Tuesday, November 19, 2013

One after another

My wife has polycystic kidney disease. Her nephrologist said he would prescribe Tolvaptan for her. It was recently approved to slow the growth of the blood-filled cysts that progressively destroy the kidneys of people who have PKD. This is good,  but he said he could only prescribe it because she has health insurance through her new job.

A course of Tolvaptan costs $100,000.00 a year. One hundred thousand dollars a year.

Things like this remind you starkly that life is a series of temporary measures. Some remain in effect longer than others, but each is just a fragile refuge against implacable forces of destruction.

As long as she has insurance she will be allowed to purchase the drug on which her life depends. Its cost must be spread across the whole group of policy holders.

How much is the price distorted by the fact that the maker of the drug knows that an insurance company will be forking out for it? How much of the stated price actually gets paid? Someone with insurance is not expected to ask. Most probably don't. They're just glad to get what they need. It would only matter if the insurance went away.

Should I go on and write a Malcolm Gladwell-style book on all the temporary circumstances that make up every life? It's late and I have to go to my own job tomorrow. That was a temporary measure that has turned out to persist a remarkably long time.

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