It's not just a tight economy that makes considering the cost of long term medical care daunting. Some of us can live years, decades, or longer while being treated for cancer or after having a cancer removed. So when I found out what the anti-tumor drug, Arimidex, that I'm scheduled to take for five years would cost without insurance coverage, I was kind of speechless.
My husband turns 62 in a few weeks. Although I think he can't work forever, he claims he will need to, and beyond good insurance coverage that comes with the job, it's pretty clear to me that I'd soon go off many of my prescriptions, especially one that costs $250.
Granted, there are groups like the Partnership for Prescription Assistance, set up to match people with public or private programs to get medications to those who need them.
But how many of us aren't looking for a handout?
We don't want our friends to raise funds for us. We're not asking to get our medications for nothing. We don't want other taxpayers paying for our medications either, in some feel-good utopian ideal society where we're all equal because the state imposes that on us.
We especially don't want to be stuck living a subterranean, windowless existence our kids' basements because even pooling our money we can't afford to build extra rooms onto their houses AND pay for medical care and we don't want to take money that should be used for their family vacations at Disney World and piano lessons for the grandchildren.
But we're still shocked when we discover what our medications really cost beyond our copay of someplace between fifteen and thirty-five dollars.
The truth can be daunting
The future looks much less sure than it used to. Ten years ago I had planted firmly in my brain the image of being the healthy old lady my grandmothers were. And I wonder how many of us would make different choices about medical care for breast cancer - or anything else - if we factored in possible future financial fallout of whatever we will need as a result of decisions we make now.
Given my age, it could be that I am just delaying more tumor growth for 5 years, thus insuring that a recurrence will happen when I'm covered by Medicare and thus have many fewer options.
The AZ&me program looks like it may make it possible for to get a 90 day supply of Arimidex for $50 for a retired couple on a very low fixed income but by then what other medications will I need?
It seems obvious, but unspoken, that there is a cost, both emotionally and financially to keeping people with chronic or terminal illnesses alive.
And beyond that, it's not just a question of living - but how we live.
Do we as a society insist that if our people are kept alive through modern medicine, that hand in hand with that goes having their pain controlled? Do we as a society also take the responsibility of insuring that the living are not just warehoused but feel productive? Is that really our responsibility?
All of it may be something we as a country need to think about. Choices are hard. Hell, the whole topic is hard.
It's easy to philosophize about when the topic is an abstract one. It's easy to write a prescription plan to send to Congress. But as for living the everyday of it? Pfft. Not pretty.
Is going back to hiding under the covers and believing that tomorrow some magic will happen an option, because if it is I'll take it.
And if I win the lottery I'll make sure I sock it away for that really bad day down the road. It's just that lately, I'm not sure what a real emergency looks like.