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Peginterferon-Ribavirin, Failed it twice. Incivek, Failed it. Sovaldi Olysio, failed it. Harvoni, failed it... Transplant Patient Zepatier and Sovaldi...we'll find out!

Monday, May 26, 2014


Sometimes I will break in my usual conversation about HepC, and this is one of those circumstances.
This is about the financial costs of my condition. Is all of this expensive? If it weren't for Health Insurance, FSA management and Health Advocates, I would be over five million dollars in debt.
I am the outlier in Healthcare, I’m not the biggest outlier, but I’m a part of a growing minority.
Here’s a breakdown of a year (why a year, not a month? Calm down, I’ll get there, once you've been to enough doc appointments. You start to understand why you’re called a Patient)
Each year I have 2 Internal Medicine/Gen Practice doc appointments to check on my overall physical and emotional health.
Each Year I have around  15 Specialist GI visits, and usually about 3 referrals to other specialists.
Each year I have a mandatory cancer check via Ultrasound, via MRI, and sometimes via CAT scan.
Each year I have about 30-40 blood Draws, 12 of which are not associated with a procedure.
Each year i have 1-2 Endoscopies, most of the time I am banded, which results in a 3rd.
These are just standard costs, the Treatments, Biopsies and Bleeds have cost me so much more. I’ve taken the liberty of ironing out my costs over the last 15 years of my healthcare experience. I took about an hour of going over past bills and my Medical History
Healthcare need
Avg. cost PER VISIT
Avg. Out of Pocket
Total Yearly
18 Specialist
2 Internal/Gen Prac
Lab work (CAT, MRI, etc): 6
12 Blood Draws(typically insurance covers a draw when it’s involved in a procedure, however not have insurance plan is built the same)
2 Endoscopies
Associated RX (10 refills)


The Treatment Prep cost total of 150,000 with an Out of Pocket of 1,500
The Treatment RX cost total of 740,000 with an Out of Pocket of 3,700
Complications and Biopsies cost total of 460,000 with an Out of Pocket of 3,500
These are not consistent costs, but rather sporadic events, so totals work better. My Total out of Pocket has been 8,700, The Treatments began 10 years ago, while the costs were in three big lumps of about 2,500, but lets add it to the yearly costs of 580 per year.
This is up until a few months ago, total amounts will be updated post treatment.
My total cost per year is 149,600, Total over the years is around $2,244,000
My yearly costs are effectively around $3,560 per year out of pocket.  I always max my health FSAs, which increases my overall effective income by about 1,000. On top of that, up until this year my Out of pocket max was about 2,000. So I was able to differ most costs, however RXs and some visits don’t automatically factor this, so sometimes I've had to do some odd reimbursements.

Presently I have Covered California’s best plan. Which is why I’m keeping the numbers for a moment, I just hit my 4,000 out of pocket max this month as I prepare for treatment later this week.
At the end of the year, I will be able to fully illustrate the benefits of health insurance and why Obamacare has given me years of extra life and saved me hundreds of thousands of dollars in debt I would never pay off, because I would have to declare bankruptcy. Next time you think we don’t need Obamacare, just walk up to me and explain to me why I deserve to die a horrid painful and debt ridden life. Yes, it’s actually that seriously effective.

But wait, wasn't that article touting the failure of a Obamacare? Nope, read past the bias to an objective standpoint, Obamacare is merely a tool; we need better ones. With all kinds of abuse and lobbying, we need better regulations to assist basic living. The Affordable Care Act (Obamacare) was originally written to deal some seriously heavy blows to Pharma, Mega-corporations and Insurance companies. But years of political misrepresentation and lobbying weakened it.
I am a lifelong Republican; from a long family line of Republicans, and I assure you this kind of legislation is only at odds with those who haven’t read it. And with that, I borrow the words of my Alma Mater: Si Se Puede.

When your life is in the hands of strangers, you have to pay attention.

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