Recent changes in insurance coverage for prescription drugs will make it impossible for many of our most ill citizens: people with cancer, multiple sclerosis, rheumatoid arthritis and other autoimmune diseases, to afford the treatments that would either save their lives or drastically improve the quality of their lives.

News of these changes came to light in an incredibly disturbing piece in this week's New York Times. It seems that most Medicare plans have quietly backed off of their coverage of dozens of drugs they've deemed to be too expensive.

Calling these drugs, Tier 4 and Tier 5, the insurers have decided that there comes a price where it isn't financially expedient to save lives.

Where patients once paid $20 or $30 as a co-pay, they now find themselves paying out of pocket hundreds, even thousands of dollars a month for the drugs that are keeping them alive, saving their lives or just improving the quality of their lives.

Other HMOs are thinking very strongly about making similar moves.

The Times story told the story of Robin Steinwand, a woman suffering from multiple sclerosis. She was taking the drug Copaxone, a drug that costs $1900 a month, but had cost her only $20 a month under her husband’s insurance with Kaiser Permanente. Under Kaiser’s new policy, Steinwand’s costs went up over 1600 percent.

In the scheme of things, she got off pretty easy. Many of our most effective cancer drugs are far more expensive. Erbitux goes for $10,000 a month. Rituxan can cost up to $13,000 a month.

I happen to suffer from sarcoidosis, specifically neurosarcoidosis. This is a disease with no known cure. Left untreated, it could leave me paralyzed or dead.

I tried a wide variety of drugs, from Prednisone to Hydrocloroquine to Methotrexate. None of them worked. I was finally given Remicade and the results were instant and dramatic. Because of Remicade, I can walk, drive, work, even hit a few tennis balls.

I get infusions of Remicade once every five weeks. Each infusion runs over $11,000. Do the math. At over $132,000 a year, if I am forced to pay 25%, that’s $33,000.

When I get my infusions, I am in a room full of other patients. Most of them are getting cancer drugs. Over the past two years, I have seen those drugs work miracles. People who seemed to be on death’s door had their cancers driven into remission, many permanently.

Many of them could never have afforded to pay even a small fraction of the cost of their treatment. Many of the patients I saw hugging their nurses and doctors as they got up from their final sessions of chemotherapy, the ones given a clean bill of health, would be dead today.

Left unfettered, insurers will continue to let people die in the name of cost-cutting and profits. The Bush administration, a big fan of both the insurance industry and the pharmaceutical industry, has stood by while the cost of drugs and the cost of coverage have skyrocketed. Bush has blocked all efforts to import less expensive drugs from places like Canada.

The good news is that of the key remaining candidates, John McCain, Hillary Clinton and Barack Obama have proposed  health-care plans that will attempt to lower all health-care costs, including the costs of prescription drugs.

Such plans will be expensive and the money will have to come from somewhere. You must ask yourselves which candidate will have the budget for major health-care reform. Will it be the candidates that promise a swift withdrawal from Iraq or the one who has offered up a 100-year occupation?

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