Today, I was seeing a patient with a preceptor and we were going through a list of 10 meds that the patient was on and all of a sudden he says, ‘you know that diabetes med you started me on? Well, one pill cost me 40 dollars a pill!’, he was referring to a new med that he started last month that has already started improving his blood sugar drastically. The doc I was working with was obviously shocked and said, ‘what? why didn’t you tell me?’
We found out that drug should have been covered by insurance –he’s on Medicare– but the patient didn’t know this and as a result was paying over a thousand dollars out of pocket per month to control his diabetes. Given his job description, it was also clear that that this patient wasn’t making more than 70K annually (i.e., the national average salary).
Later in the interview, we found out that he was also paying out-of-pocket for meds to treat his hypothyroidism. The doc told me after the visit that if he can’t get an alternative med for the patient that is covered by insurance, he will have to write letters to the insurance companies on behalf of the patient, which often works but is a tedious process that draws out for months sometimes.
The moment brought back memories from when I was in high school and college shadowing a pediatric oncologist in the summers where I witnessed the problem like everyday –the docs calling and writing to insurance companies to argue that a patient needs a drug and the insurance company putting them off for as long as possible.
There must be a better way to not only inform patients that they have options when it comes to disputing healthcare costs, but also to facilitate better communication between insurance companies and doctors to streamline the outlined process so that patients are dying from lack of treatment as they await the insurance company’s decision.
Done with my rant for now. I am going to continue to edit this post with other problems I see while on my rotations so that one day someone reading this blog –or my future self– can start solving these important issues.
