And ACA dismantlement starts

[bae]

Healthcare rant of the day:

I'm on a boring medication. Once every 7-10 days, I need a single dose.

Before ACA, my doctor gave me a prescription, the pharmacy filled it, and a 3 months' supply of medication, list price, was $65.00. It was an injectable, and I dosed myself, so there's another $.25/dose for a syringe and needle and band-aid. (If the nurse/doc did the injection, the charge to the insurance was $90/dose with the office visit, which seemed wasteful, so I just did it myself, as the Doc was fine with that.).

After I was unable to keep my insurance once the ACA kicked in, because my sort of catastrophic policy was viewed as horrible, and the insurer simply left the state, my new insurance providers, in order to prevent fraud, only allowed one month's worth of medications to be issued by the pharmacy at once. So, instead of one large bottle of meds, lasting 3 months for $65, I each month would be issued 4 little teeny tiny single-dose bottles. Which cost $40/bottle.... $40.25 a dose, with syringe, compared to the previous $5.76/dose. Plus of course whatever it costs everyone each month to call in a prescription, verify, fill it, and do all the paperwork. Great cost savings there.

Now, every year since the I've had to change insurers, because insurers are fleeing this state, or at least this zip code, as fast as they can.

I called in a refill order this week. The new insurer denied it, because "it requires pre-authorization, and we want you to talk to your doctor about these other possible alternative medications instead...". Now, I'm sorry, but the paper-pusher on the other end of the phone has never examined me, or looked at my medical records, how *dare* they offer a medical opinion. I'm pretty sure they aren't licensed to practice medicine either... The problem was resolved in about 15 minutes, with a conference call with the insurer, my doctor, and my attorney, but dang.... Normally, they take 72 hours to "pre-authorize" a prescription.... (And really, "pre-authorization" for a medication I've been taking for 5 years, for which we have charts and graphs and bloodwork...?!?!?)

Imagine, if you will, some 85 year old person, taking 7-10 medications, as I don't find uncommon when I visit their homes on emergency medical calls. Imagine the hell they must go through if they are treated this way by their insurers... The stuff I'm taking isn't for any life-threatening condition, I can exist for many months without it, but what happens for more time-sensitive stuff, when the patient isn't as able to just bring down the wrath of Khan on the insurer?

The insurance system needs taken out behind the barn...

(Oh, there's another completely minor medication I take. It costs, well, next to nothing. It went off-patent many decades ago. A year's supply costs perhaps $20. They still insist on issuing me this stuff 30 days at a time... I can't imagine how much money they save doing this...)

[flowerseverywhere]

To the average AMerican that $7,000 deductible IS catastrophic. While I think that is silly and people need to budget mpre for their health care snce everyone seems to want it all for free, that is the feedback I get.

.

well, I think that many of us who are able prepared to cover a lot of our medical expenses as we aged. The problem is those many people who were forced to leave good paying jobs as factories closed, got caught in the housing downturn, lost pensions when they lost their jobs. Sometimes crazy stuff happens beyond your control.

I live in a big retirement community. I have neighbors who had several big companies in their town close suddenly as jobs went to Mexico. They lost a lot of value in their house, the man was virtually unemployable with all the other fifty year olds looking for work and she had only part time work which she tried to increase but could not. They were lucky that their son helped them buy a small house, and they live a very frugal life. A major medical problem will put them under and they did nothing wrong.

[iris lilies]

well, I think that many of us who are able prepared to cover a lot of our medical expenses as we aged. The problem is those many people who were forced to leave good paying jobs as factories closed, got caught in the housing downturn, lost pensions when they lost their jobs. Sometimes crazy stuff happens beyond your control.

I live in a big retirement community. I have neighbors who had several big companies in their town close suddenly as jobs went to Mexico. They lost a lot of value in their house, the man was virtually unemployable with all the other fifty year olds looking for work and she had only part time work which she tried to increase but could not. They were lucky that their son helped them buy a small house, and they live a very frugal life. A major medical problem will put them under and they did nothing wrong.

I have tons of sympathy for people who have no job in a place where jobs bs are no t forthcomingl and especially for older people.

I have far less sympathy for people, and I know many, who think they shouldn't be paying anything for health care and wh have means. One such couple is flying to Paris next month. They will be spending a year's worth of ACA premiums on that trip.

People just dont prioritize needs over wants. Anther set of friends we have are still working at age 70, well, the man of the house is. Actually, I know a several people still working at ages 70-80. But I digress. This one couple has to sell their house because they can no longer afford it and its not a huge house. He is working at Home Depot. I saw her come out of the nail salon last week, glad she hasnt had to give up that necessity.

[iris lilies]

I weeded for two hours on this glorious, cool, sunny afternoon and listened to NPR. The reporters barelly kept the glee from their voices in talkng about the Republican stalemate in the House re the ACA.

[ToomuchStuff]

Bae's prescription thing makes me think of my own. Before the ACA, I would pay for my own prescription, as it was one that a large corporation sells for $4 to an individual. To an insurance company it was more and according to a relative who went elsewhere, his cost the insurance company $11 for the same thing he could have paid $4 for, and guess whose pocket that money comes out, in the end, when your rates go up (with everyone elses).
After the ACA and "mandated insurance", they started charging customers the insurance rate, unless they were a next level member.
Now, because of a level of bureaucracy, I am awaiting a refill after not being on the medicine for a couple days, awaiting.

[Yppej]

My parents' post-retiree medical plan changed this year and my mom who is on numerous medications is now going through the preauthorization prescription rigamarole Bae is, and costs have skyrocketed. To try to keep them down she went to mail order meds but the letter carrier was on vacation and the post office delivered them to the wrong address so they sat outdoors in someone else's mailbox in the cold overnight. Supposedly they are still effective - if not it would be $400 of her money down the drain. She is trying to get everything switched to a PO box.

She probably spends the equivalent of one 8 hour work day every week on hold and talking to insurance and medical providers. Each time she calls insurers she gets a different person and a different story. It is now to the point she is about to give up on conventional medicine and take quack remedies that her sister advocates.

[Tybee]

I hear you! Before ACA, my rescue inhaler cost 11. After, it is 75. My other inhales had maybe a 30 dollar copay. Now the copay is 250 dollars, and I cannot afford the medicine anymore. I need another medicine and it is a 200 dollar copay.
So I am definitely going the non-allopathic medical route, and struggle along as best I can, and I do everything in my power to stay away from doctors.

IL, I don't know anybody who spends a year's worth of premiums on a trip to Paris! Everyone I know is like the couple Flowers mentions, including ourselves.

[LDAHL]

Step 1: Dictate the terms of what every health policy must include.

Step 2: Create penalties and subsidies related to who can charge how much for what to who.

Step 3: Declare that "the free market has failed".

Step 4: Move from an informal to a formal nationalization of health care.

Step 5: Begin discussing euthanasia.

[Tybee]

"Step 5: Begin discussing euthanasia."

And yet when I mentioned this in another thread, I was called paranoid.
LDAHL, your list is pretty unkind and insensitive to those of us who are living without medications. I don't think you care that you hurt my feelings, but you did.

[jp1]

Actually step one was: acknowledge that the free market has failed.