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Monday, September 22, 2008

Breaking the Law

It’s really hard to not break the law these days for even the most determined law abiding citizen. I don’t speed, run red lights, rob banks, steal copper tubing, or even use aliases and kidnap children. All I am really trying to do is get some medication to treat my migraine. And the state and insurance companies are seemingly determined to make me break the law to do it.

Before I had health insurance, I simply paid my $225 for nine tiny Maxalts. I bought them maybe three times a year. I treated each pill like gold, fighting off migraines with over the counter pain relief, and only taking a Maxalt when I knew if I didn’t, I would not be able to work the next day. For me, a single mother of three, making ends meet means working every day.

Then, the law came into effect requiring health insurance, so I signed up with Blue Cross, paying $620 a month to cover myself and my three sons. When I needed the Maxalt I was informed it was not covered. Consulting with my doctor, we found a substitute, Zomig, which was covered. My co-pay? $170. Blue Cross generously kicked in a whopping $55! I take no other medications and have no medical conditions requiring any doctors’ visits and go only once a year for a checkup. Same thing for my kids. So, I’m basically paying about $7000 a year to get a discount of $55!

Blue Cross says Zomig is a “Tier 2” drug, which is why the co-pay is so high. Does Tier 2 mean less important? My migraines cause me horrific pain, light and sound sensitivity, nausea, inability to sleep, work, drive or take care of my kids for three days at a time. I found out Cialis is another Tier 2 drug. I am left wondering who determines tier levels and how.
Before I knew about Maxalt and Zomig, I had little recourse for my migraines. The only thing that ever worked was marijuana. But I rarely used it, terrified of taking an illegal drug. I can’t pay $620 a month for useless insurance and $170 for every prescription. I feel compelled to choose between two illegal actions: dropping my insurance, or smoking pot. And yes, pot is much cheaper. One hit, I’m a new woman!

I have one other illegal choice. I have a friend who has been on unemployment most of the year. She gets free health insurance and all medication for a $3 co-pay. She developed migraines recently and will be getting a prescription for Maxalt. I’m wondering if she will be using all those Maxalts or if she perhaps may have a spare or two for a friend?

Although I have never been on any government assistance, I believe in our system of taking care of those less fortunate. I believe in universal healthcare. I believe in the rule of law. What I don’t believe in is paying for insurance and not being reasonably insured. I don’t believe that the government does enough to take care of people who work hard every single day to do the right thing, who pay their bills and taxes and ask nothing of the system except to be treated fairly and reasonably. I believe that if we have created a system that forces people to break the law, the system itself is the thing that needs to be fixed. Until it is, I guess I will try to work harder and work when I don’t feel well. I will try to not break my back doing so, because I’m sure Blue Cross’s co-payment on broken backs is more than I can afford.