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The money isn’t coming back any time soon. To some people, the Wall Street collapse may seem like fair game, but it’s basic economics – when anybody loses money, the loss gets spread. It doesn’t matter if the people on the losing end have been overpaid or underpaid, they have to cut back somewhere, and that means somebody else loses a customer, or a job. With the exception of a few hundred people who are so rich that they’ll never notice the difference, everybody has to cut back.
But this isn’t about economics – it’s about economies. You can cut back on movies, stop going to restaurants, and these industries are feeling the pain, but you can’t stop your medical expenses. Perhaps to illustrate this, on October 3rd, the New York Times reported on the job market:
The job losses continued to be heaviest in industries tied to the housing market, like construction and real estate. But retails, manufacturers, restaurants and hotels also shed jobs.
Government agencies and health-care employers – like hospitals and doctors’ offices – added jobs, as has been typical in recent years.
Unfortunately, there are no new secrets to cutting health care costs, but what you can, and should do, is take a look at the things you already know, and make certain you’re doing them. All of them. Perhaps the first rule of savings money is: don’t be embarrassed to be concerned about money. Talk to people. See what options you have. When your physician writes a prescription, ask if it’s for a generic drug, and if it isn’t, ask if there’s a generic available that would work as well, or almost as well. Sometimes the brand name drug does have advantages, for some people, so physicians prescribe it for everybody. It’s worth the effort to try the lower priced drug, because if it works for you, that can be a savings month after month.
Shop around for drug prices. There are good reasons for using the same pharmacy all the time, but they take a back seat when times are tough. If you’re using an independent pharmacy, try bargaining. You can also consider asking about getting a partial fill for a new drug – but this may not save any money. If you’re starting a new drug, there’s always the risk of side effects that may be so unpleasant that you can’t use the drug. Since generic drugs aren’t available as samples, there’s no way to know without filling the prescription. If your pharmacy prices on a percentage basis, then you might be able to get half the prescription filled, for about half the price. But, most pharmacies now work on a cost plus fee basis, where you’re charged the price of the drug plus a fixed fee, the fee remains the same regardless of the price of the drug. This type of pricing reflects the fact that pharmacy is a professional service, and the work involved is the same regardless of the cost of the drug. It may lead to high percentage profits for low cost drugs, but it means that the percentage mark-up on high cost items can be very low. Patients getting two penicillin capsules before a dental appointment may feel they’re being overcharged, but patients getting cancer chemotherapy or some types of arthritis treatments are getting their drugs nearly at cost. So, asking for half the amount prescribed may result in very little savings, but asking is free.
If you have Medicare part D, the prescription drug plan, be sure to review the plan every year. Your drugs may change, and the insurer’s formulary may also change. You can only change insurers once a year, so take advantage while you can. Ask your pharmacist to help pick the plan that covers most of your drugs.
Use every discount you can. Use discount cards, check to see if you’re eligible for manufacturers patient assistance programs, and, for over-the-counter specials, take advantage of them when you can. If you’re taking baby aspirin for your heart, it may pay to buy a 6-month or even a year’s supply compared to buying the aspirin once a month. And, while it’s probably best to buy OTC drugs at a pharmacy, if you can get a better price at a supermarket or discount store, buy it there.
Use home remedies. Chicken soup really works to relieve congestion (inhale the vapor from hot soup – and no, hot water won’t work as well1) and as an antacid (eat the soup). There actually was a study where home made soup was more effective than the canned stuff. If you don’t like chicken soup, inhale the steam from hot water with sodium bicarbonate added. It’s the alkalinity in both the chicken soup and sodium bicarbonate that breaks up the mucous, but sodium bicarbonate is a bad choice as an antacid. Also, for colds, consider getting a vaporizer instead of taking medication. The vaporizer costs more to start with, but it’s there year after year. Ice relieves pain. It isn’t always necessary to treat a cough, or a fever – so don’t waste money.
But most of all, don’t be afraid, or ashamed to talk. For prescription drugs, the biggest cost savings is always going to be switching from a brand to a generic, and for that, you need your physician and pharmacist. Talk is cheap – and it’s the only thing that is. Talk.
Uretsky is a writer/author and former assistant director for clinical services at NYU Medical Center. His column originally appeared at PatientAssistance.com