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PDF Editor FAQ

Why do pharmacies need "prior authorization" to fill some prescriptions? Is the prescription itself not enough? What is prior authorization?

If a prescription needs “Prior authorization” that doesn’t mean a pharmacist/pharmacy can’t fill the medication. We can. However, needing “Prior Authorization” means who ever is paying for your medication doesn’t want to pay. In Canada that could be the provincial government (e.g. Manitoba Health is basically a publicly funded insurance company), Non-insured Health Benefits (NIHB aka Treaty aka Department of Indian Affairs) - basically a federally funded insurance company if you have a Status Card, DVA - a federally funded insurance company if you are a veteran, or an actual privately funded insurance company doesn’t want to pay for your prescription or at least not until some conditions/paperwork are met.You can always just pay the full price by cash/credit card for the “prior authorization” prescription, but you probably won’t get reimbursed by whomever pays for your meds.

How can you tell the political bias of a financial news website?

The same way you do for any other media.Information is the interpretation of data looking for meaningful messages. The media likes to do this for you, but are almost never qualified to do so, or worse, their interpretation is designed to manipulate you on behalf of certain political or corporate interests.Where eliciting meaningful information is concerned, there is no substitute for personal expertise. That is particularly important where one’s finances are concerned.It’s remarkable to me that topics everyone needs to be knowledgeable about are rarely if ever taught in any part of our educational system as required material. It seems that the more valuable the information, the more initiative it requires to obtain it.In my opinion, the first step is to consider where and what the data is.The following example isn’t financial, but illustrates my personal process.An aggregator site I like had a link to an article in a blog that mentioned that the Impossible Burger (Burger King) had 18 million times the estrogen of a Whopper (!)That’s both data and an extraordinary claim, so I found the embedded link, which led me to another article, which linked to yet an other article, this one by the actual author, a Doctor of Veterinary medicine in South Dakota. That article had a lot more data as well as meaningful information, and it could be verified. The estrogen levels are actually documented under federal law and can be easily compared with what is known about American beef.So, I verified the data, what about an interpretation? I don’t bother going to the various “health sites” especially when the science is available directly through various academic journals, the NIHB, etc…A normal male has about 0.136 mg of estrogen in the body. A normal female has 0.513 mg. A pregnant female has 1.96 mg. One impossible burger has 44 mg of isoflavones, a molecule that mimics the estrogen in your body just as do the many synthetic varieties.The National Institutes of Health documents an case of gynecomastia caused by the consumption of large quantities of soy milk (3 quarts a day!). Soy infant formula has been documented to raise an infant’s estrogen over a thousand times normal levels and it has slightly more than half the load of isoflavones (various types of phytoestrogen molecules) than contained in an impossible burger (26.3 v 44 g). Soy milk contains 50 grams of isoflavones a quart, which meant that the case I mentioned was dosing himself with 150 grams a day, or three Impossible burgers a day…I could be wrong, the researchers could also be wrong, since biochemistry is a notoriously tricky business, but I am a believer in risk-management, so I will be eating plant matter the old-fashioned way; feeding it to cattle who reliably convert it into beef.Unfortunately, it is actually harder to get honest financial information because, as most people directly involved in the process know, the temptation to fudge is enormous and happens at the very lowest levels of data production and collection. I was personally asked to “massage” projections in my youth…

Why don't dentists offer free services to the poor?

The other answers have touched on a few main points, that the cost of dentistry is very expensive with respect to material costs from dental supply companies (they gouge dentists), staff, rent, etc….basically overhead costs are high and on average we are looking at 65-70% plus or minus being average in my province. You can do pro bono work or give people breaks here and there but you can't do it a lot unless you want to run the practice to the ground. We also have family to support and bills to pay. Dentistry is very hard work and requires a lot of skill and training, do it is not unreasonable to expect compensation.Different dentists contribute in different ways and some don't at all. Some volunteer abroad on dental missions to developing countries. Some volunteer locally, participating in programs that provide dental care for the poor, during oral health month (April). Others volunteer their time to supervise dental students delivering low cost care to the public. As said, some will make case by case exceptions to patients.I have in my days worked a lot with people on social assistance. The poorest that do qualify have at least emergency services coverage. People on disability and children of low income families will also have some dental coverage. I believe when you say poor, is the working poor who don't quite qualify for social services and don't have dental insurance and barely make enough (or not) to pay for basics like food and shelter.Let me tell you a bit about the dental fee guide for people with social services insurance and this may be the same or worse I think, for the US Medicaid program - its abysmal. Some dentists simply won't take the social services insurance assignment and some expect the patient to pay the difference, and that doesn't leave that many offices who take that insurance. The fee guide in our province hadn't been updated since 2007 (program is called MSSH) and pays barely 60% of regular dental fee guide in province (remember 65–70% overhead?). The only thing worse or comparable is the NIHB dental coverage for First Nations people. There are a lot of limitations on the coverages and sometimes you simply don't get paid and you can't do proper dentistry, only patching or extracting. The government expects the dental office, a private business to pick up the slack.Working with this population wears you down and is not for everybody. Helping the kids, the struggling single moms, the anxious patient - they are often very appreciative patients and it's very rewarding.However, there's the other side of it. It's great that they are not unreasonably demanding, but I don't think dentist are really all that well trained to manage the group with disabilities, mental and physical, and other contributing social aspects. Some patients can be downright verbally abusive due to mental health issues or substance abuse or both. Some patients have a violent or criminal past and they elevate their aggression towards you (dental office is a stressful environment for people). The appointment no show rate is high. Fillings can be more difficult to do and work fails more quickly due to high rate of dental decay, neglected teeth, multiple prescription drugs (methadone, drugs that cause dry mouth), and limited dental insurance limiting treatment options for saving teeth (they basically want you to extract everything and give everybody dentures). You end up redoing work for free and/or delaying it if short time until there is coverage again because you can't charge the patient and you don't feel good about doing nothing. It can also be difficult in helping them understand their limited insurance coverage and limited dental options. Theres the good, the bad and the ugly, it's all in retrospect and I can now laugh at it, but it really doesn't feel good going to work the be verbally abused and then fear for your safety and the only comfort is the baseball bat and pepper spray under the receptionist’s desk and that RCMP office two doors down. But it's all a balance - you help a lot of people which is a good feeling, but there certainly can be challenges to working with the poor that people may not be aware about.

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