Michigan man misled into believing he needs health insurance to get healthcare?

Today I read an article in the Washington Post that left me genuinely angry about the way too many people talk and think about healthcare in this country, and the false messages that people too often receive about how they can or cannot get healthcare. Readers of The Self-Pay Patient by now understand that there are numerous options for getting needed medical treatment even if you are uninsured. Unfortunately, and thanks (in my opinion) to the way lots of politicians, pundits, and others talk about healthcare, too many people believe that without health insurance there is no alternative to going without care, other than maybe the emergency room.

The article I read today focused on how smokers in some states may find themselves unable to buy health insurance through the Obamacare exchanges because of the surcharge on premiums for smokers (up to 50%, which won’t be subsidized at all).

Michigan smoker may face penalty, go without health insurance unless he quits long-time habit

Eric Jones…has no health insurance from his $9-an-hour job at an ice-manufacturing plant in Lansing. Under the federal health care law, he’s eligible for help from the government to buy insurance. 

But to qualify, he’ll almost certainly have to quit smoking. 

A baseline insurance plan could cost Jones, who makes $22,000 working seasonally from February to November, $775 a year in premiums. Or he could pay no premiums in the cheapest plan, which has higher deductibles and copayments.

Yet if he keeps smoking, he could face an annual financial penalty ranging from $1,600 to $1,900 that will make coverage unaffordable.

The policy on surcharges wasn’t what made me angry – there are pros and cons to the policy, and other people elsewhere on both sides will undoubtedly argue over it endlessly in the coming years.

But what I read next is what angered me:

 Jones is not without health problems. He said he should be taking medications for gout, high blood pressure, high cholesterol and severe acid reflux but instead just suffers through his conditions.

“I can’t afford them,” he said. “So I just don’t take them.”

I don’t really blame Jones – he, like countless other Americans including myself during most of my twenties when I was uninsured, likely has been told repeatedly that without health insurance, you can’t afford healthcare or prescription drugs. But we know that’s not even close to true!

I did a little checking online. Each of the four conditions that Jones suffers from are readily treatable by prescription drugs that are available in generic forms. I went online to find drugs that are commonly prescribed for each condition(I used WebMD), and then went Walmart’s site for their $4 generics to see if they had any of them available. A few results:

Gout – treatable by numerous over-the-counter medications, as well as allopurinol, 90-day supply available at Walmart for $10 in either 100mg or 300mg form.

High blood pressure – more than 25 prescription drugs available to treat high blood pressure or heart conditions, all $10 for a 90 day supply in a variety of dosages.

High cholesterol – two commonly prescribed medications, lovastatin and pravastatin, several dosage levels available at $10 for a 90 day supply.

Severe acid reflux – cimetidine, again $10 for a 90-day supply

Obviously I’m not a doctor, haven’t examined Mr. Jones, and don’t know whether he would respond favorably to any of these drugs. But it’s fairly likely he would see some improvement in his health if he were to start taking either these medications or other low-cost generics that may be a little more than $10 for a 90 day supply, but are probably far less expensive than he’s been led to believe. Four medications, $40 for a 3-month supply – that works out to about $13 a month!

And this is just Walmart – as I wrote about previously, there are other options including Costco or using a price comparison tool like GoodRx.com or RxPrice.com, which may turn up other generics that might better meet his medical treatment needs.

Hopefully someone who knows Mr. Jones and is at least familiar with the options available to self-pay patients will undo what seems to me to be decades worth of misinformation about the cost of healthcare, and point him in the direction of low-cost generics that are likely to be able to treat his conditions and end his having to “just suffer” with his pain.

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One Response to Michigan man misled into believing he needs health insurance to get healthcare?

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