Prescription for disaster

Diabetes, epilepsy, and high blood pressure are treatable conditions thanks to medications that can keep them under control. But for many Americans, like Kathy from Earlville, N.Y., who doesn’t have health insurance and doesn’t quite qualify for Medicaid, they are simply unaffordable. As she put it, she’s committing suicide slowly because diabetes affects all her organs. Sacrificing her health because she can’t afford her medicine is something no one should have to do. And yet this unfortunate scenario is playing out all too often from coast to coast.

I saw another troubling example of this in a recent e-mail forwarded to me by a neurologist colleague. The young woman wrote to say that she took two types of epilepsy medicine for almost 10 years, which cost her $45 a month. But with a new job came a new health plan, and now she says she has to pay more than $450 a month for the same drugs. She says she has to choose which bills to pay: rent, food, gas for her car, or medicine. “I have no money,” she writes. The worst part is that she is no longer taking any medicine for her epilepsy because she can’t afford the brand-name drugs, and generic versions aren’t available. She says she has applied for a prescription drug assistance program but has been denied because she has health insurance.

A recent USA Today/Kaiser Family Foundation/Harvard School of Public Health survey revealed that in the past two years, 29 percent of respondents have not filled a prescription because of the cost, 23 percent have skipped doses or cut pills in half to make a prescription last longer, and 16 percent say payment for prescription drugs is a serious problem for them and their families.

Even those with “good” prescription plans have seen a rise in co-payments, with average co-pays rising from $8 to $11 for generic drugs, $15 to $22 for preferred drugs, $20 to $35 for nonpreferred drugs, and fourth-tier drug co-pays rising from $48 to $74. Prescription drug assistance programs are designed to help people who don’t have health insurance or drug coverage pay for their prescription medicines, but people like the woman with epilepsy, who has a poor plan, and Kathy, who has some assets, fall between the cracks.  As the Cover America Tour is finding out, flaws in our health-care system have placed many people in no-win situations. Which would you choose to forgo…food, rent, or medications?

—Orly Avitzur, M.D., medical adviser to Consumers Union

Comments

[Farrah Ashline]

There are alternative Eastern therapies that can assist people in many of today's diseases. Ayurveda and acupuncture both are scientifically proven to assist in a variety of health issues while massage therapy, yoga, meditation and music therapy can help.

Farrah Ashline

[PR]

I'm on a HSA plan now because my company's non-HSA offerings were going to cost me an additional $3500/year or more just for the premiums. Now that I have to pay full price for medicine (until I hit my deductible), I've shopped around and found that the exact same medicine I used to buy here in the U.S. is about 60% cheaper in Canada.
Why is it that pharmacies in the U.S. are so much more expensive than those in Canada?

[John C]

I just recently lost all my health insurance, my dental and prescription coverage on COBRA because I was late on only one monthly payment. Apparently, congress agreed with the insurance sompanies and the employers to make a law so that anyone on COBRA who was late just once in making a monthly payment (in my case $412.00) could have their health insurance cancelled permanently. They give no warning, and they take no prisoners. They even refused earlier to accept acutomatic payments. Why? Who wins here?! Certainly not the American consumer or the poor. Interestngly, the business here was the American Association of Home Nurses in Atlanta.
Who in congress consented to vote for this overly strict and unforgiving law? Shame, shame!!

[ds]

some of us cannot afford to get accupture or go to yoga classes etc either .i am an epeleptic and because i have had it so long it is now considered a disability and i am able to pay for health insurance threw the state that covers my perscriptions it is a premium health care , i have to reaply every six months but it is well worth it otherwise i would be paying over 300.00 per month for one of my three meds just for my epelepsy.

[Renee]

Things in this country are out of control. Why is it that we can give billions of dollars in aid to other countries but we cannot take care of our own people first? If we continue on this path the people will suffer and our social services will not exist. Greed, dishonesty, and arrogance have all contributed to the demise of our standard of living. When will everyone stand up for what is right?

[Ellen]

I found something that helped me. It's something called FamilyWize and they have a prescription discount card that you can download and print and take to the pharmacy like an insurance card. They even have a price thing that lets you see how much it would be at different pharmacies near you. It's at www.familywize.org - not .com that will take you to something strange. On their site is says something about United Ways so I guess you can get some at some of the United Ways (mine wasn't on there).