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3.08.2013

THE FAT CATS GET FATTER


I like the ring, the connotation that the word ire brings with it.  It's a shorter and more intense version of the phrase "getting riled up".  When I use the word ire I picture myself in a pub with a flash of white hot anger rising to the surface to become outward.  It's going to move someone or something with great intensity.  Ire is more than just angry.  It's combined with action displayed in an outward and visible way.

To be honest, I've never been in a bar fight.  Doubt I ever will, unless it's to intervene on behalf of someone innocent.  I have though, been extremely indignant about something over the past couple of years. My indignance has risen to epic proportions with random rants spewing out of me from time.  My ire is up over HEALTH CARE and MEDICAL INSURANCE costs!

This will probably not ring clear to some who read this.  Especially those who do not regularly utilize medical insurance (don't have chronic health issues, etc.- hooray for you, really!) or who have been on Medicare or Medicaid for longer than 10 years (when the decline and sky rocketing costs of private insurance began to change dramatically).  The rest of us have had the privilege of seeing the health care and medical insurance cruise liners change radically over the past dozen years or so.

I have type 1 insulin dependant diabetes (usually called juvenile diabetes because typically that's when it comes on - as a child) that I contracted 14 years ago.  I was 32 years old at the time.  Suffice to say it is the result of a virus probably contracted after 3 surgeries and pancreatitis.  It killed my pancreas' ability to produce any insulin.  Those circumstances for the past 14 years have made me privy to major and ongoing health care costs.  With a few other auto-immune things mixed in the bag too, I've seen my share of doctors, had far too many tests run, been in the hospital way too much, and have seen the likes of Mayo and Cleveland Clinic. 

To say that the world of medicine and insurance is familiar to me is like saying a major league baseball pitcher knows the feel of a baseball.   I am thankful that 9-10 shots of various things keep me amongst the living.  Without those drugs I would not live past the span of probably a week.  My gratefulness though does not mean that I am ok with the skyrocketing and marauding cost of drugs and health costs. 

When I contracted diabetes 14 years ago my health insurance deductible was $500 a year for a married couple with one child.  After the $500 deductible was met, the 80%/20% coverage began - they covered 80% and I paid the remaining 20% until an out of pocket for the insured (me) was reached at $5,000.  Prescription drug coverage was part of that as well.  I paid a very small portion of the contracted-with-insurance drug costs.  Those costs as well went toward my deductible and out of pocket max.  Fourteen years ago I did not max out my out-of-pocket amount of $5,000 because care and medicine was covered easily.  Costs were a fraction of what they are today.

Over the course of 14 years I have seen a radical decline in what is covered by insurance companies, a rise in both the cost of care for the same condition and same medicine, and a gradual yearly increase in deductibles and out-of-pocket max amounts.  It went from a $500 deductible in 1999 to $1000 for a family deductible a handful of years later.  It then jumped to family deductibles of $1500, then a few years later individual deductibles of $1500 each or $4500 for a family. This year (2013) many deductibles stand at $6000+ a year.  Drug coverage has decreased as well along with the insurance payment percentage covered by your insurance carrier for any medical test or charge incurred.

For the past 7-8 years my out of pocket expenses have exceeded $8,000.  Every year.  Year after year.  That is on top of the dollar amount costs of my health care insurance premiums withheld from my income through work.

Like many people across the U.S., the fall of 2012 brought upcoming changes in employer sponsored health care plans for 2013.  We lost our prescription drug benefit in 2013, which meant the separate $200 drug deductible and then $40 per prescription charge was eliminated.  Instead our employee share for coverage rose to $192 per pay period (every 2 weeks-an increase of $230 a month) and the deductible increased from $4500 to $6,000 with a continuation of the 80%/20% coverage until the out of pocket max of $10,000 is met.

My case in point - real life...

2012 drug coverage amounts (prescription deductible of $200 then pays at rate below)
  • 3 types of injection prescriptions monthly at $40/each = $120.00
  • thyroid medication=$  25.00
  • test strips=$25.00
  • nexium (for husband)=$40
                                                      2012 out of pocket drug costs a month  $210.00

2013 drug coverage amounts (no prescription drug deductible or co-pay)
  • 1 of the above 3 types of injections monthly=$1400.00
  • 2 of the above 3 types of injections monthly @ $170.00 each=$240.00
  • thyroid medication=$26.00
  • text strips=$55.00
  • nexium (for husband)=$200
                                                         2013 out of pocket drug costs a month $1,921.00

I'll do the math for you...

From 2012 to 2013 we have seen an out of pocket increase of cost to us of nearly $7,200.00.  Work that into your budget - it's like having another house payment!!  To say I am outraged is an understatement.  I'm not alone though. 

Standing in the pharmacy just a week ago trying to ascertain how to get the cost of my medications down, I lamented to the pharmacy tech.  She told me that lost drug coverage has affected a great many in 2013.  So much so that many people (me included) began to stockpile refills on their prescriptions towards the end of 2012 to help cushion the costs they would bear in 2013. 

My out-of-pocket increase of $7200.00 is bankrolling someone else's ginormous salary or making up the loss that health care thinks they lose on medicare/medicaid reimbursement.  I'm tired and angry that I am paying for everyone!  You don't need a $1.5 million dollar salary Mr. Hospital CEO at my expense.  And, I don't need to pay for your insurance because you are too lazy to work and continue to live off government assistance programs.  I go to work and pay my bills and shouldn't have to pay yours too or bankroll your third BMW.

What if I had way less means than I do (I already have less than I did!!!)?  How would someone earning $40,000 manage with those kinds of costs?

My ire is up and isn't going down.  Something needs an overhaul, and I need a trip to Canada (and not to fish either!).

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