Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts

Thursday, April 28, 2016

Episode 69: Can't Afford Life-Changing Hepatitis C Treatment

Every day on TV, ads for Hepatitis C treatments promise me a new life.

I contracted Hepatitis C in 1980 when given a transfusion during a D and C--a procedure to scrape out my uterus. I'd been bleeding heavily since giving birth to my first son, and when Dr. Townsend saw me in the recovery room after the D and C he said there'd been placental material inside, most likely from Jason's birth but also possibly from a miscarriage. In any event, I bled a lot and was given two pints of blood from the Red Cross blood bank in Washington, DC. In those days, blood wasn't tested for AIDS or Hepatitis C because neither disease had been identified or named until AIDS in 1983 and Hep C in 1989.

Luck of the draw, I guess.

I need to get this publication!
https://www.opensocietyfoundations.org/publications/hepatitis-c-treatment-price-profits-and-barriers-access

Recent studies have found that most Hep C transmission is due to medical procedures, not risky behaviors. For more information on this, see this article in Internal Medicine News.

Throughout the years I've had this blog I've been searching for answers to the weird symptoms I've had, many of them neurological. Only recently have doctors found HCV, the Hepatitis C virus, replicating in the brain. That probably means my white matter/demyelinating disease, and probably my diagnosed hypersomnia--which though called idiopathic is now known to originate in the brain--are due to the decades large quantities of HCV that have been circulating in my blood. Despite this, I have never been treated.

I have HCV genotype 1a, the most difficult to eradicate. In the past, the only treatment was some 49 weeks on Interferon and Ribavirin, and the treatment frequently led to flu-like symptoms, depression, and a bunch of other problems I didn't want to invite into my life. While I was working full-time, I couldn't even think about doing that. I was already so run down with my hypersomnolence, lack of energy, and host of other diagnoses that I was pretty sure the treatment would kill me, and I was still alive (barely) without it, and being alive is better than being dead. I think. Even after going through that treatment, the odds of clearing the virus were only 50 percent.

Now, of course, brand-new treatments are available, and one is highly effective against genotype 1a and is administered over only a couple of months rather than nearly a full year. And I'm on disability now, so even if it does knock me on my ass I can absorb that for a brief period of time. I went to my gastroenterologist, though, and he informed me of the following:
  • Insurance companies will not approve treatment unless I have evidence of liver disease. My liver has held up pretty well through all of this, though I'm going for a biopsy in the morning. It has been something like 10 years since my last biopsy.
  • Treatment for Genotype 1a costs $45,000.
  • If I am liable for 20 percent, that means I'll owe close to $10,000.
  • I am on Disability and have a three-hour-a-week part-time job, so my income is just barely over the poverty line--but is OVER, so I am not eligible for any state or federal assistance with the cost of drugs that are making some CEOs out there very, very, very rich.
Let me be straight: I don't begrudge the poor people their subsidies. I am damned close to poor, and it is damned hard. I know what it's like to be comfortable; I grew up in a middle-class home; my father was an electronic engineer and my mother a homemaker. I know the difference. 

Blaming the poor and begrudging them the help they get from the rest of us just distracts us from the main problem: the fact that the wealthy do not pay their fair share of taxes (thanks to Reaganomics) and the other fact that far more of our tax money goes to the war machine and sketchy crony contracts than to help the poor, old, and sick among us.

Meanwhile, if I lived in Australia, the treatment would be paid for by my government, no matter how I contracted the disease.

So here's my dilemma now. 

I really do want to have this disease treated. I really do want to feel better. I would love to be able to go back to work full-time and make some decent money so I could fix up my rapidly crumbling home and pay off my current bills and be able to enjoy my last days without constant financial worry on my mind. 

But $10,000?  How the hell am I going to do that? I don't even have good credit, thanks to my then-employer's terminating me when I became too sick to teach full-time anymore. I had to declare bankruptcy and am slowly working my way back to half-decent credit--but who the heck is going to give me a loan?

This is why universal health care needs so badly to be instituted in this country. There is no reason for drugs to cost that much when pharmaceutical CEOs are bringing home gazillions of dollars every year in salaries and bonuses. There is no reason for insurance companies to limit their coverage when insurance CEOs are bringing home gazillions of dollars every year in salaries and bonuses. 

We are a stupid people, we Americans, to let this go on. We keep electing puppets into Congress who don't have our interests at heart--not the tiniest bit. And we are paying for our stupidity with our very lives. When are we going to wake up? I did my part--I voted for Bernie. I just hope he is the beginning of a wave of awareness in this nation. We the People need to take back health care from the vampires sucking our blood--even mine, chock full as it is of a deadly virus.

Monday, December 29, 2014

Episode 50: Down the Rabbit Hole and In the Third Stage of Grief?

Kubler-Ross's five stages of grief upon learning of one's imminent demise might also be relevant in acceptance of severe chronic disease.

I've gone through the first two, and will no doubt cycle back now and then:

1) Denial - That stage didn't last long for me. It was hard to argue with my symptoms, hard to deny that my body was failing me.

2) Anger - This, on the other hand, is still pretty fresh. I'm not so angry at the gods--I've been blessed in so many ways in my life, and why should I be immune to pain or "injustice," if that's what illness is, when others on this planet suffer so greatly?

I have often, however, been angry at the health care system and at individual health care providers for a variety of valid reasons, many of which have been described here on The Mary Dell Show.

And although I get upset when I start thinking about how a fragmented system has betrayed me, and how individual physicians and practices have made me feel marginalized, I'm moving beyond anger now.

Why get angry? That's just more energy to expend, when I have so little energy anymore at all.

And so I'm moving into that third stage, bargaining.


Wednesday, August 6, 2014

Episode 41: Down the Rabbit Hole and There are Nazis Down Here!

Readers of fiction will recognize the allusion to Watership Down in this episode's title. Watership Down, a popular book when I was in high school, is based on a completely absurd construct: A warren of bunny rabbits must fight to save its society from nasty Nazi rabbits. Believe it or not, it's a terrific read. It works. Which is more than I can say for the rabbit hole I currently find myself in.

In fact, this rabbit hole suffices as a metaphor for the utter irrationality in today's health care system. I've actually encountered Alice's Red Queen; I don't want to call her a Nazi, exactly. Or mix my allegories. Just couldn't resist the literary tie-in.

Okay, okay, enough with the figurative language.  Here's what happened, Dear Viewers, when I finally underwent the long-awaited neuromuscular examination for possible myotonic dystrophy at Johns Hopkins Medical Center. Now, to date, I've been more than pleased with my care at Hopkins, but this experience has likely destroyed my loyalty to said institution.

They'll be happy to be well rid of me anyway. Who am I but one patient, powerless against the juggernaut of Big Medicine, Inc.? One patient jacking up their costs (and their profits) with her smorgasbord of chronic disease. And now that I have Medicaid instead of Blue Cross Blue Shield, I'm doubly unimportant to the system created (but not maintained) to help me and you.

I'm a shareholder liability, that's all I am. "Let them die then, and decrease the surplus population!" Okay, okay, not yet another literary character entering this story, but I often quote Ebeneezer Scrooge at moments like this.

2010-Red-queen
"Off with your head!" says Dr. Red Queen, in so many words. "And no DNA test for you--you've overstepped yourself so I don't care to relieve your mind with an easy yes-or-no answer to an at least somewhat possible reason for your years of suffering and confusion at the ways your health has failed you! So there!"

That's her reflex hammer in her hand, and she refuses to admit the medical sign it renders in her patient, lest her patient be right about something she has no business knowing about! Off with her head, and no DNA test for her . . . NEXT! I have a paycheck to collect and a lifestyle to protect and a reputation that trumps yours, so nyiehaya!
Despite this latest horrific experience (and there have been plenty more than this and the one with my son, believe it or not, in my tumble Down the Rabbit Hole), the Hopkins visit was not a complete waste.

The electromyography (EMG)--a rather uncomfortable test in which a doctor sticks needles into your muscles and records the electrical reactions--indeed revealed some myotonic abnormalities. Thus, although Dr. RQ, as I'll call her, refuses to consider my experience as valid, the machine doesn't lie. This is not over yet.

My true purpose in telling my story is that I want you, Dear Viewer, to understand how the medical system is against YOU, the patient, and how LITTLE YOU MATTER in any quest to learn what is wrong with you or a loved one. Obviously, this needs to change. 

The medical system exists to serve US--YOU and ME, the patients. We, the People. But as this diagnostic nightmare continues to demonstrate, we count very, very little in the stories of our own lives, if we believe what our doctors and other health professionals, insurers, and governments (federal, state, local) tell us. 

But we don't have to believe them. We know our bodies; we can read; we can think; we have friends and family who want to know what is wrong; we have only this one life to live, and we deserve to know what is wrong when there is something wrong. That's what the system is for, but the system too frequently fails us.


Monday, December 9, 2013

Episode 31 - On Trickle-Down Economics--Have you noticed the word "trick" starts the whole concept?

Before I get started, I want to thank my Uncle Freeman (marvelous name, isn't it?  So Scottish).  He was on duty in Hawaii on the day Pearl Harbor was struck.  Today is the anniversary of that day in infamy.  I am so grateful that Freeman lived, so grateful he was my uncle and his wife my aunt--beautiful, beautiful Ruth--so grateful he lived so he could father all three of the sons who would become my tall, handsome cousins when I entered the family.  Thank you, Freeman, and may you be round dancing and meeting all those ancestors you traced back to the 9th Century in heaven!

Now, back to the business of the day.

One of Reagan's two initiatives that have altered our world so drastically, leaving us in the midst of turmoil and fear and need (the other being the Reagan Doctrine--another episode):  Trickle-Down Economics. Have you noticed that the word "trick" starts the whole concept?

The idea was spoon fed to the American public by claiming that the method would grow jobs and make our economy stronger.

How?  It's simple!  Before TRICKle Down, everyone in the U.S. paid approximately the same rate in taxes--that is, other than the very poor who were given a break--something the gimmes resent so horribly even though that "break" doesn't even compare to the mega-rich's robbery legally sanctioned by this policy.

So, let's take the richest among us and give them a TAX BREAK!  If we do that, they will invest all that extra money into new ventures, new jobs, and new wealth for everyone!  Right?!

How dumb do you have to be to believe that?

Let's make the money earned on investments an exception from regular old income taxes for wages EARNED.  Let's tax investments at a mere 15 percent, rather than the 30-something they used to have to cough up like the working schmucks still do.  How hard is it to do that math?  Take away money from the public coffers, and not just any money, BIG MONEY, and it will miraculously re-appear when the masses have good-paying jobs.  Um.   I think the other half of that math equation has been zeroed out.  So where will the money come from?  That's right, sports fans, you and me, the working stiffs whose checks get smaller every year theirs get fatter.  Damned obese, actually.

Let's let the rich get richer on their investments--no work required to do that, just money, and they've got plenty of that, so let's just make it easier for them to make MORE money and cut their tax rates by more than half. There's a sucker born every minute, and a whole lot of them buy into this malarkey.

Because we ALL know that the rich have the best in mind for the rest of us.  They are always willing to share their wealth. (Ooooooooooooooooooh, that sounds Socialist; gives me the chills; god knows it's a far scarier thing for everyone to be entitled to a reasonable living than for all the money to be hoarded at the tippy top while the rest of us suffer.)

But wait?  With all that extra money we've given them, why are the Mega Rich sending all the jobs overseas? That's not what Ronnie promised!  Why are they closing factories and plants here in the U.S., the  place their money was supposed to trickle down to?  Why are they buying up small corporations that are barely making it, bankrupting them, and declaring bankruptcy so they don't have to pay anything back, and leaving the tab with the taxpayers?  And WHY THE HELL do half the citizens they are shoving this to keep believing their lies and buying into their crap?  Oh, wait, they can't buy into it--they don't have enough money left.  They just give their brains, hearts, and souls over to it and watch their assets dwindle.

TRICKLE DOWN?

The only things that have trickled down in this country since the Reagan era are the number of jobs in this nation,
drip
drip
drip
drip
drip
the amount of money in our bank accounts,
drip
drip
drip
drip
drip
drip
the amount of money in our retirement funds, and, most of all,
drip
drip
drip
drip
drip
drip
drip
our quality of life,
drip
drip
drip
drip
drip
drip
drip
our hopes for the future, our hopes for our children's future . . .


Tuesday, June 25, 2013

Episode 27: Mary Dell, MD (Medical Detective)

This episode promises to meander somewhat.

I've decided to give myself an MD after my name.  That's right, Mary Dell, MD.

NO!  Not Medical Doctor--believe it or not, this isn't about my ego, and I don't pretend to know a fraction of what physicians and other health professionals know.  I've been interested in a few very specific health conditions, since they have affected members of my family, and since I became a smorgasbord of chronic disease myself.  I don't want their jobs.  I don't like dealing with blood and guts.  I like research, on anything at all, really, but since these medical problems keep plaguing me and folks I know (like all of us), that's what I'm researching these days.  And, heck, I'm a bona fide medical librarian, so I know how to do it.

No, just call me Mary Dell, MD, for Medical Detective. And this is the Mary Dell Mystery Disease show.  MD MD, MD--

Will that get me hired to consult for House?  Ha.

Saturday, June 15, 2013

Episode 26: Down the Rabbit Hole Yet Again aka Health Care Due Diligence

Health care due diligence.

Has a nice ring to it.

We patients, the so-called "consumers" of health care, expect due diligence when we entrust our bodies and minds to that system.

But that's not what the term refers to.  No, "due diligence" is an accounting term, a requirement to investigate a potential investment before recommending it to clients.  If you are an investment banker, that is.  And you know how concerned they have been about our welfare over the past, say, oh, twenty years. These shills for the megarich are selling our flesh on the open market, while the megarich buy personal physicians and specialists who come to their homes or live there, sort of like modern-day Rasputins.

And the rest of us are relegated to a system built on corruption. I don't mean the health professionals and researchers and all of those who, with integrity, are working to make lives better for their fellow human beings.

I'm talking about the ones who are exercising their due diligence.  You know, them.

"'The best sort of due diligence process begins with a game plan [or strategy], and it proceeds along that game plan, only changing as dynamics of the due diligence changes or as [new issues] are discovered,' says Mr. Van Demark," one of the principals in the investment firm quoted in an article online (URL below).

I'm glad to know our physical and mental anguish is bandied about on the market as a game. Gives me extreme confidence in the system, let me tell you.

Monday, May 6, 2013

Episode 25: Down the Rabbit Hole and Suffocating


Air.

The breath of life.

We are immersed in its invisible currents, and it travels throughout our bodies to bring life to each cell, our lungs infusing our blood with that precious O, and our blood cells in organs along the route suck it up, this life-giving element without which they, and we, will die.

Air.

How easy it is to take for granted, to forget about its ubiquitous and necessary presence in each moment we know ourselves to exist.

Thanks so much to Douglas A. Sirois for permission to use this beautiful image, one that captures my feeling about the sacredness of air, especially given my increasing lack of the element in which we are immersed and dead without! The artist has many spiritual and fantasy illustrations I love!
www.dougsirois.com
douglas.sirois@verizon.net
http://dsiroisillustration.blogspot.com/
http://www.imdb.com/name/nm4223178/

So.  Why is it that my cells are not getting enough air?  That is the medical question of the day, the hour, the year. In fact, dyspnea—shortness of breath—began noticeably for me over Christmas and New Year’s while traveling to Europe and Switzerland. Actually, it was more like utter exhaustion than shortness of breath—the shortness of breath came because I was trying to get that precious air to the muscles that threatened to give out beneath me.

Air didn’t seem so invisible to me that day.  Of course, I couldn’t see it, but I could visualize its little superhero blobs traveling newly oxygenated from my lungs through the arteries, greeted with joy and celebration by the thirsty cells waiting in muscle and tendon and bone and organ, the parts of us that need that bloody, airy drink to keep going.