Jay Lake: Writer

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[culture] Pharmaceutical Puritans

My insurance plan, like many, has multiple tiers of pharmaceutical co-payments. Most of my drugs cost me $10 per prescription filled or refilled. A few cost me $20. Exactly two cost me $50. Those same two drugs are also the only drugs I have ever been prescribed in my life for which my insurance company limits the number of doses I’m allowed per month below what the doctor prescribed.

That would be Viagra and Levitra.

Ever since my colon surgery in May of 2008, I have had persistent erectile dysfunction. The probable root cause is surgical disruption to the vagus nerve. That, and the effect of being in my later 40s with a lot of medical and life stress, has kept me from ever recovering full functionality.

If and when any organ in my body other than my penis malfunctions, insurance covers everything required. I have co-pays and other minor hassles, but my insurance carrier is consistent and supportive. They have unquestioningly paid for drugs that cost $10,000 per dose, as needed in my chemotherapy regimen, with no co-pay at all because they were dispensed in a clinic.

But when I need a drug to help me enjoy the basics of male sexuality, I’m limited to a handful (or less) of pills per month and charged 2.5 to 5 times what every other drug I’ve ever taken costs me, when I have had a co-pay at all.

Is there any logical reason for this? To my view, this is just the ingrained Puritanism in American culture. Yet another stupid price we pay for the Calvinism in our national DNA. The unwillingness of many people, most of them conservatives, to contribute to the sexual enjoyment of others. Millions for cancer, barely a few cents for a good fuck. I cannot imagine any medical or financial justification for this beyond simple, petty discomfort with human sexuality.

I know perfectly well the sordid history of health insurance and female birth control. I don’t expect much sympathy from female readers, who have borne the full cost of their sexual health for decades, until quite recently. But it’s really the same problem that conservatives so ardently and wrongly tried to smear Sandra Fluke with: people don’t want to think they are paying for other people to have sex.

You know what? I’m just as entitled to sexual health and well being as I am to any other form of health and well being. This is really a minor issue in the symphony of horror which is my cancer experience, but it’s a damned annoying one. The medication restrictions on sexually related drugs are just petty, and serve no purpose other than to make some people, somewhere, feel good about punishing me for having a libido and opportunities to exercise it.

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