Life as Crisis Management: A CVS Health Kiada Tale

I never had a single problem with my health care pharmaceutical insurance coverage during the sixteen years I worked for New York state until September of 2021, the month and the year I retired from the New York state workforce. It was then, thanks, no doubt, to a wealthfare contract New York state made with the for profit CVS Health and CVS Silver Script (a cool $140 billion plus last year), that all that changed and trouble started and it started almost immediately.

I was told by my largely useless union's health care specialist that nothing would really change when I was force switched from the prescription coverage I had been on to the new one they had "negotiated" with CVS Health and CVS Silver Script. Boy was he wrong. Within weeks if not days CVS Health forced me to accept an overpriced generic version of Advair because the doctor had not noted on the prescription form that only Advair should be prescribed, a feat that would have been impressive given that neither one of us knew that there was a generic equivalent to Advair on the market some thirty years after Advair had its coming out debutant party.

Not knowing any better given the switchover in my prescription coverage, I bought the generic Advair, took it, and immediately and had an allergic reaction to it, something I am still dealing with and have never fully recovered from. Needless to say CVS Health took no responsibility for this but then that is one of the joys of being a corporation that is a person and not a person at the same time. I didn't do it and my team of highly paid lawyers silled in delaying tactics will keep you from proving it.

This was not the end of my trials and travails with this for profit healthcare bureaucracy. Last month I was informed that CVS Health was striking the once numbered amongst the elect Advair from its holy Formulary no doubt because of money. Generics cost them less. They told me I could apply for an exception to this dogmatic rule, which I and my pulmonologist did.

When I went to get a refill of Advair from my pharmacy, however, the bill was $120 dollars for three, a bill I could not and cannot pay as I am on a $20,000 dollar a year income and have a car payment of nearly $400. So I contacted my doctor. They tried to talk reason to CVS Health but had no success. CVS sent me two letters and had a bureaucrat likely from their PRor Propaganda Ministry call to explain the situation to me, a flunky who did not even know that I and my doctor applied for an exception to the holy rule because I had an alergic reaction to the generic version of Advair and could not take it.

My solution--one I was forced into--was to opt for a similar drug, Wixela. So the doctor wrote me a prescription for it and sent it to Lincoln Pharmacy. They called me to say they had to order it and then, an hour or so later, to say they could not get it from their distributor. Not surprisingly I was forced to put in a prescription for it to CVS Health's CVS Caremark Pharmacy. Needless to say, I was shocked, shocked. 

So that is where we stand at the moment. Let me simply note, in conclusion, that the US health care system with its millions uncovered, undercovered, and manipulatedly covered by Mr. Potter like for profit health care companies is the worst in the "civilised" core nation world, a fact pointed up not only by the fact that the US has millions uncovered or underovered while corporations doing the same things--a little thing called unnecessary redundancy--make millions for their morally bankrupt shareholders and corporate elites but also by the fact that the US numbers among the leaders in infant deaths and mothers dying during childbirth. Now that is something to be proud of. 

Let us now pledge allegiance to American exceptionalism...

Life as Crisis Management: The Walmart Kiada

 

I really dislike Amazon but then there is a lot to dislike about Amazon. It is a monopoly. Its CEO, Jeff Beezos, is yet another one of those avoid corporate taxes liberal who likes to throw his weight--his monies, in other words--around to defeat candidates like Kshama Sawant, a socialist  member of the city council in Seattle who strongly supports union. Beezos--I am shocked, shocked--doesn't. He wines and dines with other pinky liberal elites of his political and ideological and narcissistic ilk like the Clinton's and the Obama's and even the Saudi's. He plans to join Donny "Tangholio" Trump in that "heaven" that is ruled by the self-proclaimed High Priest of the Low Church of Ideological and Political Correctness, Blarmey Ronnie DeSantis. And he now presides like the sun king over an empire that used to have one of the best websites on the internet but which now has one of the worst. For all these reasons and more I decided to try to wean myself off the overgrown and overripe pig that is Amazon. I decided, therefore, to take more of my business to Walmart.com. That decision, it turns out, was  a bad one.

During my month or so on Walmart.com I was sent an item that did not work, an item that was lost in transition, an item that was put outside my house on the steps rather than in the foyer below the post boxes, an item that was not as pictured, and an item that was supposedly delivered but, while it may have been delivered somewhere was not delivered to my. Now to be fair Walmart.con, oops Walmart.com, was only complicit in the item lost in transition, the item that was not as pictured, and the item that disappeared into another dimension. What they are complicit in is that in the last two cases they, when I contacted them, did the Pontius Pilate jig and washed their hands of the whole affair. In fact, in the case of the item lost in transition--a large bottle of Method dish soap--they told me to contact my bank to try to get the monies back. One of the problems with that scuzzy solution was that I actually put the on my American Express card, something they could have found out if they simply looked at my account.

Long story short, I deleted my online Walmart account and will no longer be making purchases from them on the web. What I will be doing is filing a complaint with the New York Office of the Attorney General to get back the monies Walmart stole from me. As to buying in the brick and mortar store I think I am going to switch my business to Target and see if they are as skanky and slaggy as Walmart. Needless to say, Target has a Herculean task in front of it if I wants to become part of the that group of slaggy corporations that includes Amazon, Walmart, CVS Health, a lingload of tax preparer corporations online, and Tracfone.

Postlude: Walmart did refund my money after much prodding and thanks to the help of the New York Attorney General’s office.

Life as Crisis Management: The Great American Taxpaying Kiada

It is time once again for that dreaded event that happens every year in the United States, paying one's taxes. I spent several hours doing mine yesterday all in the midst of being told by the fascist and vampiric CVS Caremark a division of the skanky and slaggy CVS Health, that a medicine I have taken since 1990 and which I depend on would no longer be available to me because it was no longer one of the elect on the corporte formulary. This meant, in turn, that this essential medicine had become too expensive for someone on a very limited budget like me to purchase. This just added to the inherent pain that is doing one's taxes in the backward we love the stone age United States.

Over the years, despite the stated intentions of those governmental and corporate elites who have the power and authority to determine how taxes work in the United States, doing one's taxes has become ever more difficult. It did not used to be this way. At one time the US Internal Revenue System, the government bureaucracy that collects American taxes, had what they called an 1040 EZ form that people who had limited incomes and who took the standard deduction could file. Between 1982 and 2017--the day the EZ form died--I always used the 1040EZ to do my taxes save for one calender year when I was self-employed while working on the Encylopedia for New York State thanks to Syracuse University Press's decision to treat its Encyclopedia personnel as freelancers rahter than employees for obvious reasons. Then Dandy wolf boy Donnie "Tangholio" Trump and his "tax reforms" came along and the EZ form disappeared and those of us who had no problem doing the EZ form were suddenly faced with a far more daunting and absurd project, doing a much longer tax form, the 1040.

Those of us with tiny incomes did have another option by then. We could do our taxes online. Of course, tax preparer services, both independent and corporate, have been around for some time, something that is at least partly a measure of how easy and difficult filing taxes in the US was and is.The private H&R Block, for instance, was born just after World War II to help taxpayers do their taxes. With the coming of the brave new digital age, not surprisingly, tax preparer services went digital offering software that could be purchased and used by taxpayers to file their taxes and later online services that could be purchased by taxpayers and used to file taxes. Turbo Tax, for instance, came into existence in 1984 and offered software for sale to those who wanted an easier way to file US taxes and now offers the same services online.

In the early part of the twentieth century, after some criticism of the cost of these private services, the Free File Alliance of tax preparing bureaucracies arose and entered into a public-private partnership with the IRS in order to allow those on limited incomes to file their American taxes online. This public and private partnership is supposed to allow Americans who make less that around $70,000 dollars a year to file their federal taxes (and in some cases state taxes) free. But do they?

To take Turbo Tax, a service I have used for several years now and which opted out of Free File Alliance in 2021 after being at the forefront of its founding, investigative reports have, over the years, found that this now Intuit owned corporation made their free tax service forms hard to find and that Turbo Tax intentionally steered free form users to paid services. They still do. Turbo Tax, for instance, which I have used to do my taxes for the last several years, channelled me, thanks to, they claimed, the massive $26 dollars in book royalties I received last year, onto a pay platform despite the fact that my income was well under the $70,000 dollar threshold--it is around $20,000 dollars--the fact that I owed no taxes and got no tax refund, and despite the fact that $26 dollars in royalties does not an aristocrat make. I could find no way around this honey money Berlin Wall like trap pot Turbo Tax had put in place though there supposedly is one, according to online posters, if you want to start all over again--and have lots of fun, fun, fun in the process--and then hitting some virtual buttons. 

To digress a bit, I had the exact same problems with Tax Act and another "free" tax service whose name I have forgotten this tax filing year in addition to Turbo Tax. Free for them is not what we generally mean when we talk about getting something for  free, namely not paying for it. They make it virtually impossible for the uninitiated not to pay for their "services". Perhaps I will see what EZTaxReturn is like next tax season. I suspect I will find more of the same.

This political lobbying by private corporations, of course, points up the real nature of the public and private partnership between the IRS and various private for profit tax preparer services in the US. The IRS, which could easily do the taxes of those who make below a certain income threshold and who take standard deductions, is handcuffed by the fact that the wolves, in this case the for profit tax preparer corporations and the politicians they control, are in charge thanks to their economic and political power and lobbying efforts and they have no interest in supporting programmes that would help most Americans but cut into their profits. 

These private companies use all sorts of strategies to maintain their privileged positions including lobbying the American legislature, contributing to political candidates, and forming their own "governing" bodies. Paradoxically, it was Intuit which helped form the Free File Alliance to head off possible federal government investigations into their flim flam and snake oil practise of using the claim of "free" tax filing to entice those who use their services onto pay platforms in order to futher enrich themselves. Like Hollywood and like comic book peddlers in the US a before them online tax preparers instituted a private body to allow them, the wolves, to continue to guard the henhouse without any government "interference" to assure that what the tax preperation services said they were doing, namely offereing free tax services for those on iimited incomes, is what they were actually doing. 

This cynical prophylactic seems to have worked at least for the moment. But, as I noted, the rhetoric is different from the reality. "Free", for these vampire corporations, actually means getting as much blood from the stone as they possibly can. Will things change in how the US collects their taxes? Will the IRS be given the power to file forms for taxpayers who make less than a threshold income and who take the standard deduction? Will American politicians put people over corporations and their never ending obsession with nore and more profts, an obsession that borders on if not passes over a sadomasochistic fetish line? Will a private corporate service arise to help online tax filers get around the firewalls put in place by tax online tax preparers to wring monies out of tax filers for a fee, of course. I doubt it. See the government-corporate complex. But hey, stay tuned, perhaps Pollyanna was right and America isn't a bunch of pink houses for the 99% to live in.

The Continuing and Never Ending Saga of Corporate and Governmental Merry-Go-Rounds...

 

I have written about the hair pulling and soul killing experience dealing with bureaucracies--corporate and governmental, public and private--are many times before on this blog. Today, I am going to talk about it again because dealing with bureaucracies of all kinds never ends in a life cycle that, in the brave new digital bureaucratic world, has become increasingly about managing crisis after crisis caused by bureaucracies.

So, today the bureaucracies I want to talk about are four: Intuit Turbo Tax, the Empire State CVS Caremark prescription programme, and the New York State Civil Service. Let's start with Intuit.

Today I got up early in the morning--around six am to be precise--to do my taxes, one of the most hated things I have to do in addition to going to a laundromat, going to doctors, having one of those CT Scan dye tests, being forced to watch American television and YouTube reaction videos, and dealing with bureaucracies in general in my life. Though I have used Turbo Tax before I could not get into my account this morning because they wanted to send me--shades of idiocies past--a security code to a phone number that is no longer in operation as the phone died and I ended my awful relationship with Tracfone. Will they send the security code to my email which they have? Of course not. Welcome back to Kafkaville.

Now on to CVS Caremark and the New York State Civil Service. The problems I had with CVS Caremark and the New York State Civil Service this morning are the same and both revolve around the same thing, prescription issues. Some backstory first. I have been taking Advair for my asthma since 1990.  When I retired and my pre-retirement prescription coverage was changed to CVS Caremark Silver Script things changed despite claims to the contrary by the good old useless union who told me little if anything would change for me. I was immediately given a generic version of Advair that unbeknownst to me and my doctor, had just come on the market. I did not know that I should not get this generic given the change in my coverage. Now don't get me wrong,  I like generics and I find it morally disgusting that the rich pharmaceutical companies do everything in their power--and their power is extensive; just ask the lawmakers in DC--to keep cheaper generics off the market. They care more about profits than people after all. However, I unfortunately had an allergic reaction to this generic Advair which my health has still not recovered. So, I had to go back on Advair.

Jump ahead some two years later: CVS Caremark (remember corporations are always about profits over people despite their demagogic rhetoric), took Advair off my formulary, the holy list of the elect and the damned kept by America's insurance corporations. Both I and someone at my doctor's office noted that I had an allergic reaction to this medicine and that therefore Advair should be approved for me at formulary prices. CVS Caremark denied this peasant's petition saying the PA who put in the request did not have royal permission do so. Given this my pharmacy had to charge me $120 dollars for the medicine. Needless to say, I skipped this honour, this act of royal health insurance patronage, as I don't have that amount of monies to pay for this medicine on a regular basis and even if I did I would would not pay such an obscene price for it. Welcome back to Kafkaville.

So, I contacted my doctors office and I called the number on the back of my Empire Plan, NYSHIP, CVS Silver Script prescription card, 877.769.7447. Empire Plan NYSHIP, CVS Silver Script, in turn, told me to call New York State Civil Service. So I called NYSCS at 518.457.9375. They told me to call Empire Plan, NYSHIP, CVS Silver Script...AGAIN. Since Empire Plan, NYSHIP, CVS Silver Script had previously told me to call NYState Civil Service that seemed like a no go. Welcome back to Kafkaville.So, I asked to speak to a supervisor. He put me on hold--of course--and tried to transfer me to the New York State Retirement System. Eventually I was able to request a call back but since they had my telephone number completely and utterly wrong I don't have much hope for a call back. I did, of course, put in the correct number but that was followed by a request for an extension, which I, of course don't have since I have a personal rather than a corporate phone. Welcome back to Kafkaville.

At this point I have given up. I simply can't deal with this bureaucratic bullshite anymore. I am fucking tired of having to manage crisis after crisis every month of my retired life. The doctor's office, the only competent one of the bunch, is trying to get this rectified. I am at the point, however, in favour of going on a less effective medicine that is on the Holy Formulary simply to avoid this never ending bureaucratic bullshite. Bureaucracies, after all, particularly in the unmerry-go-round world of brave new digital age, wear and beat you down mentally and physically, eventually.

So, the doctor's office reports that I can no longer get Advair. The alternatives on the formulary are too expensive. Let's hear it for the American health care system, the worst in the "civilised" world, the health care unsystem that puts profits over people's health. Speaking of profits over people, GSK, who makes Advair, no longer offers assistance to those who use it now that it has gone all generic on my allergic arse.

For your information...Notes from my doctor's office on this matter...
Note One:Hi Ron, I am on the phone right now with Caremark, they manage Empires prescription drug plan. They confirmed that the Advair Diskus 100-50 is non-formulary, but they did approve it with a PA last year, I confirmed the PA on file is active, I explained that you have trialed basically every formulary alternative they have suggested, generic or otherwise, and you copay for the inhalers have gone up from $10/3month to $120/3 month and that's not appropriate for a medication that we have obtained Prior Auth for and there are no reasonable alternatives for you to trial. I am also submitting with your insurance a "Tier lowering" form to see if we can get the cost reduced. The plan also recommended that you contact the number on the back of your card for member services. Just in case we cannot get the tier lowering form approved with your insurance, they may have other options for you such as patient assistance programs and such. As far as alternatives, there are not many available in the class of inhaler you are prescribed that are comparable and formulary and would be as effective. 

Note Two: I hit a road block myself too. I got all the way up to the clinical specialty pharmacist. Medicare has really covered all of the loop holes, and I tried to get the formulary tier exception pushed through. So even though you have a prior auth on file, its not assigned a "tier" what the pharmacist told is that means they cannot lower the tier because the PA's don't officially have a "tier" assigned, even tho it sounds like it gets assigned to the highest tier anyway. I reiterated that you have tried almost every formulary alternative, generic, etc. And that none of the alternatives that are preferred or lower tier that are in the class of med you are taking are appropriate. Medicare guidelines also don't allow tier lowering exceptions for Brand medications, only generic. And Medicare has been smart by taking a lot of the generics off the formulary and putting the brand medications as "formulary" this year. So now they set the brand medications to a slightly higher "tier" so that we cannot request a tier exception. There are only 2 other inhalers that you haven't tried that your insurance recommended that are on your plan, both name brand medications so they are set at Tier 2. One is Breo Ellipta, the other is Trelegy. The Breo is in the same class of medications as the advair diskus so it is comparable. The Trelegy is a triple therapy inhaler. Both of those inhalers are $30 for a 30day supply, $90 for 90day, Advair 100-50 diskus that you are currently using remains at $40/30day, $120/90 day. Wixela is the generic for Advair Diskus that you trialed in the past, that one is formulary preferred tier 1 but not appropriate for you to be on because you had a medication reaction. I am at a loss I am so sorry. I spent over an hour on the phone today trying to get this to work. Would you be interested in trying the Breo ($30 a month is still a lot)? Or would you prefer to discuss further with Dr. Conuel when you see him on the 28th? 

So much for the bs that CVS takes exemptions seriously and that they CARE. Bullshite. Welcome to Kafkaville again. Hospital here I come.

A Critical Ethnography of Social Media: Californication, Disneyfornication, Googlefornication...

 

YouTube! Edward Abbey once is supposed to have said that "[s]ociety is like a stew. If you don't stir it up every once in a while then a layer of scum floats to the top”. YouTube and other social media prove the truth of that quote every second of every minute of everyday thanks to their generally vacuous, mundane, banal, and at best, mediocre recraperation videos. Scum, as social media shows, generally does indeed rise to the top.

Quakers, of course, have long talked of the need of speaking truth to power. In thie era of continuing mediocrity and of mediocrates slumming for monies on YouTube, which, in turn, makes monies off of the banal, the mediocre, the mundane, and the ill researched videos they broadcast--lest we forget, YouTube is home of never ending if more readily available digitalised opium--it is long past time to speak truth to those who believe and those who enable videos grounded in the fallacious notion that anything said is worth saying. It isn't. Of course, I do realise the quantity of quality digital media is, historically speaking, no less or no greater than the quantity of quality books, television, or movies. There isn't much quality anywhere in the mass media world. The crap, however, is more widely spread on the stale bread producing hallucinations that is social media. And nowhere is this fact more in evidence in the core nation world than in the not so mythical kingdom of media bread and circuses, the USofA, that home of Califonication, Disneyfornication, and now Googlefornication. 

Golly gee that is something to be proud of. I hope the employees of Google, land also of paternalistic censorship, are basking in the glorious and radiant heat of their brown hole sun.

The Books of My Life: The Vimy Trap

 

Humans, as all social scientists should know by now, need myths and fairy tales to live by. Myths and fairy tales, particularly in their disneyfornicated form, help weak humans, both individually and socially, survive the struggle that is life just as religion has done for centuries. If history is a guide it is clear that most humans need myths and fairy tales, for example, that explain why, or so it is perceived, good things happen to bad people and bad collectivities in real life and vice versa, myths and fairy tales that generally deflect attention from the real factors that cause suffering in life such as class, status, gender, ethnicity, and unequal cultural capital, to note a few examples. They give humans a sense of purpose. They provide humans with meaning for their lives, and meanings to their lives within the collectivities they are part of. They provide the happy or stoic faces humans need to live by in order to survive in a world of chance, pain, tragedy, drama, and comedy.

Collective human myths and fairy tales, of course, are, generally speaking, deeply embedded within and deeply imbibed and imbibe from the universal waters of ethnocentrism. Australians, for example, think they are the bee's knees. Americans think they are the best thing since sliced bread. South Koreans think they are the real middle kingdom. One central form that ethnocentrism takes in modern and postmodern life is nationalist or civil or civic religion. Like myths and fairy tales in general, national myths and fairy tales socialise most humans in modern and postmodern societies and cultures into comic book like emotional and sentimental laden tall tales in which we are superior to them, in which we are innocent and good while they are devious and bad Boris's and Natasha's.They create civic rituals associated with these ethnocentric nationalist faiths, rituals that take place, for example, at monuments to those killed during one of humanity's many and seemingly never ending biggest cock on the block wars. Finally, these nationalist myths and fairy tales have symbolic and iconic hero figures that are akin to those in earlier stone age tales and in contemporary superhero comic books who have been transformed into the saints they never were and never could be in real life because they are human,

In their follow up to their excellent Warrior Nation Ian McKay and Jamie Swift explore, in their The Vimy Trap or, How We Learned to Stop Worrying and Love the Great War (Toronto: Between the Lines, 2016), one of these nationalist myths and fairy tales of late twentieth century and twenty-first century Anglo-Canadian life, the Vimy myth and fairy tale. McKay and Swift do an excellent job exploring the Vimy myth and fairy tale. They note that the myths and fairy tales associated with Vimy, namely that it created or helped create a Canadian identity (if one erases Quebec entirely, of course) which today dominates much of Anglo-Canadian civil religion has actually been contested in hot and cold culture wars between dominant, counter, and sub cultures since the Great War even beyond French Canadian culture. They show that the Vimy myth and fairy tale is the product of what is essentially a power grabbing advertising campaign by late 20th century Canadian elites with their Canada is a city on a hill public rhetoric in order to promote a variety of things including a common Canadian (translation Anglo-Canadian) identity and the need for Canadian militarism in alliance with that other city on a hill, imperial America. They note the similarities between the publicity and advertising campaigns that turned the limitedly effective Canadian Vimy battle and its close Australian cousin, the dismal failure at Gallipoli, into stirring mythic and fairy tale tales in which Canadians were made Canadian and Australians Australian. Even tragedy and meaningless wars, you see, can be turned into comic book superhuman triumphs in nationalist fairy tale myths. They explore the humans who the national faith turned into inhuman saintly hero icons and symbols such as Currie, the romanticised and sanitised Canadian grunt and villainous others, to wit those dreadful British officers who thought father knew best and the Hun, of nationalist manichean myths and fairy tales. And they explore the attempt of official and semi-official court polemicists--some of them academics--to demonise those on the "wrong side" of manichean myth and fairy tale "history" such as critics of these fairy tales and myths and pacifists, who pointed out again and again the surrealist absurdities and human rights violations association with almost all wars.

I highly recommend The Vimy Trap to anyone interested in cultural history, cultural anthropology, cultural sociology, ethnocentrism, and the human ability, or at least the ability of some powerful humans, to create hybrid fictional and factual discourses to live by. I particularly liked how McKay and Swift drew on Martin's Caedels's ideal types--militarists, crusaders, defencists, pacificists, and pacifists-- to explore the contradictions and complexities of this Canadian (and Western) culture war over war and its associated myths and legends. My only qualm about the book is that I wish McKay and Swift had explored in greater detail the role power and the media--mainstream media, after all, has been and is generally controlled by those embedded in the nationalist passion play--played and play in the construction of the mythic and fairy tale worlds most Anglo-Canadians live by today.