In 2010, at the age of 30, I ran my first half-marathon. A year later I ran my first full marathon (4:25:10 — you never honestly forget your first marathon time). I was in the best shape of my life. Although I gave myself a few months off from long-distance running, I started planning for my next half-marathon. Unfortunately, I began having intense joint pain in my hands, wrists, hips, knees, ankles, and feet. I was only 31 years old but felt like I was 80 — simply getting out of bed in the morning was a physically painful endeavor. Turning the pages of a book could cause ridiculously excruciating pain. It felt like my joints were being stabbed repeatedly with a knife that was on fire. Imagine going from running a marathon to just a few months later struggling to open a car door.
Numerous Google searches told me I most likely had psoriatic arthritis. I made an appointment with my doctor and the testing began. Because psoriatic arthritis isn’t something you can directly test for, I had to be tested for everything else that it might be. Blood tests ruled out rheumatoid arthritis, lyme disease, and parvovirus. I was then referred to a rheumatologist and officially diagnosed with psoriatic arthritis. Psoriatic arthritis is an inflammatory arthritis in which an overactive immune system attacks the connective tissue in the joints. If it is not treated, it can lead to irreversible joint damage. 15-30 percent of long-time psoriasis sufferers (I have had it since the age of 14) develop psoriatic arthritis, and I am one of the lucky ones. My rheumatologist prescribed hydroxychloroquine, a form of quinine, which suppresses the immune system. It provided some relief and life became a little bit easier — I even started running again — but my immune system still wasn’t working properly and I needed frequent doses of Aleve.
In 2014, my insurance plan changed and the rheumatologist I had been seeing for the past two years was no longer an in-network provider, so I had to change doctors. Although I grumbled about it at the time, it was probably one of the best things to happen to me medically since the pain began. My new doctor was astounded by the swelling in my ankles and in addition to telling me that I should absolutely not go on any more 10-mile runs (unless I wanted to start talking about ankle replacement surgery), he wanted to pursue a much more aggressive treatment plan. He prescribed Humira for me and the life-changing effects were almost immediate. My psoriasis cleared up entirely, the joint pain eased considerably, my energy levels increased, and I started to feel pretty good again. Humira is another immuno-suppressant. Although it sounds counter-intuitive, with a suppressed immune system I am sick much less often and much less severely than I was prior to Humira. In the two or three times a year I get sick now, I can usually work through it: pre-Humira I was sick once a month (or more) during the flu season and would miss at least three days of work at a time. Humira allows me to be a more productive, tax-paying member of society.
My two medications retail for $4,900/month and $175/month, which annually amounts to the cost of approximately 87 iPhones.
My experience with psoriatic arthritis and Humira have taken place entirely within the timeframe that Obamacare has been in effect. I do not have a job that provides health insurance. For the past 14 years, I have worked for a sole-practitioner attorney. I am his only full-time assistant. I serve as receptionist, office manager, paralegal, and more. My boss has always treated me well and is, quite honestly, much like family. I have helped to build his law practice into the success that it is today. My husband is a self-employed public policy consultant. We purchase our insurance on the marketplace and rely on the Obamacare subsidy to make ends meet. For our family of three, our silver plan premium (without the subsidy) is about $840/month. Our premium will increase substantially next year, especially if the ACA is repealed, and we will be paying more money for less coverage. If we lose our subsidy and our rate increases the 20-30 percent that is projected, our premium will be unaffordable for us. Without insurance, my two medications retail for $4,900/month (Humira) and $175/month (hydroxychloroquine—generic), which annually amounts to the cost of approximately 87 iPhones. On a side note, Humira was $3,200/month when I was initially prescribed it two and a half years ago—the drug has been on the market for 16 years, so the research and development has been done and over with for a long time. This mark-up should shock the conscience of anyone with a soul.
Thanks to Obamacare, my insurance cannot drop me or charge me more due to my condition. I have worked, paid taxes, and been insured my entire adult life. I am college-educated. Aside from the Obamacare subsidy I receive, I have never relied on public assistance. Psoriatic arthritis is not the result of unhealthy choices or stupid life decisions. I realize I am expensive to treat medically, but I am also a valuable member of society, as are many other similarly-situated people. No one is an island, and despite Ayn Rand’s writings to the contrary, civilized society requires a bit of compassion.
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