Where does all the money go in healthcare? Have you ever wondered?
I stumbled across an article from last year about a federal drug program that is being discussed heavily in the medical community. The program, 340B, requires pharmaceutical companies to provide cheaply discounted drugs to certain hospitals so that the medication can be provided to low-income patients.
See: Primer: Understanding the 340B Drug Pricing Program
See: The Coming Storm Over The 340B Rx Drug Discount Program
See: 340B Drug Pricing Program: Serving Vulnerable Patients or Enriching Hospitals?
Have you heard of the 340B Program?
I won't pretend that I fully understand all of the nuances of the program because I don't. But the articles that I found online all pointed to one huge issue that caught my eye. The regulation was created to offset an unintended consequence of another law. It was supposed to level the playing field, so to speak, so that low-income, or non-insured patients did not end up paying a lot of money for necessary medication. However, some of the language in the provision was so vague that it was being exploited by some participating hospitals.
But... there are always some scammers in the bunch.
Here's what has been happening. The hospitals would receive these low/reduced priced drugs and were administering them to patients with full health insurance and charging the market rate for them. They then pocketed the difference in costs.
Now... I can be little dense sometimes, and while I understand basic business concepts (buy low, sell high)... something about this STINKS. The hospitals claimed that the vague language in the regulation allowed them to do this switch up because the money they "earned" could then be applied to other necessary functions within the hospital that did serve these under-served and low-income patients.
*deep sigh*
I'm a patient. I can't speak in any way about how to run a hospital or an oncology clinic. All I see when I look at this is another example of another entity in this entire healthcare cycle that is making sure that they get paid. Whether fair or unfair to others.
Most people tend to think of the pharmaceutical companies as greedy corporations who don't care. That may be true but when you're the one receiving the medication that gives you more days... it doesn't feel that way. However, because they make a ton of money, I can understand the impetus to want to take advantage of any opportunity to make money using them. But is that what the discount is for?? That's my concern. What is the regulation truly supposed to do and is that happening? It feels slick and smarmy. I don't like that and I feel that everybody in this pink ribbon machine has found a way to cash a check based on the misery of the patients...
What about the patients and survivors? Who is going to answer that question?
Oh, let me be clear... in one article it was mentioned that because some drugs that are offered at a discount have to be administered at a hospital/medical facility, certain patients were more likely to have been charged full price for discounted drugs, e.g. cancer patients, HIV patients, etc. That's why I'm particularly hot about this -- though I'm just as hot about the switcheroo for other patients. This goes DIRECTLY to the anger that I have about this machine that surrounds the cancer community in general and breast cancer specifically.
Everybody at the cancer table is finding a way to make a dollar off of our misery. That takes life being unfair to a new level I think.
Breast cancer is expensive! And the ones at the bottom of the food chain are the patients. That sucks.
Breast cancer is expensive. And I've said it before that I was blessed to have great health insurance when I was diagnosed. I felt particularly favored that I was diagnosed when I was because I was without health insurance for a number of years before I was diagnosed. I just happened to start a new job that offered great benefits and I was diagnosed with breast cancer only a few months after I started that new position. Had I felt that lump a year before... only God knows how things may have worked out for me. Diving timing worked in my favor.
Still searching for an answer. There must be one.
I don't know how to feel at this moment, other than angry and motivated. Angry because once again I am really realizing just how much patients seem to be pawns in this equation. Motivated because I truly believe that there has to be a way that patients, survivors, and caregivers can find a way to offset the enormous unfairness of the diagnosis, the treatment and the subsequent burdens (financial, physical and emotional) that come with a cancer diagnosis. There has to be an answer out there.
Some communities, like the black community, for example, are hit very hard when a diagnosis of breast cancer hits a family. Too many of us are already hanging on by a thin thread... it's no wonder that we're damn near our breaking point. And people wonder why some women don't continue treatment after they've been diagnosed. Even choosing to save their lives could be putting their family at risk. The amount of time required to treat breast cancer can cost you your job. The risk is great.
(Do not suggest to me that it's not possible because I know that people lose their jobs because of cancer on a regular basis. That may not be the reason they're told they won't have their job anymore... but it often is the reason. Too many missed days from work. Too many late days. And so on...)
I have a new outlook on life. I do. I am happy to be alive and I feel ALIVE and really blessed. But sheesh... do I have to be broke forever and have everybody else in this cycle make a dollar in some way off of my misfortune (and the misfortune of others who have been diagnosed with this disease)?
Today... I am annoyed.
That's all for now. Love and kisses,
Nic
