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mostlysignssomeportents · 5 days

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What the fuck is a PBM?

TOMORROW (Sept 24), I'll be speaking IN PERSON at the BOSTON PUBLIC LIBRARY!

Terminal-stage capitalism owes its long senescence to its many defensive mechanisms, and it's only by defeating these that we can put it out of its misery. "The Shield of Boringness" is one of the necrocapitalist's most effective defenses, so it behooves us to attack it head-on.

The Shield of Boringness is Dana Claire's extremely useful term for anything so dull that you simply can't hold any conception of it in your mind for any length of time. In the finance sector, they call this "MEGO," which stands for "My Eyes Glaze Over," a term of art for financial arrangements made so performatively complex that only the most exquisitely melted brain-geniuses can hope to unravel their spaghetti logic. The rest of us are meant to simply heft those thick, dense prospectuses in two hands, shrug, and assume, "a pile of shit this big must have a pony under it."

MEGO and its Shield of Boringness are key to all of terminal-stage capitalism's stupidest scams. Cloaking obvious swindles in a lot of complex language and Byzantine payment schemes can make them seem respectable just long enough for the scammers to relieve you of all your inconvenient cash and assets, though, eventually, you're bound to notice that something is missing.

If you spent the years leading up to the Great Financial Crisis baffled by "CDOs," "synthetic CDOs," "ARMs" and other swindler nonsense, you experienced the Shield of Boringness. If you bet your house and/or your retirement savings on these things, you experienced MEGO. If, after the bubble popped, you finally came to understand that these "exotic financial instruments" were just scams, you experienced Stein's Law ("anything that can't go forever eventually stops"). If today you no longer remember what a CDO is, you are once again experiencing the Shield of Boringness.

As bad as 2008 was, it wasn't even close to the end of terminal stage capitalism. The market has soldiered on, with complex swindles like carbon offset trading, metaverse, cryptocurrency, financialized solar installation, and (of course) AI. In addition to these new swindles, we're still playing the hits, finding new ways to make the worst scams of the 2000s even worse.

That brings me to the American health industry, and the absurdly complex, ridiculously corrupt Pharmacy Benefit Managers (PBMs), a pathology that has only metastasized since 2008.

On at least 20 separate occasions, I have taken it upon myself to figure out how the PBM swindle works, and nevertheless, every time they come up, I have to go back and figure it out again, because PBMs have the most powerful Shield of Boringness out of the whole Monster Manual of terminal-stage capitalism's trash mobs.

PBMs are back in the news because the FTC is now suing the largest of these for their role in ripping off diabetics with sky-high insulin prices. This has kicked off a fresh round of "what the fuck is a PBM, anyway?" explainers of extremely variable quality. Unsurprisingly, the best of these comes from Matt Stoller:

https://www.thebignewsletter.com/p/monopoly-round-up-lina-khan-pharma

Stoller starts by pointing out that Americans have a proud tradition of getting phucked by pharma companies. As far back as the 1950s, Tennessee Senator Estes Kefauver was holding hearings on the scams that pharma companies were using to ensure that Americans paid more for their pills than virtually anyone else in the world.

But since the 2010s, Americans have found themselves paying eye-popping, sky-high, ridiculous drug prices. Eli Lilly's Humolog insulin sold for $21 in 1999; by 2017, the price was $274 – a 1,200% increase! This isn't your grampa's price gouging!

Where do these absurd prices come from? The story starts in the 2000s, when the GW Bush administration encouraged health insurers to create "high deductible" plans, where patients were expected to pay out of pocket for receiving care, until they hit a multi-thousand-dollar threshold, and then their insurance would kick in. Along with "co-pays" and other junk fees, these deductibles were called "cost sharing," and they were sold as a way to prevent the "abuse" of the health care system.

The economists who crafted terminal-stage capitalism's intellectual rationalizations claimed the reason Americans paid so much more for health care than their socialized-medicine using cousins in the rest of the world had nothing to do with the fact that America treats health as a source of profits, while the rest of the world treats health as a human right.

No, the actual root of America's health industry's problems was the moral defects of Americans. Because insured Americans could just go see the doctor whenever they felt like it, they had no incentive to minimize their use of the system. Any time one of these unhinged hypochondriacs got a little sniffle, they could treat themselves to a doctor's visit, enjoying those waiting-room magazines and the pleasure of arranging a sick day with HR, without bearing any of the true costs:

https://pluralistic.net/2021/06/27/the-doctrine-of-moral-hazard/

"Cost sharing" was supposed to create "skin in the game" for every insured American, creating a little pain-point that stung you every time you thought about treating yourself to a luxurious doctor's visit. Now, these payments bit hardest on the poorest workers, because if you're making minimum wage, at $10 co-pay hurts a lot more than it does if you're making six figures. What's more, VPs and the C-suite were offered "gold-plated" plans with low/no deductibles or co-pays, because executives understand the value of a dollar in the way that mere working slobs can't ever hope to comprehend. They can be trusted to only use the doctor when it's truly warranted.

So now you have these high-deductible plans creeping into every workplace. Then along comes Obama and the Affordable Care Act, a compromise that maintains health care as a for-profit enterprise (still not a human right!) but seeks to create universal coverage by requiring every American to buy a plan, requiring insurers to offer plans to every American, and uses public money to subsidize the for-profit health industry to glue it together.

Predictably, the cheapest insurance offered on the Obamacare exchanges – and ultimately, by employers – had sky-high deductibles and co-pays. That way, insurers could pocket a fat public subsidy, offer an "insurance" plan that was cheap enough for even the most marginally employed people to afford, but still offer no coverage until their customers had spent thousands of dollars out-of-pocket in a given year.

That's the background: GWB created high-deductible plans, Obama supercharged them. Keep that in your mind as we go through the MEGO procedures of the PBM sector.

Your insurer has a list of drugs they'll cover, called the "formulary." The formulary also specifies how much the insurance company is willing to pay your pharmacist for these drugs. Creating the formulary and paying pharmacies for dispensing drugs is a lot of tedious work, and insurance outsources this to third parties, called – wait for it – Pharmacy Benefits Managers.

The prices in the formulary the PBM prepares for your insurance company are called the "list prices." These are meant to represent the "sticker price" of the drug, what a pharmacist would charge you if you wandered in off the street with no insurance, but somehow in possession of a valid prescription.

But, as Stoller writes, these "list prices" aren't actually ever charged to anyone. The list price is like the "full price" on the pricetags at a discount furniture place where everything is always "on sale" at 50% off – and whose semi-disposable sofas and balsa-wood dining room chairs are never actually sold at full price.

One theoretical advantage of a PBM is that it can get lower prices because it bargains for all the people in a given insurer's plan. If you're the pharma giant Sanofi and you want your Lantus insulin to be available to any of the people who must use OptumRX's formulary, you have to convince OptumRX to include you in that formulary.

OptumRX – like all PBMs – demands "rebates" from pharma companies if they want to be included in the formulary. On its face, this is similar to the practices of, say, NICE – the UK agency that bargains for medicine on behalf of the NHS, which also bargains with pharma companies for access to everyone in the UK and gets very good deals as a result.

But OptumRX doesn't bargain for a lower list price. They bargain for a bigger rebate. That means that the "price" is still very high, but OptumRX ends up paying a tiny fraction of it, thanks to that rebate. In the OptumRX formulary, Lantus insulin lists for $403. But Sanofi, who make Lantus, rebate $339 of that to OptumRX, leaving just $64 for Lantus.

Here's where the scam hits. Your insurer charges you a deductible based on the list price – $404 – not on the $64 that OptumRX actually pays for your insulin. If you're in a high-deductible plan and you haven't met your cap yet, you're going to pay $404 for your insulin, even though the actual price for it is $64.

Now, you'd think that your insurer would put a stop to this. They chose the PBM, the PBM is ripping off their customers, so it's their job to smack the PBM around and make it cut this shit out. So why would the insurers tolerate this nonsense?

Here's why: the PBMs are divisions of the big health insurance companies. Unitedhealth owns OptumRx; Aetna owns Caremark, and Cigna owns Expressscripts. So it's not the PBM that's ripping you off, it's your own insurance company. They're not just making you pay for drugs that you're supposedly covered for – they're pocketing the deductible you pay for those drugs.

Now, there's one more entity with power over the PBM that you'd hope would step in on your behalf: your boss. After all, your employer is the entity that actually chooses the insurer and negotiates with them on your behalf. Your boss is in the driver's seat; you're just along for the ride.

It would be pretty funny if the answer to this was that the health insurance company bought your employer, too, and so your boss, the PBM and the insurer were all the same guy, busily swapping hats, paying for a call center full of tormented drones who each have three phones on their desks: one labeled "insurer"; the second, "PBM" and the final one "HR."

But no, the insurers haven't bought out the company you work for (yet). Rather, they've bought off your boss – they're sharing kickbacks with your employer for all the deductibles and co-pays you're being suckered into paying. There's so much money (your money) sloshing around in the PBM scamoverse that anytime someone might get in the way of you being ripped off, they just get cut in for a share of the loot.

That is how the PBM scam works: they're fronts for health insurers who exploit the existence of high-deductible plans in order to get huge kickbacks from pharma makers, and massive fees from you. They split the loot with your boss, whose payout goes up when you get screwed harder.

But wait, there's more! After all, Big Pharma isn't some kind of easily pushed-around weakling. They're big. Why don't they push back against these massive rebates? Because they can afford to pay bribes and smaller companies making cheaper drugs can't. Whether it's a little biotech upstart with a cheaper molecule, or a generics maker who's producing drugs at a fraction of the list price, they just don't have the giant cash reserves it takes to buy their way into the PBMs' formularies. Doubtless, the Big Pharma companies would prefer to pay smaller kickbacks, but from Big Pharma's perspective, the optimum amount of bribes extracted by a PBM isn't zero – far from it. For Big Pharma, the optimal number is one cent higher than "the maximum amount of bribes that a smaller company can afford."

The purpose of a system is what it does. The PBM system makes sure that Americans only have access to the most expensive drugs, and that they pay the highest possible prices for them, and this enriches both insurance companies and employers, while protecting the Big Pharma cartel from upstarts.

Which is why the FTC is suing the PBMs for price-fixing. As Stoller points out, they're using their powers under Section 5 of the FTC Act here, which allows them to shut down "unfair methods of competition":

https://pluralistic.net/2023/01/10/the-courage-to-govern/#whos-in-charge

The case will be adjudicated by an administrative law judge, in a process that's much faster than a federal court case. Once the FTC proves that the PBM scam is illegal when applied to insulin, they'll have a much easier time attacking the scam when it comes to every other drug (the insulin scam has just about run its course, with federally mandated $35 insulin coming online, just as a generation of post-insulin diabetes treatments hit the market).

Obviously the PBMs aren't taking this lying down. Cigna/Expressscripts has actually sued the FTC for libel over the market study it conducted, in which the agency described in pitiless, factual detail how Cigna was ripping us all off. The case is being fought by a low-level Reagan-era monster named Rick Rule, whom Stoller characterizes as a guy who "hangs around in bars and picks up lonely multi-national corporations" (!!).

The libel claim is a nonstarter, but it's still wild. It's like one of those movies where they want to show you how bad the cockroaches are, so there's a bit where the exterminator shows up and the roaches form a chorus line and do a kind of Busby Berkeley number:

https://www.46brooklyn.com/news/2024-09-20-the-carlton-report

So here we are: the FTC has set out to euthanize some rentiers, ridding the world of a layer of useless economic middlemen whose sole reason for existing is to make pharmaceuticals as expensive as possible, by colluding with the pharma cartel, the insurance cartel and your boss. This conspiracy exists in plain sight, hidden by the Shield of Boringness. If I've done my job, you now understand how this MEGO scam works – and if you forget all that ten minutes later (as is likely, given the nature of MEGO), that's OK: just remember that this thing is a giant fucking scam, and if you ever need to refresh yourself on the details, you can always re-read this post.

The paperback edition of The Lost Cause, my nationally bestselling, hopeful solarpunk novel is out this month!

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/09/23/shield-of-boringness/#some-men-rob-you-with-a-fountain-pen

Image: Flying Logos (modified) https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png

CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/deed.en

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drvineetagoeloncologist · 2 years

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Dr. Vineeta Goel is best known for providing solitary brain metastases treatment in north delhi an delhi ncr; you can get in touch with her for solitary brain metastases treatment in east delhi, solitary brain metastases treatment in west delhi.

#solitary brain metastases treatment in delhi #solitary brain metastases treatment in south delhi #solitary brain metastases treatment in north delhi #solitary brain metastases treatment in east delhi #solitary brain metastases treatment in west delhi #sbrt for liver metastasis #sbrt for lung cancer #srs for brain tumour #srs for brain metastasis #sbrt for spine metastasis

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cipheramnesia · 6 months

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It is possible I'm leaning too hard into the concept of a parasite POV protagonist which explores what it means to make yourself into the shape of another body (re the starfish comic and a bunch of bits in it), when the body in question is a trans woman who has undergone a severe amount of involuntary biomechanical body modifications, in an experimental attempt to utilize her poorly understood mutated nervous system as a kind of living weapon against a parallel universe which is inadvertantly unraveling our own world in isolated but escalating highly destructive incidents involving sudden explosive release of energy where they intersect.

But when the events proved fruitless, leaving her wracked with trauma and metastasized cancer, they threw her into a care home / prison where she died of the aforementioned cancer, and this is all in service of answering the question of where The Body which becomes the host originates. However, being as the parasitoid mutant blind millipede colony does not enter a corpse with a template, and merely threads into whatever pre-existing physical and neurological systems are part of the host corpse as-is, not only is the colony collectively entrapping itself within the boundaries of a host body, but it is operating on the assumptions that all the surgical and hormonal alterations, as well as the cancer, are a part of the body which they should also include in the neural network they extend themselves into.

Meaning the actual outcome is the world as seen through a parasite colony which, as it consumes and partially replicates both nervous system and brain of the host, believes itself to inhabit the world as a human, while in actuality it is oblivious to the fact that it now exists as an expression of the traumatic abuse which an authoritarian state under threat will inflict on a human body, as well as the cancerous expression of consequences of this abuse, all stemming from a body which, in a world facing an existential crisis, has an unconventional non-human nervous system which allows it to engage directly with an alternate universe.

Which all plays out because the apathetic management of the care home sold her corpse to a religious order / conservative activism group dedicated to the preservation of the mutant parasitic millipede colonies out of the fervent religious belief the colonies represent the unending cycle of life from life and life from death, and also because the millipede colonies act as natural predators to the Dalton County Dump Roundworm Infestation, which has been taking over large portions of the country via its exponential growth and lack of any competition. So now I have a completely sensible background derived for the parasite colony protagonist who is also fifty percent of the dead trans woman they consumed in the process of infesting her corpse, who is now a kind of holy relic to the temple which infected her, but who also wants retribution for the horrific abuse she suffered, while simultaneously experiencing her twisted and broken body as the correct form as derived by the parasite infestation, which is also her.

Simple.

#long post #parasites #girl bites god #body horror #millipede

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jbake595 · 2 years

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On my current rewatch of Breaking Bad and I noticed another reason why Jesse’s character is so well-written. We know Jesse has a huge capacity for learning and technical prowess, but only in things he cares deeply about. Once he starts to care, he learns very quickly, and he performs at an expert level. Jesse struggles with basic scientific concepts, especially when he tries to recall their names. In s3e10 “Fly”, he can’t even remember the word for condensation, saying “you know, like on a cold beer”. However, in that same episode, Jesse recounts how he noticed signs that his aunt’s cancer had metastasized to her brain. His specific and unflinching use of the term “metastasized” is pretty jarring for his character. Over the course of the show, Jesse’s knowledge of cancer is accurate and helpful, as he even gives Walt tips for chemotherapy. It’s a subtle way the show tells us of how deeply and sincerely Jesse cared for his aunt. I wonder how much the writers considered his aunt’s passing on Jesse’s overall behavior. How much did it contribute to his delinquency prior to meeting Walt? How much does it color how Jesse and Walt interact?

#breaking bad #jesse pinkman #walter white #better call saul #el camino

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frostytherobot · 6 months

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*shows you an average looking white man in his 40s* listen. you know what i’m gonna say but if you don’t allow me to speak my awful mind it will start to metastasize in my cranium and i will die. i will develop mega cancer and my brain will liquefy and leak out my ears and i will just collapse and it will be your fault cuz you didn’t let me tell you how sexy i find this mediocre white man.

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help-im-a-medstudent · 2 months

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Never trusting a "can I handover my patients to you, there's no jobs to do" ever again

"He's having a ct head I'm sure it's going to be fine, GP just needs to refer to memory clinic" the CT head was not fine, had to do a referral to neurosurgeons and tell a man and his wife he had brain metastases and probably some cancer somewhere else in his body

"Waiting for a troponin if it's normal they can go home" the troponin was not normal

"Just waiting for a bed on the ward, everything's done" continued vomiting, required discussion with surgeons, ct had to be arranged

"Ortho are on their way to review" ortho were not on their way, because the day team had not handed it over to the night team

#obviously none of these were the peoples fault that were handing them over to me #because i knew i could trust them that they had actually done what they said theyd done #just the results were unexpected and patients deteriorate #(there are people i am very wary of taking handovers from and check the notes very thoroughly)#just unfortunate this all happened on the same shift #emergency medicine #medblr #help im a doctor

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bjornkram · 7 months

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House: The patient has a head ache and a swollen testicle at the same time which would point to robofloxicity but she doesn't have a toothache which rules out the obvious answer. We need to find out what can account for the lack of toothache in the patient before her balls swell up so large that they'll be a featured balloon at the next Macy's day parade.

Chase: it could be encephalitis

Foreman: she's obviously on drugs

Cameron: it could still be rebofloxicity theres the possibility that a gormpinictal growth on the testicle has made it so she can't feel her teeth.

House: wrong, did you all actually graduate from med school or are we going to have some confessions to make. No the obvious answer is that she bumped her head on a pole and is lying about it. Now why would someone bump into a pole and try to hide it? Well I'll give you a hint and it starts with p and ends with empogison's disease. Her brain rattled around in her skull a little too much after the bonk and damaged her memory. She's not lying she forgot. Administer 500 mcs of wembinzin and start her on an himictalin. Schedule a O.R. for 4, we're going to drill into her brain to see if the pempogison's is being caused by an underlying clot.

Foreman: If it's not pempogison's the wimbinzin will make her heart explode.

House: And if it does we'll know if I'm wrong or not

Willson: Cancel the surgery, we've got a problem, her liver just metastasized into her stomach. She's going into full badrienal shock. Also I'm cheating on my wife again.

#house #every epsiode sounds like this and bitch im eating it for breatfast #grumbles

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avelera · 1 year

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Along the lines of, "Fanfic Writers Always Get the Sequels Wrong Because They Just Keep Remixing What They Have and Focusing on the Romance", here's my predictions for Good Omens S3:

My Fanfic Brain: Aziraphale does his best to stop the Second Coming but realizes he's outmatched when the other archangels gang up on him. Cornered and without hope of getting the important information/McGuffin he's acquired to the people (ie, Crowley) who need it in order to stop the next Apocalypse, Aziraphale is forced to face his greatest fears and Fall from Heaven. He shows up at Crowley's door, broken and singed, and together they reunite to stop the machinations of Heaven and Save the Day. I literally do not not care about any other shit that happens but I hope we find out that Angel Crowley was someone Powerful and Important, possibly Raphael. The End.

My Realistic Writer Brain: We open up 3-4 years later after the events of Season 2. The antipathy between Crowley and Aziraphale has had a chance to metastasize to the point that they are now Bitter Exes. As per Pratchett and Gaiman's hints at what 668: The Neighbor of the Beast would contain, Jesus Christ descends from his silver plane in America, surrounded by secret service, and goes missing. Now, both Heaven and Hell are looking everywhere for the missing Son of God. After a stint of trying to track Jesus down on his own (and also trying to sneak glances at porn while on Earth, Aziraphale reluctantly teams up with Crowley, who he has humorously reencountered, and Aziraphale and Crowley end up on a comedic roadtrip across America in search of him, filled with Bitter Ex energy, Aziraphale convinced that he can Fix Things if HE gets to Jesus first, Crowley committed to a replay of the first Canceled Apocalypse, not sure what he'll do but committed to stopping it.

The two grow close again over the course of this adventure, other wacky hijinks ensue and if Avelera is very lucky, the Long Night of the Soul beat will include Aizraphale being forced to Fall once he learns the full extent of Heaven's machinations and we'll learn that Crowley used to be Hot Shit as an Angel, but there is no actual guarantee on either front. The ultimate goal will appear to be Burn Down the System of Heaven and Hell to Save the World but since this is also a Pratchett work, and Pratchett is a great lover of Systems and Civil Society, it's more likely that Aziraphale's conviction that Heaven can be Fixed and Crowley's conviction that it needs to all be avoided and/or burnt down is actually a Debate, and we end up with some sort of happy medium between the two. Then they retire to the South Downs. The End.

#good omens #good omens meta #good omens spoilers #spoilers

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frownyalfred · 1 year

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“I have five months to live and you’re making me do this alone?!”

but it’s Bruce and Clark. Bruce with terminal, quickly-metastasizing cancer and Clark just. Leaving, because his brain literally can’t handle the idea of his best friend dying. Can’t watch him go through chemo and see him wither away. And Bruce being furious.

#tw: cancer #cw: cancer #someone rewatched house md ok #the way wilson yells that at House???#omg it kills me #bruce wayne #batman #dc #superbat #clark kent #superman #thoughts #fic ideas?#so sad tho #Bruce is like why won’t Clark even look at me???

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camgoloud · 3 months

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okay obviously house letting his whole team + wilson and cuddy go around for days thinking he had the terminal brain cancer he was lying to another hospital about having in pursuit of drugs was a major dick move for about seven reasons but the one i can’t get over is the way he managed to pick the specific terminal illness most likely to trigger the hell out of all three of his employees. i mean. come on. foreman? mom currently dying of alzheimer’s (brain). chase? dad died of cancer like maybe ten months ago (cancer. also. father figure dying :/). cameron? husband died of CANCER that metastasized to his BRAIN lmao i say once again that if i had been one of house’s fellows i would have killed his ass for real

#the way they all looked so happy when they showed up at his apartment to break the news and he crushed their little hearts… 🥺#he’s SUCH an ASSHOLE (i love him)#house md

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drvineetagoeloncologist · 2 years

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Get Solitary Brain Metastases Treatment in Delhi for Liver

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formosusiniquis · 1 year

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bela lugosi's dead

written for the @steddiemicrofic prompt: suck | wc: 480 | T | cw: none | tags: vampire!Steve

Like every good freak worth the nickname, Eddie made a habit of reading Dracula every Halloween.

The first read led to closeted daydreaming about getting abducted by a handsome vampire. Letting himself poke at desires he hadn’t been ready to commit to. With age his fantasies and aesthetics matured, until he was the bloodsucking creature of the night stealing pretty boys away to give in to their secret temptations. So, if he's honest, he’s having a hard time dealing with life and the lemons it’s juggling off to the side of him.

“It isn't fair.”

“Hmm,” Steve, with his red puffer vest and his coordinating Nikes, sat across from him at some point in full view of Eddie’s misery over his annotated copy of Dracula.

“There's an aesthetic you're failing to appreciate and it isn't fair that you-”

“Are we going to do this every time?” He asks around the straw in his mouth, poked into a blood bag labeled ‘Robin:)’ like he’s sipping from a juice box.

“Until you stop dressing like a JCPenney catalog model, or vampires become lame, yeah we probably are, Harrington.”

“Fine,” he sighs, having the decency to pull the blood bag away from his face, “I'm sorry that you had to have five blood transfusions and basically have new, non-vampire blood. No one has ever suffered the way you, Eddie Munson, have.”

“You're being sarcastic, but I have suffered so apology accepted, Stevie.”

“Now you.” Steve prompts, gesturing with the bag in his hands.

“Now me what?”

Steve sits up, a languid move that makes Eddie’s prey brain sit up at attention and his horny boy brain poke its head up too. “Say I'm sorry, Steve, that you had to save the world for the fourth time so a bunch of freaky bat venom metastasized-”

“You absolutely stole that word from Henderson,” breathless, the jab doesn’t carry the weight it could.

“-in your bloodstream and combined with the remains of the experimental Soviet drugs and now," He crawls closer, "you can't eat garlic anymore.”

“That's the hang up for you? Not the blood drinking?”

“I'm Italian, I can’t eat anything anymore. Sure I can supplement the blood with raw meat, but what’s the point if everything is poorly seasoned.” Blood bag all but forgotten in the arm chair, he has Eddie pinned in place looming overtop of him, talking shit about what he’ll never be able to eat again.

The white collar of Steve’s t-shirt is visible beneath the color-block vest, even that isn’t enough to stop his brain from screaming predator on repeat. Supernaturally strong, it doesn’t take more than a hand on the shoulder to push Eddie down horizontal on the couch. He has to feel Eddie’s heart beat, the way it pounds in his chest as Steve noses up the collarbone to his neck. “Really does suck for me, huh baby?”

#steddie #steddiemicrofic #steddiemicroficoctober #my fic #vampire steve harrington #listen this microfic does have lore and hcs though so #steve becoming a vamp is the straw that breaks the camels back vis a vis claudia finding out about the upside down #nurse claudia doing regular party and parents blood drives to keep her boy fed #each bag gets labeled with its donor after steve insists he can taste the difference ala coke v pepsi #stobin soulmates forever steve thinks robin tastes the best #sorry eddie you're second best but he prefers it from the source

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