Second-grade teacher was no match for flu, co-pay

The nation’s health insurance system seems to have played a role in the death of a school teacher in Texas who balked at the copay for the medicine that might have saved her life.

Heather Holland, a second grade teacher, held off getting a prescription filled for anti-viral drugs because of the copay: $116.

She died Sunday morning from the flu.

She saw a doctor for it a couple of weeks ago but delayed picking up the prescription, her husband said.

By the time he found out and bought it himself, it was too late.

“Friday night, things escalated and she ended up in the ICU,” her husband said. “The doctors got the blood cultures back and they had to put her on dialysis early Saturday.”

“She wouldn’t go get medicine because she’s a mama. Mama’s are tough,” her pastor told a local TV station. “She just kept going. She had a job; she had kids. Frank was going to be out of town for a day or two. I think any mom does that. I don’t think she is being irresponsible. I don’t think she thought she was that sick. It happened so quick.”

  • BReynolds33

    USA! USA! USA!

    Sigh.

  • >>I don’t think she is being irresponsible<<

    And you would be wrong.

    • Brian Simon

      If only foresight offered the same infallibility as hindsight.

      Certainly the pastor’s words sound clumsy. But the victim made the best decision she could given the information available to her at the time.

      • The whole co-pay structure, IIRC, was to “incentivize” people to feel the “true cost” of medical care and act accordingly. They wanted people to have more “skin in the game.” Passing up care is exactly what that means. This is the system.

        • Brian Simon

          No argument here. The system is designed to maximize profits rather that health. The co-pay structure intends to reduce waste, a laudable goal, but at a significant cost, as demonstrated here.

        • Yet another reason we need universal healthcare in this country.

          • KTFoley

            Yeah, but we’re not going to get there by blaming the dead patient.

          • In this case I think both can be argued.

  • JMR

    >>She saw a doctor for it a couple of weeks ago but delayed picking up the prescription, her husband said.<<

    I had the flu in January and I was bedridden for 3 days. I can't imagine having the flu for weeks. After this season, I'll definitely be getting my flu shot because it was so horrendous.

    After getting the flu, I ended up having an ear infection, of which my bill was $123, even with decent health insurance. I laughed when I saw that my insurance plan gave a $4 discount, cause you know, that's really what was breaking the bank. But alas, that darn deductible.

  • Lindsey

    Part of the issue is that the flu is thought of as a minor disease, an annoyance, not a killer.

    Another part of the issue here is that she did not do a cost-benefit analysis here. She simply looked at the cost without thinking about benefits.

    • RBHolb

      She also may not have had a spare $116, and the pharmacy was not willing to cut her any slack on payment.

      • PaulMN

        I’ll bet they paid over $116 for cable and cell phones last month. You prioritize where you spend your money. Why would you expect the pharmacy to “cut her any slack on payment”???

        • theoacme

          Either prove that her cable and cell bill was that much AND that it was unreasonable (for instance, did she have a landline, and does she live in an area where broadcast television signals are iffy?), retract your statement, or accept that you make the pre-transformed Scrooge and Grinch look like beautiful people by comparison, and make me glad that you aren’t my neighbor…

          …as for “the system”, I hope that you very publicly wind up in this woman’s situation, so that we can see what you, oh perfect person who is a zillion times more Godly than this woman, would do…

        • RBHolb

          First, she died. Any hectoring or scolding should take that into account.

          Second, “cutting some slack” for the co-pay would mean something like not demanding it all at once. A lot of people would do that out of a belief that it is a good thing for someone who is ill to receive needed medicine.

          Third, a woman is dead because she could not pay for medicine. That point cannot be overemphasized. Whatever satisfaction you may obtain from the thought that she pissed her money away on cable or cell phones should be tempered by the knowledge that she died.

    • Erick

      There is no way to know the benefit on a personal level. An actuary might be able to say that over a population everyone who gets sick should rationally pay out $116 but she would have no way of knowing whether it was a good investment or not. The system is set up to encourage people to take a crap-shoot with their health. It is the system that is at fault, not the woman who was the victim of it.

      • PaulMN

        People need to take responsibility for their lives. Stop blaming “The system”.

        • This is a common argument from right-wing and libertarian thinkers, and it’s used to shut down any conversation about an entire spectrum of problems, in this case one of public health. It’s always about judging, blaming, and scolding – not about practical ways to solve problems.

      • Lindsey

        It’s about what she makes in a day (or so). So if the medicine caused her to miss one less day of work, she made it up.

    • Mike Worcester

      //Part of the issue is that the flu is thought of as a minor disease, an annoyance, not a killer.

      I think to when I was a kid and one might miss a couple days of school because you had a “bit of a flu bug”, like it was an upset stomach or something. What is making the rounds now is Influenza A (both my step-daughters have it); a lot more than just a bit of a bug. Being it’s 2018, let’s all recall that one hundred years ago, our population was hit hard by an epidemic of….Influenza. (And how many of us recall the great Swine Flu scare of 1976 that closed many schools outright due to high absentees and infections?)

  • Jeff in the NE

    I understand the vaccines only target certain strains directly. Can it be determined if the strain that killed her would have been covered by the strains the vaccine covered? (My assumption could be wrong, but Ithought that was one reason this recent vaccine has been regarded less effective than ones passed because it targetted the wrong strain.)

    • DavidG

      The anti-virals are different from the vaccine. As far as I know, the anti-virals are not strain specific like the seasonal vaccine.

  • Jack

    I also had the flu this year and yes, I did have the flu shot. I also self-quarantined (sent spouse to get the Tamiflu) to keep others from getting sick from me.

    I’m trying to avoid the second round of it but so many people don’t take into account that they are making others sick when they come to work sick.

    This year’s flu is especially dangerous and people aren’t taking it seriously enough. Maybe it’s because I remember the history of the Spanish flu, but I am not taking any chances with my health.

    It’s like my comment to the pharmacist over the Epipen (when it was ONLY $250), it is still cheaper than the alternative.

  • AL287

    The anti-virals must be started within 2 days of the onset of symptoms. They include Tamiflu and Relenza.

    Researchers are still trying to figure out why this particular strain of flu has been so deadly in healthy school children and young and middle-aged adults.

    The going theory is the body’s immune system mistakenly attacks itself causing overwhelming sepsis, shutting down vital organs and systems.

    Even though this year’s flu shot is not terribly effective, it does act like an anti-viral medicine making the symptoms less severe and less likely to cause life-threatening complications like the ones that killed this teacher.

    Get your flu shot, folks! It might very well save your life.

  • Credit Warrior

    Sad story as no doubt she touched the lives of many that she teached. My daughter had influenza A last month. First time in her life she had the flu. She was out of work for 8 days. She was prescribed Tamiflu and she took it to the Walmart pharmacy that gave her the generic, oseltamivir phosphate, for much less than in the article. The pharmacy also directed her to coupon which lowered 10 tabs for about $48. We sometimes think we can “tough” are way through anything. Cutting corners when one is sick is dangerous. I feel for family and all of her school kids and those educators that worked with her.