The Water’s Boiling . . .

Time to Get Out of the Pot

Humans are a discerning species. We compare things. We have access to memory banks that allow us to remember things that might save us from making a mistake as well as helping us predict the probability of something happening again.

These are useful survival traits. Sometimes, however, we lose the keen sense of discernment that guarantees survival. Like the teaching story of crabs in a pot of hot water, where the water temp is raised gradually until, too late, the crabs realize they are cooked. This is what has been happening to us in recent years.

Clear and Present Danger

More and more of us are just now waking up to the multiple clear and present dangers that are surrounding us. For example, I was re-filling a prescription today that I have been on for decades now. It is a generic, so I rarely pay attention to the cost, as it has been reasonable, manageable, and well within my budget for longer that I can remember.

I use Cost Plus Drugs to fill all my generics because I get the best price. I use my insurance, which is supposed to cover the cost of this essential (to me) medication. But when I filled out all the fields this morning, I was shocked to find the price of my medicine had almost doubled in cost and shipping and handling had skyrocketed. I had never paid this much previously.

This Is Our Hot Water Moment

I am old enough to remember compounding pharmacies, where the pharmacist in his white tunic would be mixing potions from colorful bottles and powders. These would be put in glass bottles with droppers or carefully formed into individual pills, counted out by hand and sent home in a small box or envelope. My expectations of what a prescription looked like — and what it cost — were formed in that world.

Today, sitting in front of my computer and ordering my medication is simple and effortless. All I do is click a box, confirm my shipping and payment information, and magically my medicine ends up at my door in a day or two. I am remarkably lacking in curiosity about how all that happens. Instead, I get frustrated when it doesn’t.

Stepping Down from My Righteous Platform

Mind you, I have been rather prideful over the years because I understood the ins and outs of the labyrinthine world of corporate health insurance and pharmacy benefit management. I thought I had found a reasonable work-around that provided me with medication that is treating a chronic condition successfully for a manageable cost. The water in my pot was lukewarm, at best.

I read, on an increasingly frequent basis, stories about older adults having to make the hard choice between paying for medications or choosing food. I railed against the unfairness of it all! But it wasn’t impacting me directly – or so I thought. The temperature of the water was rising.

We Don’t Know What We Don’t Want to Know

Fact of the matter, I didn’t want to know what was happening to others. I was only concerned about my own little bubble. I found myself taking strong stands against the health insurance industry. I wrote essay after essay explaining their greed and attempting to influence my elected officials to do something about it. But I didn’t mind the water temp. As a matter of fact, it was actually comfortable.

This is another quirk of being human. We have been given empathy, but it is only a substitute for actually experiencing our own suffering. I think I know what others are going through, but until it actually happens to me, it is all just imagination.

Of course, once it does happen to me, it becomes fact – and fact worthy of 36-point headlines in the NY Times! I also become infuriated that others aren’t as upset as I am. This is not hypocrisy. It is a fundamental design flaw of our human wiring.

If we are lucky, we will lay down sufficient memory neural pathways to at least spark awareness that our suffering is also the suffering of others, just to a different degree. From that awareness might just arise the impetus to find ways to ease that suffering not just for me, or those close to me, but for others. This is how change happens.

Unmet Expectations

To the healthcare insurance industry and to faceless shareholders in multi-billion-dollar investment banks, I am nothing more than a line item in the profit or loss column. In spite of lofty mission statements and soaring corporate visions, the literal bottom line is that my existence functions as a tool for profit — nothing more.

My expectation, however, has always been simpler: that I can access effective, affordable medication for as long as I need it, and that my insurer will be there when I need them most. Those expectations, it turns out, were set in a different era.

How Times Have Changed

To be clear, I am not suggesting that things were better in the ‘good old days’. My point is that my expectations were set differently. What I take for granted now is far more complicated than it once was. Pharmaceuticals are sourced and manufactured around the world. Distribution requires understanding international economics, trade agreements, and shipping forecasts. Delivery to my doorstep requires complex algorithms, data systems interoperability, and electronic banking.

The system grew more complex, but my awareness of that complexity did not keep pace. That gap — between what I expect and what is actually required to deliver it — is precisely where my shock lived.

The Water is Getting Hotter

I am now aware of just how hot the water is getting. Because I have lived seven decades plus, I can predict with fair accuracy that we are in for a rude awakening. I am also aware, having lived this long, that too many will be shocked and surprised to learn that their ‘but-it’s-always-been-this-way world’ has changed.

This is the design flaw I mentioned earlier. Instead of acting when the water was tepid, the default was just to hang out a little bit longer. In those intervening years, we lost the ability to gauge the change in temperature that would have allowed us to get out, re-set the pot, and move on without too many negative consequences.

Paying the Piper

The bill has now come due. The cost of my medications this month has gone up almost as much as the cost of gas at the pump. I am in that untenable position of both needing my medications and needing gas. My income has not bridged that gap sufficiently, so I am now “economizing.”

Too many of us haven’t the luxury of “economizing.” This is no longer a problem for “them”; it is a problem for “me”!

The Fulcrum of Change

This is the point where change happens. The recognition that my life is impacted motivates me to first expect others to fix it, and then to come to the realization that if it is to be, it is up to me.

But here is the good news: we are not without tools. Those of us who have lived through previous upheavals — civil rights, economic recessions, health crises — know that change is possible when enough of us decide the water is too hot to ignore. We know how to organize, how to vote, how to speak up, and how to show up for one another.

The methods may need updating, but the will does not. Get involved. Stay informed. Talk to your neighbors. Keep contacting your representatives. Support organizations that are fighting for affordable healthcare and fair medication pricing.

We are seeing change occurring. It is building momentum daily. My hope is that I can get out of the pot before it’s too late. And I hope you can, too — not just by hoping someone else turns down the heat, but by reaching over and turning that dial yourself.