DR. JOHN’S VIEW
Through 20 years of medical practice, I have watched patients navigate the complex world of health insurance with skyrocketing premiums and deductibles. Every December, I would manage the onslaught of requests for surgeries and procedures because patients had “met their deductible”. I remember one time in late December a young guy walked into my office complaining of elbow pain. I examined his elbow and found that he had a small piece of bone floating in his elbow that would occasionally catch and cause pain. I asked him how long it had been bothering him, and he said “Since I injured it 5 years ago”.
I commiserated with him and agreed that we should go in and surgically take this loose piece out of his elbow. He got excited and said “That’s great. One catch is we need to do it in the next 4 days before my deductible resets.” The irony here is that he was just one out of dozens who had already said this type of thing to me in the final 2 weeks of December. And this little song and dance happened every year.
DR. ANA-MARIA’S VIEW
I have watched eczema families struggle with the same issues. Eczema doesn’t know when your deductible is resetting – nor does any disease. Yet this yearly financial tango to save money on medical costs continues to worsen as more payment responsibility is heaped onto patients.
For example, the latest and greatest eczema drug pushed by big pharma is called dupixent, an immunosuppressive agent. The monthly cost of Dupixent is $3149 totalling $37,788 per year. I won’t even go into the fact that this drug does nothing to address the root cause of eczema, rather it squashes the immune system into submission. In the midst of a highly infectious viral pandemic, who is excited about an impaired immune system?
Dupixent is obviously the extreme case, so let’s look at the more typical case. Most families start with a visit to their pediatrician as eczema most commonly strikes in childhood. The average family deductible in the the United States was $3722 in 2020, and that number rises each year. So the entire sick visit for your child will hit against that deductible. A sick visit, Level 3, which gets you about 15 minutes with your pediatrician will cost around $140. Assuming your provider is not an integrative doctor, they will likely prescribe topical steroids, moisturizers, and possibly anti-itch medications. A recent study in the journal Dermatitis reviewed patients out of pocket expenses for eczema whether they were insured or not. Families spent an average of $50 per month on steroids, $50 per month on creams/moisturizers, and additional funds on a multitude of other eczema related products, many of which are listed below.
Suddenly, just your visit to the pediatrician and a month’s worth of over the counter creams and medications have set families back $240 – and this is a conservative estimate.
The same study found that 42% of people spend $1,000 or more annually on the condition and 8.5% who spend $5,000 and up. That means more than half of all families with eczema spend well over $1000 per year on the problem. In fact, the out of pocket cost for eczema is higher than the out-of-pocket costs for hypertension and diabetes. The resulting financial burden of this finding is especially troubling in light of how many responders additionally reported using multiple prescriptions for treatment; 89.6% of responders had at least one prescription to treat their eczema, while 57.5% percent had three or more different prescriptions.
And even if you are blessed with a Cadillac insurance plan you are still affected. A 2017 survey by the National Eczema Association (NEA), revealed one in five people with eczema spend more than $200 a month on over-the-counter products and one in four spend more than $200 monthly on prescription medications to treat their disease.
And here is the kicker – none of these treatments address the root cause of eczema or lead to long term healing. The rates of eczema (and asthma allergies) are skyrocketing in our country with more and more cost of care shifted to families.
Beyond the cost, the simple fact that a baby may be on three or more prescription medications is appalling to me. Yet I remember being in that same position with my own children and my colleague telling me, “The next step is monthly injections”. That was the tipping point for me – and I have found many other families are reaching their tipping point as well.
What if there was a better way? An approach that doesn’t rely on long term medication use, visits to specialists and expensive testing?
I think the first step is looking at how we spend our money – Americans seem to balk at spending money on anything outside of meds and doctors. When I changed my family’s food, my husband was the first one to gripe about the grocery bill. And we are talking about a few hundred dollars difference over the course of 3 months! Yet, no one was worried about the monthly $250 cable bill or our $325 cell phone bill. I listen to patients and folks on Instagram continuously use the cost excuse for healthier options – but stacked against what we are already spending our money on, it’s a farce.
Each year the Bureau of Labor and Statistics conducts a Consumer Expenditure Survey which looks at the average spending of American families based on household size. The chart below shows some monthly costs for a typical family of four from 2019.
And since I am assuming most don’t eat lots of fresh fruits and vegetables when eating out, the low percentage spent on fresh fruits and veggies is even more worrisome. The food industry has convinced us that a calorie is a calorie— and we should simply let our wallets and taste buds decide what to buy.
And guess what the biggest year over year increase has been the past 2 years? New car purchases, up 10.5%. It gives you an idea of where American priorities lie. If you look at our expenditures, it looks like our priorities line up something like this:
Tolerate crappy health, decreasing life expectancy, lots of prescriptions meds, but drive a nice new car!
I can’t tell you how many times I have recommended buying organic food to a family and they insist that the cost is a problem—yet each member of the family has the latest iPhone and trendiest sneakers. This is a priority problem.
A simple shift in spending can drastically improve a family’s health. You don’t need any increase in income to make these changes – just the mindset to do it.
BACK TO ECZEMA
Returning to the topic at hand, we know more than half of families spend more than $1000 per year on eczema treatments, and this number is likely underestimated. But given that the current eczema treatments don’t address the root cause of autoimmune dysfunction, this becomes an annual cost. And remember, over 20% of eczema sufferers will carry eczema into adulthood. Thus for the child with eczema who becomes a 20 year old with eczema, the cost is over $200,000.
Compare this to my Eczema Transformation Program – one time cost $697
What you get:
97 Instructional lessons and videos on getting to the root cause of eczema, managing diet, lifestyle, environmental concerns, skin relief measures, getting off steroids, healing your gut, and a whole lot more (just the lessons alone are $7 per lesson)
26 Live sessions with a highly experienced pediatrician specializing in eczema AND 26 Live sessions with an experienced health coach knowledgeable on the food and cooking for eczema relief to answer questions and give support. (just the group visits alone equal $13 per specialist doctor visit and $13 per expert health coach visit)
Access to a holistic eczema community and other moms for support and advice
Food plans and detailed schedules
Infant and formula guides
One more comparison, 26 visits to your pediatrician or dermatologist would cost $3,640 out of pocket or “going to your deductible”!
An experienced health coach charges $150 per session which equals $3,900 for 26 visits.
Yes, I am selling my program here but I am also making a point. Maybe for the New Year we take a hard look at our finances to assure our spending habits align with our health goals. If your family is suffering from eczema, the likelihood is that you are not getting the value of our dollar and your child is paying the price on their skin.
Yours in Good Health,
Drs. Ana-Maria and John Temple