Wednesday, March 13, 2013

Tylenol: That will be $16.95 please

I just have to highlight this.  In the AHA release in response to the Brill article, they address the issue of why it costs $17 for a single tylenol when you're an inpatient:
A dose of Tylenol provides a good example. In order to take medications in a hospital, even over-the-counter medicines, they must be prescribed by a doctor (a little bit of cost for the doctor), that order gets transmitted to the pharmacy (a little more cost), the order gets filled by a pharmacist or pharmacy tech who retrieves just one Tylenol pill and individually packages that one pill (still more cost), the pill gets transported from the pharmacy to the nursing unit where the patient resides (a little more cost), then the pill is retrieved by a registered nurse who personally gives the pill to the patient and then must document the administration of that pill in the patient medication administration record (a little more cost). All of this process to give a patient a single dose of Tylenol in a hospital bed is regulated by agencies that accredit hospitals – a condition of participation in the Medicare program. In other words, this is what hospitals must do to administer a pill in compliance with all pertaining regulations (a little more cost).
Apparently this was not written as an intentional parody.  At least I don't think so.  It's always possible that they're putting us on.  But maybe not.  Maybe they really have conducted thorough internal audits on the costs of "transporting the pill from the pharmacy to nursing unit" and "individually packaging a single pill".  Bureaucracies have been known to do worse. 

It's like when you get sucked into going to Applebee's and everything on the shit menu is $13.99 or more and you ask the waitress, why the hell does boxed pasta noodles with pesto sauce from a can cost so seemingly much?  And the overly enthusiastic waitress, the kind who intermittently widens her eyes while talking, to emphasize particular points, to connect with you or whatever, probably while squatting down by your table so she's at eye level because some corporate higher up read somewhere that levelling the eye contact playing field makes the customer feel more in control and better about himself-- she, while chomping some sort of fluorescent aqua gum flavor, squats beside you and says, "well hun, you see, someone has to open that box of rotini (a little cost) and pour it into a boiling pot of water (stove usage cost!), while another guy in the back has to retrieve the pre-cooked chicken chunks from the walk in cooler (doesn't cool itself for free, ya know!) and then a pre-determined volume of sauce has to be measured out (still a bit more cost, copyright charges on the recipe) and then once it all gets whipped together someone has to arrange it on your plate (cost!) and transfer said plate to the larger tray where similar orders for your wife and children have already been arranged (costs, hun!) and then I get notice and so I grab the nearest expediter to help me transport a not inconsequentially heavy order all the way from the kitchen to your table (costs indeed!).  So, ya know, it's like $13.99 is sort of a good deal, once you break it all down".  She smiles a ghastly smile, whips her head to the side to wink at my terrified daughter.  And then she is gone. 


Paracelsus said...

You've managed to add a horror movie flavor to this absurdity. Well done.

Attorney Andy said...

I'm assuming for a squatting server to be at your eye level you are in a booster chair, right?

Anonymous said...

chances are that tylenol came pre-packaged in it's unit dose container from UDL or some such. and, if pre-packaging into unit dose is needed, it's done in batches for commonly used items, not per tablet on demand.

tom p said...

And the med is probably kept in a pyxis unit or some other med ATM device that gets filled routinely, not on demand.

Reponses like this one do little to assuage the concerns of the general public about how hospitals work.
Why not just speak the truth and say because so few payments for service cover our cost, for those patients who can pay we charge them extra

Anonymous said...

Let's keep it real simple.....there was once ONE single person sitting in a hospital board meeting who was in charge of those whom treat souls in need of their medical knowledge and services. Realizing that their team had skills well needed and , in fact, life quality-dependent and/or Actual LIFE-dependent, they thought to themselves, "how can I increase our profitability? Papa needs a brand new pair of shoes and this will look real good to the higher ups....Hmmmm....if I just charge a LITTLE bit more for Tylenol....". Then, the good news spread to all the others....and the story was written. It is amazing how one act of greed will spread insipidly throughout our world. One small small LARGE consequence to humankind. What if patients can order off a a la carte menu....Let's see....I have good insurance today....I will take a IV push...and....ummmm...oh yeah....a broad spectrum antibiotic for my friend here. He only has an 80/20 coverage. It's my treat".