Retire Better: Food or medication? The dangerous choice many seniors have to make


You need to keep a roof over your head, food in the fridge and keep up with your medication. But what if you can’t afford all three? What do you do? The choices are difficult—and potentially dangerous.   

This is the way it is for many Americans, says a study by GoodRx, a Santa Monica. Calif.-based healthcare company that tracks prescription drug prices across the country. 

In 2020, notes Amanda Nguyen, Ph.D., a GoodRx health economist, nearly 40% of those surveyed said paying for prescriptions was financially difficult. Writing in a company blog, she added that “over 20% said they struggled to pay for basic necessities like food and shelter as a result.” 

The COVID-19 pandemic, which has thrown millions of Americans out of work, has obviously made this worse. Job loss usually means loss of health insurance, forcing people to spend down savings, take on debt “and (make) potentially dangerous changes to their prescribed medication regimen,” Nguyen writes. 

In January, a separate GoodRx survey reported that the price of 832 drugs rose in price by an average 4.6%. Of those, said the company’s Tori Marsh MPH, 822 were brand drugs, 175 were specialty drugs (meaning they were probably expensive to begin with), and the rest were healthcare practitioner-administered drugs (available only under the supervision of a healthcare provider). The across-the-board increases appeared to be the biggest in years, she said. 

The prices of some medications are rising even faster. The world’s biggest selling drug, Humira—an anti-inflammatory medication used to treat rheumatoid arthritis, psoriasis and Crohn’s disease—rose 7.4% in January, and is up 21% over the past three years, Marsh says. Humira is a cash machine for its manufacturer, AbbVie Inc., which said it was responsible for $5.152 billion in net revenue in the fourth quarter of 2020 alone. The Food and Drug Administration incidentally, has approved five generic versions of Humira, but so far these “biosimilars” (as the industry calls generics) have yet to stop the AbbVie gravy train.  

GoodRx’s study covered all age groups, but there’s no doubt that these kinds of price increases can be particularly overwhelming for seniors, who are likely to be out of the workforce and overly dependent on Social Security. As I’ve mentioned before, the average Social Security recipient is getting $1,543 a month this year—up just 1.3% from a year ago—and for millions of Americans, that’s the only source of income they have.

So when the cost of a needed medication shoots up at a faster rate than that, difficult choices have to be made. 

Marsh says this is what many people are doing. 

“In 2020, 20.7% of people reported taking on debt or declaring bankruptcy due to the cost of their prescription medications. Borrowing from friends or family was the most common financial action (16.8%), followed by getting loans (5.0%), taking out another mortgage (1.2%), and filing for bankruptcy (1.0%).”

Imagine that: Having to mortgage your home or declare bankruptcy because the combined cost of keeping a roof over your head, food in the fridge and meds in the bathroom cabinet is too much. I have a feeling this isn’t what the term “golden years” is supposed to mean. 

What can be done about all this? The U.S. healthcare system is a gargantuan mess. We spend more on healthcare—twice as much as the average developed country in fact—but have worse outcomes, says this depressing report by the Commonwealth Fund. Trust me: It’s a downer. 

And yet some proposals center on the notion of spending even more money. As a candidate, Joe Biden suggested lowering the Medicare eligibility age by five years to 60. But most Americans—85% of Democrats and 69% of Republicans—want it lowered even more, to as young as 50, according to a 2019 Kaiser Family Foundation poll.    

Where’s the money going to come from? Medicare’s finances are already wobbly. Its Hospital Insurance Trust Fund, for example, won’t have enough money to cover all benefit costs beginning in 2024—right around the corner. What happens when millions of new beneficiaries get added to the system? Sharply higher taxes would appear to be the painful answer. Good luck getting a big tax hike through Congress anyway. 

And even if Medicare’s eligibility age stays at 65, thousands of Americans become eligible for it daily. Tough choices for millions—food, rent, meds and more—await. Tell me your story. Do you have to make choices like this? Between food/rent — and your meds? I won’t identify you if you’d prefer. My email: [email protected].

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