So About That Health Care Post....

(You know, the one I had planned to post the day of the dog attack?)

Some of you know that the health care crisis here in America is one of my hot button issues. I am fortunate that the drugs my children take are not necessary to sustain life. But they are necessary to maintain a certain quality of life.

At one point, we had to fight our insurance company tooth and nail to cover a twice daily dose of Strattera for our oldest son. This dose was arrived at through much trial and error, which was closely supervised by not one, but two doctors; his pediatrician and his psychiatrist.

And yet, our insurance company denied us coverage because the "standard" dose of Strattera is once daily. They would cover a once daily dose of 80mg, but they would not cover a twice daily dose of 40mg. OR, we could get 60 pills, but we would have to pay two copays. Does this make sense to you?

Well it makes perfect sense if the bottom line is your main priority.

And that's where the problem lies. Capitalism and Health Care are two entities whose interests are at cross purposes, and as such, creates a gross conflict of interest.

When you start talking about socialized medicine, people get nervous. And, you know what? I get that. I understand that people are nervous about putting decisions as personal and far reaching as those regarding our health, maybe our lives, into the hands of bureaurocrats. And I realize that socialized medicine is not the perfect solution to this problem.

But it is a solution.

Right now in the United States the percentage of uninsured Americans is at an all time high. Premiums are climbing and employer sponsored coverage is decreasing along with the number covered procedures, services and pharmaceuticals.

There are chronically ill people who are choosing between food and medicine. There are people with fatal illnesses who are having to choose life saving treatments over providing for their children, or vice versa.

And that is just wrong. That is worse than wrong. That's criminal.

According to this article, 1 in 10 cancer patients is unable to provide basic necessities for their families. 1 in 12 made the decision to delay or forego treatment because it was too costly.

How costly is too costly?

The prescription drug Zofran, which is an antiemetic, and sometimes the only thing that keeps cancer patients from wasting away to nothing during the numerous and brutal rounds of chemotherapy, costs $42 per pill. Per. Pill. Most cancer patients take it at 8 or 12 hour intervals in the days following chemotherapy.

Herceptin, a relatively new drug in the cancer arsenal, and one of the few that is effective against inflammatory breast cancer, costs $48,000 for the recommended year of treatment. Wholesale.

Avastin, which is primarily used to treat colorectal cancer can cost up to $50,000. If used to treat breast and lung cancer, the cost can double because of increased dosing needs.

Why are these drugs so costly??

Drug development is expensive and the companies developing them are not government sponsored. That means that they must foot the bill for development costs, testing, and marketing as well as turn a profit to keep shareholders happy.

See...it's that word "profit" that mucks everything up. It should never be about profit. It should be about keeping healthy people healthy and making sick people well. Period.

Most startling of all, there is currently no accountability holding these drug companies to ethical pricing practices. One company, Genentech, raised the price of their drug Tarceva by 30% when they realized it was more effective than preliminary testing indicated, and thus, more sought after by patients.

That's just one example among many of why healthcare costs are skyrocketing and more and more Americans are going without basic medical care. But it clearly illustrates why Capitalism and Health care should not be joint endeavors.

We won the fight regarding our son's medicine. Now we are fighting a different battle. Our insurance company only wants to cover 12 visits annually to Diminutive One's therapist. But she feels that for now, once weekly is optimum to track his progress, monitor his moods, (which can be affected by his medication) and make sure that he's not experiencing any co-morbid conditions, which are very common with these types of disorders.

So let's recap. Our son's doctor, who has a degree in psychology and who has specialized in this subset of disorders for 25 years, feels he should go weekly. But our insurance company, who has never met Diminutive One, nor reviewed his medical records, feels once a month is adequate.

But we are lucky. We can afford basic health care for our children. Well checks, vaccinations, office visits when they are sick, medicine when they need it and two tonsillectomies for different reasons, but both equally necessary. But they wouldn't have died without the tonsillectomies. They won't die without Strattera or Concerta. They won't get Tuberculosis, Measles, Mumps, Rubella, Whooping Cough, Polio or Scarlet Fever.

There are some people who cannot say the same for their children.

And that's why it makes me so freaking frustrated when people vote down bills like the Children's Health Care Bill.

I know socialized medicine is scary. Socialized anything is scary. And people are afraid bills like these are a foot in the door for governmental micromanaging of our health care choices. They see it as yet another freedom in danger of being curtailed.

But make no mistake...this is not just an issue for the poor or underprivileged. There are lots of families out there who would be devastated if they had to bankroll treatment for a life threatening disease, a debilitating accident, or a chronic illness.

Think about it. That's you and that's me.

But hey...you're doing well, right? You have a nice house, two cars, some luxuries like cable and internet and dinner out a few times a week. And you have some savings right? A couple hundred? One or two thousand? Five? Ten? Twenty?

If you had cancer you could blow through twenty thousand in a month. And then what?

You can't work. How do you pay your mortgage? How do you feed your kids? How do you keep the lights, gas and water turned on?

This is an issue that affects all of us. And it's not about giving up control because we never really had any anyway. It's about taking it away from the insurance and drug companies who are getting rich at our expense and putting it back into the hands of doctors.

Yes, there will be some red tape. There will be some micromanagement. There always is, isn't there? It's just a part of life.

But what's more important? Choice and convenience? Or coverage?

For some, any coverage is better than what they have now, which is, nothing. Maybe you can still afford your premiums and your increasing co-pays. I can, but it's getting harder and harder. Combined, our prescriptions cost around $240 a month. And we don't have many. That's one for each of the boys, Restasis and 2 migraine meds for me. The co-pay on the boys meds and my Restasis is $60.

The median household income in the United States is $46,326. Though we are a one income family, our income is substantially higher. And yet sometimes it's a struggle even for us.

But, we can give up family movie night. We can give up frappucinos and lunch out and lawn care service. We could go without pest control, but here in the South, I'd do almost anything to pay my beloved Orkin man. He's my saviour.

But a lot of people can't. For a lot of people, $240 a month would be simply impossible. And for a lot of people, there's simply nothing left to give up.

So...as I said, it's not a perfect solution, but it is a solution. Or at least, the beginnings of one. It's a foundation, if nothing else. A place to start.

And in the absence of anything else, I think it's our best bet for the 16.5% of Americans who are uninsured. That's roughly 37 million and it doesn't include those who are not naturalized citizens. We can add another 10 million right there.

And a whopping 9% of the uninsured are children.

Is that acceptable to you? Would it be if one of those children were your own?

For me? No contest.