This past week healthcare once again became a stressful issue in my life and it seemed more than pertinent with the healthcare debate we have raging in our country right now. Here’s my story:
My mom recently changed jobs; therefore, our family health insurance changed too. Being that I am 23 and will soon be a full-time student at NYU, I am still on my mother’s health insurance. Without divulging too much personal medical information, I currently take a medicine that not only treats an illness I have, but will make me sick with withdrawal symptoms if I stop taking it not to mention allow my original illness to return. Unfortunately, even if I was weaned off this medication gradually under the supervision of a doctor, I would still suffer the side-effects of not taking this medication. Thus, its important that I take my medicine every day at approximately the same time in the same amount. My stress came when the pharmacist at CVS informed me that my new insurance would only cover 30 pills a month versus the 90 pills a month I take meaning I would have to get two prescriptions a month with two separate co-pays just for what I had always been getting in one prescription for one co-pay previously under my mom’s old insurance. So I gave a call to my new insurance company.
I told them my problem: I needed to take this specific medicine that has no generic currently at this specific amount every day and that if I fail to do so I will get sick. The representative told me all I had to do was call my doctor and tell her to fax a paper to them stating I need this specific medicine at this amount each month. Because I know insurance companies are untrustworthy I then asked if they would validate my need for 90 pills versus 30 pills a month after my doctor faxed the form to them. It took me about 5 minutes to get a straight answer from the representative, but finally he said, “Maybe.” Awesome. Oh, and the other great part to this call was that I found out that this medication was going to cost me $50 per co-pay “because it is a tier-three medication!” I was incredulous. My last co-pay for this prescription was $25 per co-pay which was bad enough, but now I have to pay $50 per co-pay because of this different insurance company when my mom’s probably paying just as much a month? Are you still following me here because even I’m feeling lost, but I’ll do a recap: So what I found out is A.) My doctor needs to inform the insurance company of my need for a specific amount of this medicine which exceeds their validated monthly amount B.) That I will be paying $50 a month for this medication C.) They can still choose to deny my doctor’s claim which means I’ll still be paying more than $50 a month because there’s no generic brand which I have absolutely no control over. Got it? Good, because I’m almost getting to my point.
As if all that’s not frustrating enough, I need to buy at least one of the scripts the pharmacy has for me because I’m running out of meds and we already know I can’t skip dosages. But what I bought is only 30 pills, so now I still need my doctor to call my pharmacy to have them fill me a specific number of pills that will help me finish out the month of August. However, I also have to make sure that the pharmacy fills a complete prescription of 90 pills in September rather than the 60 pills that I need to go with the rest of my 30 for August because chances are they’ll screw it up in September if I don’t make sure.
So here’s my point: If I’m a 23 year old energetic young woman with one major prescription to deal with a month and this is what I have to go through to get it, what must it be like for the 90 year old guy with very little energy and 5 different prescriptions to deal with each month? And that leads me to my next point. All this bullshit (an excuse me, but that’s what it is) that we’re hearing about death panels and Nazi-like Obama healthcare and the end of our rights to choose the care we want from these conservative pundits is merely a way to distract people from the real issues at hand. Healthcare in the United States is not “healthy” nor is it “care” and for something that is that oxymoronic, it has become far too expensive. And okay, $50 for one prescription? You might be able to swing that. But in my family each of us have multiple scripts to fill each month not to mention the different types of general check-ups one needs and the ailments and pains that you don’t count on having i.e. viruses, thrown out backs, infections, etc. The costs start to add up.
People are scared about so-called death panels, but we already have them – our insurance companies. They’re denying dying people every day life saving treatments. AND they do it even when they’ve already taken your money every month for 10 healthy years! How is that right? And why should someone dying of cancer or a parent with a child who has a genetic illness have to argue over their right to health insurance? I mean, in the end was it worth it to pay during all those years of health if in sickness the insurance company bails on you? Those that can turn away and say, “That’s not my problem. I work hard; I can afford my health insurance,” God forbid one of these illness ever befall you. God forbid you ever get breast cancer or colon cancer or your child get into a car accident and need assisted living for the rest of their life.
I’m probably just preaching to the choir, but I felt that what healthcare reform is really all about had to be reiterated. Its about people being able to take care of themselves without going to the poorhouse. Its about people with terminal illnesses being able to live out their final days in peace, not fighting with stupid representatives on the phone who give you the run-around. Its about societies taking care of each other because you hope its what people would do for you should you ever find yourself in a bad place. I ask, when will Americans learn we can’t do everything on our own, that its better to work together and take care of each other, and most importantly there’s nothing wrong with asking for help when you’re truly in need? I know that I’ll get my prescriptions figured out with my insurance company one way or another, but I will still continue to think about those who won’t get it figured out and will really suffer because of it.
aka the bean
p.s. for those of you following the junkyard press, i won’t always post such on such serious topics, but rush limbaugh and glenn beck really chap my ass. plus, i figured i’d start off with a bang. BANG!