I see it all the time–patients and families making decisions no one should have to face. Do I pay for food or prescriptions? Do I pay the electric bill or buy my heart pill? Christmas for the kids or my diabetes pill? As a parent, providing for the kids in the short-term far outweighs the intangible “possible” future risks of skipping the medication–UNTIL they have a stroke or heart attack or loose his/her vision (or a leg!) from uncontrolled diabetes. Hind-sight is 20/20 and now the parent/spouse/friend is permanently disabled or dead.
Why are families facing situations such as this?? Recession? Unemployment? Economic funk? Poor budgeting? Maybe these issues come into play, as we are all human. However, some medications are $20,000 a DOSE! What does one do when confronted with a situation like that? Is it an extreme example? Not really. Basic maintenance medications can run hundreds of dollars monthly, even with insurance. In my case– my sheltered, insulated, well-insured, well employed, solidly middle class self was forced into bankruptcy by co-pays in about two years. I wasn’t even in a high-risk group!!
Pharmaceutical companies cite research and development costs, production
expenses and marketing costs as reasons for such extreme prices, then fall back on “There’s no price too high when a life is saved.” As if saving life was their goal. Keep this in mind: Pharmaceutical companies focus on the medications producing a profit–NOT the ones saving the most lives. The basic, inexpensive medications that save lives every day are in critically short supply; the companies are producing them less and less because the profit margin is falling lower and lower. The same thing goes for common, basic medications stocking crash carts around the US. During a code, time is CRITICAL. It doesn’t make sense to fumble around looking for a medication that should be there but isn’t–because it’s in such short supply. What about the value of life then? Would this be the case if the REAL goal was saving lives? REALLY? Sounds like big businesses’ excuse for inexcusable behavior.
It is even MORE inexcusable to force families to choose between purchasing basic, maintenance medications and creating family hardship, especially when he/she is unable to take the least expensive option. A classic example is medications used to control seizure activity. The patient MUST have them. On the less expensive end of the spectrum there is Dilantin and the
cost moves upward from there. The doctors try each one progressively (based on more than cost, but it is a consideration) until he/she finds the one that “works” for the particular patient. It may be a medication on the $4 list at WalMart ~OR~ it might be another medication costing $1,000.00 a month.
What is the answer to this mess? How can we help these families ~OR~ what is the answer to our flawed system? NO clue….
In some cases, pharmaceutical companies offer programs for those without insurance, where the medication is either free or steeply discounted. On the down-side, the paperwork is arduous and medical offices are not always happy about filling it out. It’s also a lot to expect from a sick person if he/she is struggling through an illness alone. Additionally, some medical staff view the programs as “welfare” and treat the patient poorly. What the HELL? Another drawback is the lack of options for those who are under insured. Yes, the insurance pays part of it, but the patient’s co-pay is still $500. How does one work out that issue?
In the end, these are the patients who end up on disability from preventable or manageable health problems. After years of working, neglecting themselves to care for the family– and barely scraping by, he/she is FORCED onto disability and into the system in order to survive. Had affordable medications and treatment been available, the whole process could be avoided–or at LEAST postponed for decades. NOTE: These folks are separate from those on disability who DO NOT deserve it and suck the life from our system (while they work for cash under the table). Enough about that tho–I’ll save them for a post of their own later on.
How can we redesign our system to stop creating its own sick? Where should we intervene in the process to break the cycle of health poverty? As you can see, I have so many more questions than answers.