Retired Iowan: My Health Care Costs More Than My Mortgage

The average annual cost of family health coverage has now eclipsed $20,000, according to new data from the Kaiser Family Foundation. That’s like buying a brand new compact car year-in and year-out — and that’s just for employer-based plans.

On average, about $6,000 comes out of workers’ pockets. But that number only includes up-front premiums, and does not take into account co-payments, deductibles, visit charges, prescription costs and other cost-sharing factors.

As health care and drug costs continue to rise, and the Donald Trump-led Republican Party continues to attack the Affordable Care Act, many Iowans have found themselves paying more for less coverage.

“I pay almost $700 a month in premiums,” said Vicki Pilcher, a retiree from Independence in an interview with Starting Line. “I have to pay to Medicare, I have to pay my supplemental plan and I have to pay for my prescriptions. And then I have doctors’ appointments. I have to go every three or four months to get my eyes checked, and then the meds.

“My biggest life expense, even beyond my mortgage, is health care,” she said.

Health Care Deniers

A couple years ago, Pilcher went to an eye doctor to consider treatment for cataracts surgery, but that quickly changed when she was diagnosed with retinal bleeding. Based on that diagnosis, Pilcher was told she needed to take Humira, an immunosuppressive drug with anti-inflammatory properties.

But her doctor’s recommendation was met with an immediate roadblock when her insurance company denied the request. Thankfully, her doctor helped her secure assistance and she was granted access to the drug for one year.

After successfully taking Humira for a year, Pilcher’s limited access ran out and she was forced to again ask her insurance provider for assistance covering the costs of a drug working to save her eyesight.

“The following year when I turned 65 and was added to Medicare, the drug company again denied me Humira and I was forced to pay hundreds of dollars to receive the medication I needed,” Pilcher said. “It was a struggle, one that many Iowans understand firsthand. Over the following months, my cost for Humira skyrocketed to over $900 for a three-month supply.”

Despite coverage through Medicare and a supplemental insurance plan, Pilcher’s health care costs continue to compound despite the efforts of her and her health care providers.

“Medicare puts me in the gap, so it’s like $700 to $800 a month – that’s just too much. And the thing is, I have no say. I picked the best supplemental insurance money can buy and I’m still stuck – and people are stuck all the time,” Pilcher explained. “It’s just immoral; it’s all about profit, it’s not about helping people or people getting the care they need.”

Humira’s Cost Trend

In recent years, drug prices have continued to rise past the rate of wages and inflation. Humira isn’t new; it was approved by the Federal Drug Administration in 2002.

Yet the cost of a year-long supply of Humira doubled over the last six years, going from $19,000 to $38,000, leading a Democratic Senator from Oregon, Ron Wyden, to compare AbbVie‘s market control over the drug to “Gollum with his ring.”

Not only that, but Trump’s 2017 tax bill lowered AbbVie’s tax rate from 20% to 1%, increasing its net income by 43% and allowing it to buy back $15 billion worth of stock.

“It’s made me angry for me, and other people, that Joni Ernst and Chuck Grassley and all the Republicans vote to take even more health care away from people. It’s all to pay the piper, to pay the people that give them all the big money for their campaigns. I’m sick of it,” Pilcher said. “I’m tired of big money and dark money running this country. It’s not about the people anymore at all.”

One of the more popular arguments against price negotiation is that lowering pharmaceutical profit margins would put a damper on research and development, and the emergence of new, life-saving drugs. However, in the last 10 years, other pharmaceutical companies have chosen a similar path to AbbVie, spending more on dividends and share-buybacks than they have on research and development.

“These costs are already outrageous, and are ample cause for fighting like hell with elected officials like Senator Ernst for taking huge campaign contributions from big pharma and allowing companies like AbbVie to double the price of the drug for people like me,” Pilcher said.

 Taking Affordable Care Out Of The ACA

Passing the Affordable Care Act was a significant step toward making health care more accessible to more people. When the Obama-era policy was implemented, it made tremendous strides. But after a few years of the Trump Administration, much of it has been undone, leaving folks wondering why they’re even paying for insurance.

“Before the ACA came along, we were getting insurance through our work and the premiums were going up huge every year until the ACA came along and then they leveled off,” Pilcher explained. “But the last couple years, they have started shooting up more again with less coverage, higher copays, higher co-insurance, and paying more premiums since Trump got in and started playing with it to undermine it.”

As a retiree, Pilcher is reliant on accessible, affordable care. She’s done working, and is burning through money she received from her husband’s life-insurance policy to keep her eyesight. Even as she struggles, she’s using her voice to help put an end to the mistreatment and to see an entire, aging generation be taken care of as their health care needs increase.

“My story is no different than thousands of others,” Pilcher said. “Not only is it wrong that we have to jump through so many hoops to get access to medication, but it’s devastating that we can be denied medications —especially ones the FDA has approved for use — because of insurance and pharmaceutical company’s greed.

“It’s absolutely disrespectful, it’s like they want to kill us off. It really is,” she said. “They don’t care one bit about human people, it’s just all about the money. This country has just gone to hell as far as I’m concerned; it’s just disgusting.”

By Josh Cook
Photo by Laurynas Mereckas via Unsplash
Posted 9/29/19