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One time or another, we will all need health insurance

By Ernie Williamson / Special to The Bulletin

It was a Hail Mary attempt at getting me walking again.

On four consecutive days of every month, an ambulance would pick me up and transport me to my neurologist’s transfusion center. There I would be administered intravenous immunoglobulin (IVIG), a plasma product used to treat autoimmune and inflammation disorders.

IVIG is made by extracting antibodies from blood donations. Each batch of IVIG requires donations taken from 3,000 to 10,000 people.

IVIG was an “off-label” treatment for my transverse myelitis. Off-label means a drug has been approved for treatment of certain conditions, but not yours. In other words, while legal (20 percent of prescriptions are off-label), there were no guarantees I would be able to throw away my wheelchair.

Whether it worked for me is debatable. I still can’t walk, but my neurologist and my wife argue the IVIG may have prevented further damage to my spine. Conceivably, if not for the IVIG, I could have ended up quadriplegic, not paraplegic.

What’s not debatable is the expense. The cost for each infusion was $11,500. I received 4 infusions a month (that’s $46,000) for 11 months ($506,000).

When I add the IVIG treatment to the cost of a month at TIRR Memorial Hermann, numerous MRIs, CAT scans, blood tests, physical therapy sessions, doctor visits and prescriptions, I don’t want to even think about the total bill for my 7-years of treatment.

Fortunately, I didn’t have to think about it. I had excellent health insurance.

Only once in two years with my employer’s group insurance and five years with Medicare did my insurers reject a physician-ordered procedure. And that was for a relatively minor procedure. I am still in a wheelchair, but it’s not the insurers’ fault. They let us try everything.

I often wonder what would have happened without insurance. Would I have paid for the IVIG gamble myself? Would I have paid for rehabilitation at TIRR? Would I have paid for physical therapy? Would my health be worse now? Would I be broke?
I suspect every day we would be facing a Hobson’s choice: Pay for treatment and go broke in hopes of getting better or save the money and risk deteriorating health.

Let this be a cautionary tale for those of you who can afford insurance but, for whatever reason, haven’t bought it. You, like me, could be perfectly healthy one day and disabled the next. Battling chronic disease is difficult. Battling chronic disease without insurance only makes the struggle tougher, if not near impossible.

For those of you who cannot afford insurance, you have my prayers.

As well as our current health care system has worked for me, I know it needs fixing.

The statistics are humbling.

A Gallup survey showed that 13.7 percent of Americans did not have insurance last year, a 4-year high.

According to an analysis published in the Journal of the American Medical Association, the U.S. spends twice as much on health care as other high-income nations.

And, contrary to popular opinion, the researchers did not find that people in the U.S. use the medical system significantly more than those in other countries.

Instead, high prices for labor, drugs, procedures and administrative services seemed to be the major reasons.

Are we getting our money’s worth? The World Health Organization ranks the best health care systems. We rank 37th.
Clearly, something is broken.

In the coming months, presidential campaigning will shift into gear with health care, sure to be a divisive issue. You will hear about Medicare-for-all, universal health care, socialism, the public option, and pre-existing conditions.

I am not knowledgeable enough to offer advice on improving the system. However, I do know one thing: Someday you, as healthy as you may be now, will probably need health insurance.

So pay attention.

(Ernie Williamson welcomes reader input. Please contact Ernie at williamsonernie@gmail.com)