United States, this means either illegal immigrants or prisoners. Since the news media seems to be against all forms of illegal immigrant labor, I think it's best that we embrace the incarcerated labor force. Prisoners work even cheaper than migrant farmworkers, and we certainly have more of them. This is not a perfect plan. For instance, you're going to have to drive to your local county clink instead of your neighborhood Walgreens to pick up your overpriced Boner pills. But such is the price of progress.



" Mr. Green, your prescription is ready. Please see Mr. Tiny. He is the one with all the homemade tattoos wearing the red bandanna. And, if I were you, I wouldn't bring up the fact that you have a co-pay card and that he's going to have to reprocess your entire order. When he was raping me in the shower this morning, he mentioned that he's fashioned homemade shiv out of a plastic beach pail shovel that he stole from aisle three."

when you think about it, they've been using the scared straight approach to keep kids off of illicit drugs. Perhaps the same scared straight approach will work to help break Americans from their addiction to overpriced pharmaceuticals.


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