Hello, friends!
This week has been busy and will only sort of calm down later today, after my family and I come back from seeing Hamilton. It’s playing in nearby Providence, Rhode Island, and we got my 12-year-old tickets for her birthday last month. I’m excited because I’ve never seen a Broadway show before (if even this version is not actually on Broadway). The rest of last week G had two basketball games, a school concert, and practice.
This coming week there’ll be one basketball game and the last week of school in 2024.
As I write this (on Saturday), I’m still happy from seeing a friend I haven’t seen since high school graduation in 1995. It was terrific and heady.
Anyway, let’s me get into this week’s update.
Welcome to the 100th installment of Gauthic Times, the newsletter about my writing, my life, and how healthcare in the United States is fucked.
Wait! The 100th installment?! This one makes 100 of these things I’ve done? I should do something cool to mark this event. But I didn’t plan ahead, so I guess I won’t. But I’m truly happy you’re here to read these words and appreciate it.
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If every subscriber or reader of this newsletter, or every social media follower I have became a Patron at even just the $1 tier, I could write more and pay my bills better. The same would happen if they bought copies of my books.
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Anyway, let’s go!
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Project: Amusement Park saw me hit page 397 last night (Friday). Lots of blue ink being put down to edit the writing. A word crossed out here and there will make a big impact later.
The chapter I’m working on has a character who is not a major character but an important one. Their POV doesn’t take up much of the book but this chapter fills in some story that happened during other chapters and helps move the story along a little further. It’s a tough chapter, though, because it can’t feel too much like exposition and also needs to further the story and characterize two other people. All that and the character is a teenager who has recently come out as nonbinary and preferring the pronouns they/them.
There’s another teenager who is a trans girl (she’s actually one of my favorite characters in the novel) who is a much more major character. The balancing act I’m attempting I hope pays off. I’ll definitely need to make sure it does, when the time comes.
The good news is that this chapter is nearly done and then I can move on. I suspect there’ll be even more editing and revising that’s needed.
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With the murder of the CEO of United Healthcare still very much in the news, we’ve seen an odd response from the general public. The killer, Luigi Mangione, is being treated like a modern day Robin Hood. I’m not surprised and, honestly, I get it. In the week or two since the killing, many people have told horror stories of health insurance denying treatment that led to deaths of loved ones.
My story is not that drastic and has a happy ending, but it shows, I think, one smaller (but important) way the United States healthcare system is a horrific mess.
Back in June 2000, two months before my 23rd birthday, I nearly died. My undiagnosed Crohn’s disease had ruptured my intestine and I was going septic. I’d had some pain and was feverish for days. Finally, I went to the emergency room where they performed an appendectomy. My appendix was fine. Exploratory surgery led them to find my ruptured intestine. It was during this time I was diagnosed with Crohn’s.
A quick aside. I’d been experiencing symptoms of Crohn’s disease as early as junior high school. Every time I went to the doctor’s, he gave me a pill and told me to lay off of caffeine. When I felt better, he decided that’s what it was and sent me on my way. If I had pain that felt like someone was making balloon animals with my intestine, I’d chill for a bit and then would feel better. If the doctor had done a simple blood test, they’d’ve found Crohn’s and I might now have had the issues I had in 2000 (and 2001).
Well, here we are in 2023 and I’m on a medication called Stelara. It’s an injection I have to give myself every two months. I’m pissed off that I have to give myself an injection. I hate doing it. I have no choice, though, because the health insurance refuses to allow me to go in to have the shot. It’s not cost effective, you see. Just like I’m not allowed to get prescriptions for my acid reflux and have to find good over-the-counter stuff that’s not Omeprazole, which fucks me up.
There was another change in my health insurance which makes us on the hook for more of the deductible and whathaveyou. Sometime in 2020, I got a letter about something strange with what looked like a credit card. It was supposed to help pay for the Stelara but since I was only paying $15 a dose, I didn’t enroll. Well, I got another letter like that in 2023 but, again, ignored it. Now, September 2023 comes and I need my next dose of Stelara. I go on to fill the prescription and it says I owe nearly $7,000!
Now, I know my health insurance is slow paying, but really? Well, I order and wait and in a few weeks I see that I owe nearly $14,000! Now I’m making calls and here’s what I find out.
I’d been getting calls that I thought were sales calls. They were from something called Pillar Rx. When I call them, I find out that they’ve been hired by my insurance, Blue Cross Blue Shield, to make sure that the company that makes Stelara, Janssen, uses their payment plan options to help pay for the medication.
Here’s where I start looking at the costs of things for real.
Janssen produces Stelara and sells it for nearly $30,000 per dose. It ranges from one place to another but I suspect saying $30,000 is a good–and fairly accurate–number. Now, health insurance companies should pay this, right? Well…mostly. After BCBS does their thing, post deductible, that makes the out-of-pocket nearly $7,000. That’s almost one month’s salary for me.
Because of the cost, Janssen has a payment company that helps people pay for it. They send patients a special MasterCard to pay for it. After they get involved and pay themselves for their own medication, my out-of-pocket cost is….
…ready?…
$5.
It’s less than what I was paying when my insurance was better.
But wait! Because Janssen can’t be trusted to pay the whole thing, BCBS hires Pillar Rx to make sure that Janssen does.
So…
Janssen makes a medication that they charge $30,000 to BCBS, who then only pays some of it, which makes Janssen make a company to help pay the remainder, in my case around $7,000, to themselves, and BCBS hires Pillar Rx to make sure that Janssen pays the manufacturer (again, themselves).
When I started teaching in 2007, our health insurance was really good. In the 18 years since, it’s become terrible. The school pays for less and less and so does the health insurance. Yet, the prices keep rising.
The anger is justified, but not only with the horrible health insurance companies. The drug companies and the medical companies are also to blame. For-profit healthcare and deregulation has created a nightmare.
Honestly, I expected violence in 2020 as the pandemic was at its height. I think with the results of the 2024 election in and the horror show we’re about to endure for the foreseeable future in many people’s minds, there’s many who are tired of these billionaire fuckers who are recording record profits but delivering nothing in return.
It’s a hard time to care about others because so many are hurting.
I don’t know if Luigi Mangione is a hero or a madman, but I know that his will not be the last case of this. Violence begets violence, and the badministration (I’m stealing that from David Gerrold) coming in loves violence, and the health care system has been perpetrating violence against patients for decades. Something’s gotta give and I think we’re about to see that happen.
I hope that I’m wrong and clearer minds will prevail, but if 2016 and 2024 showed me anything, it’s that clearer minds will not because they play by the rules and if you have enough money and are loud enough and can reach enough angry, undereducated people, you don’t need to have rules.
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For the last time, I’m still interested in what people think about me revising the essays I’ve written about the Nightmare on Elm Street movies. Right now, it seems like the interest is in me publishing the essays as a book. I’d have to find a publisher or do it myself. We’ll see.
If you haven’t taken the poll, why not?
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That’s it. I’m done! Thank you for reading and for your support!
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Gautham: Bill Gauthier.com 
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