When you get sick in this country, you better be sitting on a pile of money

In response to my recent health scare which resulted in spending ten days in the hospital, nine of those days in intensive care, I vowed to myself that I would do whatever I needed to do to never let that incident ever happen again.

My diabetes was a contributing factor to the problems I had. Since getting out of the hospital, I’ve gotten my diabetes totally under control. I avoid carbs whenever I can. My days of eating chips, pizza, and pasta are over. I test my glucose levels up to ten times a day to ensure that it’s as close to 100 as I can get it. Before going to the hospital, I was on a bunch of medication for my diabetes. Now I’m only on two; Humalog, a fast-acting insulin and  Xultophy, a once-a-day injectible pen.

As soon as my anemia is under control, I plan on adding daily exercise to my routine.

The other thing that put me in the hospital, the thing that contributed the most to me almost dying, was the blockage in my gut that caused the infection. They determined in the hospital that it was due to intestinal inflammation. Why my intestines were inflamed is still not known, at least by me.

Because I’m self-employed, I’m covered by my wife’s employer-provided insurance. The way it works is that at the beginning of the year, everything is out of pocket. We pay for everything. Once a certain monetary threshold is met, insurance pays for eighty percent and we pay for the remaining twenty percent. Once another monetary threshold is met, the insurance pays for everything.

Because I was lucky enough to get sick at the end of the year, insurance paid for everything. Our thresholds had already been met for the year, thanks mostly to all of the drugs I was taking for diabetes. Some of them were quite expensive.

My hospital bill totaled over $35,000. Insurance paid for all of it.

This past Wednesday I had a CT scan of my abdomen. As far as procedures go, it was pretty awful.  I had to arrive early at the imaging facility that was doing the scan and sit in a special waiting room where I had to drink three bottles of this nasty tasting lemon-lime concoction.  It tasted like flat, store brand 7-Up that had been thickened.

Once I got those three bottles of yuck down, I went in for the CT scan. I was hooked up to an IV and given a drug and made me feel hot all over. I was told it would make me feel like I wet myself. I didn’t feel that, but it did feel weird.

The next day, I got a call from the Target pharmacy. I was told they received a prescription, but it was very expensive. My out of pocket was going to be $2,400 for a three-month supply. The prescription was requested by my gastroenterologist. Evidently, he saw something on the CT scan that required this very expensive drug. I don’t know because he never contacted me.

My wife called the gastroenterology office the next day and spoke to the doctor’s assistant. She explained $2,400 was a lot of money for a three month supply of a medication and asked if there was something cheaper or a generic version I could take. The assistant relayed the question to the gastroenterologist and later that day I got a text from the Target pharmacy. I had a new prescription ready for pickup. My wife called the Target pharmacy. The new drug was going to cost $700 for a three month supply.

My wife called the gastroenterology office again. A few hours later, I got another text from the Target pharmacy. Two new prescriptions were ready for pickup. One cost less than two dollars, the other was 27 dollars.

Why weren’t these two much cheaper medications prescribed in the first place? What do they not do that the more expensive drugs do?

I don’t even understand why I’m being prescribed medications. I go in for a colonoscopy on Wednesday. Shouldn’t the gastroenterologist wait for all of the tests, both the CT scan and the colonoscopy, before prescribing medication? If he’s able to prescribe medication with only the results of the CT scan, why do I still need a colonoscopy? Is the gastroenterologist ordering the colonoscopy because I need it or because that’s what gastroenterologists do, perform colonoscopies?

It seems to me that if he was ready to prescribe a medication that costs $2,700 for a 90 day supply, he is done with the troubleshooting phase.

So far I’m not very pleased with the gastroenterologist. Communication seems to be severely lacking. The reason I’m seeing him and not another gastroenterologist is that he saw me in the hospital, although I don’t remember it.

I was out of it quite a bit while in the hospital, especially at first when the infection was at its worst.

And because we’re at the stage in our insurance where everything is out of pocket, I have to pay $1,018 when I arrive for the colonoscopy. I don’t know how much the CT scan cost because they didn’t make me pay up front. They will bill me. As much as things are costing out of pocket, we should be hitting the first insurance threshold sooner rather than later.

Remember, we have the best healthcare in the world as long as you’re sitting on a pile of gold like the dragon from The Hobbit, a lot of money in savings, or a credit card with a large amount of available credit. If you don’t have any of that and you experience a catastrophic health problem, you’re screwed.