Clarifying the Dispensing Fee and Fingernail Friday!

Skip to the end for the fingernails if you wish......

Alrighty. We have covered the fact that the $7 dispensing fee that the gpvt pays is not enough as it stands right now. However, who is REALLY paying the dispensing fee? In many cases, it's NOT the government. That's right. ODB is a 2 tier system. People on lower incomes ($16 000 a year for a single person, $24 000 for a couple) pay a $2 copay. People that make more than the cutoff pay the first $100 a year then they pay $6.11 . (this is all per prescription) The $2 and the $6.11 are actually the dispensing fee. The govt pays $5 for the lower income people and $0.89 for the higher income people. So, really, the government is NOT paying the fee. Or even most of the fee in many cases. Thus all their posing is just that, posing. Now, the government claims that they are giving us a raise in the dispensing fee. Who is going to pay that? The client or the govenment? I have not heard a clear answer on that. But I bet it's NOT the government.

and now, on to the important part of the post...FINGERNAILS!

What You Get for Your Money

What do pharmacists do to earn their paltry $7 fee?

when I get a prescription, it is entered into the computer. Hopefully, you get all your medications at one store, so I can look quickly at your file and deal with any issues. Some of the common issues:

1. Drug interactions. Some are a big deal and I have to call the doctor with other suggestions or options. Some are not a big deal and can be ignored.
2. Dosage changes that weren't really meant to be. Doctor wrote for the 100mg when last time it was 50mg. Generally I ask the patient if they are expecting a change. If not, then I call the doctor.
3. Illegible prescriptions or prescriptions printed off a computer where the doctor chose the wrong thing off the drop down menu. I have to call the doctor to clarify
4. Drug isn't covered on your plan. I call the doctor to suggest alternatives that ARE covered to save you a few bucks.
5. Drug is something called a 'limited use' drug, which requires that the doctor write a code on the prescription so we can bill your drug plan. And the doctor didn't write the code, or used the wrong code.
6. Drug is no longer made or is on back order or is something so rarely used it is a special order which won't be in till tomorrow

These are the ones that spring to mind, There are many other less common issues that crop up on a daily basis. All of the above require a call to your doctor to sort out.

Other things you pay for with your fee:
Counselling when you pick up your prescription. Advice on what over the counter medication to buy when you have a minor problem. Triage services. Basically, should you go to the emergency room or not? Pretty much anytime you talk to your pharmacist for free. It is 'free' because of the dispensing fee.

Some of the funnier questions I have had over the years:
I broke my mercury thermometer in my swimming pool. What should I do? (call a pool specialist)
I was doing some renovation work on my house and took the grate off the heating vent. My cat climbed into the hole and won't come out. What should I do? (How would a pharmacist know? Call an HVAC guy)
Do I know where the phone caller could buy jimson weed? (um, no)
I dropped my Zantac pills into the sink and tried to dry them out by putting them in my frying pan to dry off. (they actually brought those in. They were scorched black and STUNK!)

What is a Dispensing Fee?

Currently the Ontario Government is forcing sweeping cuts to how pharmacists are compensated. One flashpoint is how prescription drugs are priced. There is a perception that drugstores are cash cows. The reality is very different.

Basic pricing on a prescription is as follows: Drug cost at manufacturer cost+8%+dispensing fee.

This seems fairly clear. However, the cost at the manufacturer level is not the same price I can buy the drug at for sale in my store. I must pay a wholesaler their cut. So, if a drug costs $5 a bottle, I pay $6. My 8% markup is based on the $5 price. So my profit has started to erode. The dispensing fee is the cost to fill the prescription. It was put into place many years ago for the simple fact that the pharmacist pays the same level of attention to a drug that costs $1 as to a drug that costs $400. So the 'real' profit may be considered to be in the dispensing fee.

The dispensing fee the government pays is $7. The actual cost of dispensing a prescription is around $14. An average pharmacy in Ontario does over half their business with ODB (Ontario Drug Benefit)

Where does this other $7 come from? Basically, from professional allowances. These are, in essence, bulk discounts. The manufacturer says "buy $X worth of drugs and we will give you $Y in rebates.

More on that tomorrow. Otherwise this post will be waaaaay too long!

Pharmacy in Ontario

As many of you who read my blog know, I am a pharmacist. Recently the Ontario government announced sweeping changes in how pharmacy operates. First, a little background information.



All pharmacies in Ontario are PRIVATE retail businesses. The government does not own any of them. The government runs a drug plan called the Ontario Drug Benefit program. ODB for short. This plan is similar to Blue Cross, Green Shield etc. In fact, most drug plans base their model on the ODB medel. The way it works is thusly: A patient brings in their prescription. The pharmacist enters it into the computer along with the patient's drug plan number. This information is sent over the internet usually (sometimes by dial up modem etc) to a centralized computer, be it the Green Shield computer or the ODB computer. Said computer then spits back a response. This response is usually a 'paid' response. In this response is the patient's deductible (if any) and how much the plan deigns to pay the pharmacy. Yup, what we bill and what the drug costs is NOT necessarily, or even often, what we actually get paid.



Here is where it gets tricky. Basically, as the province's largest drug plan, ODB has negotiated a cut-rate fee. Similar to how , say, an interior decorator may get a discount on paint because she buys so much. However, ODB and many other drug plans, have started to cut back what they pay us. This happens in a variety of ways. One of the easiest things for the plans to do is...nothing. So when the manufacturer ups their price on the medication, the plans conitnue to pay the old price. So that eats into our proft margin as well.

The other way that the government eats into our profits is by not changing what they pay for the dispensing fee. Remember, the fee is basically where the profit would be. The government has increased the fee by a whopping $0.54 since 1989. That works out to around an 8% increase for a 21 year span. Clearly costs have increased more than 8% over 21 years! Do you know anything that has not increased more than 0.38% per year???? Basic inflationary costs are around 3%. Per year. So the govt has been getting a MASSIVE deal for their $7. Yet they claim to be paying too much.

Next installment. Where the money goes. Or what you get for your money

Garthering Supplies

I am getting the finishing touches together for my bag. Found some nice, basic fabric in a non-icky colour for lining. Couldn't find a zipper at the same store. I need a 12" zipper. All they had in 12" were plastic ones. Which didn't strike me as very sturdy. Not sure where else to look. We only have the one fabric store in town, really. Do quilting shops carry zippers? Michaels? Anyhow, here are the pieces I've gathered so far:

Off to search for zippers.....

Could it be?

Finished. And then again it might not be. But the Bag is closer to being finished than ever before. Yup, the body of the bag is done. I have started strap knitting. Oooh! That sounds kinky. I made the bottom a different colour for kicks and also made it a bit wider than the pattern calls for. As written, the bag would be about 3 inches wide on the bottom. I wanted a bit more so I aimed for 4-ish inches wide. All in all I am pleased.

Ciao

Fingernail Friday on a Thursday

Since this friday is Good Friday, I decided to do fingernail friday a day early:

Tada!

Cake Goes To Town

I hang out a fair bit on Ravelry. One of the forums I frequent is called the CPaAG. (Completely Pointless and Arbitrary Group). On this forum, a lady make Cake the Eleohant. And now we send him around to different towns and take pictures of him having adventures. Cake decided to go to the LYS> I know, shocking. Malabrigo was found:

Cake also found Christmas ornaments to match herself!

And I am sure that even as you read this, Cake the Elephant is having more adventures. Somewhere else!

At Least the Knitting is Safe

I put down my purse knitting. No, the knitted purse I am working on for forever, it seems. When I came back, I found this:

Is he protecting the knitting or just curling up in the warm spot my haunches left? Who knows. but at least he didn't chew up the knitting!

Had to share1

!

Fingernail Friday!

Other Knitting

Since knitting on my new purse makes my hands achy, I am working on another knit for those times I want to knit but don't feel like dealing with cotton.

I cast on for a sock for the hubby. He likes his handknit socks. In fact, his socks are wearing out faster than I can knit them! Now, that's a compliment!

ciao

Still Working At It

This knit is killing me! Okay, not really. But I don't think I will choose to knit with dk cotton again any time soon. It's been a while since I showed you my Bag. I have finished the top half of it and am almost done repeat 4 out of 7 for the bottom.

I really like the way it is turning out.

Ciao!

Bartering

Ravelry is a very good website for bartering knitting stuff you aren't going to use. Many moons ago I accidentally bought a lonely skein of sock yarn. Not enough to do anything with, really. So, I listed it on my Trade/Sell page on Ravelry. Memoe33 took me up on it and sent me this in trade!


I especially like these stitch markers:

and a closup of the pattern tamers (cause I can)



So I got a skein of yarn outta my stash that I had no idea what to do with, and got these lovely items that I can actually use. That's a WIN in my book!

Fingernail Friday-Radioactive Edition!

More Music Critique

Right, so 'The Bag' continues. I am past the halfway mark. So picture the knit a bit bigger than the last post :)

At the risk of appearing 'old-fogy-ish' Rihanna's current song 'Hard' is pushing several of my buttons.

Button the first: Bad grammer.

They can say whatever
I'ma do whatever
No pain is forever
Yup, you know this

I'ma???!!! I'll let the 'yup' go, but I'ma???!

Which leads to weird slang that is not particulary clear:

Trying to sell they peeping my bag they can't afford it


Then there's the Madonna vs whore problem:

Sincere, I see you aiming at my pedestal
I betta let ya' know

Putting a woman on a pedestal means appreciating her for qualities other than her personality. Such as her virginity or 'pureness'. Argh. This kind of reference really makes me irritable. If sex for a male isn't 'dirty', then sex for a female isn't either. End of discussion. This sort of unthinking use of a sterotypical phrase shows how little people actually think about what they are saying and the behaviour patterns it subtly reinforces.

Rihanna is trying to say that the nasty things people are saying about her don't hurt her because she is 'hard'. As in donning her armour. At least, that is my take on it. So that would make her empowered. However, the pedestal phrase disempowers her. I wonder if she even thought about it. Probably not.

So, I applaud Rihanna for trying to find her way after that terrible relationship, but I don't think she has quite found her way out yet.

Cat Olympics

In the spirit of the season, I present to you, one of the many events int the Kitty Olympics. The "sit inside something" event. Points awarded for style and creativity.

So, who is the gold medal winner?

The Winnerz R..

And the winners for the free copy of "Home is where the Wine is" are:

Heather, Sharon, Radarkaty, Madmoon and Pieheart.

Send me your snailmail address so I can tell them to send you your new book!

Fingernail Friday-Hopeful Spring Edition

Don't forget to comment on yesterday's post for a chance to win a free copy of Home is Where the Wine is!

Blog Tour-Home is Where the Wine Is

(The publisher is giving 5 lucky readers of my blog a free copy of this book, so don't forget to comment for your chance to win!)

Crazy Aunt Purl. Also known as Laurie Perry. The lady writes an amusing blog. She covers everything from gardening adventures to how rain messes up traffic patterns in a very entertaining fashion. This book is no less entertaining.

She writes about her trials and tribulations on a journey of self-discovery. Don't think this book is of the self-helpy variety. Oh no. She gently pokes fun at herself while letting us in on the 'AHA!' moments.

Overall this book was a fast, fun read. With bonus patterns! Not just knitting patterns, she challenges us to stretch our fibre-y fun to crochet too.

Don't forget to comment. 5 lucky readers will get a FREE copy of Home Is Where The Wine IS. Names will be drawn February 22, so comment before then! (sorry, only people who live in Canada or the United states are eligible. )

Palate Cleanser

I am slogging awway on my 'The bag". However I was needing a quick change-up. You know how boring project monogamy is :) Besides, a lady of my aquaintance fell a few weeks ago and broke her wrist. The cast is coming off soon and I thought that it might be nice to give her a little something to keep the wrist warm.

Ta Da!





Pattern: Glovelies
Yarn: Sirdar Country style DK
Needles: US 6 DPN's
Modifications: Made shorter than the 12 inches in the arm the pattern calls for

In other news, Thursday, February 18, I am having a little event! (Yes, that's this thursday). please stop by. You might win something!

A Rant

This song has been driving me mad.

Whatcha Say by Jason Derulo. Specifically, the lyrics.

So let me in (let me in) give me another chance (another chance)To really be your manCause when the roof caved in and the truth came outI just didn't know what to doBut when I become a star we'll be living so large

So, dude acted like a jerk and is wanting a second chance, His bait to bring his woman back is money. So he's trying to buy her off. IF he gets some money. So really, he's trying to bribe her with hypothetical money. Right.

I know what I did wasn't clever But me and you were meant to be together

If they were meant to be together, then why did he screw it up so bad?

don't want you to leave me
Though you caught me cheatin'

Oooookaaay. So, let me get this straight. Dude cheated on his woman. He got caught. He didn't have a ready excuse. He now is trying to bribe her with possible future monies cause they were meant to be together. If they were meant to be together, why did he cheat on her?

I know what I say. Git yer ass to the curb boy and don't let the door hit you on the ass on the way out. The video shows her being swayed by this incredibly poor excuse for a man.

headdesk

What songs do you hate and why?

Oooh, Shiny....

Yup, I got a bit distracted. By this:

And this:and this:and this:Nope, I didn't cast on for all of those. But I wanted to. What a lovely book.....

Chugging Away

Do you ever feel like you are knitting and knitting and the knitting isn't growing? Yup, I'm at that stage right now....

I mean I know, in my head, that I have done 4 out of 6 repeats for the top half, and that it IS growing. Yet emotionally, it doesn't feel like it. It feels like I am on a treadmill....

Ah well, I'm off to knit on my never-growing bag....

testing it again

Does the new comment system work on a new post?

ETA: It appears to be working! YAY!

Testing....

I have installed a new comment widgit. hopefully this works! Try commenting and let me know if it doesn't work! (email me at the address to the side of my blog...)

ETA: Removed it...wasn't working. Please hold...

rEinstalled. now it works if you click ont he post title only. Hmmmm

Fingernail Friday!

Need Help

Okay folks, I need your help. I have been using Haloscan for comments. That program emailed me a link with your email so I could respond. Now they are discontinuing it. So I have removed Haloscan and gone back to the standard Blogger comment system. BUT, this does not appear to send me an email with the commenter's email. Blogger sends me an email with the comment, but that's it. DO NOT LIKE! I want an email with your email address so I can answer you. I don't want to answer in the comments on the blog. What do you use?

I'd Rather Be....

Sunning myself beside a nice pool:

Instead, I got this:(cat and pool belong to the MIL...)

The Bag Continues

I'm 2 repeats into the top part of the pattern. It looks thusly:



It's kind of neat to see the chevron pattern emerging:


This knit seems to be taking a while. I think it's because I have to keep taking breaks. Knitting with dk weight cotton yarn is completely different than knitting with worsted weight cotton. My hands get stiffer faster. Or it could be age taking it's toll. Heh.

Ciao

I Iz Fierce Beast!

New Bag

I decided to knit myself a new bag. Not that I needed one, you know, I just wanted one. It so happens that I had the correct yarn in my stash in colours that match too. Huh. Go figure.



It's The Bag by Wendy Wonnacott in the book No Sheep For You. If you decide to do this bag, a couple of notes. First off, you really want to use stitch markers to section off the knitting the way Grumperina suggests . Secondly, the knitting mirrors itself. The knit row sets up the colour pattern for the next ,purl, row. Do not screw up the knit row.

I have had to tink back half a row several times because I screwed it up. I really wish this was charted. It would have been so much easier. Charting it now, after I fought my way through it is pointless though. Ah well.

Ciao

Fingernail Friday

Hardboiled....Penguin?

I was making hardboiled eggs this weekend. one of the eggs cracked it's shell. Resulting in this work of art:

I ate it anyways.....

Snuggles

I have never had 2 cats that got along as well as the 2 I currently have. It is adorable. in my humble opinion of course....

'Louboutin' Slippers

Everyone that knows me, knows I have a 'slight' obsession with shoes. I love my shoes. One day I will own a really and truly, honest to bob designer pair of shoes. Until then, I can dream....and knit! My felted clogs have really bit the dust. They are full of holes and I clearly got my money's worth out of them, so to speak. I started a new pair. With a lovely red sole, a la Louboutin shoes. Today was felting day! Pre-felting:

Post felting:Before the felting, the red sole was 11 inches long. It is now approx 9.5 inches. Now they have to dry. Are they dry now? How about now? Now? ARGH.....

Candy

My favorite candy, aside from chocolate of course, is Sweetarts. I love me some Sweetarts.
When it comes to chocolate, I have very little self control around Cadbury's Mini Eggs.

On a related sidenote, why do I keep spelling chocolate as choclate?

Had To Share

I saw this and had to share!

Out with the Old

With temperatures dipping to -25C around here, warm feet are hard to come by. Thus, felted wool clogs are a lovely addition to the flannel pyjamas comfortable clothes I wear around the house. I knit myself a pair last winter. Now they look like this:

Clearly a new pair is required! This pair I'm going to call my Louboutin Clogs.Lipstick red soles, babeeeeee!!!!!

ciao

Grafting Garter Stitch

There are many explanations on the intertubez that 'explain' how to graft garter stitch. Badly and/or incorrectly, as I found, to my sorrow. I turned to Ravelry where ZaftigWendy explained it very clearly. I was gonna try to explain it myself, but then I realized I could show you what she told me:


The hard part is that for grafting garter stitch, you have to pay attention to whether you have knits or purls facing you.
If you hold the two needles to be grafted in your left hand with the knitting hanging down, just like you would when grafting a sock toe, then you want the last row of EACH of the two needles to have purls facing you. When you graft a sock toe, the front needle has knits facing you and the back needle has purls facing you. For grafting garter, you want them BOTH to have purls facing you. If you don’t, then knit one more row on ONE of the needles, and then arrange them again.
Once you have that, it’s easy. Start with going purlwise through the first stitch in front and pulling the yarn through. Then do the EXACT SAME THING on the back needle.
Then go knitwise through the first stitch on the front needle and remove the stitch from the needle, then purlwise through the next stitch. Then do the EXACT SAME THING on the back needle.
Repeat until all the stitches are gone.

She also found a video



Hope this all makes sense!

Fingernail Friday

Melonhead Hat

The husband has a big head. No seriously, he can't wear adjustable baseball hats cause they are too small. This means that most winter caps are rather tight on his head. So I found a hat pattern that you plug your gauge into and it tells you how many stitches to cast on etc to get the correct sized hat! It's called Zeebee. The pattern is straightforward and easy, The tricky bit is at the end when you have to graft garter stitch. Voila the hat.

Yarn:Paton's classic merino in, obviously, black

I thought I had found how to graft garter stitch by googling it. I did not. I had to go to Ravelry and ask someone how to do it. I'll post the right way to graft garter stitch another day. Gotta get it together in understandable words. Tthe husband has already worn it a couple of times and seems to like it. We'll see if he keeps wearing it....

Olympic Mittens

Want your own red Canada Olympic mittens? Can't find the ones sold in stores? Make your own! Swatchless came up with a pattern and is donating the proceeds to the YMCA Aquatics Program Penguins Can Fly, a program for kids with disabilities and their able bodied siblings.