Mission: Healing November 3, 2011 Business of Medicine

PGY 39, Day 125

Today, I stopped at Walgreens to pick up a few things. As I pulled into the parking lot, I noticed several flimsy signs reading something like ... Free Flu Shots ... in bold. As for the fine print ... if you have Medicare Part B. So, being the curious guy that I am and seeing that I just put the blog up on "FLU SHOTS" yesterday, and, since I had a few minutes, I commenced an investigation ... follow the $$$ and report for the blog. Little did I know that this would end up being quite an exercise. Who am I kidding ... it is exactly the bumbling third party nonsense that I would expect.
First, I buy my stuff and pay for it ... 10 minutes ... a few items ... no problem. Then I go to the pharmacy and ask them about the flu shot. Specifically, I asked for a brochure, which the pleasant cash register lady and asked her how much they cost. She asked, "Do you have medicare?", I said, "No" (do I look that old?) and she sheepishly told me $31.99 while she went to the Walgreen website to find and print the scoop on the inactivated vaccine that they offer.
So, I come home and continue my snooping on the COST of the vaccine and the reimbursement from Medicare part B. First, I ask MR. Google, "What is the cost of influenza vaccine?" and this is what I get ... PERFECTION from CDC! It is the current price list for all vaccines.

http://www.cdc.gov/vaccines/programs/vfc/cdc-vac-price-list.htm

So, the cost for the inactivated Influenza vaccine is a max of about $14/dose in the private sector, but the range is from less than $8/dose to about $14/dose.

Then I check with Medicare to see what the reimbursement rate is for the Flu Vaccine. Good luck with that ... it is a wild goose chase. Check for yourself, and see if you can find what they pay. Let me know if you find it.

http://www.medicareinteractive.org/frames.php?URL=http://www.cms.hhs.gov/AdultImmunizations/Downloads/0506vaccreimburs033006.pdf

Here again, multiple third parties are involved ... $, $$, and $$$ ... caching!

Then I check the Walgreen website for fine print about other insurance. There, availability and co-payments apply and I find that they work with some other third party with regard to the administration of the vaccine. So, let's guess they make $5 - $ 10 for each dose given on their turf. How much is that? LOTS of money! I would like to know exactly what they make on the draw and the immunization itself.

So, in the process, they draw people away from their Docs and into the BIG BUSINESS MACHINE ... THIRD PARTY ... party $ after $$ party $$$, Business of Medicine makes money on the BACK OF THE DOCTOR-PATIENT relationship.

Sickening!

When I started in practice, the immunizations were generally given as a part of a well visit or follow up visit for a chronic medical problem, and they were a part of a comprehensive & individualized health care plan for each patient. Cost of the vaccine and the administration would have been perhaps double the cost to us. But, more importantly, it would have been part of a larger effort to address each patient individually with regard to their total health care needs. In the current scenario, each thrid party contributes to the fragmentation of care, the "disintegration" of care and the cost of care. It is a pathetic and unnecessary state of affairs. That's why I am an advocate for Non Profit Doctor Patient Cooperatives to CAP the BUSINESS OF MEDICINE take all third parties out of the picture and return to the DOCTOR-PATIENT RELATIONSHIP to the realm of OPTIMAL PATIENT CARE and PATIENTS FIRST.

Let's fix it!

Do the right thing and enjoy!

Dr. Mike