Tuesday, May 1, 2012

No health insurance? Good luck with your meds...

No health insurance? Good luck with your meds...

I went to the pharmacy today to pick up some medications I use. I'm 51 years old, overweight, I take medicine for asthma (Advair and Singulair), high cholesterol (Zocor) and acid reflux (Aciphex). All three are fairly common ailments and fortunately, all three are controlled well with medication. A lot of people take these medications and I imagine a lot of people take all of those meds, just like I do.

My charge today for refills on those four medications was $160.00, which works out to be a little over $1,900.00 a year. I'm not complaining, mind you, but its a chunk. Factor in my wife's meds, which are similar to mine price wise, we're pushing $4000.00 a year for meds. We do benefit from various discount cards and coupons provided to us by a primary care physician. They save a great deal of the cost for those meds. Instead of paying $160.00, I paid $60.00 out of pocket. Nice. A $100 bucks still means something to us, you know?

As I stood in line today, I wondered what would we be paying if we didn't have insurance? When I got home, I opened up each of the information flyers that come with each refill. Here's the info:

Advair -     $277.19
Singulair -  $200.29
Zocor -      $  19.89
Aciphex -   $308.69
Total monthly cost for refills: $806.06
Total annual cost for refills: $9,672.72

Remember, that's just for me. Let's double it to reflect adding my wife's medication needs. Now we're pushing almost twenty thousand dollars for the medications we need, if we didn't have health insurance with a prescription plan.

With a nice round number like that, let's say our combined household income is around $100k/yr. That means, if we lost our insurance, we'd have too much income to qualify for any relief. 20% of our annual income for just our medications, (not doctor visits, tests, procedures, etc...) is a pretty big expense, but we'd manage. Maybe we'd take half doses and try and stretch our medication. Maybe we'd try and go without a few of them. We'd get by. We'd find the money in our budget somehow.

But...what if its a different family, taking the same meds but with a lower income? What if its a family of three, with half of our annual income. Fifty-thousand dollars a year is way too much money to qualify for Medicaid assistance in any State, so there's no help there. Who can afford to spend 40% of their annual income on just medication? We couldn't. Could you?

We'll have the decision from the Supreme Court in about six weeks. According to many pundits, it doesn't look so good for the Affordable Care Act to survive intact. If it does get overturned, or gutted sufficiently enough to render it ineffective, millions of people may lose the coverage they rely on to pay for things like medicine. Politically, this issue is a divisive one. I hope if the decision goes the way the opponents of the ACA want it to, they'll keep situations like the one I described above in mind. The celebration I anticipate will occur will be a fools prize. To many its almost a game. Beat Obama/Democrats at any cost. Passion run high on this sort of thing, but there are real life impacts. While some may gloat if the ACA is weakened or struck down entirely, I hope some effort is devoted to problems like the one above. Its not in the free market's interest to give away medications. If they are not compelled to offer health insurance at an affordable rate, and those uninsured are not compelled to purchase it, there will be little reason to feel optimistic about how we as a nation plan to solve problems such as this.

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