So I have dry eye. When you hold your eyes open without blinking, your tears are supposed to take about 10-15 seconds to evaporate. Mine take 2.

The eye doctor says she’d like to see 7 seconds for me to be able to safely wear contacts without risking infections, etc, although she hasn’t told me to stop wearing contacts (which I wear as-needed for exercise, glassblowing, going out, not full-time). With a previous course of medicine, I got up to about 6-7 seconds two summers ago, but have since fallen back.

So I’m going back on Googleproofed Medication, which is eye drops twice a day for at least six months, which is supposed to convince your eyes to make more tears. It’s expensive—$130/month. In addition, it comes in 60 little vials for a month, each of which holds about 8 drops of medicine, but you are only supposed to use 1 drop in each eye and then throw the rest away, because “there’s no preservative”. (My eye doctor explicitly said I could use a vial twice.)

So now they have this rewards program—$25 off each prescription, your 7th prescription free, a gift card after the 4th prescription.

Now, I have a good job, with good insurance. But we just changed insurance providers, or that is, we shifted from a big company to a management company that will run a self-insurance program. And I was all pissed, because the previous company just allowed the medication, but the new company made me try some over-the-counter remedy first for two weeks, and then go back to the doctor for a check-up, to prove the expensive medication was needed.

But the old company assessed a $50 co-pay, and the new company only demands a $15 co-pay. Which the rewards program covered for me. Maybe I should believe “there’s no preservative” and use a vial only once.

The financial infrastructure of health insurance in this country is all screwed up.