The healthiest sickie around
It's annual enrollment week at work, and I finally had time to sit down and read through the plan changes. At first I was really pleased: Despite all of the horrible things I've been reading in the press about skyrocketing employee insurance costs, the monthly cost of my plan isn't changing at all. Isn't that great?
And then I got down to the details.
The cost of generic medications is remaining the same, $10 a pop for a three month supply. For non-generics, however, it's a different story. Instead of paying a flat $45 for a three-month supply, employees are now required to pay a significant percentage of the medication's retail cost.
I'm on three generic medications and four non-generics which are still under patent, so there's no generic alternative. I phoned the pharmacy that processes my prescriptions to find out what the retail cost of the four non-generics is and found that my costs are indeed going up.
The magnitude of the increase relative to what I pay today?
More than four hundred percent.
Yeah.
I'm seeing a couple of different sources of irony in this situation. First, I'm lucky because I even have insurance, even though it's costing me more than two thousand dollars extra in 2010 just to get the same medication I take today. Second, even with the de facto salary hit I'm about to take, I'm also lucky to have a job right now.
Finally, you'd think that with seven medications, I'm probably a pretty sick person. Nothing could be farther from the truth: I have two auto-immune disorders that certainly could make my life miserable (the reason for three of the medications), but they're under control and most of the time I hardly even remember they're there. I also have extraordinarily sensitive skin that looks good because a few years ago my dermatologist hit on a combination of control meds (four in total) that works for me. My heart rate is 40, my weight is perfectly normal, and I'm running a marathon in a couple of weeks. If I'm sick, I've got to be the healthiest sick person around.
I've given polite but admittedly strained feedback about this change to my plan administrator, but I already know it's not going to do any good. In the meantime, I was looking forward to resuming online investing in 2010 after I top up the rest of my emergency fund, and I was even thinking about splurging on a little piece of jewelry if I qualify for the Boston Marathon in a couple of weeks. In the short term, I guess I'll be saving up an extra couple of thousand dollars to blow on medication instead.
For some well-reasoned and far more articulate thoughts on health care and health care reform than I can give you, I'd suggest stopping by my friend Shadox's blog. In the meantime, I don't recommend watching this if you get the vapors about crude language or gestures, but here are my thoughts on the matter, more or less:
What's your health insurance situation at the moment?
10 retorts:
Don't have health insurance, have a chronic disease, take lots of vitamin supplements and go to the gym...my plan is not to get sick.
My situation is better than in a long while. I had a free financial advice session through my union, and the adviser was able to switch me to a much better plan at only marginally increased cost (especially for GP and physio appointments which are not covered by the State in Ireland).
I was also able to obtain a basic form of critical illness insurance, on the basis that I do not have any of these illnesses (talking cancer, stroke, heart attack, HIV). Like FZ, I am a healthy sickie with a number of permanent health conditions I hardly notice, but which mean I am ineligible for income continuance insurance should I fall critically ill. The policy I bought insures me for 50,000 Euro in the case of serious illness, and is from a reputable company. I know they have paid out for others. That's a major PF headache resolved!
On the salary/tax front, it doesn' look near as good, with the Irish public finances being what they are, and me working for the State. I hope I will still be able to follow some personal dreams next year. This may sound egotistic, but for so long I was poor due to personal bad luck, that being told to make sacrifices for "the common good" leaves me feeling crabby. And it isn't like it was me who crashed the Irish economy!
In Australia we pay a flat fee of about $A32 (USD 29) per prescription. I take one medicine (thyroxine) which I can get as 4 prescriptions per year in total. A doctor's visit works about the same. This is government healthcare (called Medicare). But about 40% of Australians have private insurance. I don't see the point. There are tax incentives to encourage us to get private insurance, but at our current income levels they are not sufficient to make us get it.
Just to add to what mOOm has said, in Australia there is the Pharmaceutical Benefits Scheme (PBS) which makes certain medicines available to patients at Government-subsidised prices, usually around the $32 mark per prescription for most (or $5 for people with concession cards - ie low income earners - aged pensioners, the disabled, the unemployed).
It doesn't necessarily cover all medicines though (but most).
Every time I hear about the US healthcare system I never failed to be amazed. It sounds so convoluted. The thought of an employer having responsibility for a worker's health care(or being involved in anyway really) just sounds so odd to me.
I know this is a long-term hot-button topic in the US (and I'm a leftie at the best of times).
By the way, I didn't know if Americans would 'get' Flight of the Conchords. Very impressed that you do! :)
Oh, FZ! Love me some Flight of the Conchords! And yeah, what else can you do?
I am currently unemployed, no insurance. Before I moved, I made sure my daughter's immunizations were all up to date, we both got checkups, I participated in a thorough health screen, and we both went to the dentist and got everything up to speed. And now we are eating right, exercising, and getting enough sleep, and pretty much doing everything we can to maintain our - thankfully - great health status. Just feels like we are flying without a parachute, but I'll probably avoid risky athletic stuff (skiing) until I'm covered again.
Thre may be a good chance that some of those patented drugs will be generic soon. There are a lot of drugs coming off patent in 2010 and moving forward. So take hope that these may be part of the ever growing number of products to go off patent.
I'm on that lovely program known as Medicare. But, really, I'm just thankful to have insurance. Next year will be harder, though, because I no longer qualify for Medicaid, which covered my premiums each month. That means $96 less each month, along with the extra costs of any supplemental programs I'm on. I plan to go to a drug store and have them help me find the best affordable plan for next year.
That said, it's not a bad deal. I definitely need to avoid the ER -- something like a $1,000 deductible -- but my visits to a psychiatric nurse to help me manage my medications was relatively low. It was 50% of what Medicare paid, so about $25.
Unfortunately, one of my prescriptions isn't covered by Medicare, as it's an off-off-label use. So I have to pay out $340 every three months to get the meds by mail. (It's $400+ for a one-month supply from a pharmacy.)
I guess you take the good with the bad and hope that you can get decent insurance one day.
You may want to consider talking to your doctor about the meds that don't have generics. Find out if there are any that do the same thing but aren't under patent. It's worth a shot. And if the new med doesn't work for you, you can switch back. I need to find a doctor down here, and I want to talk to him/her about alternatives to the pill that Medicare won't cover. I know there are a couple of others, but the only one I've heard about is Adderall, and I don't want the long-term harm to my teeth & bones.
Oy. It's come to the point where the best you can say is, *sigh* at least you still have insurance? Rough. But I'm glad you still have both job and insurance, even with the drawbacks/loopholes/etc.
Anon the first - I hope your plan works for you. I get every germ that marches in my direction, so I'd find it a scary situation to be in.
goldsmith - It sounds like Irish health insurance isn't as inclusive as my impression of European health coverage overall is. Is that because you're from another EU country, or is it standard for everyone in Ireland?
moom - I take thyroxine as well, for Hashimoto's. It's generic, fortunately, so the cost is minimal. Thanks for the info about Australia's health care coverage.
Penny - I think it's a little bizarre as well to link employment to health care, but apparently it's the byproduct of wage policies during WWII. Here's an article from the Times that describes it in more detail: http://economix.blogs.nytimes.com/2009/05/22/is-employer-based-health-insurance-worth-saving/ FWIW, the article is slanted in favor of national health care reform, but I don't think that'll push your buttons in any way.
And yes, I LOVE Flight of the Conchords. It is freaking hilarious. I've never seen a full episode because I don't have TV, but I've seen ALL the clips on YouTube!
MtnMama - Glad to see a fellow Conchords lover! I hope you can stay healthy and I think you're smart to be risk-averse with physical activities until you're insured again.
Knitty - If only. . . two of them are fairly new and have quite a way to go before their patents expire. For the other two, however, it's quite possible and thank you for mentioning that - it's worth looking into.
Abigail - I hope next year doesn't get too tough for you. I did ask each doctor who prescribed the patented drugs last time I had checkups, and in neither case was there anything off patent that the doctor thought was a suitable replacement. Thanks for the suggestion, though, and good luck to you.
Revanche - Thanks. . . I know a lot of people are in MUCH worse situations than I am, and I keep reminding myself that even if an extra $2k hurts like heck, as long as I'm still employed (check with me in about a week on that), I can afford it.
I've been self-employed and have had a very affordable private insurance plan for over 30 years. Love it and will be very sorry (actually, very angry) to see it go if the U.S. health care system is "reformed" as currently proposed.
My plan started out costing US$27 a month and slowly increased until the mid-1990s when my state started mandating various extra coverages (acupuncturists, naturopaths, etc.) That made it take a hike. But it was still under $150 a month until two years ago, when the state mandated mental health coverage. Now it's $307 a month. Of course, I'm 32 years older than when I started with it.
It does not pay for preventive care or prescriptions, and has a $1500 a year deductible. But I'm a careful and frugal health care user, and it has worked beautifully for me. I pay about $300 a year for my check-ups, lab work and occasional office visit, about $150 a year for prescriptions, and three times I've exceeded my deductible, at which point the insurance kicked in and paid big-time. Sweet.
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