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Here’s a ‘Fun’ Anecdote About Our Healthcare System

What not to say to someone with a heart condition.

"Healthcare" by Jason Rosenberg is licensed under CC BY 2.0

I’ve got a wonky ticker. You can read all about it if you’d like. You don’t have to, though — no skin off my back. I’m not gonna stress over it, because, as it happens, when you’ve got a heart condition, “not stressing” is pretty important.

Equally important, it turns out, is Eliquis — a little pink rhombus of a pill I take twice a day to ensure my blood keeps pumping at a reasonable rate.

Given the relative significance of “not stressing” and “little pink pill” in my life, you’d think the pharmacist who called me the other night could have been a little more…understanding? circumspect? considerate? when she interrupted the Real Housewives of Salt Lake City Reunion Pt. 3 to notify me that my next 90-day supply of Eliquis would no longer be the zero dollars I had paid last time I picked up my prescription. Instead, she explained, it would cost me fifteen hundred dollars — of which my insurance would helpfully cover….$300.

“Hm,” I managed to mumble (at least, I think so — as is often the case when I’m given bad news that simply does not comport with my understanding of the universe, my brian sort of went on autopilot here). “That sounds bad.”

“….Yeah…” the pharmacist agreed, clearly realizing she was dealing with a special kind of quick and sophisticated wit. “Maybe you should call your insurer, while I call your doctor and see if we can get you on a generic version.”

“Hm,” I mumbled again. “Maybe I ….should?”

As you might have guessed, a good 70-80 percent of this call was long, uncomfortable silences, as I tried to wrap my head around what was happening, and she tried to awkwardly disengage from my inability to do so. By the time we both hung up, we each had our marching orders: I would call my insurance company to ask “what the fuck???” and she was going to call my doctor to see if there might be a cheaper generic alternative I could take instead. And I really was going to call my insurance company — truly, I was — but I was working out the right combination of motivation and existential outrage to cut through their layers of bureaucratic bullshit, first. And then, just as I was about to hit that perfect equilibrium of “furious” and “resigned to stay on hold for hours at a time” I got a call from my cardiologist’s office that went roughly as follows:

“Okay, so, we looked up your coverage, and it seems like all you need to do is search Google for Eliquis — got that? [I did.] Then click on “customer assistance, okay? [OK] and call the number there. Then just answer a few questions on the phone, and you’ll receive a copay card which will bring your monthly costs down to about [keyboard clicking in the background]…. yeah, to about $10 a month. Is that okay with you? [it is!]”

From $1,500 for a 90 day supply down to thirty bucks. THIRTY BUCKS!

Look, I know I’m far from the first, or most eloquent, or most convincing person to make this point, but holy shitballs is our healthcare system just insanely fucked up. And I’m a lucky one! How many people out there don’t have the time, or the resources, or the access to a pharmacist or physician who would actually do the legwork to figure out how they can cut the cost of their extremely important heart medication by a factor of 100? I mean, Jesus Christ what kind of a backward-ass, punitively evil system is that?

Anyway, I’m fine. Just annoyed. And a little stressed out, which is alright I suppose. At least now I know I can afford it.