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Fam Pract Manag. 2000;7(9):11

Dear ___________:

I wanted to thank you for your recent letter and the accompanying, very impressive, very colorful, very glossy, very expensive-looking mailing. It's reassuring to know my premium dollars are being put to such good uses. You can show this mailer to anyone who suggests that health plans just waste money, and especially to those who complain about the high salaries of health plan CEOs.

The message of the mailing — that you want me to “take control” — is heady stuff. After feeling like a ping-pong ball for the insurance industry all this time, I'm going to need a while to get used to the idea that you're giving me control and that you want to do what works for me. Imagine that!

I'm glad to see that you're starting small, asking me in the colorful little survey things like whether I want discounts on alternative medicine or on “health-related products and services.” Baby steps, that's the ticket: baby steps to control. It's like giving water to someone who has been in the desert for a week; you have to start slow. (For what it's worth, I'm not interested in the alternative medicines, and I can't imagine why I would expect my health plan to provide discounts on health-related products and services, but it's nice of you to ask.)

New and improved

Still, you know, I think I am ready to take a little more control. Take that part of the mailing where you say we're getting a “new and improved pharmacy program.” New and improved sounds great, but when I read later, “keep in mind that your benefits do not change,” I suddenly realized that I must have missed the part where you explained just what improved.

I've looked back over the mailing now, and although it says “new and improved” in two or three places, I still don't see the part that explains why this is good news. Are you sure it's improved? All I could find was that I have a new insurance card (very pretty color, by the way!), that I have to make sure to show the card at my doctor's office and at the pharmacy the first time I visit after its effective date (in a month or so, but I'm sure I'll remember) and that I'll need to get “new hard copy prescriptions” for the new mail-order pharmacy. I'll admit that all this does sound like some welcome excitement for my dull life, but after that, it sounds as though nothing about the plan will be different. What am I missing?

All you have to do is ask

I would have been happy to exert some of my newfound control here if you had just added a few questions to the little survey — questions like these:

  • Do you find it inconvenient to change mail-order pharmacies when it means you have to get new hard copy prescriptions for every chronic medication you're taking? Yes.

  • Does it embarrass you to have to ask your doctor for a new prescription for a reason like this, and months before the refills on the old one would run out? Yes.

  • Do you think your doctor still feels like the insurance industry's ping-pong ball even though you the patient have all this new power? Yes.

  • Do you think it only fair that the health plan should pay your doctor a little extra for writing all these new hard copy prescriptions? Yes.

See what I mean? Just a few simple questions and you'd have been able to put me in control that much sooner! I would have been happy to help.

Don't get me wrong. I don't want it to seem that I'm picking at little things like the prescription program. I think this control thing is great. I'm delighted to know that you're going to stop using me as a ping-pong ball and give me some power in the game. I can't wait to get my hands on the paddle!

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