My Drug Problem, and Yours
I've spent the past seven days lying around the house in a drug-fueled haze. Sort of like Charlie Sheen, except in my case the house is occupied by only one female (my dog) and the drug in question is Levaquin, a powerful antibiotic they only give out for the really nasty stuff.
I'd been fighting a recurring fever for weeks -- I know, I know -- and last week, driving into Greenville, SC for a meeting, I just couldn't go any further. I pulled into the hospital, staggered to the ER, and they took one look at me and admitted me, instantly began running an alarming series of tests, and hooked me up to an IV.
The IV, I'm here to tell you, was like a wonder drug itself. I instantly felt better. I could easily get used to having one a day -- what I like to call the Michael Jackson Lifestyle.
So, five hours and many many terrifying tests later, I walked out with a quasi-diagnosis -- massive bacterial infection of some kind -- and a scrip for Levaquin.
As of today, I have no idea -- zero -- what the whole thing cost. (My insurance is good, for which I'm grateful.) I do know what Levaquin costs -- about $40 per pill, which for a 10 pill scrip is a lot of money. I paid $15 for the whole bottle, which is another reason I'm pleased with my insurance.
And yet.
This is a perfect example of the problem with the American health care system. I was treated -- essentially for free -- in an emergency room, but only because I left it until it was too awful. In other words, I created the emergency. For which I was penalized not a jot.
Had I left my grocery shopping, say, to 3AM, I'd have to go to the all-night grocery store. And I'd pay a little more for the privilege.
Look, there are two ways to reduce the costs of anything. One way, the Obamacare way, is to create a price-management authority and set prices from a central office. That hasn't worked, ever, in the entire sad pageant of human history. Potatoes in Poland, rents in Manhattan, health care in America -- control the price of something and you get less of it, at a higher cost.
The solution is for more of us -- especially people like me -- to pay more out of pocket, to be price-sensitive, to create a market. The market creates lower prices for everyone, even idiots like me who leave it all until it's too serious for regular office hours and the el cheapo antibiotics.
What I mean to say is, I should have to pay more, and I should have had the incentive to get this all dealt with in a less urgent fashion. Instead, without a financial incentive, I did it all the most expensive way possible, an expensive way shared and subsidized by everyone else in the Blue Cross system, for which my total cost is about $15.
This is no way to run a health care system.
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Mar '11
Re: My Drug Problem, and Yours
I just want to know if Rob picked up his Legionnaires' disease at a Playboy hot tub.
Jul '10
Re: My Drug Problem, and Yours
"Thanks, Doc. Put it on My future Grandkids' tab."
Jun '10
Re: My Drug Problem, and Yours
Do tell: What was in the IV?
Jul '10
Re: My Drug Problem, and Yours
Rob, didn't you mention connecting through Charlotte? Which terminal were you in? I need to know where to avoid on my trip home Thursday. (I'm only half-joking).
Aug '10
Re: My Drug Problem, and Yours
Rob Long:... except in my case ... one female (my dog) and the drug ... Levaquin, a powerful antibiotic they only give out for the really nasty stuff.
I'd been fighting a recurring fever for weeks -- I know x2 -- and last week, driving into Greenville, SC for a meeting, I just couldn't go any further. I pulled into the hospital, staggered to the ER, and they took one look at me and admitted me, instantly began running an alarming series of tests, and hooked me up to an IV.
This is a perfect example of the problem with the American health care system. I was treated -- essentially for free -- in an emergency room, but only because I left it until it was too awful. In other words, I created the emergency.
In order not to violate the Ricochet ROC, I will moderate myself.
BOVINE FECAL EXCREMENT - yep Rob, BFE on your squishy rinoish statement.
You were ill, you treated it normally - it wasn't normal! You are not a dude who rolls into the ER looking for Tylenol because you are too lazy to buy it yourself, like too many I can mention. The system is exactly designed for YOU.
May '10
Re: My Drug Problem, and Yours
Rob, I believe the bills for your stay in the ER will catch up with you. Not enough time has passed for you to see the actual billing. Please keep us posted. :-)
May '10
Re: My Drug Problem, and Yours
Our brave leader, caught on a hospital security camera as the doctor informed him he might have Legionnaires' disease...
Feb '11
Re: My Drug Problem, and Yours
BUT ... you will want to wait until you get the collection notice from the hospital. By the third bill you can almost safely assume that the remainder is indeed your responsibility, and not slow paying insurance.
Jul '10
Re: My Drug Problem, and Yours
Well played, sir. Well played, indeed.
Oct '10
Re: My Drug Problem, and Yours
Legionnaires' disease seems to have been liked to the fetid water in cruise ship tanks. Save that fell away in the interests of the involved. Try to be more carefull in future. Never know, try the water in Mexico....Not !
Re: My Drug Problem, and Yours
I'll go you one better, Rob. Several years ago I was hired over a summer for contract work in Indonesia, to last about two months. There were warnings at the time for several rather nasty infections one could get there. Went to the doctor to get checked before I left and he writes me a prescription for the very same Levaquin. "Take it with you as a precaution," he said. "You can't get this stuff over there, particularly if you aren't in the capitol." Like you, I paid my $10 co-pay with no damn idea what the pill costs.
However, it's worth noting that the cost to you if you pay out of pocket in the US is not likely their real cost. I just checked a couple mail-order Canadian pharmacies, and they'll sell you pills at $1.15 to $2.50 depending on dosage. I don't know what the insurance company gets charged by the pharmacist here, but I'm going to bet it's not $40 a pill.
Nov '10
Re: My Drug Problem, and Yours
Not to worry; you probably did pay more if you were told at the ER that Levaquin costs $40 per pill. In the real world, it costs $2.35 per pill. (I live in FL- home of bacterial challenges - so I know these things are true)....
Feb '11
Re: My Drug Problem, and Yours
I'm sympathetic to the idea that a more market oriented health care system would reduce costs and improve efficiencies, but I'm not sure Rob's analysis of his experience logically follows.
If a given health care consumer were more sensitive to costs than Rob was, wouldn't he be less likely to go to his GP for a fever in the early stages? Most likely he would say to himself, eh, it's a virus of some sort and it will pass, so I think I'll save myself the copay or deductible just to have my doctor tell me to go home and rest. Add to that the fact that Rob is a man (albeit a RINO squish, but still a man) and men just don't go to the doctor as frequently as women, especially when they don't have a (human) female in their house to nag them to go.
May '10
Re: My Drug Problem, and Yours
Exactly. Then the health care providers would lower what they charge since fewer people would come in. That's the demand in supply and demand.
Jul '10
Re: My Drug Problem, and Yours
A friend was suggesting once that I seek a job with Microsoft, pointing out the zero co-pay, zero deductible, 100% health coverage they enjoyed. Having examined the levers on price, cost, and value in the health care market more than once, the concept appalled me. Even though Microsoft can afford it, just opening a fire hose of indulgence (on the patient side) and over-billing temptations (on the provider side) were frightening. I personally lean toward catastrophic care coverage, and handle the rest out of pocket, but it has been decades since that option was legal in my area.
The insurance pays a likely lower, negotiated price as a bulk buyer. Your $40 a pill is less a market price than the free-range American price trying to make back the "negotiated" price in single payer countries, where the state exercises an effective monopsony. Every bit as ugly as a monopoly, single payer countries apply Obama-like logic to drug pricing and, in doing so, reduce incentives to bring new drugs to market. New drugs not developed are an invisible cost. The buying power of the state drives rewards out of the market, along with talent and competency.
May '10
Re: My Drug Problem, and Yours
Saline or Lactated Ringers. Staying hydrated when battling a fever is crucial.
Re: My Drug Problem, and Yours
Hey, Rob, I'm in Blue Cross, and by my math, you owe me 63¢. I'll take a personal check.
May '10
Re: My Drug Problem, and Yours
Get better soon, dear Rob. America needs you.
May '10
Re: My Drug Problem, and Yours
Preventative medicine only seems cheaper if you look at it on a per-person basis. Imagine a population of 100 people. If five get sick it costs $100 each to cure them but it would have cost only $5 each to prevent them from getting sick. BUT, preventive medicine has to be applied to the whole population of 100 people. So it would cost $500. Same as $100x5 people. If the preventive medicine costs $6, then it is cheaper to let the five guys get sick.
Edited on April 19, 2011 at 4:38amMay '10
Re: My Drug Problem, and Yours
I agree with your premise, Rob, but I also agree with oleneo65. I can't imagine you got all that care, out-of-network, and it will only cost you $15. That's unheard of...unless you're in a union. So, if your cost is really that small then your healthcare benefits are through your union?? Many union healthcare contracts are horrible for the very reason you described. Any cost sharing on the part of the beneficiary is zeroed out and at an enormous cost to the corporations paying the premiums. I know because I used to calculate all the HMO premiums for 35 of St. Louis' largest corporations, which included all the Autos. Two of us ran the company, so I did more than just calculate rates, but it was quite insightful. The structure of the union benefits was completely irresponsible.