Health Care Reform Has Significantly Improved My Quality of Life, Part One

President Obama’s health care reform law has made my life better.

The frustrating abstraction that is government and health care reform and pharmaceutical companies is not something I feel compelled to master. But I can give you a truthful account of what happened to me.

I have been self-insured for a while, and it has been pure hell.

Before health care reform passed, I was paying $220 a month and getting nothing for it.

Now, thanks to the Obama-led health care reforms, I’m paying $186 a month and getting something.

And I didn't even vote.

After health care reform passed, I was advised to re-enroll in a new version of the same plan, because Care First had “made some changes” to it.

I have gotten several letters over the last several months “advising” me of changes in my health insurance plan. Some of them are technical and not very interesting.

Some of them have changed my life -- for the better.

In September, after paying my $220 premium, I had to pay out-of-pocket for a prescription: $430 for 30 pills.

I take medication for depression. I have since college. I got a new prescription last year for a new drug that has really helped me a lot. After a couple of months on the drug, I was suddenly charged $430 for the bottle of 30 pills.

What happened? I had hit my insurance plan’s “$1,500 prescription drug maximum,” which I had never done before. Apparently, my insurance covered up to $1,500 in prescription drug costs, which was fine when I was taking generic medication.

Now, I was on a brand name drug, and $1,500 was chump change.

My doctor thought the patent had expired; after some research, I discovered that it was supposed to expire in 2010 but the FDA extended it for 5 years in exchange for the drug company doing some research study.

Not only that, this particular medication was part of a “first generation” of new drugs – (“That’s why it’s working so well for you!). There are no generics yet.

I was paying $220 a month. For nothing.

It was a difficult decision for many reasons, and you might not agree with it, but I decided to pay the $430 until I could figure something out. I tried to get the drug free from the company but my income was too high. I looked at some online pharmacies, but their prices were no better (and somehow I got the impression the drugs were coming from India anyway). I harassed my doctor until he tried to get a better price for me – and failed. I contemplated a trip to Tijuana. I paid for August and September and kept calling my insurance company in a futile attempt to stand up for myself.

Imagine my shock when the federal government came to my rescue.

Finally, one of the times I called Care First, a woman advised me to enroll in the “new old” plan.

I was sure it wouldn’t work, but I was so desperate I actually gave it a shot.

And guess what? In my "new old" plan, THERE IS NO $1500 PRESCRIPTION DRUG MAXIMUM.

I now pay $60 a month for my brand-name prescription. And $186 for my health insurance.

Which, by the way, now includes dental.