In October of 2013, the New York Times ran an article titled The Soaring Cost of a Simple Breath. I think I came across it on Google News, Facebook, and the links sent to me by many friends. Yes, asthma does cost a lot. It’s something I know all too well. Reading the article left me wishing my asthma only cost that much. I realize in a way I’m bragging by telling you how much I spend on healthcare, but I also want to point out what it’s like for those with severe asthma as opposed to mild or moderate forms of the disease.
The NYT article profiles the Levi family and their two daughters with allergic asthma who live in California. In the video that plays a shot is taken of their medication spread out on a table. They mention Pulmicort and Rhinicort Aqua; I also noticed Veramyst, nebulizer meds, and allergy medications. I am very fortunate right now to have decent, employer-provided insurance; I work a full-time job and am able to afford my medications and treatments. There was a time in the not so distance past where I did not have insurance through my job and I bought most of my medicine from an online pharmacy in Canada where $900 of Advair 500/50 only cost me $400 and change. For a period of a couple years I had to make the choice of what to pay for – my medicine or rent, food, and whatever else seemed important. At times I was not taking all my medication because I simply could not afford it. When I disclosed this embarrassing knowledge to one of my physicians, they gave me some information on assistance programs in the state. I looked into those programs and discovered I would have to have no insurance whatsoever for 6 months before I could apply to see if I was even eligible for assistance. That is in no way acceptable or even thinkable. That could have easily killed me.
I’ve also had to plead and argue with insurance over what I really need to keep me healthy. Often times Tier 1 drugs don’t do the trick for me and after trying many alternatives my doctors agree I need to be on the Tier 2 or Tier 3 variants. This has often resulted in my insurance trying to place me on generics or suggesting I try Albuterol, the most common drug prescribed for asthma as a just-in-time rescue medication, instead of Advair, Dulera or Xolair, maintenance medications that don’t even act in the same way as Albuterol or accomplish the same task. When you make people’s well-being a business the important factor becomes a spreadsheet with credits and debits where the bottom line better be a large, black number and not a red one. They tend to forget people are dying while waiting for treatment and medication.
So what do you do? For starters I looked for discounts and coupons on all the major drugs I was taking. Often times the manufacturers have assistance programs. I quickly found coupons/discounts for Advair and Dexilant, and later Dulera. Some of the medications I was taking were generics so that helped as well. The biggest assistance I found for myself was purchasing my medications through Universal Drugstore and the worst of it was popping Benadryl as a way to save money on Allegra/Fexofenadine. They say that stuff makes you drowsy, but I quickly built up a tolerance for it.
At the end of the NYT article, it stated:
Even with good insurance, the Hayeses expect to spend nearly $1,000 this year on their daughters’ asthma medicines; their insurer spent much more than that. The total would have been more than $4,000 if the insurer had paid retail prices in Oakland, but the final tally is not clear because the insurer contracts with Medco, a prescription benefits company that negotiates with drug makers for undisclosed discounts.
This is where I chuckled because I spend so much more than $1k a year just for myself, not two people. At the moment I’m on:
- Fexofenadine (Allegra)
- Allergy injections
- Xolair injections
- Maxair (discontinued, but I have a stash)
When I have asthma flares, bad allergies or actually become sick with something I’m on even more medication. My insurance also uses Medco to negotiate prices for drugs and I use them to purchase three months worth of my maintenance medications at a time to save even more. Last year I spent roughly $2300 on medication which cost my insurance company just over $20,000. If I didn’t have insurance or Medco negotiating prices for me this would have cost much closer to $40,000+, mostly due to Xolair, which there is no way I could have afforded. This doesn’t include doctor visits, labs and x-rays/imaging, ER visits and hospitalization, durable medical equipment, supplies, travel and lodging, dental, eyeware, and insurance premiums. I also lost 20% of my projected income in 2013 due to unpaid medical leave on top of the 24 paid vacation and 10 paid sick days I earn every fiscal year.
In 2013 my healthcare combined with income lost due to illness cost me roughly $25,000.
This may sound like a lot or not so much depending on your economic status. Combine this with rent, food, utilities, car loans, school loans, gas and car maintenance, internet access at home, cell phone, toiletries and other monthly supplies needed at home and I’m not left with much or any money left. This doesn’t even take fun things into consideration like cable TV, a Netflix subscription, an occasional Mt Dew or birthday presents for my kids. Fortunately my wife and I both work, but sometimes we wonder for what. In the past seven years we could easily have banked $100,000 if most of our money wasn’t going towards my chronic disease.
Whenever I hear or see people saying there’s nothing wrong with health care in this country or are screaming about the Affordable Care Act ruining the economy, I have to assume one of two things:
1) they have no idea what it’s like to be really sick and/or
2) they’re either dumb enough to believe the lies certain politicians and “interest groups” are telling or they’re too rich and privileged to know what it’s like to pay for one’s health.
I’d try to describe this better, but I think the Daily Show did a good job of portraying this in their Third World Health Care – Knoxville, Tennessee Edition clip.