Healthcare hitting home

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Source: Clipartpanda

We’ve all heard about the issues with healthcare. Where you are in your life can influence your opinion. When you are working in a secure job with great benefits, you wonder what the big deal is. I had some eye openers this week.

This week one of the regulars in my walking community was missing. The group has all ages walking at all levels. Some with walkers and some, like me, hoofing it at high speed.

This particular woman (I’m guessing she’s close to 80 as she was a slow walker) got dizzy on the drive home. She pulled over. I assume she was driving erratically because a woman pulled over to help her. The Good Samaritan was a nurse and called for an ambulance.

Getting to the point of the story, the woman was diabetic. She couldn’t afford the insulin so she started to cut back. If you know anything about diabetes, you can’t do that. You have to keep your blood sugar regulated tightly.

This isn’t unusual. I know people who have cut back on eye drops (which are outrageously expensive) and some other medications too. Some are not life threatening but it affects quality of life. Or mobility. Or vision. Or makes you more susceptible to something else.

Insulin is expensive but not near as expensive as some heart and chronic illness medications. My biggest worry has always been that we are one catastrophic illness away from bankruptcy.

You know those drug ads you see? The ones that work wonders and people are miraculously helped? Some cost thousands of dollars a month. Many are new and are not covered by insurance especially Medicare. Oh yes, and because of our sluggish (and big pharma supported) government, Medicare is not allowed to negotiate with drug companies for better rates. Medicare patients are not eligible for drug cost reduction programs either.

Some basic facts about Medicare — it’s not a welfare program. Working people pay into it their entire life. It’s not free. There is a cost and because the coverage is skimpy, you need an additional supplemental plan and a drug coverage plan. In my case, it costs far more than what I paid for my employer’s plan and the coverage is not as good.

It’s also complicated. There are different levels of payment and donut holes.

There is something wrong with this picture.

Other walkers reached out to this woman. There are cheaper places than the local drugstore to buy insulin syringes but insulin is expensive. You can’t buy it in back allies. (I had a diabetic cat that required human insulin so I know all about navigating the costs.) It’s not easy especially when you are older and not technically inclined.

Comprehension also takes a hit with age. Not everyone understands even when it’s explained several times.

The people in the greatest need do not have the technology or the information they need. That is very sad indeed.

 

73 thoughts on “Healthcare hitting home”

  1. It’s a sad picture painted for some people I just read an article about a young mother with terminal breast cancer. The only thing keeping her alive, which has also caused the cancer to essentially disappear, is a new procedure. I won’t go into detail but it costs 17,000 a month and is not covered by insurance because they believe it’s experimental even though it has saved thousands of lives So this mom is going to have to make a decision to either continue treatments and send her family into debt for decades or stop the treatments and die. That’s a choice no one should have to make.
    There’s a special place in hell for insurance companies.

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  3. Oh dear, Kate…you’re right. There’s something very wrong with this picture. Here in the UK, we have the fabulous NHS. It’s not efficient, doesn’t always get things right, it’s over-burdened and many people here take it completely for granted..but no-one here would swap it for the ‘best’ U.S system. And re technology – many older people are being entirely excluded as companies/government organisations go ‘on line’. Best thing we can all do it keep ourselves healthy…so stick with the gym and the walking!

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  4. I think everyone is struggling with healthcare costs these days, but a diabetic cannot cut back. That’s so scary. My mom is on tons of meds for her myriad of health issues and they are astronomically high. Even with good benefits, we pay over $10,000 a year for healthcare for the two of us. The hubs always searches online for specials and coupons for meds. He finds good deals on occasion, but not often enough. 😦

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    • I remember when I first started working, my company paid the entire premium. I had to $20 when I went to a doc but I was very rarely ill. Oh to be young again! I was lucky enough to get a coupon for a free month’s supply of an outrageously priced eye drop from my doc. I did a happy dance.

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  5. Venice, Florida which is in Sarasota County has become incapable of offering enough great health care because of that influx of retirees. Venice, a once quiet, low population of retirees/snowbirds is hurrying to build another hospital for the Sarasota Memorial Hospital system and they can’t get it built fast enough. They truly are overwhelmed by the people that continue to move here. A woman that works with Sarasota Memorial Hospital in helping people find Doctors told CH that the last five years have just exploded with the need for new doctors and medical facilities. Good care is here, you just have to wait in line for it. We weren’t used to that in the small rural area we left. When we were living in St. Louis we could see all the health care facilities scrambling then.

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    • Something we are seeing here is that the big cancer centers are partnering with local hospitals so you can do clinical trials locally. That’s a step in the right direction. Although we are just about equal distance between NYC and Philadelphia, getting treatment without a 2 hour drive is best.

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  6. So sad for this woman in your walking group. It took us 7 months to find a Primary Care Doctor here in Florida that was accepting new patients with Medicare. We have an excellent supplemental plan but you have to get your foot in the door. You can’t get any decent care here at the urgent care centers because they are full of snowbirds. I thought Florida would have excellent health care and have found just the opposite. We needed three specialist but you need referrals and for that you need a primary doc. I found a little known way to work around that and we have the specialists we needed and like them. Health care simply stinks because it is a doubly burdened system. And Kate, you are so right, the paperwork alone is enough for you to throw up your hands and give up. I think the last thing you should have to be doing when you already feel like crap is trying to fill out endless paperwork and dealing with gatekeepers that enjoy playing power games while standing in the way of your health care. And the other thing that irks me here that I had never heard of before… Concierge Medicine offered to me by my cardiologist so that I can have the extra benefit of always seeing him instead of an extender. Crazy, it is 10,000 dollars a year. What is wrong with the US healthcare system?????????????

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      • I have a friend who subscribes to concierge care. It’s very expensive. He can afford it and he has multiple serious health issues. Unless I win the lottery, I’m not doing that. Locally we have two major health networks who bought up all the doc practices. My problem is that once connected to one, you almost have to stay within the network so the docs can easily share data. Our former neighbor moved to Florida more than 10 years ago. He told us that the health care was great because of the influx of retirees. Maybe not. According to various doctors, they say that Medicare does not pay well nor does it pay timely. They live in their multi-million dollar homes so I’m not sure how much sympathy I should give.

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  8. We have such a messed up health care system–more than twice as expensive as in any other developed country and worse outcomes. While people are suffering, our politicians prefer spending money on the military and on tax cuts for the rich. It’s discouraging.

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  9. This isn’t at all unusual, but that doesn’t make it any easier to hear. It breaks my heart. I hope this particular woman is able to get things sorted out so that she can return home and be well. I personally think that anyone can’t get medicine, or has to mortgage their house to afford it–a national disgrace!

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    • Many, many years ago a friend’s mother developed dementia. Her husband took care of her as long as he could but she had all the bad symptoms. She was surly and fought with everyone. This sweet woman got combative. He had to institutionalize her for her own safety. It cost him his security. He was only allowed to keep his home for as long as he lived and car. Everything else was turned over. So sad.

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  10. Thank you for enlightening me Kate – I had no idea that the cost for the Medicare supplement was that expensive and the coverage was so poor. My mom had many medical problems and at the time of her death (January 2010), she was just paying a supplement of about $27.00 a month. I am on Obamacare now and sing its praises as I paid $600.00/month for the same coverage after my boss and I left the Firm and my COBRA period was over. And then, just like now, that coverage does not include dental or optical. Woe are we as we grow old and cannot afford to stay healthy. I do not like that the concept of Medicare is bandied about like it is some type of gratuity – not when it is a right that we are entitled to by virtue of our paying into it all those years. I too am disgruntled. My friend Carol, whom I mention to you often, has severe dry eye syndrome. I don’t recall the price of the Restasis drops. She was able to get vouchers to get a reduced rate from her doctor, but she uses them sparingly and says the hole in the dropper part of the bottle is way too big … the drops come out too quickly and are wasted as careful as she is and Carol supposes that this is intentional on the part of the drug manufacturer – I don’t doubt it.

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    • I have never heard of a plan that low. Medicare payments are taken out of social security checks so most people don’t realize they are paying for it. Our drug plan alone is around $35/month each and that’s not the medical supplement.

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      • It’s been a while for my mom Kate – I don’t remember how much her social security check was, but I do know the supplement was relatively low and at that time (before 2010) she sent in a check every month. I think she always prepaid a month or so in advance in case the check would get lost. So what you are saying is that this likely was just the drug plan? When my boss lost his mother in 2016, he handled the estate. His mother lived about 100 miles away and so he had all the mail routed to the office and I had to type a running list of bills paid for the estate paperwork and to distribute to his brothers. Her Medicare supplement was about $125.00 – I was amazed at that time how much she had paid. They had already sent in the payment for June 2016 and she passed away the last week in May 2016. She was in assisted living the last 3 years of her life due to dementia. No wonder my financial guy suggests I work ’til age 67. Sigh. Thanks for enlightening me.

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        • That could be right. You pay for Medicare through the SS check and the supplement directly to the plan. Working until full SS age is thought to be a good thing as long as you have your health but everyone’s financial situation is different.

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          • SI never knew that it was taken from her SS check – she did not have a very large check to begin with (that’s probably why). My mom did have a small SS check from Canada as she had been age 40 when we moved to the States. You could collect SS from Canada (they call it “the Old Age Pension”) and live here/abroad as long as you had reached your 40th birthday while living in Canada – she turned 40 in February 1966 and we moved here in July of 1966. So what she paid was drugs only – interesting.
            She was on a lot of meds for pain and her chronic cellultis (daily antibiotics and a flare-up would have her on stronger antibiotics, sometimes administered by I.V.) I am 62 now but will wait as he suggests.

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  11. So scary! I have good insurance from my old job. But they are purposely raising the cost of my plan so dramatically that I switch plans. I feel for people with no insurance or awful insurance.

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  12. Thank you for this post. You are so right. Like you, I have good insurance, but there are way too many people that do not. What is the matter with people that they do not care about others as long as their own needs are taken care of? Is this what we have become. Well, it makes me too angry to comment more. It’s just plain selfish and mean.

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    • I’m sure your question is rhetorical but I’ll answer anyway. People don’t care as long as they are taken care of. I was angry when I heard about this woman. She’s older and frail and her only son lives across the country. Her choice is to stay with him and miss all her friends or come back home with no help.

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  13. My late FIL was diabetic and at one point decided to cutback on his insulin to save money. What a fiasco that was. Besides passing out then falling down at the mall while walking, he hurt his knee. Hello ER. And then getting him regulated back on the insulin proved to be difficult and more costly than if he’d just done what he was supposed to do. And who benefitted from all of this? Take a wild guess…

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  14. God, Amen x 1000 for this post, Kate. I am increasingly agitated by the number of politicians now running on a “healthcare” platform who only a year ago were voting to cut benefits and restrictions against pre-existing conditions. That Big Pharma controls the levers of legislation as much as it does is a travesty. People shouldn’t be cutting back on their meds in order to save money. This is insanity. – Marty

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    • I know. Especially with the insane profits that go on in the pharmaceutical companies. I know all about research costs but come one. They will double the cost of a drug for no reason. I remember when they found a vaccine for polio. Everyone got it for FREE. That doesn’t happen anymore!

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  15. My Canadian friends are shocked at the moral bankruptcy throughout our (the U.S.) healthcare system. Those who claim that our system is “the best” have either never faced a serious illness, amazing insurance, or enough money to pay the outrageous costs.

    I am glad that we live close to Mexico… my husband and I don’t currently take medications, but at least we have easy access to cheaper versions in case we do. I hope your friend – and everyone in that terrible situation – can find relief. Sadly, I’m not confident our government has the moral and political courage to do anything at all to fix it.

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  16. There are far too many stories like this one. I hope this one ends better than some of them. The worst was the man who was $5 away from reaching his Gofundme goal for insulin and died. It is maddening. Single payer, please.

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  17. I fear that nothing is going to change. We’re all going to die horrible deaths from global warming, hurricanes, earthquakes, mudslides, mass shootings, the black plague, medical shortages, water wars, famine, wildfires, the flu, TB, and . . . zombies, witches, and warlocks.

    Happy Halloween. Watch out for masked madmen.

    (I might be feeling a tad “pessimistic.” Maybe we’ll turn things around in time. Fingers crossed.)

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  18. Healthcare for profit is wrong on so many levels. I hope your friend finds some affordable solutions and/or resources. A person shouldn’t have to decide between getting by and living a semi-decent life in their old age.

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  19. It shouldn’t be, but the “cost of living” varies quite a bit between Provinces (presumably like your States), so the only way to achieve a standard pricing structure would be to take it away from the Provinces and have it administered by the Feds. I don’t think we have a politician strong willed enough to try and do that. 😦

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  20. The Pharm Drug scam drives me nuts. I take a really old drug – absolutely necessary – and the generic isn’t the same/close enough to work it’s a very old drug, a basic one – and costs a darn fortune (I could switch to generic as the pharmacy/drug plans always want – and die as it isn’t the same…maybe that’s their plan) Husband couldn’t get into the cancer drug trial, but our doc knew their doc/research group and was able to locate the equivalent off label – but we have to pay for it – insurance, nope. (they only want to collect money, not pay any out. )
    All that money the drug companies spend on ads – ought to be prohibited until prices come down. And you know all those little notes about “if you cannot afford your drug..” IF you are willing to sign up to their “free” programs, you have to give the company right to use your data and medical info “for research” – and few realize, the amount you don’t pay is absorbed and paid by others who do have insurance /can afford to pay the high price – pharm companies do not loose money.
    We are lucky so far, but looking down the road is grim.
    All those ultra elite millionaires- instead of funding massive commercials for candidate/gun debate – how about doing some real humanitarian good and fund drug payments for the elderly, the chronically ill, the children born with terrible diseases.
    How do insurance companies and drug company boards/CEOs sleep at night?
    Hope your friend stays near her son. You have to have a clear thinking determined advocate these days

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    • I don’t know the status now but when the Hep C miracle drug came out the price tag was $70K. Seriously? I use an eye drop that is $400/month if you take as directed. I have learned how to stretch it out to 4 days. I looked into the company’s program to help people cut the cost but you have to be at poverty level to get any discount. Also it favors people with commercial insurance rather than Medicare. I feel so badly for the elderly who have no one to help them out. You are right, dying is preferred. Hope your hubby is ok. There are some significant break-throughs for cancer but the price tag, yikes!

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      • With this one, all they can do is halt it – can’t get rid of it, but so far so good…thanks to a good doc.Your eye drops sound like one nasal spray… Many docs battle daily for their patients. They are exhausted and frustrated Something’s got to give. (And the insurance coverage drops as premiums grow high each year) Stay healthy ( don’t eat all the leftover Halloween candy HAHA)

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  21. The pharmaceutical companies are full of crooks. My Remicade infusions are almost 15k a pop…not a year. An infusion friend of mine who has a different disease must have 6 hour infusions, every 3 weeks to the tune of 100k. My aunt and uncle cross the border into Mexico to get many of their prescriptions, dental work, etc.

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    • I have a friend who lived in California and she and her friends always went south for drugs and dental. She said there were huge pharmacies and dental clinics right across the border and they were skilled. I saw a comparison of a high replacement between the US and Spain. Same result and technique. You could live there for 3 months plus have the surgery for the US cost of surgery alone.

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    • My daughter, who is an actuary whose specialty is medicare and medicaid, says that worse than the pharma companies are the middlemen. The worst ones are the go-betweens between the drug companies and the drug stores. They make enormous profits for doing next to nothing.

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  23. This is not the first time I’ve heard a story about someone who wasn’t taking their insulin because they couldn’t afford it. I have no appropriate words for the pharmaceutical companies who have priced common life-saving drugs beyond reasonable reach and the insurance companies who provide programs that can best be described as sieves. This is morally corrupt.

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  24. it is… and I have tears in my eyes for this woman and for all others in need… it is hard to find our way through all paper jungles this time, without me my mom would be lost like this old lady… ;o(

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  25. I consider our healthcare system to be quite good, but there are still hiccups as the different Provinces have different coverage and rates etc. We recently had a case where an Ontario resident was hospitalized in British Columbia, and her resulting bill hit the headlines here!

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  26. Agreed. It is the “Seniors” in general that suffer the most with an inadequate healthcare system, due simply to the aging process and inherent medical issues. Equally sadly they are not the largest voting sector, so any politician that “spins” healthcare changes which benefit the young and middle-age voters at the expense of the seniors, will only make matters worse. As we do seem to be heading in the general direction of a more self-serving society (Trump is setting the pace), then the future for seniors is rather questionable.

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    • This woman’s son flew in from California (and took her back with him) to sort things out. She wants to come “home” so I don’t know how it will end. Older people need an advocate (usually a child) to help them through the paperwork and other road bumps.

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