Personal Musings

Yesterday, the dermatological nurse I visited prescribed an antibiotic and a topical medication for the rash behind my right knee. Shortly after that visit, my pharmacy called to inform me that the deductible for the topical would be $387 and asked whether I would like them to fill that prescription. I appreciated the call; it saved me a disappointing trip to the pharmacy because my answer was “no.” My call to the nurse has not been returned; I hope she prescribes something more affordable. Yet, if that ointment is the only option (which I doubt), I could pay the deductible. However, I learned the price of some other medications and related services yesterday that, if they were not fully covered by insurance, could easily bankrupt me during the course of treatment. The charges presented to Medicare and my supplemental insurance carrier, for a single chemotherapy session, amounted to more than $59,000. Only slightly less than $18,000 of that amount was approved by Medicare and Medicare paid only a bit more than $14,000; the difference between Medicare-approved and Medicare-paid was covered by the supplemental insurance. Had I not been covered by Medicare and my supplemental policy, I believe I would have been billed for the entire $59,000. For one treatment. But, if all goes well, I will need only four full-scale chemo treatments. While very expensive, I might be able to drain my savings and cover the costs. After those four treatments, though, I will undergo an additional 35 immunotherapy treatments over the course of two years. The cost of just one drug involved in that process is $31,400 for each treatment—$1,099,000, excluding several hundred dollars of ancillary drugs and services for each session.

It may sound absurd to say it while facing treatment for a potentially deadly disease, but I am exceptionally fortunate. Unless the situation changes dramatically, the disease may still kill me, but the treatments for it probably will not bankrupt me—assuming I do not reach a maximum coverage limit (if any such limit exists) with my supplemental policy.

What about people who have no insurance? Or people whose insurance is insufficient? Or people who are employed and must deal with the astounding cost of treatment while facing a loss of income because of the amount of time they must miss work? A single illness, injury, hospitalization, etc., etc. can bring financial ruin down upon them. I wish our society actually provided a safety-net for people who find themselves in such catastrophic circumstances.

I wonder what proportion of the costs of healthcare—especially extraordinarily expensive components of healthcare—flow toward corporate and individual investor profits? My guess—purely a guess—is that the proportion is staggeringly large. I am in favor of medical professionals, researchers, and others involved in healthcare being paid handsomely. But I am not in favor of massive profits flowing to any component of the industry, such as pharmaceutical companies. Healthcare should not be a profit-oriented enterprise, in my opinion. Ach, but my opinion doesn’t really count. And it won’t unless and until I do more than complain and wish.

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In a country well governed, poverty is something to be ashamed of. In a country badly governed, wealth is something to be ashamed of.

~ Confucius ~

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I wonder how those of us who live in circumstances of relative wealth can justify using that wealth to maximize our own enjoyment, rather than to minimize the pain of those who live in abject poverty? The justification I hear often suggests we “need” the fuel that pleasure provides to enable us to make meager contributions to relieving others’ pain. On one hand, I can understand and accept that argument, but I question just how much joy we “need” to feed our altruism. Who knows? I do not. Perhaps asking the question without taking action to seek an answer simply ingrains feelings of guilt in us. If that is all, the questions have no value and, instead, are unnecessary self-punishments. But maybe those questions, repeated over time, will eventually propel us toward action. Or, perhaps, others may see the guilt and shame embedded in those questions and take action themselves as a result. Or maybe the entire conversation is pointless and without value.

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If poverty were a man, I would have slain him.

~ Ali ibn Abi Talib ~

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And again, for innumerable reasons, here is Shakespeare’s Sonnet 116. It brings tears to my eyes every time I read it, for very personal reasons.

Let me not to the marriage of true minds
Admit impediments; love is not love
Which alters when it alteration finds,
Or bends with the remover to remove.
O no, it is an ever-fixèd mark
That looks on tempests and is never shaken;
It is the star to every wand’ring bark
Whose worth’s unknown, although his height be taken.
Love’s not time’s fool, though rosy lips and cheeks
Within his bending sickle’s compass come.
Love alters not with his brief hours and weeks,
But bears it out even to the edge of doom:
If this be error and upon me proved,
I never writ, nor no man ever loved.