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Thursday, February 28, 2019

I am a Pre-Existing Condition

One of my most popular posts ever was entitled "The Price is Wrong." To prove its points that A) meds were overpriced and B) that they were really overpriced for those without insurance, I asked what costs more: a month of rasagiline or some random product.

The end result was this:

If you don't go generic, and you choose Azilect, you can expect to pay over $700. Since I had to go to CVS with my plan, and I'm between month 1 of COBRA and switching to my wife's insurance, we're paying out of pocket and getting reimbursed, so our price was $524.

Yep. You read that correctly... $524 for 30 1 mg pills or about $17.50 a pill.

You can read it in its entirety HERE.

I mention this because two days ago, buried in the Michael Cohen (a sad state of affairs) and North Korea non-deal (a good thing) there was a Senate hearing on drug pricing. Trump had made this excessive gouging a point of his campaign that we agree with. Unless your name is Martin Shkreli or you're really in favor of the freer market / Law of Supply and Demand & are NOT a pre-existing condition or know someone(s) with one (or more), you're probably wondering why drugs cost so much. Then again, lobbying money is really good, I hear.


There are no results yet from the day's hearing, but I've included a few articles on it here since, even though they were talking more about insulin and Humira, by virtue of reading a post written by a guy with Parkinson's, you or someone you know / are friends with / love someone who is a pre-existing condition. Their / your ability to be insured and covered is important. Not to get all dark, but chances are, someday you or someone(s) you know will be. That's life because the human body is "fra-gee-lay."

When we fight to fix the system, we want to know that when crap happens, we're covered. When we're young, we may not be helping ourselves, but it's kind of like the Law of Wedding Gifts. You bought me mine so someday, I will buy you / your kids yours / theirs. What comes around goes around in a good way. Although sometimes, like my dad remarked, "You don't want to buy some people's offspring theirs!" That said, reciprocity is nice when it helps us and those we love, so (in my opinion), we do what we need to.

On a similar note, if you believe in free community college for all, like the state of Tennessee, that's the end goal, too. You educate yourself to fund a community of trained people to take care of you and yours. It's not really free. You just pay a fund for your entire life. Thus, for those voting for Bernie on the basis of free, free is not free. You're just ensuring (hopefully) a pool of trained workers to support you for the rest of your working life. If they have the credentials and better the community / world, that's nice. Like anything else, it has its drawbacks, but that's another story.

This article is about not getting gouged by a reckless necessity of an enterprise.

Sadly, with medical coverage, as many of us pre-existing conditions know (whether born with or inherited), even the healthiest of us someday find stuff happened. It's not pretty. It's not ideal. It is.

Setting up an acceptable way to treat people who get ill represents what I feel is a necessary social safety net. We don't give people sticks to burn until the wolves come to get them anymore.

I think that makes sense, and I hope it spurs some real action on Capitol Hill. It's something Trump and his opposition can agree needs fixed, even if how will be a compromise. Personally, I'd like to think that a community that cares for the community is essential to being who we are, whether that's American or some other nationality.

But in a land that begs for privatization of government entities while taking the government's cash, something is amiss. In a land where I'm forced to watch the Otezla people 2-4 times an hour on television so I can choose that drug like I'm choosing where to eat, something is really amiss (especially when I get the feeling I'm paying to advertise medications (?). That's why I'm rooting for our government, all of it (not just one side), to hold these people accountable and take care of my fellow pre-existing conditions present and to come.. 

I think many of you out there with your pre-existing conditions (and your family members with them) are feeling the same. 


If you're interested in the hearing, here are some articles.



A couple good editorials


"A vial of insulin that cost less than $200 a decade ago now sells for closer to $1,500. Actimmune, a drug that treats severe malignant osteopetrosis and sells for less than $350 for a one-month supply in Britain, costs $26,000 for a one-month supply in the United States. And the prices of many drugs — that treat cancers, high blood pressure, allergies and more — have risen so much that average consumers are rationing them, at grave peril. Not even experts seem to know how those prices are set or why they keep rising."


"Not only do we pay high drug prices, our tax dollars supply more than $30 billion per year for life-sciences research through the National Institutes of Health."

FORBES on the Trump Administration fighting this.

"At present, without the ability to institute direct price controls, there's little the Administration or Congress can do to rein in list prices. The Trump Administration has made it clear, however, that it won't tolerate business as usual. And, legislators on both sides of the aisle appear to be similarly inclined."

HEALTH AFFAIRS on the Trump Administration's considered plans

"The plan contains three key elements: substituting private-sector pharmaceutical vendors for the current Part B “buy and bill” practice, changing the Part B Average Sales Price plus 6 percent reimbursement system to a flat fee, and implementing international reference pricing.  The first two of these were attempted – and failed – in previous administrations."