And included treatment for other autoimmunity illness meds that are outrageously expensive. Three months of my kid’s meds are $16,000! Luckily the drug co picks up the bulk of that. My last med co-pay was over $500.
I am on medication that is $35K every three weeks. I am about to see how much Medicare and Medicaid will pay. I have to pay my doctor $281 but I don’t know if that was for one visit or more. I will have to pay something for nursing but hopefully $90 every three weeks. I am not sure yet though what it will be. And Medicare will pay for the meds after we go through various hoops and hurdles but they will it cover the $5K test needed to get through those hoops and hurdles. Nice trick, right? And I think I will need this test every year to keep getting the treatment authorized.
I feel for you. One of mine had gov ins and they denied medically necessary testing. We got notification that it was declined (with thirty days to appeal) after the appeals date had already passed! By then I had already skirted that system and gone through private ins. She had had the test, been diagnosed and started treatment! I am thankful we had that choice bc she was a minor. It is infuriating, disgusting and scares the shit out of me. I tend to think people who are in full support of making this our universal coverage haven’t the experience with the system. I desperately want health coverage for all but in a system where logic and the goal of wellness prevails instead of red tape and complacency.
This is one of the scariest things I’ve read. Ever think of moving to Canada or Sweden or something? Don’t let bills and hospital fees affect your health.
It is scary. I cannot speak to Sweden but can for Canada. It isn’t a walk in the park their either. My uncle has been deemed too old for some treatments based on age alone. Treatment he’s had to wait two years to find out if he would be approved. Waiting times for procedures can completely wreck you. I have loads of family there and lived there. My cousin, who is in the medical field comes to the states for anything major and often for second opinions. Overall it has loads to offer though.
Insurance covers the vast majority of the cost. I have $5K when needed to get the testing. Most or many Americans wouldn’t have $5K to play this game. If I didn’t have it I guess I would have to do what many others do: create a GOFundMe page.
While type 2 is caused by lifestyle that doesn't mean that everyone who is type 2 "did it their self". Their genetics makes them more likely to get type 2.
With that being said I'd much much rather be type 2 than 1 because I can be reversed where as type 1 is a life sentence of stress
And how much of the price of the medication is pure profit? I don’t know.
Edit to add: Medicare requires a $5K test to get the diagnosis confirmed and treatment authorized but doesn’t pay for it because they are counting on people not having $5K every year or two to reauthorize the treatment. They don’t want people to get this treatment. That is pretty sh*tty, IMO.
This is what freaks me out about Medicare for all. Medicaid/Medicare isn’t run well and their practices are not logical. They slant towards declining necessary tests and procedures. There have been strides in some states to improve this but it it still wildly problematic
Medicare and Medicaid are honestly great in many ways. My kids are on Medicaid. Pediatric visits are all covered. Dentist is covered (haven’t needed anything fancy yet). Medicare I still don’t understand the ins and outs of but for all the routine stuff everything is covered. I just have a rare disease with expensive treatment protocols and for that alone I have to go through hoops and hurdles. For everything else, it has been better than regular insurance because I don’t get a surprise bill. And for my regular medications (nothing fancy) for me or my kids (can’t remember which), the pharmacist charges me $0 and once in a while $1.30.
My private is similar to what you’ve explained except we pay for the coverage. One of mine has medicaid as did my Dad. Our state expanded it (too late for my Dad) which does make it better imo. The first year of expansion an insurance co managed it, last year they offered a choice of three companies. All basics and preventative are covered like with our private. Anything over and above is a ridiculous red tape debacle while watching a lived one suffer. We have three in my family with chronic health issues. It’s a full time job to manage. It’s also expensive either with dollars or wellness. I would certainly take it over nothing but know that it could be modified from what we have now to a much better system bu going a different route. Legislators do not know enough about the ins and outs and REAL struggles with any of the healthcare issues. If you don’t know the potential problems how can you fix the system? I have dealt with Medicaid for elderly, medicaid for fosters including WIC checkups, private for all ages, Medicare and experimental therapy here that is standard care elsewhere. The systems are so twisted with little accountability.
Well, they probably don’t much a significant amount of profit compare to other medications like insulin or viagra. Your disease is likely to be rare, so you’re probably not highly profitable in the grand scheme of things.
Also, a rough calculation is that your medication costs 606k a year. A lot of people could be saved if we allocated those resources elsewhere. The healthcare system is pretty great that we can support ONE patient with a yearly medication fee of 606k a year, not including medical and test costs. When people talk about how shitty healthcare is.. they forget that it’s outliers and people who fail to take care of their health that raises the costs.
Healthy individuals are paying for the costs of unhealthy or patients that wouldn’t be alive if this was 20 years ago.
US is prob the reason why poorer countries can have cheap medications. Newer drugs come out with expectations of making the most in the first few years before companies can make generic duplicates. A lot of people keep saying “fuck” pharma but fail to realize they’re the reason people are living past their due dates. The person with 35k meds would’ve died without pharma.
13
u/epitenomics Oct 12 '21
Should have been $0