Cristiona de Pisan

Cristiona de Pisan
Bio
Cristiona is a 30something bisexual, liberal, feminist woman who clearly does not choose her online personas based upon silly concepts like ease of pronounciation. She enjoys talking about politics, racism, religion, feminism, sexuality, the environment, technology, tv, books, cats, knitting, mental health, news, and the Oxford comma. This would go far to explain why she is rarely invited back to parties.

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Editor’s Pick
AUGUST 10, 2009 9:59PM

These Donuts Suck

Rate: 9 Flag

"At least right now it's just your mom on medication," my dad said to me over dinner last night. "Can you imagine if I was sick and we both fell into the donut hole?"

"The what now?" I replied, showing off the college education that he'd paid such good money for.

Apparently I'm one of the last people to find out about the infamous Medicare Donut Hole. On the odd chance that I am the second to last person to find out about it, the Donut Hole refers to the gap in coverage that occurs when you've had $2,700 worth of prescriptions but not yet $6,100. During that gap you get to pay for all of your meds out of pocket, 100%.

My mother has lupus, depression, and schizophrenia. Saying that she has prescription needs is like saying that fish have water needs. Take her meds away and I don't have a mommy anymore.  Literally. She'd kill herself. (That being due to the mental illness, but the lupus isn't making her life any more fun either.)

Thankfully my dad is in good health and had sound retirement planning and wasn't one of the people whose retirement savings vanished with all the companies that collapsed from Enron until today. He can pay for Mom's meds through that hole and I can continue to remain 100% away from being an orphan.

But it boggles my mind that some jackass back in 2003 proposed this gap, thought it was a good idea, and got it approved.  Because god knows that the people living in that $2,700-$6,100 range are just made of money, as all people with chronic illnesses are so well known for being.

And while my folks are luckily enough to go through this hole and not get lost, the key word there is "lucky." One twist of fate and things could have easily been different. To say nothing of all the people out there who didn't have the benefits that my parents did in terms of money and savings. Mom only just started Medicare this year. What if that had been her only option her entire life?

I've lost count of how many friends I have who need to go to doctors, particularly psychiatrists, but who can't because they have no coverage for the visit or, even if they do, oftentimes no coverage for the medication that will help them.  I certainly had to delay my own care until I had insurance to help pay for it. God forbid I lose my job or run into the dreaded "pre-existing condition."

I suppose this pisses me off most of all because, damn it, it's my mommy we're talking about! But it's everyone's mom, or dad, or child, or friend, or whoever. Any of us or all of us could be facing this exact same issue. It's just the luck of the draw.

I'm glad the proposed health plan is looking to get rid of the donut hole. I'm not comfortable with phrases like "compromise with pharmaceutical companies" but I suppose small steps are better than none.

Chalk it up as another reminder that we currently have rationing of health care. It's just being done by corporate greed.

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this was awesome- obviously the editors just haven't seen it yet.
I know all about the donut hole. As a pharmacy tech, we were the ones that got to explain it to our customers because they had no idea until ALL OF A SUDDEN! their prescriptions weren't covered. It's awful, awful, awful. I do not know how that idea got passed. I'm pretty sure it's been going on for at least 3 years.
My quickly done research says 2003 is the year it all went down. I could be wrong.
Which exactly why the Obama deal with the pharma companies was so outrageous. I'm 42, have two rare neurological disabilities, one caused by an illegal termination from a six figure job on Wall Street and the worsening of the first one as a result (TBI, which I share with alot of vets by the way), which has led to both a visible disability (so fat chance getting another job), the EEOC has taken two years and counting on just investigating my case while my ex company got bailed out with two injections of billions of dollars but no punishment or regulation in sight, and my pharma bills, since I'm now officially in poverty, come to about six grand a month. Which the government pays for, but is also directly responsible for the high price, because it created a monopoly on who can manufacture the pills I take in the first place, there are no substitutes on the market, and it's taken so long to investigate my case. Not to mention punish those who caused this in the first place.

Apart from the fact that Obama's deal is illegal, because it violates the 1973 Rehab Act, it will also raise the cost of everyone else's pharma and by extension, health insurance costs too, even if you have private health insurance and no disabilities. By law, private companies cannot underbid the government on any product they sell. So the pharmas are going to jack rates to every single private health insurer in the country. Leaving guess who to cover not only increased costs for government health coverage for the poor, people with disabilities, which it deliberately redlines and keeps out of the workforce, but your own health insurance and copays too. The average cost, to even someone with good private health insurance, with a neurological condition, is thirty grand a year in copays alone. This deal is going to make that bill skyrocket. Apart from say Michelle Obama, who got a $200K raise when her hubby got elected to the Senate, who the hell can afford to pay that?

Obama is a disgusting hypocrite who only cares about himself. And of course, making alot of money from his newfound corporate friends once the White House gig is over.

So much for change we can believe in. Much less hope, reform, and making this a country of opportunity for all.
Would the healthcare reform Obama is proposing help with that, though? You seem to be saying that those with private insurance and low income would suffer, so to me switching to a public plan (if we ever get one) would fix that.

I ask as an honest question, because I do not know the answer.
Margurite-
I really am sorry for what you are going thru. I agree that there are major issues with the Pharma folks. It's heinous that they can get away with such treatment. However, as one unintentionally honest pol said, "You just don't know how powerful the pharmaceutical companies are." These guys are multinationals. They are heavy on the bean counters, sells reps, and light on the scientist. (How's that for stupid bullshit.) The insurance companies are very powerful, too. Healthcare is still is a long shot with all the sick misinformation. The only way it is going to pass is by massive demostrations and citizens lobbying for the program. I mean massive. The senators and house members need to be shocked and awed by the response.

I believe you have to throw these big interest a big bone. They have our healthcare hostage and this is the ransom. I do not see Obama as intrinsically selfish. Although I can see how one might come to that conclusion in this instance. I see that even the president of the United States is not as powerful as the multinationals in insurance and pharma. Money is power thru politicians who cannot win without support ( time for massive election reform)., propaganda thru the biased media (F*kd New Network), and their influence over docs, lawyers, those in the profit part of the biz, and bean counters. If this is passed then it can be changed over time. When people start getting reports on the gouging that these insurance and Pharma co's are getting they should demand more accountability. Pharma doesn't want people questioning them.

If the government sets up reasonable studies, say a review of 1,ooo charts for certain illnesses, then they might be able to tell if some of the older drugs are as good or better than the expensive new ones. This will save a fortune by itself. As it is, drugs can be put on the market if they are better than a placebo at treating a problem. Often they are not as good as the older generics. Same goes for surgeries and certain extreme measure that do no good, and a few that actually do harm. This will require some research money for the NIH, FDA. One way to keep the NIH/FDA guys honest, they rotate in and out of big biz Pharma, is to pay better and pay bonuses to researchers if they run tight studies that stand up to scrutiny. They also need to sign a contract that they cannot quit, move to pharma, and then come back to government work.

Im concerned about what they will end up with in the compromise, too. I am totally sure that there will be no increased assistance without throwing these interest a big juicy meat covered bone. Like it or not we're going to have to dance with the devil.


Im serious about healthcare. I have hints on my blog about slogans and replies to people and arguments against healthcare reform. Im not trying to promote myself, Im trying to promote action. I read on NPR that there were states where 25% of the population were birthers and fifty percent of Republicans were birthers. The numbers may not be right on, but the proportions are right, and that's mighty shocking. With the same passion and energy of those opposed to healthcare, although not with their bad behavior, please go out and talk, protest, and lobby all involved. This is an important issue. We are supposed to be the government. Time to elect ourselves.
@sscape sscape Good comments! Another thing to consider is how pharm companies will make a tiny change to a drug so they can charge more and/or keep the generics away.

I think one of the key things is that the companies aren't motivated by good health, they're motivated by profit. I'm not saying everyone who works at a pharm. company is like that, just that the industry as a whole is. I'm not comfortable with a world where healthcare has more to do with money than with health.

Mind you there's a flip side to the brand vs. generics issue, which is that some people legitimately can't take the generics. Because of my mom's lupus something as seemingly minor as a different coating or dye can mess her up and make a pill harmful to her. There are some generics that she's tried and just can't take. It's name brand or nothing. But that means she and my dad are fighting to get her pills covered because they won't cover name brand if a generic exists.

What we need is a system that is cost-effective yet motivated by what's best for the patient.

While I'm on the topic I'd also like a pony.
Big Pharma has another way to squeeze us. When a drug is about to move into the category when it can be manufactured and sold by generic drug manufacturers (I think it's after 12 years as a brand name, exclusive right to manufacture, but I could be wrong on the time period), the pharmaceutical company will pay off the generic manufacturer NOT to make the drug. That way, the original manufacturer can continue to charge extremely high prices for medications. This affects everyone, not just those taking the medication, because it contributes to higher insurance premiums. The latest drug to have this happen was Provigil.
Well said, Cristiona! Glad I didn't miss this one. And congrats on the EP!
@Owl_Says_Who Why thank you!