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Author Topic: Tier 4 Health Care! Phat Lewtz!  (Read 998 times)
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Farscry
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« on: April 16, 2008, 02:30:50 AM »

First: I apologize for cross-posting (I just posted this on GWJ), but it's a big topic for me as you'll see, and I just want to make people aware of this, even though it won't affect most who'll read it.

http://www.nytimes.com/2008/04/14/us/14drug.html

Quote
No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.

Let me put a personal face to the article. I'm one of those people. Since starting on Humira a few years ago, I've been able to live without my old regimen of taking high doses of pain medication every day at the cost of my stomach's health and elevated risk of cardiac failure. Pain meds also do nothing to halt the progressive nature of my disease, instead purely treating the pain symptoms and ignoring the ongoing damage to my body. Humira stops my body's immune system from attacking my body by inhibiting the production of a specific range of proteins (antibodies).

It's not an exaggeration to say that, for me, Humira is essentially a miracle drug.

My medication would cost me ~$1600 per month without health insurance. It's caused me to stay at my job just to keep my health coverage rather than take a more flexible job (without insurance) that would allow me to more effectively pursue my studies.

Right now 10% (according to the article) of health insurance providers have migrated to the Tier 4 pricing plan. Eventually they'll all spread to that, as it's more profitable for them. When that happens, all I can do is thank God that I don't have a terminal illness -- just one that will eventually all but cripple me and leave me dependent upon public assistance when I can no longer work.

Hell, just toss me in the fucking Soylent Green vat now and be done with pretenses. Tongue All you currently healthy people who don't see a problem here, good luck. I hope you have the fortune to stay that way until our "health care" system is overhauled so that you're not punished even further for having the misfortune of being sick.

I mean that. I wouldn't wish my forseeable future on anyone else, and I'm not even as bad off as those with potentially terminal illnesses.
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rickfc
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« Reply #1 on: April 16, 2008, 03:03:27 PM »

Wow, that's terrible.  My wife is on Humira, Celebrex and Cymbalta among others for her RA.  I will definitely be doing more research on this.  Thanks for the heads-up, Farscry.

P.S. If you are on Humira due to arthritis, have you talked to your local chapter of the Arthritis Foundation?  They're usually trying to get new laws passed, etc exactly for reasons like this.  My wife is on the board for the Houston branch, and she's always going to meetings and speaking to groups and lawmakers.  You should check it out.

PM me if you want more info or what have you.

Good luck.  I know it's rough.
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coopasonic
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« Reply #2 on: April 16, 2008, 03:40:13 PM »

Quote from: the article
the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year
...
She had been taking Copaxone since multiple sclerosis was diagnosed in 2000, buying a 30 days’ supply at a time. And even though the drug costs $1,900 a month, Kaiser required only a $20 co-payment.
...
But Sprycel, which he will have to take for the rest of his life, costs more than $13,500 for a 90-day supply
...
Wellcare declined to say what Tykerb might cost, but its list price according to a standard source, Red Book, is $3,480 for 150 tablets, which may last a patient 21 days.

Well that's yer problem right there.

After years of not really being concerned with health insurance. This year has been a wake up call for me. We've paid about $2k for my son getting tubes in his ears, and I'm looking at a denied claim for $7k for a CT for me that wasn't precertified and took maybe 10 minutes to perform, wondering when the bill will come in the mail.

Luckily we don't have any on-going prescription needs and we can survive these costs if they don't continue to stack up, but crap healthcare is expensive.
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Farscry
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« Reply #3 on: April 16, 2008, 08:28:48 PM »

Quote from: rickfc on April 16, 2008, 03:03:27 PM

Wow, that's terrible.  My wife is on Humira, Celebrex and Cymbalta among others for her RA.  I will definitely be doing more research on this.  Thanks for the heads-up, Farscry.

P.S. If you are on Humira due to arthritis, have you talked to your local chapter of the Arthritis Foundation?  They're usually trying to get new laws passed, etc exactly for reasons like this.  My wife is on the board for the Houston branch, and she's always going to meetings and speaking to groups and lawmakers.  You should check it out.

PM me if you want more info or what have you.

Good luck.  I know it's rough.

I didn't realize the Arthritis Foundation was that active, I thought it was more of just an information group. I'll definitely have to look into that.

I'm lucky that I have a milder form of arthritis than your wife: psoriatic arthritis. By "milder" I just mean that it doesn't progress quite as rapidly and severely as RA does, not that it's actually a mild disease.
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