BlogHer - Health Care Crisis: Are You Cutting Back on Prescription Medications to Save Money? - Comments

It looks like

Therextras — Tue, 28 Oct 2008 06:46:50 -0500

we think alike, Debra, in making decisions for our families. What do you think of news reports like the above post? Does it reinforce what you already think? Does the news give you new information? Is it helpful?

Thank you for taking the time to comment.

Barbara H. Boucher, PT, PhD, OT TherExtras

My cable bill is $40 a month

9to5to9 — Mon, 27 Oct 2008 18:03:14 -0500

My broadband access is another $40, and it's essential to my job. My former job, that is.

I've cut the cable bill three times in the past year, by the way. I did so the first time before switching to the generic medication. The next step is to eliminate it, though I'm down to a basic plan. I've already eliminated the land line, which also cut $40 a month from the budget.

My food bill is $300 a month, which is downright reasonable these days for a family of four and lower, by the way, than what the government is a "thrifty" meal plan. We do it by not eating out, other than an occasional trip to Starbucks for $5 a trip. The guys share a drink.

Our entertainment budget is $0, unless you count wear on sneakers and the guys' blue jeans from jumping around at the park, other than the previously mentioned cable bill. Note to self: Invest in Toughskins. The knees last longer.

My gasoline bill was $50 a week when I was working. I suppose I could have bought car that uses less, but that didn't make financial sense when the one I have now will be paid for next month. AndI could have considered moving closer to the office, except I'm paying rock-bottom rent at a home I've lived in for 10 years so any gasoline savings would have been more than negated in increased housing costs.

My utility bills run roughly $270 a month, give or take depending on the month: $137 for water/sewer/garbage and the rest a combination of high electric costs in the summer and high natural gas in the winter. The thermostat's at 84 on the AC and 67on the furnace. We survive.

My health insurance is $1,400 a month. It's a more expensive policy due to the asthma and allergies, but it doesn't cover hair plugs. Or antihistamine. I spend at least an additional $70 a month out of pocket.

My child-care bill was $966 a month when I was working. I definitely could have cut that by choosing a cheaper provider, but I liked the loving atmosphere and the fact that the guys went to a preschool rather than a baby-sitter.

So I suppose the headline for me would have been, "Parent chooses education over medication."

Not a scientific or even anecdotal poll, but a snapshot of one middle-income family. I suspect, though cannot prove, that a lot of folks are making these same kinds of decisions on bases not nearly as frivolous as cable over medication.

Debra Legg
9to5to9

Alternative headlines

Therextras — Mon, 27 Oct 2008 09:39:57 -0500

Thank you, Debra, for reinforcing that insurance companies make medical decisions based on costs, possibly detrimental for the patient, and not cost effective in the long run.

I'd like to know about the $360 differential cost to you. Are you saying that you could afford the additional cost, and were forced to because of the limits set by the insurance company?

Here's a comparative cost question - not just for you, Debra, but to make my point about poor reporting - how much does your cable tv cost? Let's just guess that $360/year is within range of typical cost for cable tv.

Suppose I did a survey of parents and asked if they had to choose between cable tv and a more appropriate medicine (copay), what would you choose? Better yet, what if the survey questions were under the auspices of a family budget quiz, and the answers revealed that in some homes parents who paid for cable tv had cut medications for their children due to high copays?

The headlines could read: Parents Choose Cable TV Over Medications for Their Children. Read into the article with this heading, and you find that 22% of the families were represented in the headlines. Would you consider that good reporting? For those who do not question news reports, what effects might this kind of reporting have?

(Offside: Is cable tv considered so much a basic lifestyle expectation that people do not question the costs?)

A rewrite follows this quote from Catherine's post (which is reported from someone else):

"In addition, 22% have reduced the number of times they go to the doctor. The statistics come from a national survey conducted over the summer of 686 consumers by the National Association of Insurance Commissioners (NAIC).

Americans are essentially putting their health at risk in order to save money, according to the NAIC's press release on the survey."

Rewrite: 151 Americans across the US have admitted to reducing the number of visits to the doctor because it costs them more money out of pocket. Only these people know whether their decisions put their lives at risk, but should you take the chance yourself?

(And we will never know if those 151 Americans are representative of all of us, how they were asked, and if they all have cable tv.)

Again, reporting questionable research to make a point is common. Be careful who you read for information.

Barbara H. Boucher, PT, PhD, OT TherExtras

On a different ethical note ...

9to5to9 — Mon, 27 Oct 2008 01:40:52 -0500

The only medication costs I could possibly cut back on would be those for my asthmatic 5-year-old, and, ethically, I can't do that to him.

Having said that, a little more than a year ago I did opt for a daily over-the-counter antihistamine when my insurance company dropped the medication his doctor preferred from its formulary. The cost savings was $30 a month, which was a not insignificant amount given my budget situation at the time.

The OTC antihistamine worked almost as well as the prescription, but not quite. My son started wheezing after exertion, and exercise-induced asthma had never been an issue before. He had noticably more drainage, and congestion is a concern with asthmatics.

As a result, his doctor prescribed an increased dosage of another medication. One that, coincidentally, remains covered under the formulary. It was a step that wouldn't have been necessary had the insurance company not been so dang skin-flinted to begin with. And we're not even talking about a high-priced experimental drug. We're talking about antihistamine, for Pete's sake.

His doctor, who's also head to the local asthma coalition, has fought the insurance companies for years on the antihistamine issue. He finds it incredibly disingenuous, as do I, for the insurance companies to create asthma awareness programs and publicity campaigns but at the same time refuse to cover preventative medication.

At least, that's the understanding I get from my healthcare professional.

Debra Legg
9to5to9

Reviewing my thoughts to

Therextras — Sun, 26 Oct 2008 22:16:56 -0500

Reviewing my thoughts to paraphrase (in numbers) myself (will review for typos before posting)....

Reporting 'facts' stated by Catherine Morgan, excerpted from other sources, whereby the reader cannot fully evaluate the acquisition of the data, means or motivations of the acquirers - who are not the reporters - 1) weak reference, loosely researched and reported - to what point? 2) Apparently to cause the reader to question their own medical/health decisions - last 2 sentences. I point out that the effect of negative (albeit poor) reporting is to promotes helplessness among those who associate with the (poorly substantiated) 'facts' of the report.

3)When people question their present state of healthcare, they often resort to thoughts of universal healthcare. You seem to make a case for agreeing with me, kaitykat, with "the majority of people can agree there is a case to be made for government subsidized healthcare".

The kind of reporting in this article is weak, and common, and since it has a negative affect on readers, I think it is wrong and unethical.

Intentionally, I want to say that news outlets are poor sources for information for forming opinions on healthcare. As much as possible, get information from primary sources. I encourage people to explore options and gain understanding through healthcare professionals.

Barbara H. Boucher, PT, PhD, OT TherExtras

Prescriptions cheaper in the third world

gringainteguz — Sun, 26 Oct 2008 19:31:20 -0500

I have been living over a year in Honduras. I have been sick a few times, and once, hospitalized. It is no secret that medication is cheaper here. My anit-depressant is 1/2 the price that I am charged in the US. The same goes for other maintenance meds as well as the costly antibiotics that I needed during my hospital stay. How can pharmaceutical companies charge US customers such high rates while the same medications are much cheaper here? I don't know.

I try to buy medicine here, and to not rely on buying them in the States. Even without prescription insurance in Honduras, it's cheaper to buy here.

I know there are people who cannot afford medications in the US. One trick that I learned was to order a higher dose of a regular medication, and use haf a pill. Often the same medication was only a few dollars more expensive for twice the dosage originally prescribed by my doctor.

Laurie

laurieishere.blogspot.com

Ethically wrong? I think not.

kaiteykat — Sun, 26 Oct 2008 17:24:46 -0500

It may not be your point of view, but as a journalist, I'm offended that you would label it an "ethical breech of journalism."

First off, I hope you meant breach, not breech.

Secondly, there is no doubt that journalists can distort facts, however, I think by this point, the majority of people can agree there is a case to be made for government subsidized healthcare.

Even if you disagree with the idea completely, which is absolutely fine, suggesting it is "ethically" wrong to write about the possible positives of such an approach is extremely short-sighted.

Illustrating deficits

Therextras — Sun, 26 Oct 2008 16:06:35 -0500

in the reporting of healthcare issues does not mean that there are not problems with how healthcare (cost) is (not) managed.

Deficits occur in the reporting by media. Reporting that subsumes that insufficient insurance is the source of the problems and more insurance is the resolution to the problems.

Commonly, people segue into thinking that government should supplant an industry that supports big CEOs and profits from illness.

The issue is not whether medical care is a right or not. Education has legal definition of a civil right (IDEA; since 1975). Problems in education have not been resolved by providing more money or more regulation.

The implication that government subsidized healthcare insurance - expanding the current system - will cut costs and restore quality is an ethical breech of journalism - facts distorted or slanted, purposely or without understanding the effects.

Barbara H. Boucher, PT, PhD, OT TherExtras

"Tier 4 Drug" Co-Pays Are Even Higher!

apietrangelo — Sun, 26 Oct 2008 14:26:27 -0500

$25.00 or $50.00 co-pays are one thing. If you need a "Tier 4 Drug," you are really in for sticker shock! How about a co-pay of $500.00 per month or more?

Those of us facing life with a chronic illness like multiple sclerosis often pay higher co-pays for our prescriptions than people with other illnesses. This is true on the individual insurance market, and is now becoming an issue with group insurance as well.

The only weapons we have at our disposal to fight off MS disability are "Tier 4 Drugs." There are no generics.

Additional Reading: MS Drugs Offer Hope, But Can You Afford Them?

Ann Pietrangelo

AnnPietrangelo.com

And how

Therextras — Sun, 26 Oct 2008 08:42:59 -0500

does affirmation that others struggle too help you with your situation?

Undoubtedly medical treatment decisions are difficult not only based on cost but also on effectiveness and side-effects.

I think the articles brandishing the horrible are unhelpful to readers for making those decisions. The fomented response is helplessness and hopelessness, increasing the desire for someone else to fix the situation.

As difficult as your medical decisions are, MiaHysteria, I encourage you to be discerning about where get information for making those decisions.

Barbara H. Boucher, PT, PhD, OT TherExtras

Meds and Therapy Sacrifices

MiaHysteria — Sun, 26 Oct 2008 08:11:38 -0500

My husband recently went to a medication that was 1/4 the cost of his original one. It doesn't work as well as the original, but it costs a heck of a lot less.

Other things that we are considering cutting though is our son's therapy. The out of pocket expenses are killing us...it's sad that this might have to make this kind of decision.

~Mia.

My blog is General Hysteria~

Who do you trust?

Therextras — Sun, 26 Oct 2008 07:58:56 -0500

Also from the New York Times, published in my local paper on Oct 24, byline Gardiner Harris: Is your doctor telling truth about your prescription?

"Half of all American doctors responding to a nationwide survey say they regularly prescribe placebos to patients."

So would we conclude that only half of those going without prescriptive medications -no matter the reason - are really at risk? That's the kind of reasoning and statistical expertise I read in news media.

The percentages are near meaningless unless you track how the data was collected, from whom and pay attention to the interpretation.

Media quoting media quoting media possibly quoting media-distilled interview published in media.

The title is 'shocking' news. Why else would anyone read it.

See my page titled "Subjectivity" linked in the left sidebar.

Barbara H. Boucher, PT, PhD, OT TherExtras

Health Care Crisis: Are You Cutting Back on Prescription Medications to Save Money?

Catherine Morgan — Sun, 26 Oct 2008 04:44:07 -0500

The New York Times featured an article this week, about how our poor economy, is affecting many patient's ability to buy prescription medications. This isn't a new phenomena, but it is happening on a much larger scale. I've done this myself on more than one occasion. Not only are we putting our personal health at risk when we do thiis, but we also risk profound implications to the health care system.

Although other forces are also in play, like safety concerns over some previously popular drugs and the transition of some prescription medications to over-the-counter sales, many doctors and other experts say consumer belt-tightening is a big factor in the prescription downturn.

The trend, if it continues, could have potentially profound implications.

If enough people try to save money by forgoing drugs, controllable conditions could escalate into major medical problems. That could eventually raise the nation’s total health care bill and lower the nation’s standard of living.

From Angie Drakulich at Pharm Tech Talk...

I have another radio story to share with you....driving to work the other day, I heard a report that 11% of US consumers have cut back on the number of prescription drugs they take or on the dosage of those medications in order to make the prescriptions last longer.

In addition, 22% have reduced the number of times they go to the doctor. The statistics come from a national survey conducted over the summer of 686 consumers by the National Association of Insurance Commissioners (NAIC).

Americans are essentially putting their health at risk in order to save money, according to the NAIC's press release on the survey.

From Judith Graham...

Getting the medical care you need isn't easy. Resources can be hard to find. Weighing the costs and benefits of proposed interventions can be difficult. Choosing a doctor or a hospital, negotiating with your insurer, staying on top of treatment trends, getting the best care possible -- all these can be nerve-wracking. This blog will bring you useful information, connect you with important resources and highlight the stories of other people like you.

I See the Failure of the Health Care System every day...

I also see patients like those highlighted in this week’s New York Times health section—people deciding not to take some or all of their medications because of the cost. Sure, some of those people will do OK. There are well-documented problems with polypharmacy (when too many medications actually create health problems), particularly in older adults. And not every person at risk for a disease (heart disease and stroke, for instance) will actually get it without being treated.

But many who skimp on their meds to save money will pay the price later, when uncontrolled high blood pressure leads to a stroke, or undertreated diabetes leads to vision loss or heart disease.

From Hilary Lewis from the Business Sheets...

With the skyrocketing prices of prescription drugs, it's sort of not surprising that consumers are rationing their doctors' orders. But it is still disconcerting that people are cutting back on prescription medicine. Perhaps the recession will finally lead to a drop in prescription drug prices. Here's hoping.

From Stephanie Miles - When Money Is Tight...

When faced with skyrocketing premiums, deductibles, and prescription drug costs, more people are choosing to skip doctors visits and forego their prescription drugs, according to the article, which found that:

22 percent of people surveyed said that they were going to the doctor less often because of money woes, while in a different survey, 11 percent said they were cutting back on filling their prescriptions.

The number of total prescriptions filled fell 0.5 percent in the first quarter and 1.97 percent in the second, compared with the same periods in 2007 -- the first negative quarters in at least a decade.

Drugstores like Walgreens are reporting slower sales of prescription drugs.

Health services company LabCorp. says that blood tests and lab work are down 8 percent in the second quarter of 2008, compared with the 1 percent quarterly growth it usually sees.

Also See:

The Queen B - What I'll Do For Medications

Are High Gas Prices Affecting Your Health?

Have you considered skipping medications because of the cost? Have you considered the implications of that decision on your personal health?

Contributing Editor Catherine Morgan
at Catherine-Morgan.com, The Political Voices of Women, Capessa Health & Fitness