I have a lot of friends who are against Obamacare and who have issues with socialized medicine. These same people are proud that America's healthcare system is based on capitalism. Let me tell you a brief story about healthcare when it's a money-making empire.
Two years ago, my doctor switched me to Cymbalta as a migraine preventative. And it worked really well. Really well. For over a year, we paid (after insurance) $52 a month for that prescription.
It isn't my most expensive migraine medicine but, when you are a chronic pain patient (I take over seven medicines, three on a daily basis), you want to save money wherever you can on the oodles of medication needed to live a normal life. So, Mark and I were really looking forward to June 2013 when Cymbalta was to become generic. We hadn't been this excited since Botox was approved for migraine treatment by the FDA (that saved us $350 a month).
Only... Cymbalta didn't become generic in June. The manufacturer, Eli Lilly, sued the FDA for a six month extension. And won. There was a price change, though. Cymbalta cost more. It was now $60 a month. Mark thought that was a little odd, but he shrugged it off and paid for my most needed medication. The next month, the exact same prescription was $72.
Okaaay... Mark asked my pain specialist, Dr. Robert Hansen, if he was writing the prescription differently; nope. No change. Hmm. So Mark asked our pharmacy if there was some new surcharge we were paying. Once again, we received a negative answer. In fact, the pharmacy said it had never levied a surcharge.
Three days ago, Mark refilled my Cymbalta for the 8th time this year. It was now $90. Mark called the insurance company for answers. HOW could the price of my medication almost double in three months?
Long story short, Eli Lilly is saying the cost increase reflects how difficult it is to make Cymbalta. I'm not sure how something becomes MORE difficult to make every 30 days. You'd think that, overtime, the process would become streamlined rather than problematic.
I do know that the company has already successfully sued the government to keep Cymbalta from going generic (for no reason other than to keep money in their coffers)... and I can add two and two well enough to see that my September refill will probably go up another ten or 20 dollars.
Why? Because the company sees the end of the road, money-wise... and they want as much as they can get between their grubby little fingers. As optimistic as I usually am... I am in agreement with Mark that the company will probably sue the government, again, to avoid losing money to a generic form of its medicine. And I agree that it will continue price gouging the users of this medication.
And it sickens me... literally. Because I cannot afford all my other medications AND my Cymbalta if this price trend continues. The manufacturer REALLY has me between the proverbial rock and a hard place because of how WELL it works in preventing my migraines. So, we will continue to pay the higher amounts for awhile. A short while. Until the price is no longer affordable. Which means I will become sick. Quite sick. Again. We can look for other medications that are similar, but I will first have to come down off the Cymbalta and then build up to the necessary levels of the new medicine. And I will suffer the 'are the side effects worth it' dance a few times until we find a medicine that keeps at least half the migraines at bay without costing me the loss of feeling in my extremities or constant shaking or insomnia or high blood pressure, etc.
So, for about one-and-a-half to two months (best case scenario)... I will be in serious pain on a semi-daily basis. I have shots that work EXTREMELY well fighting migraines, but my insurance only covers 12 of those a year (and I've already used half of those this year). How quickly do you think I'd go through six shots if I had no major daily preventative? Yes, I also have Botox/Myobloc shots... but those keep the level of pain from a migraine from exacerbating. They do NOT prevent my migraines.
And folks... we have decent insurance. What happens to those folks who have poor insurance or no insurance? Do you think Eli Lilly gives a damn? I don't. So please... don't tell me how horrible socialized medication would be... unless you want to pay the plus $1000 a month after insurance (and rising) for me it costs to be able to live, love, and laugh (never mind work) and function as a normal human being.
A person's access to medication and healthcare should NOT be determined by wealth. Ever.
Marjorie I totally agree with you on that level, however, I do NOT believe that socialized medicine will improve anything for ANYONE! I have friends who live in both the UK and Canada who ARE on socialized medicine and it scares the beezeebbers out of me!
ReplyDeleteIt takes MONTHS to get in to see a specialist and that's ONLY IF you can get a referral from your family doctor. And while you may be thinking, "I am fine on that front." Don't be so sure that your family doctor will #1 continue to be your doctor, or #2 that your family doctor will make that referral you need so desperately. Why? Because the gov't will be controlling who sees a specialist and for what reason. If the treatment you need is not considered important enough, you will not be sent at all. If the gov't doesn't approve the treatment you are on, then you will no longer have access to it. If the gov't doesn't think you are young enough for that particular treatment, then you will no longer be eligible for it.
I have a friend in Canada whose son has needed treatment for a speech disorder and possible autism for as long as my son Ben has. That's 4 years for the record. He JUST started getting some attention. Early intervention for kids like ours is imperative! Ben speaks like a child far older than he, because he received the necessary intervention that started when he was just 18 months old. However, my friend's son is 4.5 years old and is not getting the care he needs. Will he ever have the success my son has? No one really knows, but my guess is probably not, due to the delay in treatment.
Then there is the issue of treatment for things like cancer. If you are in your 60's or 70's and you need treatment for cancer, you cannot assume that the gov't will approve care for you. It is highly likely, they will use a formula to estimate your lifespan and then look at whether or not it is cost effective to treat you and the answer likely will be that it's not cost effective and therefore you will only obtain treatment if you have the cash to pay for your treatment in full.
I agree our system stinks and something needs to change, but letting the gov't decide who gets what is not the answer. What might be a better option is legislation that prevents price gouging by any and all medical companies. This would include doctors, clinics, pharmaceutical companies, pharmacies, and hospitals. Anyone who provides any kind of medical care should be prevented from over charging, but keep the competition in the market to keep the costs down and stop insurance companies from dictating what they cover and don't cover. We need to require that all care be covered, but allowing the gov't to make health decisions for us is NOT the answer.
As long as people make money on the health of others, the system will be corrupt and extremely damaging to those on the lowest levels of the economic ladder.
ReplyDelete