Can Obama Health Care Help Me? the High Cost of Being Sick when You Already Have an HMO

Perhaps the end of the world hysteria over the recently passed Government Health Care Bill, is coming from those who are wealthy and healthy. Maybe they aren't suffering from a chronic debilitating disease, which is ruining them financially.

Today, I don't care about the country turning communist. I don't care about the deficit or the people who make over $250,000 a year having to pay more taxes. I am annoyed by those Tea Party folks. They are an embarrassment to us real Bostonians.

It's all about me now and others like me. I am sick with a chronic disease. There's a good chance I could get better, but I can't afford the cost. The HMO health plan that my school teacher husband has, barely covers what I need.

It can happen to you and it just might. Pray that it doesn't. My life changed in an instant. A bad fall took me almost a year to recover, and left me unable to work. Even having 3 kids, I always worked and contributed to the family. We sent our kids to private schools and colleges. We had a nice house and we traveled. We did everything right. We were happy and healthy. Life was fine. We were saving for retirement until one day I fell.

The fall was bad enough and I seemed to be recovering, until one day I woke up nauseous with a swollen knee, fever, rash and aches all over my body. I ended up in the hospital for five days. This was the beginning of my life with Rheumatoid Arthritis.

Rheumatoid Arthritis is not a sore elbow or knee caused by overuse. Rubbing on some over the counter cream, or drinking special Kool Aid, does not make it go away. Most arthritis is Osteo Arthritis. You probably are not going to end up in a wheel chair or dead, if you have Osteo Arthritis. In some cases replacement joint surgery is all you will need.

With Rheumatoid Arthritis (RA) the prognosis is quite different. RA is a chronic auto immune disease that attacks and inflames the joints and bones of the body. The joints swell and cause pain, swelling and pressure on the surrounding nerves. You hurt most of the time. Pain pills are your friend. You will probably end up disabled.

The inflammation RA causes, can also invade the lungs, heart and blood vessels which could result in death. The eyes, skin and gums also are affected. Stopping the inflammation and keeping the joints mobile are the goals of treating RA. .

In my case even with an HMO.... medications, co payments and doctor visits cost almost $1000 a month. Two of the 3 medicines for my eyes cost $200. I also can't work or drive so I am not contributing any money. My medical costs even with an HMO are wiping us out.

I want and need physical therapy. I know it works. The HMO pays only $1500 per calendar year, that's about 5 visits. I also have a $50 co- payment. I maxed out my credit cards paying for therapy myself, and no longer can afford it. ObamaCare is said to provide preventative care which our HMO does not offer.

For treatment of RA there are many super drugs heavily marketed to doctors by the pharmaceutical companies. Who knows if the drug will work on you? All these drugs have serious side effects ranging from fatal allergic reactions, heart failure, respiratory failure, infection, and even cancer.

These drugs are very expensive. But some work very well in stopping RA's symptoms. They can cause the disease to go into remission for a long time. You can have your life back. You have to take the chance.

My doctor urged me to try Embrel, which is a drug given weekly by shots you administer yourself. Embrel has worked wonders for many, so I decided to give it a try. We soon found out because of our income (a Florida teacher's salary) we had to pay the first $2500 and then our HMO would take over. Long story short, Embrel didn't work and we were out the money.

I have been on prednisone and methotrexate for almost two years, an inexpensive drug treatment for RA. Prednisone is a steroid known for its terrible side effects, but it reduces inflammation, and it is cheap. In my case it causes bleary vision and high blood sugar. I manage fairly well, but the eye thing scares me. I want to stop taking it, but I need something else.

My doctor has been pressuring me to try Rituxan, a drug which is given intravenously every few months by hour long infusions. During the infusions, a life threatening allergic reaction can occur, so the patient is also given prednisone by IV.

Knowing my reluctance to spend another $2500 on a scary drug that may not even work (Rituxan does have an 80 percent success rate however) he suggested I participate in a clinical study.

I would get the Rituxan infusions for free, but not with the prednisone IVs which could save my life if I had a potentially fatal allergic reaction. Instead, I could take the prednisone in pill form. I asked him if something went wrong and the prednisone pills didn't work quickly enough, could I call 911.

I will not be on Medicare for a few more years, and I am too rich for Medicaid. But guess what...Medicare and Medicaid are both government health programs and they both have been paying for Rituxan infusions,

My son has diabetes. The company he has been with for 12 years is experiencing layoffs. Without Obama Health Care, he could be refused future health insurance because of his pre existing condition. He is a young man.

About those death squads that will keep seniors from getting health care? Not to worry, they're already here. And by the way, don't get sick.

Source:

Personal Experience.

Rituxan. The RA Support Forum