Healthcare Hell

    The other night I went to the pharmacy to get a new prescription filled.  It’s an anti-inflammatory that will hopefully prevent my knees from occasionally giving out.  For some reason, the pharmacy techs couldn’t find my insurance information and said the one month supply would be $71… and that’s for the generic.


I’ve been thinking a lot about the cost of healthcare lately… possibly because of the national healthcare bills, and possibly because come August 22, I will turn 25 and will no longer be covered as a school-going dependent under my mom’s insurance. 

….and quite frankly, that scares the hell out of me. 

While a lot of people my age seem to get by without healthcare coverage, I seem to be a bit lacking in the “youthful health” department.  Now, don’t get me wrong, I typically feel bright and healthy, but that is with medication. 

So, let me give you a “brief” rundown of my medical history:

• As a child, due to myriad ear infections, I not only developed awesome balance (hah!), but also incurred hearing loss.
• At 3 or 4, I had to have my feet fixed because they were angled wrong. Introducing: orthopedic saddle shoes until age 7!
• At 6, my permanent teeth started coming in with soft enamel.  Next came a lifetime of dental procedures.
• At 8, I started needing glasses.
• At 12, braces (hey look, now my top and bottom teeth actually touch so I can chew!)
• At 15, I had my wisdom teeth removed. 
• At 16, I was diagnosed with generalized anxiety disorder, depression, and chronic migraines. However in order to discover this, I was sent to a bazillion specialists and had an absurd amount of tests done. 
• At 17, I had surgery for enlarged turbinates (the things in your nose that pull the air through so you can breathe...which is apparently important)
• At 19, I had panic attacks, blackouts, and was also diagnosed with ADHD and endometriosis.  I had surgery to remove endometriosis.
• At 20, due to all of the medical problems, I started freaking out a lot and became really unhealthy and had to have a lot of bloodwork done. Then I endured six months of chemically-induced menopause to get the endometriosis that the surgery didn’t get.
• At 22, I fell down a flight of stairs and got a concussion, then had to go through therapy to teach my brain to talk to my hands again.  Additionally, brain scans showed potential signs of MS, and a tumor was found in my right knee.  We’re keeping an eye on the brain.
• At 24, after several years of knee issues, I’ve been seeing an orthopedic surgeon and have had x-rays and MRIs done of both knees.

...that was pretty brief, right? 

Fortunately, my dad had a good job with good benefits that continued on after his death (and a legal battle with his company), but I won’t have those benefits much longer.  So, two weeks ago, as I was driving home from the hospital after having MRIs of both knees, I wondered how much an MRI might cost without insurance… or even my prescriptions. 

For some time now, I’ve taken three different prescriptions daily: an anti-depressant for generalized anxiety disorder and depression, a stimulant for ADHD, and birth control to help control endometriosis.   

Without prescription insurance, those three medications cost $140, $321, and $86 respectively*… per month!!!  In addition, I take a migraine medication about once or twice a month which is $24/pill.  Add that new $71 anti-inflammatory to the list, and it’s $642 each month… over $7700 a year in medication alone.

Obviously I need to visit a doctor to get those prescriptions:

• Four trips to the neurologist in a year is $360.
• My yearly visit to the vaginacologist is $170, and standard checks like the pap smear add another $307.
• Two trips to the dentist cost $174, not including x-rays.
• My annual optometrist checkup however, is free, thanks to the eye doc being my sister’s best friend.

Therefore, assuming everything stays as-is, I’m looking at an annual cost of $8715.


Of course, as my medical history shows, the chances of remaining “as-is” are slim: 

For example, the cause of endometriosis is unknown and its eventual return is inevitable. Now, while some things help make it better, like birth control pills or pregnancy (the latter being an obvious bad idea when it comes to reducing healthcare costs), I will probably have to go through at least one more ($7000) surgery and/or chemically-induced menopause in my life.  The way menopause works is by an injection of Lupron Depot once a month for six months.   Those six shots are $785…each. 

In a couple years, I’ll need another MRI of my brain to check on the lesions, and if anything has changed, a spinal tap to be sure.


Heaven forbid I become ill.


What about preventative medicine? 
At some point, I’d like to get the HPV vaccination, which is three shots for $156 each (and even my current company doesn’t cover it).  I know I’m also at risk for skin cancer, so I might want to see a dermatologist at some point.


Clearly things might be cheaper with some health insurance, even crappy health insurance.  But how the hell am I supposed to be approved for it? 

Pre-existing conditions?  Yessir.  Granted, all of my conditions have nothing to do with taking care of myself.  On the outside, I’m a young, healthy, 5’9” female weighing 169 pounds (within the healthy range for my build and height).  I don’t smoke, rarely drink alcohol, wear sunscreen, eat my fruits and vegetables, have strong bones and muscles, a healthy heart, low blood pressure, low cholesterol, an exceptional IQ, and take vitamins.  Hell, I’ve only ever had one cavity in my life!


If I cannot afford doctors bills and prescription medications, where does that leave me? 
     I see the following as my options:

• Reduce medication by half where possible.
  
• Pros: Reduce costs by $200 each month
• Cons: Reduced effectiveness
• Take different medications (for example, methylphenidate instead of time-released Concerta).
• Pros: Reduce prescription costs to about $72 per month.
• Cons: Side effects are inevitable, and the medications may not work well with my body chemistry.
• Go to free clinics like Planned Parenthood for health services.
• Pros: Affordable
• Cons: Difficult to get in, they don’t have a sense of my medical history, care probably isn’t as good

   
Saying “to hell with healthcare” is clearly not an option for me.  Untreated, I would  be subject to crippling pain, absurd blood loss, depression, panic attacks, brain damage (as a result of untreated migraines), and infertility… for a start. 

At that point, it would be a good thing I wasn’t trying to pay for healthcare, because I certainly wouldn’t be able to work. 

So I ask you, how can I focus on starting a business and saving the world when my own personal wellbeing is at stake?  While I’m busy factoring things like taxes, profit-and-loss, market research, and business frameworks, in the back of my mind I’m freaking out. 

The thing is, considering all of the medical conditions I don’t have, I think I have it pretty good.  I feel very fortunate for the health that I have.

...but how the hell am I ever going to manage to pay to keep both myself and a business healthy?

* Prescription prices are from www.drugstore.com and Target Pharmacy.