It’s the Economy, Stupid–Affording Arthritis

Posted on 18 June 2010

Let’s face it: rheumatoid arthritis is an expensive hobby. Quarterly or even monthly visits to the rheumatologist, multiple prescriptions, physical therapy…who can afford it? Well, if you have to, you can…

Whenever I research an article, I scan website after website for pertinent information…which means I often read the same general information several times a week. Usually, I am able to scan through without any major incident; the other day, however, I read something that I’ve read probably a dozen times before, but this time it made me want to put my fist into the computer: “People who are educated and affluent tend to deal with RA better than those in low-income homes.”

Really? Well, who would ever guess?

Apparently, not the researchers who conduct these very expensive, often taxpayer supported studies. Personally, I would like to use some of my wasted tax dollars to pay off some of my medical debts…or, here’s an idea: maybe I could use the money to get a couple of degrees so I, too, could afford to have arthritis.

Sorry. Guess that struck a nerve.

Still, if it weren’t for comments like that, the odious expression “Well, duh!” would have fallen the way of “far out” and “radical, dude!” into slang death. Of course, well-to-do people deal with RA better…they’re the few people in this country who can afford RA. Not only can they afford a rheumatologist, they can afford to go to Mayo or Duke or Johns Hopkins to get the full arthritis spa treatment: JAMA superstar rheumatologist, specially trained nurse, physical therapist, occupational therapist and even a psychiatrist to help with the transition. Afterwards, they can drive straight to their pharmacist with a prescription for Enbrel—absolutely secure in the fact that their insurance will cover it—and go back to their jobs which involve telling other people what they should build/design/type.

So, do I resent rich people? Hell, no. I resent that I can’t afford to be healthy. Without a doubt, America offers the finest medical training, technology and treatment in the world and yet we are ranked 12th in health care. (Italy, if you are interested, ranks number one). Sin is not a word that I frequently use, but I truly believe that it is a sin for anyone to be denied adequate medical care because they lack money…and as much as I love this great country of ours (and who isn’t patriotic, these days?), I believe that this have/have not system of health care is one of its greatest shortcomings.

Often, while on this subject, someone will say to me, “Yes, and look at the animals in prison. All of their medical treatment is paid for by you and me…” usually followed by the suggestion that bad people be put in a dungeon/ on a deserted island/ to death. My beliefs are even more radical: I believe that all members of the species Homo sapiens—even those of the slimy, single-cell variety—are entitled to health care. I honestly believe that it is our right as human beings to be treated when we are sick, no matter what our financial situation.

Don’t get me wrong: I may be a pinko, commie liberal, but I don’t have the first clue as to how to reform the health care system; I also respect that doctors, pharmaceutical companies and insurance companies would like to enjoy the fruits of a free market society as much as the next guy. (I also recognize that—given the times—it may be years before health care reform is even mentioned again).

I do, however, have an idea on how to get the lawmakers in this country to at least think about the high costs of health care: let’s take away their fancy health benefits. Why not? You and I pay for it, we should be able stop paying for it. Let these fat cats pay for their own colonoscopies and bypass surgeries. Maybe after shelling out $300-$1500 a month for prescriptions, they might decide it’s in their best interest to spend a little time studying solutions for an overlooked national crisis.

In the Meantime…

Some of the more astute readers out there may have detected that I am slightly bitter about this issue. You’re wrong…I’m very bitter. I’ve just concluded a two-year fight with my insurance company over Remicaide (they have finally conceded, if only to shut me up…but they still won’t pay for Enbrel), and while I am grateful to finally be able to use Remicaide, I can’t help but be angry for that wasted time, for all those flares, for the new deformities, and…for all those other people out there who are slowly being crippled because they, too, can’t afford to be healthy.

Or can they? Those who can afford to shell out $12,000 a year for Remicaide/Enbrel can afford the Cadillac-brand of health insurance that already pays 100% of prescription/hospitalization. And I’m not talking about the truly poor, who can qualify for Medicaid—which also pays out 100%. I’m talking about people whose insurance pays 70 or 80%. I’m talking about me (because when I really get angry, it’s usually because I’m mad at myself).

It wasn’t that my insurance company wouldn’t pay for Remicaide at all…it was that (and I won’t bore you with the details of why) they would only pay 70%. Well, by my calculations, 70% of $12,000=forget it. So I fought them and did without for two years, limping about the house and secretly resenting my husband for not saying, “Just go ahead and do it…we’ll manage somehow.”

And I’m the one who hates martyrs.

I know that I’ve used this analogy before, so bear with me: if I had cancer, I would do whatever it took to get well. If I had to hold fundraisers, collect cans by the side of the road, sell my body for pocket change…you name it, I would do it. So why didn’t I take my own treatment as seriously? Rheumatoid arthritis, if not treated, can ultimately be fatal. But, because it’s not fatal tomorrow, I think that many of us are shortchanging our health because we don’t want to add (more) financial strain on our families.

I’ve said it before and I’ll say it many times again: medicine is just as important as food. Just as you don’t need to ask permission to eat, you don’t need anybody’s permission to pay for proper medical treatment.

Are you sure you can’t afford your medical care? Do you have cable? Do you drive a late-model car? Do you cave when your children insist on labels instead of clothes? Most of us could cut expenses if we had to….and guess what, we have to.

And, because I am psychic (a lie…if I were psychic, I would be rich and this article probably wouldn’t even occur to me), I know what many of you are probably saying by now: haven’t I sacrificed enough? Hasn’t my family? Yes, of course you have…it’s obscene how much many of us have sacrificed and I doubt that any of us have unaffected families, either. But suppose the treatment you are denying yourself really worked! Perhaps you would even feel well enough to get/retain a job. In other words, denying yourself adequate medical treatment may actually be an exercise in false economy.

Please do not get me wrong. Smile warrior that I am, I am also deeply in debt. Even with insurance grudgingly picking up 90% of the tab, my medical expenses run roughly $300-$500 a month…and that’s not including treatment for my son’s asthma or my daughter’s chronic—and very debilitating—migraines. Every month, I scheme and scramble—through eBay or making and selling this and that—to come up with a hundred here and there to at least put a dent in our debt and keep my already-resentful husband from going on one of his tirades.

It has occurred to me that not only will some people remain silent in the face of need, they will sleep well at night if you are crippled because of it…and to hell with that. Even I’m not that much of a martyr.

So, though I scheme and scramble, I also remain resolute: I will get proper treatment…if I have to sell my soul to the hospital, I will not go without proper medical care again, nor will I ask permission to do so. And neither should you.

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