Nickled and dimed and hundred-dollared to death

I’m starting to warm up to Sen. Dorgan’s drug importation amendment in a big way. Since Sticks’ diagnosis and our subsequent behind-the-back rescission of COBRA coverage, we’re putting bandaids across the checkbook to try and stretch it far enough to stay afloat until some relief in some form comes.

I thought I had it all in line, but I didn’t. Right now, the monthly bill looks something like this:

1) Syringes, test strips & supplies: $100/mo
2) Insulin: $100
3) Lialda (UC Medication) $354/mo
4) Generic Adderall XR $166/mo
5) Actos+Met 117/mo

Grand total: $837/month for meds.

Docs are another $150, blood tests to monitor various levels another $80/month. All told, about $1000/month to manage and hopefully beat down this thing to something he can live with. Ultimately, the insulin cost should go away when and if he can manage to taper the prednisone for the colitis. So far, every time he’s gotten close to tapering, the colitis pain has roared back. They’re trying again now, slowly. Very slowly.

Here’s the crazy stuff. That Lialda there in the middle? The doc gave him tons of samples and told us he shouldn’t have to pay more than $10 for a monthly supply. The doctor would be right, if we were insured.

For this particular medication, insured people pay no more than $10. Uninsured people pay $354.00. What’s wrong with that picture? Seriously. The only way that makes sense to me is if there’s a deal cut between Shire and the insurance companies for a discounted price and then a further discount from Shire to bring higher copayments down to a net price of $10. But for schmucks like us, the full retail price of $464 gets dropped to $354. Whoopee.

That’s not manageable, nor is it fair. If pharmaceuticals are going to roll around in bed with their insurer siblings, then they can suck up the possibility of seeing their sweetheart deals fall apart in favor of drug importation.

This isn’t just about me, or our checkbook. If health care reform is going to work (and Medicare not bankrupted), then pharmaceuticals are fair game. There’s no excuse for changing the packaging or delivery system on an existing medication (a la Lialda) and jacking the price 900%. None.

In other news, it looks as though an expansion of Medicare might be getting some traction, at least for uninsureds age 55-65 (though I keep hoping they’ll push that down to age 50…). That would solve a big chunk of what keeps me up at night. Getting BigDog covered just in case would be a huge relief. I could probably slide Ms. Dancer and I into some sort of affordable individual plan and hopefully get Sticks into the immediate national high-risk pool until all the reforms kick in.

The most interesting part of what’s going on right now, though, is that Democrats are closing ranks in favor of finding creative solutions to the problems at hand, despite introduction of that nasty Nelson-Hatch-Stupak-Catholic bishop abortion amendment. Given the recent embrace of the Republicans around Medicare with both arms and a wet kiss, it will be pretty difficult for them to walk back that support when confronted with a truly practical solution to Medicare’s cash flow needs and the uninsured group between 55-65. They can try, but it will negate all the traction they got “defending seniors”.

I’d say things are looking up for the possibility of a Christmas present from our Congress. At least, I’m willing to cautiously say so.

Tagged as: cost control, health care reform, medicare expansion, medication, pharmaceuticals, Politics