Unfortunately, I am in the middle of a health emergency. My wife has been diagnosed with multiple myeloma, a blood disorder of the plasma cells that has affected her kidneys. It has been a brutal and frightening experience for my wife, an emotionally draining experience for me.
The prognosis is cautiously optimistic. If all goes well, my wife and I and our Siamese cat Mimosa will all grow old together.
This experience has exposed me to the advancements of modern medicine and has shown me the best that our health system has to offer. It also makes me question a number of things about our health system that take away from the good work that so many people do, and end up making our health system too expensive for too many.
My wife and I are in our sixties and on Medicare. Like many, we enrolled in a private Medicare Advantage plan that so far is working out for us. It is not clear to me how a private insurance company can offer more benefits at the same price as government Medicare, but so far, we have not experienced any issues.
My wife’s journey began with her primary care physician reviewing the results of her standard bloodwork and finding something alarming relating to her kidneys. We were referred to a nephrologist who monitored her condition, advising on diet and exercise and weight. He worked out of Holy Name Hospital which was less than ten minutes away from our house.
Unfortunately, and inexplicably, my wife’s kidney function continued to worsen over the next few years. The nephrologist added tests to my wife’s blood work, and he found something alarming. He referred us to an oncologist who reviewed my wife’s condition, conducted a bone marrow biopsy, and proscribed a whole-body CAT scan. She is the one who diagnosed the multiple myeloma, which is a form of blood cancer.
The oncologist referred my wife to a hematologist, who reviewed my wife’s condition and chose a cancer-fighting chemotherapy drug regimen for her. In addition, he proscribed an echocardiogram to see if her heart has been affected by the multiple myeloma, and a belly fat biopsy that was performed by a specialized surgeon to determine if my wife had a secondary related condition that needed to be addressed.
In addition, prior to beginning her chemotherapy, my wife needed to obtain clearance from her dentist that she was orally infection-free. She was not, so she needed to have an infected tooth extracted.
My wife has now received her first chemotherapy treatment at the infusion center at Holy Name Hospital. The hope is that after eight weeks of treatment, the multiple myeloma will be controlled, and sufficient kidney function preserved so that she will avoid the need for dialysis or transplant.
As my wife’s hematologist has said, people my wife’s age most often end up dying of old age and not multiple myeloma, and we hope that this will be the case for her.
The fact that a cancerous condition such as multiple myeloma can now be turned into a treatable chronic condition like diabetes is a testament to the advanced clinical research that is being done in the U.S. and other developed nations worldwide. The value of this work cannot be overstated.
The progression from primary care physician through the work of four specialists to arrive at a hopefully life-saving chemotherapy has to be seen as an incredible benefit of our medical system. We have some of the best hospitals and doctors here in New Jersey, and to be honest, this quality of treatment may not be available everywhere in the U.S., but it shows just what can be accomplished.
Without exception, the medical personnel we have dealt with were highly professional, caring, patient, compassionate, and reassuring. They made this frightening experience altogether bearable, and never once did we feel alone.
So now my wife and I are trying to resume our normal life together, which includes watching the news and entertainment.
We all know that we pay 2-3 times more for our prescription medicines in this country compared to the price paid in other countries. The latest justification from the pharmaceutical companies is that because Americans have access to new medicines sooner than people in other countries, we should pay for this early access privilege. This self-serving explanation does not justify a continuation of higher costs once new medicines are widely available.
The pharmaceutical companies also blame the pharmaceutical benefit managers for raising the prices of drugs. Three pharmaceutical benefit managers – OptumRx, CVS Caremark, and Express Scripts – control over 80% of the prescription drug traffic in the U.S. These three companies essentially control the entire prescription drug market, and they make more money when drug prices are higher.
These three companies negotiate drug prices with pharmaceutical companies to create a profit margin for themselves. They may restrict patient access to prescribed drugs that are less profitable for themselves. They dictate pricing for the cost of drugs that pharmacies pay in order to fill prescriptions. There are no regulatory controls on their activities, and they act as financial parasites within our medical system.
My wife and I are fortunate to be obtaining our care from Holy Name Medical Center, which is the last independent nonprofit hospital in New Jersey. The consolidation of hospitals into large corporations and the emergence of for-profit hospitals is quite concerning. One can expect that the cost of medical treatment will ultimately increase as profit, i.e., return on investment, becomes a primary concern. One can only hope that patient care will not suffer from cost-cutting and profit-driven business considerations.