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Saturday, September 17, 2016

Dolla' dolla' bills, y'all!

That's what being sick really comes down to, in the end. So, what is the real cost?

You obviously want to have health insurance. Well, you HAVE to have health insurance. Unless you want to become intimate friends with the call center people at a collections agency. So that, at its cheapest is going to be $200 a month. But then, there's the deductible; how much did you end up choosing? Because that cost will be out of pocket. Is everything paid in full after you meet that point, or will you still have to pay 20% of the bill when you go to the doctor?
Maybe you went for the higher monthly cost and lower deductible, which also usually means less out of pocket after it is met, if any.

This is the expense people often think of when they think of being sick: your health insurance bill, your co-pays at the doctor, your amount due on procedures (if they've ever even had a procedure to realize that it has a different pay scale than a standard doctor's visit.) But there is SO. MUCH. MORE. to being sick.

Did you pick the insurance plan with the good drug coverage? I hope so, because this shit ain't cheap.  Well, that's not totally true, the ones that actually take care of my disease like Enbrel, those are fucking car payments every month without help; no worries though because your trusty, controlled substance Xanax is only $7.15. So you'll be broke, but you won't care as much. Groovy. Even with my insurance, my Enbrel would cost me over $300 a month. AFTER INSURANCE. That's how much the insurance cost me, are you fucking joking? Did somebody type the period in the wrong place and they just rolled with it after that? Nope. That's actually what insurance brings it down to. Without it can be upwards of $1000 a month. A. MONTH.
I take leflunomide every other day, which, if you're good at math (and most of us are pretty good at knowing how many pills should be in a bottle) amounts to a quantity of 15 for a one month supply. Do you know how much that costs me? $35. For fifteen fucking pills. This isn't a brand new drug, either. It was approved by the FDA in 1998, which in my head is like 5 years ago, but is actually almost TWO DECADES ago. Yet even as a generic, it has very specific uses and virtually no side scribing to force much cost prohibition amongst competition. So I'm paying more than two dollars a pill. (For diarrhea. That's the most noticeable thing it does for me, give me diarrhea.)
For the newer, still branded drugs the companies try to incentivize doctors and patients by offering co-payment plans. This is a godsend, provided the company still has a need to incentivize. So, the Enbrel that would cost over $300 after insurance comes down to $10. TEN DOLLARS. I am paying less than half for a pack of 4 syringes prefilled with cutting edge biologic medication (read: the shit is manufactured in living organisms.) compared to the 20 year old tablet at $2.33 a pop.
My Lyrica would be $75 for a quantity of 60 (only $1.25 a pill, mind you) except for the co-payment card from the manufacturer that brings it down to $25.

So, for one month of just my disease related drugs I have spent $65. Not terrible in the grand scheme of things. But there are other medications that I have to get. Tramadol? $10. There's the cheap ass Xanax for $7 I mentioned earlier. There's generic Ambien for when I can't sleep, again going for $10. I have the option to go for generic Buspar to help with OCD at bedtime instead, that one at $7.  The generic Prozac for the anxiety issues? That one is only $5, which is good because if it had cost more than the Xanax I would have seen even more underlying issues in our society. Generic Prilosec for the stomach issues that come with constantly taking NSAIDs, that one cost me $10. There's generic Phenergan for the nausea from taking poisons on a regular basis, also about $7.

I didn't make any of that up. I pulled up my Walgreen's app and looked to see how much I paid each time I filled them. Oh, don't let me forget the round of antibiotics here, there, and everywhere for whatever bullshit you've picked up- that's going to run between $5 and $10 depending on what you've got.

We've brought my base for each month up to $90, God willing none of the PRN meds need to be refilled. And how much do you think I spend on Ibuprofen?  Jesus Fuck, I don't want to tally that, my stomach hurts just thinking about it.

Those are all things that would be a debit of money from your paycheck or credit card total or however you're living month to month. What about the lack thereof?

I can't work full time anymore- that has been made abundantly clear to me. And even with that shorter schedule, I still get sick. Kids come into the office and they have snotty noses and they rub them and then they touch everything in the room while I'm gone and I'm pretty sure sneeze on my pen. (I am not even shitting you, I have been sneezed on in the face by a grown-ass patient.) The general population is full of germs.  Hell, I'm full of germs, you're full of germs, we are all GIANT GERM FACTORIES. But our personal microecosystems are unique and work together to create a sort of symbiotic (most of the time) situation for all of us. It's when you are exposed to the strains of something NOT in your microecosystem that you are more likely to get sick. So being around strangers all day every day means you're just upping the odds that you'll come down with something. That like, doubles, when dealing with kids because kids. Touch. EVERYTHING. Every goddamned thing, I am not even exaggerating. (What need is there to touch the TV screen? You're holding an iPad, what do you think my screen is going to offer that yours can't? It isn't a touch screen, BTW.)
So, we get sick. And that means a sick day, and yeah, that sucks for everybody. But here's how a sick day looks money wise: Hand over $40 for the copay at the office, hand over $10 for the prescription at the pharmacy, plus another $20 for OTC meds to treat your symptoms, and then maybe some tissues or chocolate or something. Then let's not forget to add the -$xxx.xx that I would have earned that day had I been at work, because it's not like they're handing out PTO to part time employees most places. Not only was I scheduled to make less money than you, but now I've lost another day of that SO I COULD GO TO THE DOCTOR AND HAND OVER MORE MONEY.

I'm debating whether I should add in the cost of concealer, foundation, and the other makeup it takes to make myself look presentable. I'm thinking yes, and I'm claiming it all as deductions on my taxes next year.