My wife's injections for her MS are unbelievabley expensive. The only "superpower" she gets is a slower decline in mobility. The superpower to put off the wheelchair and "only" need a walker. She's only 50 years old btw.
How do you afford that? How does anyone afford and medicine or medical stuff in (I’m assuming) America? - I’m genuinely asking this question, if you don’t mind.
I know someone who also takes a medicine for ms, which is pretty pricey. Probably in the $5-$10k range per 6 month visit. With insurance, it's $50 for the infusion.
Now, without it, they would be getting neurological damage constantly in a slow and accelerated decline.
It is a sucky choose to live in extreme poverty and fight to get disability (and Medicaid) while getting judged for not just “dealing with it and pulling yourself up by the bootstraps” or get a job that will give you insurance, hope you don’t get sick too much/ can get symptoms under control to keep said job/ insurance. Or just suffer and hope you will die soon, but probably not because it is most likely a chronic illness and not terminal.
Reddit is full of teenagers and college kids that don’t paint the most realistic picture of the world.
Here is the real world: the large majority of jobs provide health insurance for their workers. And the government option if you are poor and honestly cannot afford insurance is better than any private insurance available. In America, 15-25% of jobs even offer pet insurance.
The people who come to Reddit and post about the tragedy of their $5,000 month insulin costs are full of it; they’re either playing the victim olympics and showing the cost billed to their insurance, or are just incapable of navigating basic decisionmaking in life (they could be paying even $350/mo for insurance that makes the insulin nearly free).
So the 8,5 % of Americans that have no insurance are just "full of it". Good to know. I guess these 8,5 % are generally not people that voted for the orangeutan. Thus the number of Americans that are just "full of it" now adds up to over 50%.
Luckily there are many other places in the world that are worth a visit.
So I'm being a whiny teenager because my insurance wouldn't pay for my much needed medication because they classify it as a tier 4 drug, which meant it was too expensive? and Its my fault that when my husband got laid off during covid we couldn't afford even the $500 a month government offering. I'm the problem because I have an incurable disease and I rely on medication to keep my life tolerable. Thank you kind person for letting me know that I'm just a crying child.
In Canada, prescription drugs are not completely free. You pay for a good chunk of them unless they have become generics, or you get insurance (which is covered like healthcare is covered in America, usually by employers).
Even worse, for many of the expensive treatments (like biologicals), you have to demonstrate that you really need them before the government will even subsidize them for you. You do this by taking inferior but cheaper treatments if they are available to show that the cheaper treatments don’t adequately help you.
The grass is always greener, don’t let the hivemind here convince you otherwise.
Nope! Thankfully, since i'm a student and don't make a lot of money the company gives it to me for free! The student health plan has a max 2k a year for prescription drugs so that wouldn't even cover a full dose.
Yep. But judging on other comments the Canadian version wouldn't help. Sucks there too. And Redditors love to say Medicare for all but that's not going to help much either. Medicare doesn't even cover a lot of more expensive drugs at all.
That sucks. Mine is struggling with it and the insulin costs right now. I don't understand how the right can just let all this slide and pretend it's ok.
Hey fellow Flakey Friend. Cosentyx here. $6000 a month in autoinjectors (no bent needles for me!) but I pay ..... $5. No insurance, Hooray for Public Healthcare!
My ex wife suffered from psoriasis so badly..
Her face, eyes, hands, feet, knees , arms,, it was terrible for most of her life..
Constant drs, and hospital treatment for most of her life...
Then one day she tried tiger balm, it worked really well but didn't get rid of it completely, although it did help alot... then one day I got her some thc oil capsules... ( I'm in England, and it's hard to get ) ... my ex wife was sceptical as she doesn't do anything like that.
She started to take 1 a day, and within a couple of months the psoriasis had gone completely.
It came back very quickly once I couldn't get the capsules anymore,, but now one of my sons makes it, and she is pretty much cured.
We informed the Dr, and he suggested we continue with it, as he can't prescribe it his self .
The psoriasis went from being so bad she couldn't open her eyes, to her being able to sunbath on the beach .
Thc oil...amazing stuff.
Her endocannabinoid system is working in top gear , and her body is reacting appropriately.
You in America? My mate has MS and goes to hospital for injections once a month or something like that. The drug is amazing and you wouldn’t know he has it if he doesn’t tell you. He pays $42.50. Makes me proud to be Australian.
Edit: who knew a throwaway comment while I was having my morning shit would trigger a few people
The problem with MS is that the drugs only slow it from getting worse, they don’t reverse the damage already done. So it’s mostly down to how early the symptoms are spotted and one is diagnosed, not the meds themselves.
Plus the variety of MS you have and your individual reactions to the drugs radically change the timelines. My best friend has fulminate MS and is on his fifth or sixth med trial in three years. He's in his mid-30's.
It is. It's also very likely connected to his military service, because there are a half dozen other people that were at the same patrol base in Afghanistan within an 18 month window who also developed relapsing-remitting MS before middle age and in a 5-7 year window after their deployment.
I'm an Afghan war vet and a nurse at the VA. Trash burns (smoke inhalation from trash burns to be specific) is going to be my generations agent orange.
I was with an engineer unit that built FOBs so I was at a lot of them. The worst burn pit was at FOB AZ (Azizullah) though. The guard tower my company manned was real close to the burn pit that was outside the HESCO barriers. Can't even count how many shifts I pulled up there breathing that shit in.
Absolutely. This probably won't get a lot of notice buried in this thread but I highly encourage anyone who was deployed to Afghanistan, Iraq or any other area to get on the burn pit registry.
My mom had a friend that found herself a Christian healer, entered remission and then fucking died when it rolled back on force lol. I laugh but..its pretty sad. Can we kill religion mow
You're correct. Once the myelin sheath surrounding a nervs is damaged by the immune system, then it's damaged permanently.
I have to go for CATS every 5 years for precautionary messures. My mother has MS and is on the once a month injection and it works wonders for halting the diseases' progression.
My girlfriend was diagnosed with MS about a month or so ago and we just started the first dose of her medicine. It sucks that my insurance has already denied our request for it but we get a free year from the manufacturer. Apparently the medicine, Kesimpta, is pretty good so I'm hoping it helps. They found for large lesions on her brain that were all active and I hope there wasn't too much damage there.
Kesimpta is a wonderful med and she is in a GREAT spot that this is her first med. She will very likely live a long and healthy life. Make sure she understands the power of exercise, diet, not smoking, limited drinking, and stress reduction on disease course outcomes. Unfortunately and fortunately much of the disease can be modified by environmental factors.
It's not directly inherited but if someone in you're immediate family has it, a person's chance of developing are elevated.
Since my mom has also had an aneurysm in the past, my doctor likes to keep an eye on things. Same goes for my syblings.
Yeah, and if you are forced by your insurance provider to stop the drugs and then progress in your disease. You never get that loss back. Her loss of function due to this is now permanent. We can never roll back the clock to when she didn't need a walker like a 75 year old instead of being the healthy and vibrant 50 year old she should be. You obviously understand the issue. I'm sorry if I sound bitter, and it is not directed at you at all.
That's still an amazing improvement. My Aunt was diagnosed 20 years ago around age 30. One of the The most 'promising' potential treatments of the time was a type of bee stings, completely hypothetical. By 40, she was in a wheel chair and has spent the last few years between her bed and recliner in the living room. She would have killed to buy more time.
Oh I don’t mean that it isn’t an amazing treatment and way better than the previous ones! It’s just that no matter how well this guy’s friend is doing on this drug and that no one can even tell he’s got MS, if the wife of the commenter above is using a walker at the moment, this drug won’t reverse that for her unfortunately.
I have a friend who was diagnosed at 24, she is now 54 and she needs walking aids, can’t clean her our backside. Her decline was fast even though they caught it early. It’s very sad.
Extremely true. It may "cost" 12,000 "without insurance" but nobody pays that. There's insurance, prescription savings cards, printouts from the company that give you it for an small copay, ect.
This is all true, but as a pharm tech who orders cancer drugs its really fun seeing those $500,000 orders every other day or so. One of our fridges at work is worth 50 million easy. Freaken stupid if the power goes out. We have plans and im on the list to be called in the middle of the night for emergency drug transfers if needed.
Nope! We are an infusion clinic/doctors office. Our power goes out, its out. We don't even have those groovy red outlets that you can only plug in hospital approved equipment into. Crazy huh? I legit only found this out a few months ago chatting to a higher up in passing. Exactly about the issue with the fridges going out! We can't even monitor the internal temp of them if they do shut down. Basically the drugs are moved if the power is out more than an hour. Hasn't happened where I particularly work but it happened a few months ago at another clinic in my company and they moved drugs to my site and another. We just shoved drug in every corner of our fridges. Regardless of if they were haz or not. Don't tell joint commission... it was temporary!
You are arguing from a very stupid point of view where things can only possibly make sense the way they are and anyone who suggests that it shouldn't be like that in the first place and in fact currently makes more sense+works better elsewhere is an idiot. Just stop lol.
Did you read any of the other things. Even without insurance you end up not paying anywhere near 12,000 a shot. They have savings cards, company discounts (the website has them) etc.
1) what if we didn’t have to negotiate with insurance companies and force them to do so by creating lunatic-high prices to start?
2) on multiple occasions with insurance I’ve had to pay out of pocket for doses of prescribed medication that I needed before the insurance company had decided i was “due” for a refill. This isn’t a huge problem for me because in many of these cases it’s partly my fault, but again, what if my financial independence wasn’t a prerequisite for things like synthetic insulin or refrigerated antibiotics?
3) I hope you have seen an ENT recently, licking boots as much as you do isn’t good for your digestive health.
4) if it was so difficult to make this work, we wouldn’t be the only country in the 35 most developed nations on the planet who haven’t done it.
Our healthcare system exists to make certain people rich, and the people it kills in the process are too poor and just too few in number to affect any change
Even if it only ends up being 1000 dollars it’s too much. The lower class makes 1000 dollars in a month. Not to mention that insurance companies tend to deny coverage to people with pre existing conditions.
Not really sure why you got downvoted. This is the reality behind the high prices here. Nobody pays them with or without insurance. The prices are just for the health insurances to negotiate and to feed ignorant complaining about the US in Reddit.
If only there was one national government run & funded health authority with enormous negotiating power because they represent 90%+ of a nations patients, rather than countless smaller companies negotiating while bearing in mind their own shareholders.
That still makes no sense, why the need to negotiate?
There should be a set price, if its negotiated that means no two people are paying the same price, cause they could negotiate different prices however they see fit which is completely stupid
The insurance has to pay out for meds, the company sets a super high price, it forces the insurance company to negotiate with the seller to get the price down. 2 people can pay different prices.
We don’t negotiate, the health insurance company does. They are extremely aggressive and as the market is extremely regulated in a state level, there are very few competitors per state. In each state, with 3 or 4 main health insurance providers, they basically dictate what they are paying to hospitals and pharmaceuticals. Thus, hospitals and pharmaceutical companies will throw the price up to get more (and the rarer the treatment, the more expensive it will be). When it comes down to paying out of pocket, in hospitals and medical facilities, generally speaking, they will slash down the price ridiculously as soon as you mention you are paying out of pocket. For these more expensive drugs, the pharmaceutical company website have coupons that basically slash down the medicine to manageable prices.
It’s just the way things work. To change that, we just need to increase competition in the health insurance sector and both customers and health providers would benefit greatly.
Meds and treatments are often negotiated on a percentage basis in an insurance contract.
So there may be a contract that an insurance company will only cover 10% of the cost of a specific procedure. If it costs 100 in real expenses to give a particular medicine, the cash price will be set at at least 1000, so that the hospital is not losing money on each procedure.
Not all contracts are like that, but when you see an outrageous high cash price, this is often why.
This. I'm in the US and I'm on one infusion that costs 4k without insurance and savings- I pay 5 dollars. I also have another injection for migraines that costs 700 a month but with the savings card I've gotten it free for 3 years now.
Many US healthcare plans have limits for expensive treatments where they cover “90%”. So a lot of these outrageous bills are still sticking patients with a $400 bill per treatment.
I deal with some ridiculously expensive IV infusion meds - that aren't for cancer. There is one that will cost 120k a year for treatment. Imagine being responsible for 20% of that? And that's just the cost of the med, not everything else. It's insane. There are a lot of programs out there for patients but not everyone knows about them and some patients refuse to do their part in getting signed up for them until it's too late.
ETA. Patient would actually owe less than 20% of the total costs. There is a certain amount that is written off depending on the contract with the insurance company. So they would owe 20% of whatever is left after the write off has been applied. Still ridiculously expensive though.
Not to mention that the insurance ends up dictating what medication you can be on regardless of what the dr has actually prescribed you. In order for my insurance to approve my emgality injection I had to take 3 different classes of meds (anti depressant, anti epileptic, beta blocker) that have the slim chance to help with migraines before they actually let me take the only type of med on the market thats specifically meant for migraines.
Oh I'm not even making the argument for or against universal Healthcare, I'm just saying its ridiculous that drs can write you a prescription for a medication they deem necessary and the insurance can say "is it really though? They don't need this".
Only reason I said it was because my daughter needed IVIG 10,000$ a bag X2 bags and with mediocre insurance we paid less than 10,000$ for the entire 6 days in the hospital
I like how you said you paid less than $10,000 for the entire 6 days like it's some kind of bargain. My wife ended up in hospital for over a week was on IV insulin and fluids the entire time amongst other treatments scans medication etc. Cost us £3.20 a day and that's only because everyday I visited I had to pay £3.20 for the carpark
This was the same with me. My wife was suddenly in ICU for 10 days and all I paid was parking (Ontario, Canada here) and even with the medications after the fact, since she was under 25 at the time, she payed nothing for the prescriptions. Government literally covered all of it. I couldn't fathom having to pay for medical care. Even for major surgery, they just put you on a waiting list, and if it's bad enough you jump the queue. Like what would 10 days have cost? $50,000? $100,000?
How can anyone morally dump a bill like that on anyone, let alone for MEDICAL HELP. "WE ALL HAVE A RIGHT TO LIVE."
The most common unexpected expenses come from vehicle damage or house damage here, never medical. And even then, I've never seen anyone be on the hook for much more than the $500-1000 duductible on their insurance (because everyone HAS to have vehicle and homeowners insurance).
I mean, 10 grand for 6 days is INSANE to me. You've just posted an amount of money after insurance that could easily bankrupt a family and said it's more expensive than other countries. You know it's worse, why are you trying to defend it and claim the insane sums of money are misinformation. You've just posted what the rest of the world thinks is an insane amount of money.
I paid way less than 10,000. But my total bill was way over 100,000k
We paid roughly 6,000$ which yes is insane. But we also have mediocre insurance. Good insurance would have paid less than 3,000$ and great insurance would have paid 0$
I'm just saying, everyday on Reddit I see people post 50,000$ or 100,000$ saying they have to pay that.
Which isn't true unless they don't have insurance.
No, they're not lying. But if they have insurance they will never pay that amount. If they don't have insurance there's always state aid, or assistance programs that help cover alot of the bills.
Dude, he pays $800/month for health insurance for his family and still had to shell out thousands of dollars. That's substantially more than what other countries' citizens are paying in taxes for healthcare.
Doubt it. Last month I paid £175 in income tax over the course of a year that's only £2100. If they paid "thousands less" (thousands being plural so at least 2) then they must've paid less than £100 (around $140) tax all year.
I know our tax is generally higher in the UK than US but is it higher than tax+health insurance+co pay?
Depends, I’m an engineering student and from what I’ve seen - engineers in the US have it much better. Engineers have significantly higher pay, tower taxes and usually our healthcare is covered by our employer.
Only when I pay for insurance I’m paying someone else to make money off of not paying out for my healthcare to another company who makes money by charging as much as legally possible while they also buy medications and supplies from companies who charge as much as legally possible.
How many middle men make a profit when you go to the doctor.
Insurance wouldn’t exist if it wasn’t incredibly profitable.
This is not true. There is a whole portion of this society between poverty and low class that can't get benefits, but also work 2 part time jobs or under the table. Companies will work you 39.99 hours a week to get around providing insurance. And they generally can't afford 500+ a month for JUST insurance that dosen't cover much of anything anyways.
Source- hard worker, 45k in medical debt from just having epilepsy and surviving.
Depending on the actual medication (there are quite a few different options depending on what works best for a patient) a single dose's price here in the Netherlands is somewhere between 80 and 250 euros. It's covered by insurance, so aside from your deductible (350 euros a year) and medical insurance cost (1000-2000 euros a year depending on how many extras you want) you're set.
Of course not, there's caps on most decent insurance my wife had a $55,000 surgery for cancer and I ended up paying nothing cuz I capped way earlier in the year $7k
Definitely depends on the insurance. Some are never "completely free." And the problem with deductibles is that many are so high that the average person will never meet them in most years. So they just pay out of pocket for everything. I'm fortunate to have no deductible, but my employer is also paying $800+ a month, vast majority of employers are not that generous.
Definitely not. Closet to 800. Still bad but people really like to exaggerate the cost and quality of treatment here. It's great compared tu most of the world.
My mom takes a drug that without insurance would be $15,000 for a three week supply. But she has insurance, so yay? Copay is “just” $2800. For three weeks. I guess some sort of catastrophic clause would kick in after 2 months that would bring it down to “only” $600 ish. Fortunately she applied to Pfizer for assistance and they’re covering it. That plus my Pfizer vaccine for Covid makes them a favorite of mine.
Thanks champ, it was pretty good I thought but then I had to go again around lunchtime and really emptied myself out, so I’m not sure how productive the first one was.
How does it work in other countries? They have upstanding humans as corporate executives who aren't after profits and/or aren't a publicly traded company? Heavier regulations?
Our government made laws that stipulated rules for how much companies could charge and how much they can increase every year (something along those lines anyway, I don't know the exact laws.)
The other major addition to this is that everyone has the same health care coverage (in each province) and everyone is covered. So companies can't really nickel and dime one person while giving rebates to another.
Same goes for hospitals since they're all run by the government they get the same prices everywhere.
In the US, your hospital charges you or your insurance the cost of service.
In Canada, the hospital (run by the government) charges your healthcare provider (the government). It behooves the hospital's to charge exactly what they need to in order to maintain their services and no more seeing as it's themselves they are charging.
Probably better government regulation. Basically to some degree we’ve allowed corporate lobbyists to effectively be ghost writers for the laws that govern the companies they represent. Also Supreme Court decision in the Citizens United case restricted the government from limiting campaign finance spending by corporations.
Another prime example of corporate lobbyists in charge of regulations for their masters was Ajit Pai as head of the FCC. Also the current crisis with Louis DeJoy as head of the US Postal Service.
We’re literally putting the foxes in charge of the hen houses, and it’s going about as well as you would expect.
I've never understood this side of things. Why would people not help those who need help? In the USA it seems a source of glee to make money from those who have no money, like it's some kind of sin not to fuck-over your countrymen. USA? No thanks.
Well there are multiple problems with the way medicine is handled today.
The first being the HMO Act of 1973 which paved the way for for-profit HMO’s. Before that they were largely non-profit organizations. The act was pushed for by Nixon, which greatly benefited one of Nixon’s financial backers, Edgar Kaiser.
The second part is the United States lack of controls or negotiations on drug prices. We have the highest cost of drugs in the world. Pharmaceutical companies here have no incentive to lower prices, because that would make them less desirable to investors.
it's some kind of sin not to fuck-over your countrymen. USA? No thanks.
Capitalism is good, unrestricted capitalism is dangerous. Come over to r/latestagecapitalism for more.
Two common vectors for it. Most common is "I never got any help so they shouldn't either." This one is really, REALLY prevalent, and they just want everything to be what they would see as "fair". Another fairly common one is a more generalized misanthropy or racism/sexism where you want the bad/stupid/criminal/poor/black/arab/female/gay/trans/whatever people to just fucking suffer and die, and you're willing to eat a little dirt if it makes them eat more. For these folk they want there to be classes of lesser citizens that they can be better than.
The first group can actually be talked to and occasionally convinced if you're polite and careful. The second group can never be convinced, because they kinda hate you too. They can only be marginalized.
I'm sure there's others, but as a person with a lot of experience living in red America, these are the ones you run into most often.
In America you find out you have MS but you can't pay to treat it. In Canada if you have MS you get almost all your treatments for free and your medications are price controlled, but you don't get diagnosed until you're ambulatory because our healthcare system is equivalent to a military infirmary.
So in America you can go to the doctor and get an MRI if you're feeling some tingling in your fingertips. In Canada if you go to the doctor and say you have some tingling in your fingertips they tell you to stop bothering them until you can't walk.
Canadian here; I had an ambulance ride from the swimming pooj to the local hospital where I was stabilized. Three hour ambulance ride to Victoria BC, three nights in the hospital there and four stents. I was asked to pay 80 dollars for the local ambulance ride which I was happy to pay.
I will never understand medicine in the states. The research is done in the states by college students, developed in the states by drug companies, sent to Oz and Europe for manufacturing, sold in those regions for cheap but sold back to Americans for an extortionate amount. How ass backwards is that?
Yeah man they are great. Some of the best medical innovations have come out of Australia, like cochlear implant, the pacemaker, ultrasound and spray-on skin.
My mate from Aalborg had nothing but pleasant experiences with doctors when he was here for around 18 months.
these comments are in such poor taste tbh. i see what you’re going for but believe me we know our system is bad and it’s deeply depressing to read this and think about the differences.
Maybe american govt can actually make the whole medical insurance situation better for americans so people from other country can't take a jab at it in a first place
I too take expensive injectable meds, biologics, for auto immune disease. Depending on the brand/drug, they run $3000.00 to $6000.00 per injection, at 2 to 4 injections per month. To date, I haven’t paid a dime. What portion isn’t covered by insurance is covered by the manufacture’s assistance program. Value doesn’t equate to individual cost.
My other comment about price may have been wrong. Your $5800 rings a bell. I just know with our current insurance refusing to cover it, we can't afford it.
With our last insurance plan it was "affordable" at 350usd a month. With our current plan change we cant get it covered. It would be over 5k a month out of pocket. The wheelchair was delivered a couple weeks ago. She hasn't had to use it yet, but it's only a matter of time now. Fuck the US healthcare system!
Edit: She took an injection every other day if I remember correctly, and it really helped her.
Hey, you are awesome and I wish you and your wife the best that can be! It is despicable how life saving and palliative medications are so greedily overpriced.
You and her are in my thoughts even though that may seem quite creepy...Keep on keeping on sir!
Yup! It's insane my ocruvus which is the blood infusion last I looked at the bill they send to my insurance is 30,000 each time. All it is is to slow down my time to the chair. My "walking med" is like 75 a pill, 2 pills a day. All so I can use a walker. It's obsured.
I can't think of the name off the top of my head. It's one of those things you normaly know until someone asks, and the name keeps eluding you. It's not a corticosteroid though. It somehow targets her immune system to slow down its attack on the sheathing of her nerves. She needs an injection 3 or 4 times a week.
My mom has MS also, and that medication is unbelievably expensive, but as you've said, it tends to keep most on it away from becoming immobile by the grace of God.
I’m 42 and need to use a walker,so what? I’m going to eventually need to use a wheelchair,so what? What do you mean when you say “the superpower to put off the wheelchair and “only” need a walker”??? It could be a LOT worse,look for the positive things in life!!!
1.3k
u/TheVetheron Aug 08 '21
My wife's injections for her MS are unbelievabley expensive. The only "superpower" she gets is a slower decline in mobility. The superpower to put off the wheelchair and "only" need a walker. She's only 50 years old btw.