NOVEMBER 19, 2024 – Today, finally, I understood the people who voted for Trump. At least the faction who “couldn’t take it anymore” and voted to burn the place down. Except . . . in my case my wanting to trash the system wasn’t over the price of a gallon of milk or a carton of cigarettes or the cost of a starter house that one of our sons can’t afford. Moreover, the experience that caused me to want to break every plate in the china shop didn’t last long; about a half hour, max. But that half hour of hell was emotionally and psychologically instructive. Granted—in my exaggerated reaction to mind-blowing frustration, I revealed how spoiled I am and the degree to which I’m clueless about how the world works, despite my conviction that I knew all there was to know to form an informed opinion about how much better things ought to function.
The context of my outrage was the monthly process I have to follow for the refill of what I call, “my magic potion medication”—the one that keeps my rogue myeloma cells in the figurative sub-basement of an otherwise reasonably healthy body. The “magic potion” has two salient features besides its miraculously suppressive effect on my form of cancer. First is its sticker-price of $673,000 per year, which, I can assure you, is a burden shared by everyone who pays into our massively byzantine medical cost allocation and insurance system. (Thank you for contributing. As the occasional yard sign in our leftie neighborhood says, “We’re all in this together.”) Blame a lot of it on Big Pharma, and give three cheers to RFK, Jr. The second feature of my magic medicine is that it comes with some crazy side effects. Effects so bad that a condition of FDA approval of the drug is the standing requirement that the patient participates in monthly over-the phone counseling with a pharmacist and completes a monthly phone survey. Government regulation at its finest—which President-elect Trump, First Executive Vice President Musk and Second Executive Vice President Ramaswamy have vowed to eliminate.
I’ve been through the counseling and survey process every month for nearly four years. None of either piece has changed. Together they normally take about five minutes to complete. Admittedly, they are an annoying inconvenience but small surcharge to pay for staying alive. The only catch is that for delivery the drug follows a circuitous route from its origins to the local pharmacy where I have to sign for the medicine before it will be released to me, and it won’t be shipped unless and until I complete the counseling and survey. Also, I can’t initiate the refill process until I’m down to eight (daily) capsules.
The drill is this: I get eleventeen text reminders from CVS – Specialty pharmacy that it’s time for me to apply for a refill. I then go to my online account, press “refill,” respond to a few stock questions, “submit” and wait for a phone call from CVS.
That’s where today’s fun began: the phone call. After confirming my name, birthdate and address, I dealt with the counseling. Great. So far, so good. Jennifer, the pharmacist, then asked if I was ready for the survey.
“Yeah, sure.”
“Do you want to speak to a person or take the automated survey?” Jennifer asked.
“Oh, I guess I’ll talk to a real person.”
“Good. Let me transfer you.”
A moment later Jennifer informed me that there were lots of people in the queue ahead of me.
“Why don’t you transfer me to the automated survey,” I said. Little did I know that I’d asked to be dropped down a black hole.
The automated system asked me to enter my “patient identification number . . .,” but I had no idea what digits and in what order constituted my number. Not to worry. The automated voice added “. . . such as your social security number.” I punched mine in.
“Sorry, I do not recognize that number,” the voice responded. “To speak to a representative, press one.”
I pressed one, only to hear another voice tell me, “We’re sorry, but due to an unusually high call volume, we cannot take your call at this time. Please call back later. Good-bye.”
“Damn,” I said. Having been transferred in the first place, I had no idea what number to “call back later.” I went back to my “recent” calls to start all over again. Lost in the void of faceless counseling pharmacists was Jennifer, the one whom I’d asked if I wanted to speak to a person or go the automated route, whereupon I’d innocently replied, “a person” but wound up in “automated land,” only to wind up down a black hole.
This time around, “a person” picked up my call, but it wasn’t Jennifer. With babies crying in the background, the new person was clearly working from home—if not a day care facility. One thing was certain: she wasn’t sitting in an office cubicle. After explaining my situation and quest—my “patient identification number” or ideally, someone who could administer my over-the-phone survey—the woman unfortunate to have taken my call explained that the survey is conducted by the drug manufacturer, not CVS, and the patient identification number is apparently a closely guarded secret of the manufacturer and not shared with the specialty pharmacy. At this juncture smoke was starting to flow out of my ears, and where there’s smoke, there’s fire. I was close to blaming my iPhone for the convolutions—and understanding the appeal of Trump as Torch.
As my mind flirted with the limits of sanity, I vented with the comment that I felt as if I were “living a Franz Kafka novel.” Being the well-trained professional that she was, however, the woman with the crying babies said she understood my frustration and would try to help. “Would you like me to connect you with the Bristol-Myers survey line?” I would’ve liked better the thought of having voted for Trump, just to express my frustration with “the system.”
Just then I caught myself. Until the service rep with the crying babies mentioned the Big Pharma name, I didn’t know who the manufacturer of my magic medicine was. I began to see how things worked. On every prior occasion when I’d completed the counseling bit and been asked if I wanted to be transferred to the survey line, I’d imagined a large encampment of phone-based people wearing headsets, sitting in cubes, interacting with patients all over the country, and communicating internally by messages written on paper airplanes. In other words, I naively pictured the counseling department existing side-by-side with the survey area; I’d pictured transfers going from a cubicle in one row to a person sitting one or two rows over or at most, halfway across the sprawling floor of a call center. In fact, the transfer was going from a CVS – Specialty rep working remotely from her home in Illinois, let’s say, to a Bristol-Myers rep working remotely from her home in Connecticut, perhaps.
“I’ll give you the number you can call to complete your survey,” the young CVS rep said, “but if you want, I can transfer you over now. I’ll stay on the line to see what we can accomplish.”
After the transfer, the transmission my way was terrible—sketchy, broken up, reminding me of someone at a new base in Mars trying to explain the inexplicable. A second person picked up the transfer call, thus establishing a three-way conference call. This second person asked for my full name, date of birth, and so on. Her line then went deader than a doornail. To the credit of the CVS rep, she insisted on calling the survey line back. When a (recorded) voice picked up, it informed us that “due to an unusually high call volume . . .”
The poor woman with babies crying in the background had done a remarkable job, and I thanked her for her persistence and professionalism. “Whatever they’re paying you,” I said, “it’s not enough.” If I wasn’t yet ready to go back to voting for Democrats, I’d been talked down from the ledge. Sensing that the CVS rep had carried me to the cusp of a breakthrough, I called the survey number she’d given me and got right through. Two minutes later I was across the finish line.
With my over-inflated frustration now fully deflated, I no longer wanted to take a wrecking ball to the healthcare system or even quite yet to Big Pharma, Big Tech, or the call center of CVS – Specialty or Bristol-Myers. In fact, both CVS and the pharma firm were back in my good graces, and I no longer thought it would be a good idea to put RFK, Jr. in charge of anything, let alone medicine. If at 11:00 I’d been fully supportive of Trump’s drive to tear things apart—and understanding of people grousing about the price of salad ingredients picked by illegal immigrants—by 11:30 I was glad that aided in however small a measure by my vote, Minnesota had bucked the red tide.
Most important, however, was the treatment I’d received by a service representative employed by a behemoth chain store. She’d exhibited impressive dedication to her job and taken me, one of a gazillion customers, seriously and patiently. And she’d laughed when I said, “Don’t assume that I’m a crazy person. I’m only half crazy, and if you give me enough time, I can find at least three people who would attest to that.”
It’s still early in the game, but unless Trump gives me a 100% tax break, bread for $2.00 a loaf and gas at $1.50 a gallon, the Democrats can count on my vote in 2026. I’m still planning to be around then and a number of election cycles thereafter, thanks to the “magic potion medication” at $673,000 per year plus the monthly counseling and survey hassle. That hassle by itself, anyway, isn’t worth burning the house down.
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© 2024 by Eric Nilsson
