Wednesday, June 13, 2001

The human cost of medicine

Couple losing home they love to drug prices

By Tim Bonfield
The Cincinnati Enquirer

        Donn and Jeanne Hubbard didn't want to sell their house in Blue Ash to move to California. They felt they had no choice.

        The financial burden of paying more than $900 a month for medications since Mr. Hubbard suffered a stroke in 1994 has become too much to bear. They've decided to move to a family friend's house in Laguna Beach, where they can pay a low rent while using the money from their house to pay for medical and living expenses.

        The Blue Ash house is sold. The moving van arrives next week. And Mrs. Hubbard blames much of the disruption in the family's life on politicians in the White House and Congress who still cannot agree on Medicare coverage for prescription drugs.

[photo] Donn and Jeanne Hubbard had to sell their Blue Ash home after uncovered medication costs resulting from Mr. Hubbard's stroke and cancer became too much to afford.
(Dick Swaim photo)
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        “We loved this house. We loved this city,” Mrs. Hubbard said. “It's just wrong. We worked so hard. We raised three children and put them through school. We took care of ourselves and we paid lots of taxes. It's not right that our medical situation should be like this.”

        The Hubbards, both 61, aren't senior citizens yet. In fact, if Mr. Hubbard had not suffered a disabling stroke, they wouldn't be dealing with Medicare at all.

        Instead, they'd be living out the dreams of a successful, upper-middle-class family. They both would be working full time right now, saving for a retirement dream that included plenty of travel and a cottage in Cape Cod, their favorite part of the country.

        “All of that is going down the drain now,” Mrs. Hubbard said.

        The stroke came out of nowhere. Mr. Hubbard, an executive with a venture capital firm, was on a business trip to San Francisco scouting for startup medical companies when he collapsed in his hotel room.

        It took 12 hours for someone to find him. Doctors saved his life, but his brain was permanently damaged. At age 54, Mr. Hubbard found himself relying on a wheelchair, unable to use his left arm and leg.

    Here are the prescription medications Donn Hubbard has been taking since a stroke in 1994. This figure does not include monthly premiums for health insurance, co-payments for doctor and hospital care, co-payments for a wheelchair, a brace and other medical supplies, nor the out-of-pocket costs for non-prescription vitamins, special shampoo and other over-the-counter medications:
   Lamictal, anti-seizure, $418
   Coumadin, blood thinner, $174
   Allegra, allergy, $66
   Hyzaar, blood pressure, $61
   Desowen, skin cream, $48
   Paxil, antidepressant, $47
   Tussionex, cough med, $37
   Baclofen, antispasm, $35
   Tegretol, antiseizure, $34
   Ativan, antiseizure, $30
   Total: $950
        Mr. Hubbard concentrates on the upside, saying that people who have strokes can wind up dead or far more disabled. Still, he continues to face medical difficulties.

Another threat

        In the first years, Mr. Hubbard went back to the hospital every three or four weeks as doctors worked to find the right mix of medications to control his frequent grand mal seizures. Now, emergency visits occur less than once a year.

        “It's ironic. Medicare won't pay for the medications that are keeping him out of the hospital,” Mrs. Hubbard said.

        Then this year, Mr. Hubbard was diagnosed with prostate cancer. He recently completed a series of radiation treatments and is waiting for doctors to decide what, if any, long-term medications he should take.

        “Every time something happens, it's more doctor bills and more medications,” Mr. Hubbard said. “We just can't keep paying all these bills.

        “But what can you do? You either have to go on with life or you curl up and die. And I'm not going to do that,” Mr. Hubbard said.

        The Hubbards had been in love since they were 18 and met in college in upstate New York. They got married at age 21.

        They've lived in Boston and Colorado and Michigan while raising two daughters and a son.

        They moved to Blue Ash in 1987 from a suburb of Detroit so Mr. Hubbard could take the venture capital job.

        “This was going to be our last residence,” Mr. Hubbard said.

        After the stroke, Mr. Hubbard lost his job and the company-paid health benefits that came with it. A federal law known as COBRA allowed them to keep those benefits for 29 months — by paying out-of-pocket for the plan.

        After that, the couple switched to a plan through Mrs. Hubbard's employer — a department store chain. However, Mrs. Hubbard lost her job after a merger.

        Now, she has decided that the burden of working, caring for Mr. Hubbard and trying to maintain a house has become too much.

        However, without the benefits, 10 drugs that could be had for co-payments of $20 to $30 each (a total of less than $300 a month) suddenly cost full retail price — $950 this month.

        And that figure does not include $1,000 a month in premiums for health insurance, co-payments for covered doctor and hospital expenses, and co-payments for a wheelchair and other medical supplies.

        By moving to California, the couple can save money on house maintenance and property taxes. They can be closer to their children and other relatives for support.

        And they can drive to Mexico to buy medications that cost much more in the United States.

        “I know. It's ridiculous to plan to get our medications from Mexico,” Mrs. Hubbard said. “But that's part of it.”

        The Hubbards' situation exposes several problems with health coverage for seniors and people with disabilities, said Tricia Neuman, vice president of the Henry J. Kaiser Family Foundation.

        “The expenses they face are unusual, but their story isn't,” Ms. Neuman said. “There are 10 million people on Medicare who have no prescription drug coverage. Some of them are in good health and haven't needed it, but many have a number of health problems and high drug bills.”

        Even though the Hubbards struggle to manage medical expenses, they earn too much to qualify for what government help exists, yet can't use their money to buy better coverage.

"Earning' too much

        Thanks to a disability insurance plan that pays 60 percent of his former salary, Mr. Hubbard “earns” too much to qualify for Medicaid — one way that the lowest-income seniors can get drug coverage.

        That disability pay stops when Mr. Hubbard turns 65. But his medical needs won't stop then, which means the family situation is certain to go from bad to worse, Mrs. Hubbard said.

        Mr. Hubbard does have enough money to buy prescription drug coverage through a private Medigap health plan - but no law requires any company to sell to him.

        “So here you have a person who may have the means to purchase a policy but cannot do so at any price,” Ms. Neuman said.

        The Hubbard family experience exposes the fact that Medicare policy affects more than just people over 65, Ms. Neuman said. Nationwide, about 5 million people with disabilities under 65 are covered by Medicare — and they don't have prescription drug coverage either.

        “Many of these people have multiple, chronic health conditions. In fact, they often are more likely than younger seniors to need multiple medications,” Ms. Neuman said.

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