Today I have health insurance. By Idaho’s standards I actually have good health insurance thanks to my career type position as a senior financial specialist (my employer would like to remain anonymous). However, I have spent a great deal of time without health insurance. In fact, 2 of my 8 surgeries in 2 states were without health insurance if I remember correctly. Health insurance, even bad insurance, can raise a chronic patients quality of life to new levels. For example, I now live in more pain than I ever have before but I still do ski, road bike, hike, travel, and go to the gym, just not as much as I use to. Despite this pain, I would argue that I have still had a pretty cool life and have left my mark on the world. Don’t get my wrong, I am not done leaving my mark on the world which is why I continue to write and post.
As I have discovered, life can change drastically in a matter of seconds. All it takes is one fall off a cliff while rock climbing, a car wreck, a family member passing, loss of job, or Republican’s repealing the ACA (Affordable Care Act) without a replacement for example. As much as we all strive for stability or normalcy in life, there is just life. None of us know or can predict what will happen tomorrow, let alone next week. Since I have already fallen off a cliff and have had several car wrecks I was curious to know what would happen to my financial state if I were to lose my job tomorrow and didn’t have the ACA to fall back on, purely an academic exercise I would like to stress. Specifically, I wanted to look at my current prescriptions and costs.
As I mentioned earlier, for many years before my rock-climbing fall in 2003 I was without any health insurance. Health insurance was expensive at that time which is no secret. During those years, I was working 40 to 60 hours a week as a delivery driver supervisor for a local greenhouse and in the winter I was a full-time ski instructor in addition to my delivery position. I had a degree in Political Science during that time but there were simply no “career” type positions open in Boise, only jobs for low pay. Despite not having a career type of position, I was paying for all of my meds out of pocket. Luckily, my parents are highly successful professionals (dad’s a retired one star general and mom is a retired second grade teacher) who could afford to provide me with financial assistance.
Thanks to my parent’s hard work in their lives, I could probably rely on them again for financial support for my medical expenses if I were to lose my job tomorrow. Obviously I don’t plan on losing my job any time soon mom and dad but as an academic exercise, I went to goodrx.com and looked up the price for my meds at 4 different local pharmacies so I could get a picture of my life without health insurance. If Republican’s get their way, the ACA won’t be an option much longer and since I have a ton of pre-existing conditions chances are insurance companies won’t want me. Out-of-pocket financing of my meds would be my second to last option; my last option would be to go without any meds of course. The following chart gives you an accurate look at my prescription expenses without insurance I believe:
|Nucynta ER||Lexapro||Methotrexate||Folic Acid||Meloxicam||Allopurinol||Hydrocodone|
|Average Cost Per Prescription||$613.30||$31.01||$10.85||$5.91||$7.40||$8.86||$21.53|
|Monthly Total Cost||$698.85|
|Yearly Drug Cost||$8,386.20|
|Wage Dedicated to Prescriptions||$4.03|
|Wage Dedicated to Mortgage||$3.46|
As a friendly reminder, this chart only covers the cost of my pills. Once a month, by law, I have to have an appointment scheduled with my pain management doctor in order to get my pain med scripts. This appointment is regardless of if I’m doing great or living life in tears. I am not allowed to receive any refills on my pain meds either. To put it another way, my pain management doctor is guaranteed at least 12 visits from me per year regardless of my pain levels. Also, this chart does not take into account the 4 times a year I have to see my rheumatologist before I can get his meds. That is a minimum of 16 doctor visits a year not taking into account with this chart.
In addition to doctor’s visits, this chart does not take into account any surgery. Since 2003, I have had 8 surgeries relating to my conditions in 2 different states. For the first time since probably 2003, I have no surgical possibilities on my horizon right now. However, with 2 replaced hips, a plate in my neck, screws and pins in my left shoulder, degenerative disk disease, seronegative rheumatoid arthritis, and an active lifestyle I’m never without the possibility of needing surgery again at some point. That is just the life of a rheumatoid patient.
Now, the numbers that truly amaze me in my chart are the last 2, Wage Dedicated to Prescriptions and Wage Dedicated to Mortgage. If I were to lose my job tomorrow, and without access to the ACA, any new job I might find I already now that $7.49 of my hourly wage is going just to my current prescriptions and my mortgage. For reference, that is 34% of my current wage. Hypothetically, if I were to find a new job with a starting wage of $15.00 an hour that means I would have $7.51 of my hourly wage to pay for things like food, car, utilities, fun, clothes, savings, retirement, and my gym membership. Chances are skiing and road biking are over.
Simply put, I can never again afford to have just a job because of the current cost of healthcare without insurance. If I were to lose my job tomorrow, financially speaking I need a new position that starts close to $20 hour in order to “just get by” if the ACA is repealed. Luckily, Boise Idaho is still a fairly cheap place to live. Imagine all of the chronic patients in LA or Boston that are trying to “just get by”. Without access to the ACA and health insurance, my fellow patients will need career type positions starting in the $30 to $50 an hour just to cope with their particular health conditions. Those patients who take biologics or need infusions in order to live are in need of jobs that pay above $50 an hour just to get by without health insurance or the ACA. To top it off, all these numbers are based on all of us working at least 40 hours a week. For those patients that can’t physically work 40 hours a week anymore you can pretty much double the hourly wage for them to be able to just get by without the ACA.
The ACA is not perfect by any stretch of the imagination. It can be improved. However, it is currently the strong foundation to millions of chronic patients higher quality of life. Without it millions of patients will suffer and might die. As importantly, the ACA has changed the conversation from should patients like me have access to healthcare to how much access patients like me should have access to healthcare? If the ACA is improved, so do I. If the ACA is defunded and forgotten, so will I be.