YOU ARE NOT COST-EFFECTIVE. PLEASE DIE.

OR, BECOMING PART OF THE EMERGING DEMOCRATIC RESISTANCE


If you have asthma or any kind of chronic medical problem that requires continuing care and medication, that’s the message you are getting. We have had a brief interruption during which almost everyone had access to at least basic medical resources. You could go to a doctor, get some medicine. Have your cancer removed, your broken leg treated. Now … well … who knows what lies ahead.

If you’re on Medicare, that’s the message you’ve been getting for several years. They’ve been chipping away at the benefits. Fewer dollars for medication. Fewer covered medications. Deeper deductibles for tests of all kinds. The out-of-pocket costs for an MRI or CAT-scan are beyond us. Garry hasn’t had any big medical issues, but I’ve had enough for both of us. Yet, I turned down a cancer CAT-scan last year because I didn’t have the $450 co-pay … and I’ve had cancer twice, so it wasn’t a decision made lightly.

medicare__estelle_carol___bob_simpsonMedicare doesn’t cover eyeglasses, dentures, dental care of any kind … or asthma daily inhalers. Those are the inhalers that keep you from needing emergency treatment. In the 1990s, when my asthma finally got bad enough to require treatment, a daily inhaler cost (without insurance) about $75. Not cheap, but doable. One day, about two or three years ago, the same Advair inhaler shot up to more than $500 a month. Medicare will only pay for about $12 of the total price. Although they are not paying for it, they will charge the entire price of the medication against my annual drug benefit of about $2800.

Let me repeat that because you probably think it doesn’t make any sense. It doesn’t make sense, but it’s true. If a drug costs $535 per month and Medicare contributes $12, they charge all $535 against the annual drug benefit. The amount of that benefit has been dropping each year while medication prices have soared. This makes sense only if the real goal is to kill older generation as quickly as possible.

In another bizarre but real piece of anti-intuitive reasoning, if you are prescribed a medication, towards the cost of which Medicare pays not a penny, and you pay for it out-of-pocket, Medicare still charges the entire price of the prescription against your total benefit.

It’s a lose-lose-lose. If you don’t get any medication, you will have trouble breathing. If you do get the medication, it’ll break your bank and will burn through your benefits, even though Medicare isn’t contributing anything towards the cost.

It’s true. Absurd, but true.

medicare confusion

I am not cost-effective. I have not the slightest doubt that my compassionate government would prefer I cast off my mortal coil and stop costing them money. Never mind that over a lifetime of work, Garry and I paid enough taxes to fund a small country. Our contribution vastly exceeded any amount we will get back. And we aren’t exactly free-loaders now. We continue to pay income taxes, excise taxes, as well as some hefty property taxes. And Medicare, while not expensive, is not free.

Ever since I turned 65, it’s been downhill.

The day I turned 65, I was dumped by MassHealth (Medicaid). I hoped I’d be protected by my disabled status. I’d been on disability for years which was why I was entitled to MassHealth.

Medical marijuanaNo problem getting around that. Social Security simply reclassified me, eliminating my disabled status. Poof — I’m just old, not disabled. They switched me to standard Social Security, so I get the same monthly check —  but without the extra medical protection conferred by disability. They also lowered the poverty guideline so we no longer qualify for any extra help on anything — not fuel, medication, electricity, nothing. Because apparently when you turn 65, your costs go down … or anyway, that’s the reasoning.

We’ve outlived our usefulness, so how come we aren’t dead? Why do we stubbornly cling to life? Obviously if we cared about our fellow humans, we’d get out of the way.

Meanwhile, my doctor found some samples of asthma medication that if I’m lucky, will keep me breathing for another 6 months. I expect it will get much worse. As of today, we have a president — if you want to dignify him with that title — dedicated to making the lives of everyone whose life is already difficult, worse. Compassion, common decency, basic fairness? What? Huh?

medicine wheel 8

Today was the first time, I learned being a Democrat is now being part of “the emerging Democratic resistance.”

I have to admit being part of an emerging Democratic resistance sounds much better — far more romantic — than merely being old, sick, poor — and not Republican. Maybe they’ll write books about us. Sing ballads. Talk about how brave we were right up until the moment when they put us up against the wall and shot us.

Where is Earnest Hemingway when we need him?

40 thoughts on “YOU ARE NOT COST-EFFECTIVE. PLEASE DIE.

      • I just wrote a poem about Aging and Suffering with you in mind. I wanted to shout it out from the roof tops, but hopefully many will read and take a stand and action. and yes I agree with you about him being an asshole. And yes I for one sincerely HOPE with all my heart!

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        • A lot of great people were assholes. Artists, politicians, writers, musicians … but I haven’t seen any evidence that Trump has even a spark of compassion in him. Still, there’s nothing left to do but hope. I actually don’t mind ageing. I mind having so many medical problems I can’t afford to manage. It takes a lot of the joy out of life when you can’t breathe … and you can’t breathe because you can’t afford the medicine you need. Worse, it’s insane that a controllable problem like asthma should be life-threatening because the pharmaceutical companies have a stranglehold on us. It’s crazy and it’s wrong. It’s immoral. It is UNCIVILIZED.

          Liked by 1 person

  1. We have to pay in Switzerland, but if you worked all your life have enough pension money to live on, then you can manage it, although naturally the more you pay the better the benefits. I pay a minimum but have no great problems. My expensive medicine for MS is covered, I just have to pay 10% per year as with all treatment. The first 300 Swiss Francs per year you pay yourself and the rest just the 10%. Glasses are not covered, just a bare minimum, and dental costs are also not covered. My diabetes equipment to measure blood and all the testing stuff is again covered, I pay 10% myself. If I go to hospital, I am insured for general, nothing private or half private, because I could not afford to pay the high insurance premiums, but that’s OK. You get the same treatment, it is only the room that is better. It depends on what part of Switzerland you live in as it varies from Kanton to Kanton. We are ok in Solothurn. Your system would confuse me and I do not think I could afford it and a good funeral would probably be the cheapest solution.
    England have a so-called national health service where everything is more or less free, but you have to wait your turn. It might be they are ready to perform an necessary operation and you have already died in the meanwhlie. Although my dad had intensive palliative care in the last months of his life and paid only a minimum, the rest was paid by the NHS.

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    • Our system isn’t a system. More like a mess of stuff strung together with old string and spit.

      Medicare is specifically for seniors and it’s actually not a bad system for medical care, but for drugs and medication, as well as for tests like MRIs and CATscans — it’s pretty pathetic. But for all that, Medicare is a lot better than the total lack of medical insurance millions of American had before the current crazy system. Now, most people have at least basic access to medical care … but you can still die from lack of being able to afford the medication. American made drugs are cheaper outside the US than they are locally. It doesn’t make ANY sense.

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  2. I wasn’t insured for decades… I mean… *decades*. I relied on samples and pharmacy programs for my crazy meds because I sure as hell couldn’t fork out the hundreds of dollars a month for them… And like you, I made just enough money to be “not poor enough” to qualify for any government assistance, but too poor to pay for anything beyond rent and groceries. Luckily the pharmacy companies don’t have the same measuring stick the government does or I’da been in trouble.

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    • I was uninsured for about 5 years by the end of which I was very close to death. The problem wasn’t medication as much as needing actual surgery — which had not yet been invented. I was saved by an excellent and compassionate surgeon and his hospital which took me in and fixed me without ever sending me a bill or asking for my insurance. I had none. No money, either.

      How many other people DIDN’T survive? And won’t? Miracles don’t drop into everyone’s life … and not everyone is equally good at playing Twister with the system. Especially not the elderly and children.

      Liked by 1 person

      • No, I hear ya. I led a charmed life… looking back I’m amazed I’m still alive and/or not in jail (bipolar is a bitch when it’s untreated, and I didn’t always have access to medication). But I count myself as lucky to be here to tell the tale. I have a friend who isn’t… she died of a diabetic coma because she didn’t have access to good health care and just kinda gave up taking care of herself.

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  3. My take- I have written an essay to myself about what my life has been like through all the Presidents since Ike. None of the Presidents meant diddly in my life as a child-I had a shitty childhood and no one helped me. Except for Dr;. Mitchell the doctor who brought me into the world and was my doctor until I reached 17. When I started working at 17 I only worked to help the family. At 18 I got pregnant and went on Welfare which is when the government became my friend. As a single mother and still single female I have managed to get healthcare all these years. At 20 I got a job working for the City and I had health coverage for me and my daughter. At 45 I was laid off and had to stand in long lines to get healthcare from the County who paid for my endometrial operation. My daughter started working and had Kaiser and still does. Today on disability I get help with my meds, I pay for high option dental and so far haven’t had to pay for ambulance rides. It has never mattered to me how who was President would affect my healthcare. I just knew that I had to have it and I had to get it. There has always been a way to get what I needed. I don’t think Mr. Trump or his administration will cause a great detrimental change in the healthcare situation immediately. I have always had at least basic access to medical care one way or another, as can anyone else. Marilyn I feel for you because of all your medical problems but I hope you can believe that Donald Trump will not be able to erase the help you need right away, don’t let his administration cause you extra worry, you can find the right healthcare plan for yourself, It is out there. I believe most of us live life by working at what needs to be worked at and we manage well. I absolutely hope you feel better and don’t let the almost President make you believe it is all going to go sour.

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    • I’m on Medicare, so I am probably (relatively) safe for the moment. The problems I’ve got with Medicare pre-date Trump anyhow and I’m not expecting them to be fixed. Ever.

      Most of us with long, complicated difficult medical histories started young. I wasn’t yet 20 when I had my first major surgery (spine) and for the rest of my life, every couple of years, some other piece of me needed removiing, replacing, redesigning. I don’t have that many factory original parts left and i’m not sure, if it came to that, if I could survive another round of major surgery. I think I’ve had enough.

      But the rest of the our fellow Americans … they all deserve better than to be left scrabbling for the crumbs. We deserve to be able to go and get help when we need it and we deserve to be left with our dignity. It’s going to be a very difficult bunch of year ahead. Very ugly.

      I know they can’t just remove everything from everyone in overnight, but they may try and that will be bad enough. You and I may have somehow managed to get what we needed to stay alive … but a lot of people don’t survive. You don’t hear much from the dead ones.

      Liked by 1 person

  4. I have worked with many families in a similar, and frankly, even worse boat, than you are in. It’s heartbreaking. And yet it seems to not matter how many letters are written, phone calls are made, newspaper articles are published, or documentaries made.

    I am fortunate today. I am working, I have health insurance through my job, and no reason to seek medical attention. But even with health insurance, the cost of care for me are more than what I could afford if I needed care. If I have one illness or major injury involving extensive medical care, I’m screwed.

    And no one would care about me either.

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    • I was 19 and it was 1966 when I had my first major surgery. It wiped us out. We’d just gotten married. I went into the hospital and we have almost $20,000, most of it wedding gifts from parents. When I got home, we had $28. We never recovered.

      Back then, health care wasn’t considered a major issue and although I actually ran for office and tried to make it an issue, people just laughed and said I was making a big deal out of nothing. I could see what would happen as the baby boomer generation — my group — got older. Anyone with half a brain could see what was going to happen as all of us hit middle age and later, all got old together.

      Medicare and Medicaid is still the only net we’ve got and it’s in constant peril. I’m 70 this year and I would have hoped that in the 51 years since that first major surgery, this would have been fixed. You’d think that, but instead, I believe we are going backwards. It is depressing to say the least.

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  5. Things are not quite as bad here although the present government is busy thinking up ways to cut costs by cutting benefits to those who need them most. We live in fear of an American style health “system”. I was fortunate that our Medicare took care of all David’s health costs but looking into the future I can’t help feeling that it would help my budget if I knew when I was going to die. I never used to be such a pessimist.

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  6. There was a photo, on the front page of our national news paper, of an older couple who had decided to get a medically assisted suicide. You have to wonder if this isn’t a promo to get us to off ourselves to save them from paying out those pensions.
    Leslie

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  7. Hemingway? Singulair has recently been “cloned” so there is a generic. Same with Nasonex. I don’t know if those two drugs apply to you. I remember the steroid asthma inhalers I was put on back in 2012 (not effective though Singulair proved to be). My “doc” gave me samples when she could but there was no need. My insurance would pay for the meds. Somehow she never understood that and one day I said, “Save these samples for someone who comes in here without insurance,” and she said, “I don’t take patients who don’t have insurance.” Deficente…

    The whole system is unfair and as illogical as the t-t who was my doctor.

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    • I don’t know whether I’m more upset by the unfairness or the illogic of it. I’m not sure they can be viewed separately. There are so many weird and contradictory rules in Medicare … and yet, considering the alternative, it’s a pretty good health insurance … as long as you don’t need stuff they don’t cover. Which, unfortunately, I do.

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      • I see a cause and effect in the unfairness and illogic. With impossible lies and promises, Trump exploited the need of a lot of basically good people who are struggling to win this election. I hate him. He’s everything the people who voted for him actually do NOT want. God help us.

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        • I know. We are struggling here. It is hard to see anything good coming from this. I try really really hard to not hate anyone, but if I hate anyone, yup. He’s the one. Because he isn’t merely a bad politician, he’s a rotten human being with a lot of power and no conscience.

          Liked by 1 person

          • “who are struggling to win this election” should have been cut from my earlier response. I hope you realized that.

            All the people surrounding Trump are ugly and evil. For now, I don’t want to see them or know about them or read about them or hear/read anyone’s opinion about them. All the things he doesn’t understand and that people here don’t understand, either, like art, knowledge, music — are going to be axed. Fine. Some of the greatest art in the world emerged out from under the boot of a repressive, uncomprehending governments. I just don’t want to be sick any more. 😦

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  8. This was a great insight into the issues with medication. I live in the U.K. So at current I can pick up an inhaler at prescription price (£8.20) because everyone pays national insurance to do so. I don’t mind paying out hundreds or so out of my wage a month so that a poor boy can get cancer treatment for free. It’s looking as if the UK is heading in the same direction as Brexit has instigated the dissolve of the NHS, meaning I may have to part with a lot more money for my life saving epipens which I am meant to buy two yearly.

    Keep up the great work, I look forward to reading more articles.

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    • Thank you!

      It’s good to hear from you. It’s a crazy time all around the world right now. I never minded paying a little more so that everyone would be better off. When Garry and I were both working, it seemed only right to share our good fortune with others. I don’t know what is going on in peoples’ heads these days. It really is too weird for words … and rather frightening. I feel like I’ve fallen into a different universe. Hopefully, the world will right itself. Soon.

      I’ve been preaching the importance of fixing the health care delivery system in this country for more than 50 years. It is sometimes demoralizing to realize how far we still need to go, but I will keep trying as long as I have a computer and a keyboard 🙂

      Liked by 1 person

  9. Pingback: And So it Begins… | Rumpydog

  10. I am sorry you’re going through this. I, too, suffer from Asthma and have done so since a birth defect started me down this long battle for survival. After 3 operations in childhood almost bankrupted us (and broke my parent’s marriage), I learned to live without medication, and used a lot of deep breathing exercises and biofeedback techniques to smooth out my breathing.

    I’m now 56 and on disability with a 26% lung capacity, and now unable to afford my medications since I’ve had to stop working. Choosing between food and heat is one thing, but as of January first I now have to choose among food, heat and Theo-24.

    I guess I’m now only allowed to live in the Summer, when the heat doesn’t have to be turned on (I can survive fine in the shade without A/C), and when it’s too hot to eat very much.

    I’ve only been on disability for about 16 months at this point, and won’t qualify for ANY type of medical coverage through Disability until I’ve been on LTD for 2 years – that would be July 2018 as the soonest that I can (maybe) find a way to pay for my breathing meds.

    As it is right now, I’m living in a house with a 60 degree internal temperature, in sweatshirts, hats and under blankets, and praying for the warmer weather to come back to California. The place I moved to in 1985 (from Wakefield, MA) so that I would have longer quality of life.

    I get it that I am a drain on the system. However, if they won’t let me turn myself in for peaceful euthanasia, I have no choice about what happens next as it’s now my chore to be a martyr for outliving my disease.

    I, too, was not covered medically – despite having a high paying job and paying for medical benefits – because everything was considered a “pre-existing condition” once my medical records went public in 1992, before HIPPA.

    Obamacare allowed me to have a cancer removed from my leg in 2013, and the $8,000 surgery was only $856 – the first time I’d been covered for ANYTHING in years. However, with the return of the Republican party to the white house, and with the striking of coverage for pre-existing conditions, I hear loudly and clearly that I’m not of value to the system, and need to hurry up and die. Sad but true.

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    • What about Medicaid? That’s how I survived until Medicare kicked in. It depends on what state you live in, but don’t give up. Get in touch with you local (state) representative. They have a LOT of clout and their office saved my life not once, but twice. Really. Call them. All reps and senators and congresspeople have websites and staff dedicated to HELPING THEIR PEOPLE. That’s how they stay in office. It’s what they do.

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