More on the Medicare prescription-drug "benefit," with some notes on what your friendly pharmacist can and will (or maybe won't) do for you

My recent note on the dubious Medicare prescription-drug "benefit," inspired by a NYT letter to the editor responding to a news report that 1 million people have signed up, drew this interesting comment from enigma4ever:

only ONE million have signed up, and that means over 40 million are dazed and confused—great post by the way...I was at CVS the other day and I heard the pharmacist tell this woman that he COULD NOT help her, that it was against the law....WHAT?

I for one am prepared to believe that the law either says, or can be interpreted as saying, that pharmacists can't advise customers about plan benefits. After all, whoever devised this plan from hell took the precaution of legally barring any effort to negotiate lower drug prices, which would have been an obvious feature of any plan that was concerned with the well-being of senior citizens.

In reality, though, if any of the nominal "beneficiaries" of this plan happen to benefit from it, that's likely to be mostly a matter of luck, and certainly not a result intended by the planners, whose sights were set of a payday for the drug and insurance companies—or rather a year-round payday. Talk about "the gift that keeps on giving"!

It's a curious coincidence that enigma4ever's intelligence-gathering mission took place in a CVS store with a CVS pharmacists. As it happens, I've had CVS pharmacists on my mind.

As anyone who lives within CVS's service area is aware, I'm sure, the company has been running a TV promotional campaign built around the saintly service provided by its pharmacists. I've seen two TV spots, and every time I see one, I'm almost moved to tears by the lengths to which these people will go for their customers. I forget the particulars, but I like to think that if you were in danger of fainting from hunger, they would take you home and cook you dinner.

Now I don't meant to sneer at the pharmacist-customer relationship. I have friends who depend on prescribed drugs for their continued well-being and have been lucky enough to find pharamacists who provide amazing professional service. Since I tend to think of this as an "old-fashioned corner drugstore" kind of service, I am happy to think that perhaps it is provided by CVS's people.

Still, I've had a different response to the TV spots, heartwarming as they are. I guess I would have preferred spots with the message: "We fill your prescriptions, whatever they are."

When I wrote this post originally, at this point it continued: "Now let me make clear that this is not directed at CVS. I don't have any reason to think that CVS pharmacists have been failing to fill people's prescriptions—although if anyone has any such knowledge, I'd be interested in hearing it." Later, however, I decided to attempt a quick search, and discovered that there is in fact some history of at least one CVS pharmacist refusing to fill a birth-control prescription. (I also found a fairly recent account of a Target pharmacist refusing to fill an emergency contraception prescription.)

What I'm thinking about, of course, is the brouhaha sometime back when it became public that certain pharmacists were refusing to fill prescriptions for the "morning-after pill." What stunned me, and I hope I wasn't the only one, was the discovery that apparently this is perfectly legal, that pharmacists can legally refuse to fill a prescription if they feel like it.

Huh?

I mean, isn't the "control" in "controlled substances" a governmental function? Isn't the licensing of pharmacies and pharmacists to dispense such substances the government's way of exercising that control? Has any pharmacist ever been known to have been forced at gunpoint to enter the profession? If filling people's prescriptions poses intolerable ethical problems, aren't there other ways to make a living?

I hope that by now CVS has worked out its problems on this count. I'd still feel better, though, if the pharmacists in their TV spots made clear that they fill all prescriptions, without regard to any personal feelings they may have.