Prescription: Reform

As new members of Congress got adjusted to their seats this winter, some made it a high priority to try to repeal the health-care reform legislation that became law in March 2010. Yet, in contrast to those who oppose the Affordable Care Act, there are a growing number of people who are already starting to reap its benefits: Several of its provisions are already taking effect, expanding health-care access for millions of people in the United States. While many of the gains so far have been modest, they have meant life-saving treatments are now affordable for families who otherwise would find it difficult or impossible to pay for the care they need.

Take Michael Cram, 72, of Dublin, Ohio. He used to manage drug stores -- but in recent years has had trouble getting the prescription drugs he needs. With an income of about $1,500 each month, for most of the year he can’t afford the insulin to treat the type 2 diabetes he has been living with since 1991.

Every year, he starts out sharing costs with Medicare Part D for his medications; then he falls into the "doughnut hole," in which medications are not covered until one’s costs are high enough to qualify for catastrophic coverage. After falling into the doughnut hole last March, Cram used physician samples of a less-effective insulin because the drug he needs -- which is five times more potent -- costs $753 a month.

"I am on Social Security on a limited fixed income," he says, and there is "no way I can afford that." His blood glucose levels are two to three times what they should be. Excess sugar in the blood can, if untreated, lead to serious complications such as nerve damage and blindness.

Cram, who had a triple bypass five years ago, also requires several medications for his heart disease, cholesterol, and high blood pressure. In all, he paid about $1,800 for prescription medications in 2010, including the insulin he bought before he reached the doughnut hole.

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Sojourners Magazine February 2011
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