North Texas teacher dies after getting the flu; had delayed picking up Rx because she couldn't afford $116 copay

North Texas teacher dies after getting the flu; had delayed picking up Rx because she couldn't af...
North Texas teacher dies after getting the flu; had delayed picking up Rx because she couldn't af...

Holland fell ill about a week ago and planned to pick up flu medication but felt the $116 copay was too high.

Her husband Frank Holland bought the prescription himself when he found out, but things worsened.

Still seems crazy that an otherwise healthy person can die in about a week after getting the flu.

Still seems crazy that an otherwise healthy person can die in about a week after getting the flu.

North Texas has had a crazy flu season. The number I heard last week was that more than 100 people around Dallas/Fort Worth have died this year from the flu. There was one story about a guy who got the flu, which led to pneumonia, then septic shock and had to get both legs and 9 fingers amputed. All from starting with the flu.

Yet were still the greatest richest nation? We treat those that educate the next generation like shit and pay them so crappy they can't afford meds. Shameful

We've recently discovered that my wife's BP prescription costs much less than the copay, $45 for a 3 month supply is now $5. Always check with your pharmacist.

What the fuck.

My wife is a teacher, and we ended up having to use her insurance this year. To go with the option that actually provided benefits was almost $1000 a month. That is for just me and her, no kids. We had to go with one that only kicks in after 4,000 out of pocket each, and that one is just over $500 a month. Insurance for teachers is a joke.

Obviously there's the bigger question around public insurance in general, but it's crazy how bad teacher insurance is in Texas at least.

My wife is a teacher and is on my insurance because their choices are so bad.

Lawmakers can afford to send their kids to private school. Why should they give a shit about how well public schools do? /s

That's not even sarcasm. That's legitimately what and how they think.

You almost had that right. The correct verbiage is "Insurance is a joke." Believe me, it's not just limited to teacher's insurance.

I don't know where I thought that story was going, but it wasn't where it went.

It costs about $4500/yr in taxes, it has $0 deductible, no pre-existing conditions, and no departments set up to find ways to deny you coverage.

Well jokes on you, while your taxes go to stupid things like making sure your citizens don't die, our taxes will be sensibly going towards another aircraft carrier.

Edit: disabling replies because I should probably stop getting distracted at work. But for those unaware, I am joking, and I know taxes aren't the main issue. It's the lovely, unregulated private health insurance industry that is the larger issue towards having universal health care in the States.

The more I learn about the American HC system the less I understand why anyone wants it. Aside from the Pharmacy/Insurance industries, of course.

Insurance sometimes requires a minimum copay. Sometimes the drug costs less than that. They won’t always tell you your insurance copay is more than the cost of the drug. Terrible.

To be clear: there is no 'flu' medication other than tamiflu, which only works in the first 48 hours to shorten it a couple days. She probably had a complication of pneumonia and was supposed to pick up antibiotics for that.

Also note: I didnt read the whole article but just clearing your doctors name when they say drink water and rest :)

**edit: Tamiflu and its sister drugs Relenza, Rapivab

In Canada we just have public health insurance. It costs about $4500/yr in taxes, it has $0 deductible, no pre-existing conditions, and no departments set up to find ways to deny you coverage. And bonus, if you lose your job and aren't paying taxes, you're still covered.

Folks, ED (Emergency Department) RN (Registered Nurse) here. I work in N.E. Ohio. She most likely didn't die from not taking a prescribed medication for influenza. The most prescribed medication for influenza A/B is Oseltamivir, akaTamiful. It's an antiviral drug designed to lessen symptoms and overall redduce the length of the viral coarse. IT DOES NOT CURE THE VIRUS. It doesn't work like an antibiotic against a bacterial infection. It's also STUPID expensive, running 50-200 USD/script. Most likely she died from dehydration. What I tell my patients on discharge that have been tested positive for influenza A/B is increase your fluid intake, treat your symptoms. What does "treat your symptoms" mean?

First of all if the patient is a child or over the age of 60, or been diagnosed with diabetes, heart/lung/kidney/liver disease see a doctor. This demographic are most at risk for death from influenza A/B.

MOST IMPORTANTLY WASH YOUR DIRTY HANDS WITH SOAP AND WATER FREQUENTLY & INCREASE YOUR FLUID INTAKE Caffeinated beverages don't count. Water, sports drinks, juice in that order.

Fevers- Take Tylenol dose 650-975mg every 4 hours and Motrin 400-600mg every 6 hours (be sure to take Motrin with food because it can give you a stomach ulcer)

Body aches- see above

Sore throat - you may need to be tested for strep throat which is a bacterial infection and will need to be treated with antibiotics. If it's viral in nature, it needs to run its course. Treat symptoms as stated above.

This is just a general FYI for you folks. I'm not a Doctor giving medical advice. I'm a nurse attempting to educate the community on the disease process. Do not let this information detour you from seeking medical assistance.

EDIT: Hand washing and other important mombojumbo EDIT2: Gold?! Wow, thank you!

I looked it up and Tamiflu is about 120$ out of pocket. It looks like her insurance wasn't helping her at all in this case. A $116 copay is really high.

Laughs in free British healthcare.

Cries in quickly diminishing free British healthcare due to privitisation.

I don't want to have to pay not to die :(

As a teacher we are in the trenches with sick kids. The flu isn’t presenting as the normal flu sometimes so parents are still letting their kids come to school even if they are obviously sick. It doesn’t matter how much I clean or try to avoid the coughs and sneezes I will get sick because parents either can’t or won’t take a sick day to take care of their kid. In my situation I’m also 8 months pregnant so am being even more vigilant but taking a sick day for me is a non starter. At this point it will hurt my maternity leave and leave me with one less day of pay which is only $133 dollars. So if I was prescribed this medication and had to take a sick day I would be essentially out two days of pay so I get that a teacher would not want to spend her money on this medication when thinking that the flu can’t be that bad.

Can you explain that to me (I'm not in the US)? Do I understand correctly that you had to pay more with insurance than without insurance?

Did the insurance company pay more for the medication than you would have? Or did they just claim they did? If the latter, how is that legal?

I miss hell in a cell.

This appears to be false. Her husband said she could afford it, she just didn’t do it. From the WSJ report on the case: “They had the money, Mr. Holland said: ‘It’s principle with her. She’s a very frugal person in general, always has been.’”

source WSJ

There is a heavily promoted belief here that "government-run" or "government controlled" health care has all kinds of issues.

Waiting in line to see a doctor.

Full emergency rooms.

People getting cosmetic surgeries while "my tax dollars" pay for it...

It's a Fox News sentiment, and they have a very loud mouthpiece here (and an entire political party).

Probably because she had a separate drug deductible to meet first. A new way employer paid insurance plans are slowly shifting the burden to the employee.

Everyone hates it but no one wanted to compromise or genuinely try a "sides" answer. If any healthcare bills get passed they get fought against so hard that they are barely what they were supposed to be at first and hardly functioning.

Blame the Pharmacy Benefit Manager company (probably xpress scripts) that your insurer is using. They get bank off your copays.

But that parade is going to be as sick as our citizens.

so how can you quickly tell when your flu has gone from "stay home and don't clog up the ER's" to "better get your ass to the hospital before you die?"

One thing worth pointing out is that Tamiflu does not actually cure the flu. It does, however, reduce severity of the illness and decreases the length of the illness by a couple of days. It is not a "cure" for the flu. If she had gotten the medication, she may have survived, but that is definitely not a certainty.

Edit: Actually, it appears that I'm wrong. Tamiflu doesn't seem to have any effect on mortality for patients who are not immunosuppressed. The tamiflu wouldn't have saved her.

It's not crazy that the flu can kill. People are just incredibly ignorant to the realities of the flu. I mean..that spanish flu in the early 1900s is mostly forgotten by the common man today and it was one of the most deadly pandemics in the history of the planet.

People need to stop forgetting the flu is literally deadly.

When you’re so dizzy you can’t stand, can’t keep fluids down or eat any food, etc.

Once you can no longer take measures to support your body fighting the flu (and anything else that slips by your suppressed immune system), it’s time to go to the hospital and let them put you on a nutrient/fluid IV.

At that point you’re not going to get better laying down. You’ll just get weaker and weaker, more and more dehydrated, and soon become unable to even walk, let alone stand up straight without falling.

A seemingly mild flu can turn to a critical one in only a few hours, or overnight, especially if you manage to contract something else too, e.g. streptococcus.

As is the story every damn time something like this comes up. Especially healthcare in America. They simply fail to give a shit. /sub/fuckthesepeople

As a European it seems so absurd that medicine should be a question of how wealthy the sick person are.

You can buy tamiflu online in the UK, from a private healthcare supplier, unsubsidised, for $23.00, with free shipping.

'tamiflu' isn't expensive, American healthcare is expensive.

Similar here in Alabama. Don't know the numbers, but the flu has quickly become pneumonia here and caused entire fucking messes of complications. It's the worst season I've seen in a while.

Its ironic that these topics are brought up. I work in the health industry now and ill tell you

Emergency rooms get full

People wait inline to see a doctor already

Whens the last time you didn’t have to wait 2 months prior to set up a physical exam? Whens the last time anyone has gone through an ER in less then 20-30 mins (unless its utterly empty or having a heart attack) at the ER? Ive waited with a patient 10 hours +.

Theres many more arguments but in the end It’s just as you said, dumbfounded Faux News sentiments.

To be fair tamiflu probably wouldn’t have done anything.

Just important to remember stories like this when you hear from Centrists or Conservatives that Medicare for All isn't "pragmatic".

This is state violence and our government is fine with people dying in this way as opposed to ensuring we all have truly affordable and meaningfully accessible healthcare. People should take this personally, I think. A lot more than they seem to.

God we need to pay our teachers better.

Flu set him up to contact bacterial pneumonia. Bacteria then get in his blood stream, goes everywhere causing sepsis. Sepsis quickly turns into septic shock. The shock requires some narly vasopressors (likely a combination of all of them). Those clamp down all the arteries including capillary beds which cause necrosis leading to amputations.

Tl,dr: get your flu shot folks!

Flu is apparently creating some synergy with respiratory infections due to secretions this year. A lot of the deaths I’ve read about turned into flu + pneumonia.

Influenza can seriously fuck you up. It mutates quickly and transitions smoothly into diseased like pneumonia. It’s why people are rightfully worried that the next major global epidemic is going to be a strain of flu that will kill quickly and mutate fast to make vaccination ineffective.

Viruses don’t play around.

I went to CVS last week to pick up my wife's Tamiflu prescription. The lady checking us out said to use goodrx instead of our insurance for it because the goodrx price was $72, and the insurance copay $120!!

It was going to cost MORE on insurance.

(Wife is fine. Tamiflu worked and she is much better today)

That's not a copay. That's the full cash price. The pharmacy should have looked up a discount card for her to use. There are literally a dozen free discount cards at the pharmacy desk most likely.

Goodrx for instance discounts it to $50 for the prescription.

The flu has already been a global epidemic, the Spanish flu of 1918 killed 50 million people worldwide and 500k in the US.

Tamiflu is ridiculously expensive. It makes perfect sense to me that the copay would be that high. Actually, my roommate’s copay for tamiflu a couple months ago was exactly that high.

As an American I am constantly amazed that other countries have Healthcare systems that aren't specifically designed to squeeze every last penny out of ill people.

really aggressive flu this season. same here in the UK

Hey here’s a new jet fighter you didn’t order.

So she probably COULD afford it, just didn't want to because it seemed unreasonably high. That makes a lot more sense

It's not just the parents fault, either. Our children are getting punished for staying home, too. I'm not sure about your district but ours has a "strive for 5" policy. They want 95% attendance and they reward you if you don't miss any days. Despite the flu, they've reminded us repeatedly unless your child has a fever, or is leaking out of a body part, send them.

If this ever happens to you, you need to call your insurance company and /or employer right away. All insurance plans are set up so that the patient pays the copay or out of pocket costs, but it cannot exceed the cost of the drug. You should never pay more than the cost of the drug every.

I’ve spent 15+ years working for Insurance Company’s managing plans, benefits, etc. Thanks in advance for the expected down votes :)

My boss from a previous job shuffle years ago just died of the flu this year. Got the flu on New Year’s eve, it turned into pneumonia and she died a day later

Except the flu shot this year is only 30% or so effective. Granted it’s better than 0%, but it’s still not a guarantee against getting the flu.

can’t keep fluids down

This is the real emergency. If you can't keep water down, get to a doctor asap.

The fact she wasn't being paid well enough to afford something that may have saved her life is pretty fucking telling, though.

You have to pay a certain amount of money "deductible" before your full benefits kick in, after meeting this deductible, you pay your copay.

Its strictly for profit, there's no price controls, Most of the med schools out there are fucking expensive so doctors have to have inflated incomes to pay off debt. Administrative costs in healthcare are also ridiculously high. Not to forget, most healthcare providers charge different amounts depending on if you're paying with insurance, and depending on which insurance you're paying with.

Texas spends over $2500 less per-public school student than the national average of about $12,500.

Average spent on housing an inmate in Texas for a year: $18,000.

It is. Well, Flu -> Pneumonia -> Sepsis.

It's why anytime you're sick you need to closely monitor your temperatures. And for god's sake throw away those piece of shit temporal thermometers. I usually took temps 3-4 times because I never really trusted their accuracy. One day it said my daughter was like 99.5 or something not too serious. Still took her to the doc because she looked rough, and it ended up she was at 104. Full on flu.

If I hadn't trusted my normal instincts instead of a piece of shit temporal thermometer, it could have gotten worse. And this is a highly regarded, expensive temporal thing. Not just some junk.

Ended up getting the braun ear one which is far easier and much more accurate.

Anyway, thermometer rant over. Check your temps. If you seem to be getting better (temps going down) then one day they go up again, get to a doctor. You're probably getting some secondary infection, which is what will make you have complications. Most people probably thought they were better, and for a day they probably felt better, but that was just the pneumonia ramping up and then it was too late.

My work changed our deductible to $4500 this year. Last year it was just a $50 copay. Fucking absurd

Crazy to me how people forget this. A global flu pandemic is not some far fetched plot line of a Dan Brown novel. It has happened, and will probably happen again. More U.S. soldiers died from the 1918 flu than were killed in battle during the war.

Or maybe she felt like she couldn't afford it at the moment and her husband knew she needed it more than the cost was.

Could be either honestly. Like i could afford to get the medicine, but i probably wouldn't because i Would be worrying about how i would pay for rent and my bills first.

There is substantial evidence including a Cochrane review, confirming that tamiflu does not decrease mortality or hospital admissions although it can shorten symptoms by 1 day.

That is about as strong evidence as you can get confirming that tamiflu isn’t much better than placebo for those who already ha e he flu. That said, it is an essential medicine and still should be 100% covered by all insurance. The insurance company should explain why this is not so and give strong evidence as to why it did not provide better coverage for an essential medicine.

Edit: WHO downgraded tamiflu from “core” to complimentary essential medicine. It does seem to protect those who are In direct contact with the flu but does not seem to help anyone that already has it. I was not aware they had downgraded it, however, I still think that it should be covered for her SO or any family in direct contact since it does have some efficacy in those people.

I found a tick on me last summer and thought it would be best to get tested for Lyme. They weren’t able to get me an appointment for about two months. I had to go to urgent care and to get blood drawn and tested it cost $450. Came back negative.

Not too long ago I was in a car accident. I couldn’t move my right thumb but it wasn’t broken. They put me in a brace that I had to wear for a few weeks. They charged me $200. I found the same brace online for $9 dollars, but it didn’t matter and I had to pay.

HC in this country sux.

Edit : Found the bill. It was $150. No X-rays.

China reporting in. Same here.

I've heard as low as 10% effective, with ~30% being how effective the vaccines usually is against H3N2 strains.

I think that’s how most flu deaths occur though.

I work in an ER and this is mind boggling; she did not die because she didn't get tamiflu, tamiflu mostly sucks anyway. She died of complications of the flu virus, combined with another upper respiratory bug. Tamiflu is not a cure and only minimally reduces symptoms. It's effective only if taken right from the onset of the illness.

But muh tanks

A very nice burn. Unfortunately I will just let this burn blister and fester because I cannot afford gauze

You’re actually already dead. Go find Haley Joel Osment. He looks like Mac now.

The point is she put off going to the pharmacy because it was expensive. That's a lot to ask anyone to pay for flu medication, especially someone on a typical teacher's salary.

Yes, a copay is a flat rate, normally $15 per prescription in our case. If the meds actually cost $50, you win, less than $15 then you lose. The way we discovered we were being screwed was when our prescription card expired and we had to pay the actual cost because we didn't have the new card with us. The pharmacy doesn't pocket the difference, it goes back to the benefit management company.

Unfortunately the fit and healthy was exactly who got hit hardest by that flu. It caused cytokine storms which was basically the immune system attacking the body. So you more fit and healthy you were the more the flu hurt you. It was a particularly nasty flu and we seriously need to be more vigilant because it could happen again.

Yeah its called the fucking hundreds of dollars a month we pay to stay insured. Health care is a full blown con job in this country.

This is exactly it. When my kid had the flu we kept him out a total of 7 days to make sure he was completely well and not contagious. I see other kids in his class who clearly are in the middle of it. I think the big problem is employers who don’t allow their employees the time to properly care for their children. Parents are always forced to weigh their employment with the health of their children, if both parents work. I am lucky to not be in that situation, but I know how hard it can be.

What was so terrible about the Spanish flu as well was that the specific strain actually harmed people with strong immune systems. It used their immune system to trigger an uncontrolled reaction that'd destroy the immune system, and the stronger your immune system, the worse it was.

EDIT: It's called a Cytokine Storm in severe cases

I tell my family this, and they always spew out “BUT HIGHER TAXES” and “PEOPLE IN CANADA COME HERE TO GET TREATMENTS SO THEY DON’T HAVE TO WAIT” and other talking points. Meanwhile my uncle can’t afford his meds. Good old murica

It depends on the type of virus, but essentially yeah. In the only randomized controlled trial tamiflu only reduced flu symptoms by 12 hours when it was taken right after getting the flu. It had no improvement in mortality and it made a bunch of people barf.

Really it was just an expensive exchange of cough for vomiting.

Lol, what were you expecting... sick pay? Not in America, because freedom!

Yeah, it was most likely just a high deductible plan that doesn't have copays.

"When its cheaper to not use my insurance" is a phrase that shouldnt exist

I don't want to have to pay not to die :(

In America, we call that FreedomTM

check to see if you are dying and if so head on in.

As a teacher we are in the trenches with sick kids.

Kids are basically germ-infested petri dishes. I suspect sewer rats warn their offspring to avoid schoolchildren.

Well it's double-dipped profits. The people doing the treating are for-profit, and that's after they get their money from insurance, which is significantly for-profit. Insurance carriers raking in BILLIONS in profits each quarter is why we have issues.

Anytime one of the insurers cries about Obamacare and costs, just remember they're crying because they wanted $2.1B in profits for the quarter and ended up only getting $2.05B.

It's a neat way to get people who pay for insurance to also pay for their once or twice a year need for prescription medicine.

You force people to buy the insurance, then also give them nothing for it. Everybody wins :D

Down here in Mobile and yup shit has been pretty bad most of my co workers that have kids have been constantly in and out of the hospital because them and their kids just stay sick. I want to say the biggest issue they have been dealing with is the fact that the school their kids go to has a bunch of students being sent to school sick when they should be kept at home so they get sent in and get all the other kids sick its a never ending cycle

Discount cards for medical prescriptions?

In a thriving healthy economy NO ONE should die for $116, not just teachers and kids.

Yes. My mom lives in North Carolina and just got over the flu. Our whole family is paranoid when getting sick lol, but when she called me saying she really couldn't keep liquids down and they were "thinking" about going to the ER, I had a meltdown and actually called the hospital near my parents house.

Nope, not today flu. So, go to the ER!

Yeah I have an ancestor that was fit and healthy who died at 17 from Spanish flu - my dad was named after him.

People really need to wash hands, sanitise, and be thankful for medications when it gets bad.

The USA never ceases to amaze

Oh they want it, but only for themselves. They don't think poor people deserve healthcare because they (the republicans) would end up paying for it (via taxes).

Edit: Accidentally a word.

That's fucked up, sending your sick kid to school will only spread more germs and likely delay the process of your kid getting better. People need to be more conscious about health, we all only get one body!!!!

There isn't healthcare unless you can personally afford it, or fall into extremely restrictive protective classes like: being a former armed services member, being of retirement age, having a life-long disability, or being absolutely poor.

Because there is no guaranteed care for everyone else, and you have to personally afford it - 80% of all American bankruptcies are caused by medical expenses you are personally responsible for.

Of those bankruptcies, as many as 50% had some form of "health insurance" which is a private system by which you can pay a company to hopefully cover your medical costs when you incur them, but is so poorly regulated in the past it often was able to just not, despite taking your money.

the PPACA (Obamacare) helped shore up a lot of the problems, but made others worse, and instead of working to fix those new/expanded problems the in-office GOP has instead opted to work to torpedo iot and send ups back to 15 years ago.

If the GOP (the political party in control of all 3 branches of our federal government) has its way, we will be back to a system where you pay hundreds for sub-standard coverage that has lifetime limits.

TLDR: Our healthcare system was pioneered as a benefit to get people to take jobs during the post WW2 era, and we never evolved past it and now the political party in power wants to move us backward in time far enough that getting an illness like cancer or diabetes is a death sentence or financial ruin for millions of Americans.

ANd they call it freedom.

Explain "separate drug deductible" please.

If she couldn't afford the copay, her family is going to have a stroke when they see her hospital bill.