Sunday, December 6, 2009

What if this were you...

I have a patient who is a single mother of two teenagers. She was infected by her ex-husband probably many years ago but she was diagnosed about a year ago. At the time of her diagnosis she had AIDS based on her CD4 count. Remember I said that one gets an AIDS diagnosis when their CD4 cells are below 200 because at that number they are at risk for developing opportunistic infections. At the time of her first appointment we had to start her on medications for AIDS and also for prevention of opportunistic infections. We choose Prezista, Norvir, Truvada, Bactrim and Azithromycin. The monthly amount for these medications is about $1700.oo. My patient has a PPO as insurance. She is self employed and works as part owner of a resturant. She did quaify for the ADAP (AIDS Drug Assistance Program) inititally, which paid for her medication but now her income has increased just above the line and she no longer qualifies. Now get this, she pays her monthly PPO premiums and it turns out that she only has an annual pharmacy coverage amount of $1000. That is yearly $1000. So as you can see she will not even get one months worth of medications covered.
So I called her insurance company (HealthNet PPO) to ask what I could do to keep this woman alive and they told me there was nothing that they could do.. there was nothing. Now remember she has a preexisting condition which prevents her from going and getting another policy. She makes too much to qualify for medical and she is not disabled so she does not qualify for Medicare.
Remembeer also that she is raising two kids. One is a stuent at San Francisco State University and the other is in high school. She pays their tuition and their auto insurance and her house payment and her daily living expences as well as health insirance, and there is nothing left over. How is she going to get the $17000/month that she needs for the medications that she needs to stay alive?
This has been burning at me since Friday when we found this out. I am so angry. Here is a woman that does the right thing. She works, pays taxes, educates her kids. And now what????
My plan is to try to get the pharmaceutical companies to sponsor her for her HIV medcications. Will they? I am not so sure.
I am sure that there are many people like my patient. Many people that make too much for assistance but can't afford their healthcare. Is this why we need public option? Is this why we must get rid of the pre-existing exclusions?
This woman should not be punished and her kids should not loose their mother.

What do you think of this???
This should piss you off.
This should make you scream.. How do we tell this woman that there is nothing we can do???

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