I have a minor but annoying medical condition. I decide to see my doctor. My choices go from bad to worse. Nothing that Obama says today gives me any hope at all.
Choice #1: an ointment, which I know costs $265, lasts about one month, and will require about 45 days to get the condition under control. I last used this in 2007 before running out of both the prescription and the money to pay for it. Except that when I take the prescription to Costco, it's now $420. Four hundred and twenty dollars for a bottle of stuff that'll last a month?!? And why was the price hiked 50% over two years? I know the answer: because it can. Because it's such a bargain compared to the alternative -- my choice #2. There's no generic alternative.
Choice #2: an injection, which costs $17,000. Yes, I could buy a car for the cost of the injection! The doctor gives me a slick, expensive brochure for a brand new, state of the art medicine with (of course) no generic alternative. Side effects include immune system deficiencies and lymphomas. To make sure my immune system doesn't run amok, I have to go through skin prick tests to rule out tuberculosis, x-rays to rule out rheumatoid arthritis, and blood tests to rule out everything else, just to qualify for the right to get shot up every two weeks; and there's a less than one percent chance that I'll get lymphoma. (As my face turns paler and paler, she explains that most of the side-effect-lymphomas are skin cancers, which can be surgically removed. Oh, that makes me feel so much better.) And I'm supposed to repeat the injection every two weeks, possibly for the rest of my life.
Oh, but I pay $450 every month to Anthem Blue Cross of California for an individual plan! I'm saved! I can afford these horrible choices! Uh, not really: to get my health insurance down to a so-affordable $450/month (more than a car payment!), I have had to go to a policy with a $2500 deductible. And -- this is my favorite part -- Blue Cross hates the new injections, because they're so expensive; since the injections became available, Blue Cross will no longer insure people with my condition. Further, I'm sometimes late paying my policy premium, in which case Blue Cross charges me a $50 fee to "reinstate" me after I'm dropped (any other institution would call it what it is, i.e., a late fee), and if I go onto the injection and am late, Blue Cross would drop me and then refuse to reinstate me.
Choice #3: be a guinea pig. Other Big Pharma companies want their $17,000 copycat drugs, so the newspapers are filled with ads for "study-related medications free!" Something about a more-or-less-than-one percent chance of contracting lymphoma makes me less than enthusiastic.
Choice #4: look into different health insurance even though I would probably be rejected. After all, this is the land of free choice. A few minutes with ehealthinsurance reveals some interesting factoids. Blue Cross' cheapest plans cover only generic drugs; neither my $420/month ointment nor my $17,000/two weeks injections would be covered at all. And the 107 different plans offered on this website, only six different insurers offer them: Blue Cross, Blue Shield, Kaiser, Aetna, Pacificare, and something called Celticare with low ratings. I'm in California and these are my only choices. I hear from the grapevine that none of the 107 plans from 6 insurers would accept me.
Choice #5: Listen carefully to everything coming out of the White House on health care reform, and hope that it'll benefit me. Today, in response to a question about European style health care reform (hat tip to pidgenotmidge for transcript), POTUS says:
A: Now is the time to reform the health care system. (Applause) The reason I think it's so important is that the high costs of health care is a drag on our economy and on our families. Makes people less productive and less mobile (starting new jobs). Cuts into business profits and is a drag on federal and state budgets. Will potentially "break the bank". Medicaid and Medicare are biggest driver of our deficit. All our recovery stuff amounts to a fraction of the long-term deficit and debt we're facing, the lion's share of which belongs to Medicare and Medicaid.
Blah, blah, blah. No disagreements with the diagnosis, but I want to hear his solution.
Why not do universal health care? I actually want this - that is our goal. I think we can accomplish it but whether we do it like Europe or Canada is a different question. People think this means single payer. The problem is that we have what's called a legacy set of institutions that aren't that easily transformed. Majority of Americans (historical accident, FDR) ... what evolved was an employer-based system. That's what everyone's used to. I don't think the best way to fix health care is to completely scrap what we already have, but build on system we have and fill some of these gaps. Looking to Congress to work with me to find that optimal system.
Rethink how we reimburse doctors; invest in prevention; a whole host of things we can do to cut costs, provide coverage to more people. Anticipate health care bill to sign this year.
Sorry, POTUS, this is no help to me. I'm beyond prevention, my doctor is getting paid by Blue Cross and me, and I have coverage (albeit horrid coverage). What can be done to cut costs when one company thinks it's okay to charge $17,000 to treat a minor-but-annoying illness, and another thinks it's okay to raise the cost from $265/month to $420/month, just because it can? This is not a question of trimming a bit here and cutting a bit there. This is an obscenity.