Georgia Voice columnist Melissa Carter

Melissa Carter: When capitalism tests patriotism

I love my country, and have always supported the idea of capitalism. But when the American Dream comes at the expense of the sick, I question my patriotism.

Last weekend I was taking a friend to lunch, and on the way I had to visit my pharmacy drive-thru to grab some refills. As a kidney transplant patient I take several pills a day, including two prescriptions that focus on keeping my transplanted kidney from being rejected by the rest of my body. Those were the bottles I was getting refilled, and warned my friend the attendant would be hesitant to tell me how much it would cost. I told her that happened every time I got these refilled, since even the pharmacy staff is surprised by the number that pops up on the register.

“Um, Miss Carter, these are rather expensive. The total is $313.”

I assured him I’d expected that, and handed him my credit card. As I signed for the purchase, my friend took the bag and looked at the bottles. She inquired how much the generic versions would cost, and I explained those were the generic drugs.

I am fortunate enough at the moment to have a full-time job with benefits, so the $313 is my CO-PAY. I can’t even imagine how much it would cost me without insurance to keep my transplanted kidney safe, keeping me alive. In the 13 years since the transplant, those prescription bills have increased. And since I’ll have to take these medications the rest of my life, there’s no telling how much worse it will get.

I learned later that evening that other patients have it much worse. How much worse? Try $100,000 a year for one medication if you have cancer.

It was in a report by Lesley Stahl on CBS, exploring the expense of cancer drugs. She interviewed several doctors, including leading colon cancer expert Dr. Leonard Saltz, who used the term “financial toxicity.” He says individual patients are going into bankruptcy trying to deal with these prices. He says getting started on all the necessary cancer medications could run a quarter of a million dollars!

Saltz’s colleague in New York is Dr. Peter Bach, who explained to Stahl that another reason drug prices are so expensive is that the single biggest source of income for private practice oncologists is the commission they make from cancer drugs. Bach says they buy them wholesale from the pharmaceutical companies and resell them at retail to their patients.

Houston’s Dr. Hagop Kantarjian adds that one thing that has to change is the law that ties the hands of Medicare. During President Bush’s administration, a law was passed that prohibits the federal government from negotiating with pharmaceutical companies for better prices for drugs. Whatever price the drug companies tag onto a medication, Medicare has to pay it.

“High cancer drug prices are harming patients, because either you come up with the money, or you die,” Kantarjian told Stahl.

Capitalism is defined as “an economic and political system in which a country’s trade and industry are controlled by private owners for profit, rather than by the state.” I appreciate the ideal that capitalism accommodates anyone willing to work hard enough toward any ambition. Our system of government was created by people fleeing an environment where only the rich made the rules. However, it seems the United States is coming full circle back to the mother country, and doing so by taking advantage of the vulnerable.

Transplant and cancer patients aren’t the only ones being taken advantage of. The Organisation for Economic Co-operation and Development (OECD) says the United States spends almost $1,000 per person per year on pharmaceuticals, which is 40 percent more than the next highest spender, Canada, and more than twice as much as countries like France and Germany spend.

What can we do? Get involved in politics. Drug companies spend more on lobbying than on any other industry, so reaching out to your elected officials is the best defense against these special interests. Your life, or the life of someone you love who has not yet been diagnosed with an expensive disease, may depend on it.