The Price You Pay

I’ve voiced my opinion once or twice before regarding healthcare in the United States, specifically Highmark in Pennsylvania.

I feel like I’m turning into my grandparents when I say, I remember when….(insert memory here).  But I seriously remember when healthcare was affordable.  I don’t know specifics as to why premiums have skyrocketed from lets say 25 years ago.  Seeing a primary doctor (general practitioner) and paying $20 for my entire visit, start to finish.  I would have blood work AT the office, get lots samples of a drug prescribed to see if it worked prior to purchasing it from the pharmacy.  It worked pretty smoothly.

There were things that didn’t work smoothly, such as people with pre-existing conditions being turned down for insurance. Your children had to attend college full-time to STAY on your insurance, otherwise they were kicked to the curb as soon as they turned age 18.  I’m sure there were plenty more, hence the reason for the Affordable Care Act.

Looking back now, I believe it should have been named the Accessible Care Act.  I don’t honestly know if the reason we are paying such staggering amounts of money is due to the fact that no one could be turned down for insurance, no matter how sick they were?  I don’t know the reason.  ACA is not working.  Period.

If I remember correctly, the original ACA had been revised several times so that the Republicans would allow it to pass.  What did the original look like?  I’ve heard it was 1400 pages, so maybe nobody knows what it stated.  The Republican party is very quick, as well as President-Elect Trump, to point out that it needs to be repealed.  And certainly there are quite a few changes that I see myself that need to be done.   I wonder how much of the suggested repeals were in the original document?

At any rate, my complaint has an agenda.  My current “out-of-pocket” (OOP) is 2600 per person per year.  After that is reached, I pay 10% of the charge.  Last year I reached my deductible by July 1.  The difference in fees that I paid prior to July is an exorbitant amount of money.  I just recently  called a script refill in to my pharmacy on December 31, 2016.  That date is important because I intentionally had the rx request in to the pharmacy BEFORE 2017 because I knew the new deductible would kick in and once again I would be paying out the ass for my medications.  Unfortunately for me, the pharmacy didn’t have my medication, it had to be ordered and wouldn’t arrive until Jan 3, 3 days too late.  Prior to January I paid about $8.00 for these meds.  Jan. 3 I was asked to pay $1000.  Yep, a grand.  I was told that it was much better than if I didn’t have insurance, without it I would pay $3000.  And the pharmacy tech was being serious.

What do you think that I did?  Ofcourse I didn’t get it.  Now here’s the kicker….the rx is for a medication called Duexis.  This is a pill which contains 800mg of ibuprofen with famotidine added.  Famotidine is Pepcid, which helps heartburn that you may get from taking the NSAID (non-steroidal anti-inflamatory drugs)  So there you have it.  What on earth could possibly make this medicine price in at $3000? I read this recently, which  explains it a little bit.  Apparently taking twelve 200mg motrin and four generic pepcid pills will do exactly the same thing for me, at about $0.51 cents compared to about $51.00!  So basically you are paying for the convenience of taking one pill instead of 4 every 6 hours.

I’ve been taking Duexis off and on for about three years.  I had no idea that my insurance company was being billed about $1500 each time I had this prescription filled.

This is just one example.  Just one medication of the thousands of medications that are out there.  One drug company of the THOUSANDS of drug companies that could possibly be gauging the consumer, the provider and anyone else in its way.

Do you still wonder NOW why we pay such high premiums for health insurance?  Can you imagine the mark up on medical supplies?  MRI machines? The list is endless.  When you allow a company to charge what EVER the hell they want to, especially something medical related,  where the consumption of such medicine could mean life or death for someone, then you allow someone other than God to make the decision about the quality of life.  The life that we live is being negotiated and predetermined by people and corporations whose bottom line is the almighty dollar.

How many spaghetti dinners and chinese auction raffle tickets are we going to continue to attend and sell in order to make up for the financial devastation that potentially terminal and debilitating illnesses carry with them?  Trial medications that HAVE saved lives not covered under your insurance plan?

But hey, at least they won’t cancel you, right?  You will get a second mortgage on the already too small home that you live in, replace the transmission in your 12-year-old car instead of buying a newer, more reliable model. Vacations will consist of a Sunday at the local park, if everyone is feeling well enough.  Do all the things you need to do to get by while you are paying the mountainous pile of astronomical medical bills that will NEVER be paid off in your lifetime, no matter how long or short that is.  And all the while the makers of  medicine and testing and supplies are vacationing in Dubai every couple of months, living in multi-million dollar summer and winter homes and taking a stink-less shit on a 22k toilet.

To be clear. I don’t have a problem with people making money, just not at the expense of the health and welfare of the people they profit from.

I believe we’ve been priced right out of our comfort zones, and there’s not one damn thing we can do about it aside from bending over and taking it up the tailpipe.  I don’t particularly like the personality and morals of Donald Trump, our new President.  I have no idea what kind of business man he is, but I do know that if he does a complete 180 and suddenly cares about the medically financially strapped Americans who face financial ruin rather just saying he does, I hope that he uses every ounce of his bullshit, bullying tactics to make the situation better, more affordable and legitimately fair for all people of the United States.








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