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The day Speaker Ryan withdrew the American Health Care Act from consideration, there was a wreck on the freeway.

Getting home took a lot longer than usual. At times traffic stopped completely. We were in a parking lot that stretched for miles.

The car in front of me was an Audi A8. Shiny silver and brand new, the four-door version costs about $100,000. Behind me was a city bus. On the day Trump Care vanished, it didn’t matter if you were driving a fancy German sedan, my beat-up Honda SUV, or were sitting in public transportation. You weren’t going anywhere quickly. There was some comfort in the notion that we were all in this stalled procession together.

Finally, I got off the freeway and coasted up my driveway. Safe and home, I thought.

The jabbering geniuses of television journalism were in a celebratory mood. The depredations of the AHCA had been beaten back. We were all safe and home with Obamacare.

The station switched to advertisements for two medications: Harvoni, a medicine for hepatitis C, and Opdiva, for lung cancer.

Then we were back to howls about Trumpcare: a bullet dodged.

I couldn’t stop thinking about hepatitis C, a disease that can lead to liver failure, liver cancer and death. A few keystrokes on my cell phone, and the cost of Harvoni popped up. The wholesale acquisition cost for a single pill is $1,125. If you’re cured in eight weeks that comes to $63,000, not counting doctor visits and lab tests. If you need to continue therapy for twelve weeks the total is $94,500, plus clinic and lab fees.

Opdiva’s a medicine for lung cancer. It’s also used for skin and kidney cancer. The drug costs about $150,000 for the initial treatment, and then $14,000 a month. That’s for lung cancer; for skin cancer, along with another medication called Yervoy, the cost is $256,000 per year.

The average American household income is about $51,000 per year. A medication costing three times that, or a combination that costs five times a family’s income, might as well exist only on the moon.

The problem is, there are no substitutes for these very expensive drugs. If you have high blood pressure, there are many effective – and financially accessible – choices. So also for diabetes, with very good ones costing hundreds of dollars per month. And the same for asthma: hundreds per month will keep you breathing.

Put it this way: if we’re all going home, it doesn’t matter a great deal if we get there in a German luxury car, an old SUV, or a bus. The end result is the same. The Audi may ride better; the Honda may arrive a lot sooner than the bus, but we all get where we want. In the case of lung, kidney or skin cancer, sometimes the alternative to modern medicine is dying.

According to the Kaiser Foundation, over twenty-eight million Americans were without insurance in 2015. If you average that across the entire population, that’s about one in eleven citizens. Put another way, it would be two patients in my clinic per day – except this clinic does not see uninsured patients.

According to the Commonwealth Fund, in 2014 about a tenth of us had insurance with out-of-pocket costs or deductibles so high that we wouldn’t seek medical care until we were desperate.

I’ve read that the Republicans are developing a new and improved proposal that will come along someday. For now, we have Obamacare, which provides some insurance to most of us. You may not like the mode of transportation it offers, but you’re better off with it than being uninsured.

I switched off the television and thought of the people who don’t have any insurance, and the folks who have $10,000 deductibles.

We’ve got to find a way to get everyone on the bus.

— Dr. Richard Weiner has been practicing medicine in Milwaukee since 1989. The former UW Medical School faculty member is the author of the soon to be published legal thriller, Killing Dante.

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