Musings by Marian

Reflections from the Golden Years

Help! I’ve Fallen in the Donut Hole and I Can’t Get Up

September 7, 2016

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I’m one of those people who faithfully reads the booklets Medicare sends out each year. I am especially alert to changes that impact my pocketbook. I have changed providers as my needs mesh better with a different company. In the fourteen years I have been on Medicare, I have been aware of the donut hole for prescription drugs and figured it was for people with rare catastrophic illness who needed exotic, expensive medications; it did not apply to me.

So what changed?

My donut hole kicked in.

In August of 2016 I refilled a prescription, only to find that my out-of-pocket cost soared.

In answer to my question, the pharmacist told me I was now in the donut hole.The brouhaha over the cost of an Epi-pen is a harbinger of what is to come.

I was also changed to a different blood thinner that costs over $400 per month’s supply. This has quickly thrown me into the “donut hole” where I pay much more for my drugs (this isn’t the only drug I take) for the rest of the year or until the costs of those drugs meets an arbitrary figure. Since these amounts will likely change for next year, I have not attempted to cover the limits here.

I have an appointment with my doctor to explore the possibility of going back on baby aspirin. In response to my question of why I should spend $7 per pill when baby aspirin does the same thing, the doctor’s assistant told me the drug is considered to do it better and with less risk than aspirin.

Side effects? Has she not read the information sheets that come with each and every medication these days? I love the ones that mention “death” as a possible side effect, don’t you? We are assailed daily with lawyers on TV inviting people to join class action suits against any number of drugs that were once thought safe enough to take. Now we find something as innocuous as talcum baby powder, you know–that stuff we slathered all over our infants when they were little–causes ovarian cancer.

We were once instructed to swish our mouth out with peroxide when we had gum problems or canker sores. My parents swabbed my sore throats with a mixture of iodine and oil or straight Merthiolate, which contains mercury. My brothers teethed by chewing on our windowsills, which contained lead based paint. It’s amazing any of us became adults.

My father’s remedy for a cough was a mixture of bourbon, honey and lemon juice, even for us children. Come to think about it, some of the old remedies may well have been best. There’s no warning that a hot toddy might cause death. Nor did the toddies cause me to grow up as an alcoholic.

If those that prescribe or license drugs have been wrong so many times how can we trust them now? Since people are dying while badly needed drugs are held up years and years in the approval process, others have slipped right through the process and into our medicine cabinets and thence into lawyers’ files.

I was without any insurance for 26 years because of previous cancer treatment. My doctor and medication costs were far lower during those years than they are now that I have the government’s “help”.

Once the government gets involved in paying for anything, costs soar. Remember the $200 screwdrivers and $500 toilet seats?  I am paying much more out of pocket for essential drugs now than I was when George W. Bush decided it would be a great thing for the government to pick up the prescription tab for seniors. Bush described seniors who were eating dog food so they could afford their medication. If that were true then, many of us must really be on dog food now.

It’s not just drugs we need to worry about. With the advent of Obamacare, friends have complained about soaring out-of-pocket expenses for hospitalizations and soaring premiums.

I am not just concerned about what I must pay for rising drug costs, I am worried that the increased cost to government will bankrupt the system. During the past eight years our national debt has soared to almost $20 trillion dollars and is expected to top $21 trillion by the time Obama leaves office. How long until we run out of other peoples’ money and the system collapses?

Inflation is a major contributing factor to drug costs; yet the administration is hiding true inflation by removing cost of food and housing (and who knows what else) from their calculations. By cooking the books on inflation, Washington avoids giving Cost-of-Living raises that accurately reflect inflation to SS recipients. While limiting Cost-of-Living increases; they have also increased amounts the federal government holds out of social security checks for health care premiums. The government gives with one hand and takes away with the other.

Inflation has as many side effects for our economic health as bad medicine does for our health.The most elemental student of economics recognizes that printing money causes inflation and deflates the value of the dollar. Inflated money makes debt seem smaller, therefore our government has extra incentive to print money out of thin air. The government may benefit; but those on fixed incomes get the shaft.

I worry about the illnesses and hospitalizations we face as we age to an extent I never did before the advent of Obamacare. So what is our answer? I am certainly not recommending anyone substitute over-the-counter, cheaper medication for the ones their doctor prescribes. I haven’t even decided what I am going to do about my own blood thinner, but I will continue to research and ask questions until I find a balance between cost and benefit.

Going without health insurance for decades meant I dedicated myself to a healthy lifestyle of no smoking, minimal drinking of alcohol, a mostly healthy diet and exercise. At no time during the time I was not covered did I ever seek or receive assistance from the government. I was, however, able to avoid surgery a couple times by intense research and changing the way I did certain things so the problem went away.

Considering the looming problems inherent in our medical care, we all need to attack our health care in the same way—as if we had no insurance at all. It will be good practice if we reach the point it is necessary.

If, as planned, our health care system is trashed in order to institute a government-controlled single-payer system, get ready to suffer the same shortages and rationing of medical care providers and resources that Canada and England now suffer. Also get ready for taxes to soar to meet the costs.

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