It's So Hard To Get Good Curry In The States

I went the first forty years of my life without health insurance, figuring a) I was young and invincible, and b) if I got hurt, it would either be in a car or on someone's property, and insurance would cover it.

Carl and I have been friends, buddies, and comrades-in-arms for fifty years. Carl has a rare intellect, and a keen wit. I have delighted in our jousting at wordplay. He keeps me on my toes, and he keeps me honest (with my readers, and with myself).

For the last few weeks, first on Facebook, then by phone, he told me this story as it unfolded. I told him I felt a blog coming on, and asked if he would write up a few notes that I could refer to.

Instead, he sent me what I consider to be a finished piece. As I read it, and reread it, I realized there was nothing I could (or should) improve upon. The text was straightfoward, eloquent, and cut right to the heart of the matter.

So here it is, straight from the horse's mouth. (Although, if Carl is the front end of the horse, what does that make me?)

My experience with purchasing health insurance began over 30 years ago while I was a union carpenter living in California and raising a family. The benefits of belonging to a union were fantastic - particularly in being able to provide myself, my wife, and two young children affordable healthcare. My union membership included health, vision, and dental care for my family. I believe my cost was about a dollar an hour deducted from my pay as my share of cost, or roughly $175.00/month. This went on through the 1980s into the early/mid 90s when "an unfortunate set of circumstances" caused me to lose my job for several years.

Late in 1997, I became self-employed, and no longer enjoyed the benefits of negotiated contracts on behalf of a large group of people. My good health, and the enormous jump in healthcare cost for an individual, caused me to redefine my priorities. I was now divorced, and my children had healthcare through their mother's employer, so I went without. In July of 1999, I woke in the middle of the night with excruciating pain in my abdomen, and stumbled to a neighbor's house to ask for a ride to the hospital. My neighbor Chuck took me immediately.

After the customary forms were filled out, and no proof of insurance was produced, they treated me anyway, as I was in obvious distress. Within two hours of entering the hospital, I was in surgery - getting my appendix removed. It was ready to burst, and had they not operated, I would likely have died.

Then came the bills. Admitting doctor, ultrasound, anesthesiologists, surgeon, IV drip, meds, antibiotics, an overnight stay in a hospital bed, you name it, I was billed. I actually recovered quite quickly, and within 2 weeks was working again. I paid what I could, when I could, and did my best to whittle down $15,000.00 worth of obligation. I was not making a lot of money at that time, and toward the end of December that year I actually filed my taxes around the 30th. I had claimed a little over $12,000.00 income, as I had a very slow year trying to get a business up and running.

The next day, New Year's Eve 1999, I got a call from the hospital that had treated me. The man on the phone identified himself as a member of the hospital finance department, and asked me how much money I had earned that year. When I told him around $12K he asked if I could prove it, and I said, yes, I had a copy of my tax filing that I had just done the previous day. He told me the hospital would forgive the remainder of my bill if I could produce a copy of my tax form before close of business that day. My response was, "I'll be there in 20 minutes." I was. The bill was completely forgiven.

I went the next 16 years without healthcare, and aside from the occasional couple of stitches here and there, I was as healthy as a horse. Until about a year ago. I had paid the penalty in my tax bill for not having insurance for the first two years of Obamacare. Toward the end of 2016 I decided to enroll. I knew I had played the odds long enough, and it was time to get a complete physical which I had not had for at least 20 years.

I was referred to a doctor, by a client I had done some work for, who was an emergency room trauma doctor, and I made an appointment to be poked, prodded, spindled, and mutilated. The first thing he did was order blood work for an array of things, including Hepatitis C. When the results of the physical came back, he gave me the news. My liver enzymes were going off the charts, and I had a Hep C viral load in my blood. The virus that I knew I had been exposed to decades earlier was no longer dormant. He referred me to a gastroenterologist for further testing.

The new doc ordered additional blood tests, and while he was examining me, I told him I had done research into Hep C, and was aware there is now a cure for it. He agreed, and said there was a treatment that was over 99% effective in eradicating the virus. I also told him I was aware that the cost of the drug was $1000.00 per pill, taken once a day, for 90 days.

I had no idea if or how much of my insurance would cover that, but I had discovered that a drug manufacturing company called Gilead had a production facility in India where the drug was available for $10.00 per pill. $900.00 dollars vs. $90,000.00 here. He laughed and said, "I guess we're paying for drug development for the rest of the world." To which I replied, "Why? Because we can 'afford' it?" The doc asked me to wait until the results of the additional testing were available, and that I was a very good candidate for approval because of liver inflammation and scarring. I told him he was the doctor.

One week later, I got a call from a specialty pharmacy telling me that the doctor had asked them to submit an application for approval of the treatment, and that my insurance company had given the approval. I asked how much my share of the cost would be, and was told that all but $1700.00 was covered, but that Gilead had a copay program that covered all but $5.00/month up to 22% of the total cost of the treatment. My life was saved for the cost of 3 months copay. Pretty good deal for 15 bucks!

I'm not a religious man, but thank GOD I signed up for the ACA, and that part of that included not being rejected for a pre-existing condition, which this most certainly was. I've been carrying around this virus for at least 25 years, and if insurance laws were not changed, I would have been denied. I suppose I really would have had to try to find a way to go to India for this treatment had the Affordable Care Act not been passed.

Of course, I am overjoyed at the way this turned out, but I was hoping Carl might come home with a cute, little, Indian wife. That was a really good cook.