Pharma Futility and the American Health System

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Felicity had an interesting encounter with our dysfunctional health system recently. If you’re not from the United States, you may be befuddled by this story because it couldn’t possibly be true. If you do live in the U.S., you will probably sigh in commiseration or cynically say, “Well, of course! Everyone is used to this! Are you naive or something?”

No, just humans who expect better from what’s often termed “the best healthcare in the world”.

And it’s not even a tragedy or anything, just one stupidity in a large collection.

So she’s been getting a prescription for a few years for a very generic and almost ancient antibiotic that her doctor feels is necessary to take at low levels to keep some of her problems under control. Nothing very dramatic or controversial.

All of a sudden, she got a letter from the pharmacy run by our health insurance that said “prior authorization was necessary” before the prescription could be filled. Again, this is something she’s been taking for quite awhile. For those of you not familiar with the convoluted U.S. health system, “prior authorization” means the insurance company has to approve it, not her doctor. Her doctor has already “approved” it, of course, by writing her a prescription. That’s right: the insurance company is now practicing medicine and without even seeing the patient!

But that wasn’t the the real problem.

After going around and around on the phone with various idiots functionaries at the insurance company, she finally found one that told her the truth. Perhaps you’d better sit down.

The reason the insurance company was insisting on this added level of “safety” and “control” was that they were concerned that patients might be getting too many prescriptions for this medicine and “abusing it”.


Now, there are legitimate concerns that some people use antibiotics too generally, contributing to antibiotic-resistant bacterial infections. That’s more a case of “user  error” when well-meaning patients take leftover antibiotics for viral infections, not a specific protocol of care followed by an actual specialist as in this case.

But abusing antibiotics? The mindless reaction of so many people concerned lest someone “get high” amazes me…especially when FDA-approved prescription opioids and benzodiazapenes are our country’s greatest public health problem, with a total of almost 23,000 deaths every year, way more than cocaine and heroin and all illegal drugs combined!

Institutional idiocy never fails to amaze me.

Old Hippie is a father of two boys and thankfully living in California where all this kind of thing is legal. He started smoking marijuana in 1967 in high school, experimented with mind-expanding drugs of all kinds, and then straightened out 15 or so years later to become an airplane pilot. After being diagnosed with depression in 2000, he lost his job and most of the following decade to prescription medications (such as antidepressants) which sapped his energy and will. Finally, a chance conversation with a friend led to a doctor’s recommendation for medical marijuana (MMJ). This changed his entire life, health, and outlook for the better. is his continuing story. It’s also his way to provide experienced advice on using medical marijuana effectively and responsibly, as well as advocacy, activism, and support for others. Old Hippie teaches about safe use of cannabis edibles, Canna Caps, vaporizers, dosing, and even microdosing.

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