Obamacare Begins to Trickle Down

We are starting to see the aftereffects of Obamacare starting to trickle down to patients, and there are some things that are both odd and curious.  Obamacare goes full-blown in 2014, and in 2012 some doctors started the transition process by writing electronic prescriptions, but 2013 is already turning out to be the Big Obamacare Year of Change.

The first change we’ve noticed is our insurance company no longer supports 90-day prescriptions for maintenance medication via local pharmacies.  If you want the super-cheap 90-day supply, you are forced to get your pills delivered through the USPS.  I discovered that change last month during my latest refill in the New Year when I was only given 30 pills in a 90-day supply.

When I asked why I was getting only 30 pills, my pharmacist told me the insurance company refused to fill the 90-day prescription.  My local pharmacy takes a 90-day prescription and breaks it into much more expensive 30-day “partial refills.”  When I called my insurance company to find out why this change was made, they merely confirmed the change was now “90-day supply via mail only” and that applied to every medication they cover.

Doctors who used to rely on paper are now forced to evaluate you electronically via computer.  Your doctor will ask you a bunch of questions that are entered into a computer.  The patient-written paper screening is out, your doctor entering your responses on a computer is in, and the doctors are not thrilled about that!  The questions are endless.

You will also be weighed every time you visit any doctor — it doesn’t matter if you’re seeing your primary care physician or heart doctor or GYN or psychiatrist — you get on the scale, and they all deduct differing pounds for the clothes you’re wearing, so it’s possible to lose and gain seven pounds a day, just by visiting different doctors! ll your weights are measured by being entered into a computer.

Another interesting thing I’ve noticed in this young year of Obamacare changes is that the idea of “referrals” are not longer being used.  “Prescriptions” is the new buzz word.  You get a “prescription” to go to the lab, you get a “prescription” to have radiology and other procedures done.  I’m not sure if this change is because being “in” and “out” of network will no longer apply under Obamacare or not, but you really can’t do anything in or out of your doctor’s office without an elaborately written, and computer generated, full-sheet, prescription.

As well, if you haven’t been to the doctor yet this year, make sure you bring a photo ID and your insurance card because they will need to scan them into their computer system.  They will also likely take a photograph of you to accompany your patient file.

Our doctors haven’t yet start palm scanning —

PLEASE put your hand on the scanner,” a receptionist at a doctor’s office at New York University Langone Medical Center said to me recently, pointing to a small plastic device on the counter between us. “I need to take a palm scan for your file.”

I balked.

As a reporter who has been covering the growing business of data collection, I know the potential drawbacks — like customer profiling — of giving out my personal details. But the idea of submitting to an infrared scan at a medical center that would take a copy of the unique vein patterns in my palm seemed fraught.

— and I hope that creepiness never finds a rest in the heart of my hand.

We’re getting a taste of Obamacare now and it does seem to be more intrusive and electronic and perilously fraught with a loss of HIPAA expectation of security and privacy — paper lives once in one place; electronic medical records live a million lifetimes across a thousand servers forever — but that’s the way healthcare will work everywhere from 2014 onward, and we’d better be prepared to play along or get left behind.