Out-of-Pockets to Pick

By David Icenogle

They tell me
the copay for my medication is only
a hundred and fifty dollars.
The best way to measure privilege
is the way people use the word “only.”
They tell me
I should be relieved
because without insurance it would’ve been eight-hundred.
Why not make it a million?
They tell me
never, never, never
stop taking your psychiatric medications abruptly
unless you can’t afford them apparently.
I’m already buying off-brand food
just to pay for the off-brand, generic prescriptions,
maybe I could afford the one-fifty
but what I can’t afford is the uncertainty
because last month it was one-twenty.
Spare me
the carpet-bombing of jargon that you think
will bully away my questions.
“It’s complicated” ain’t an answer
especially when it’s on purpose.
Here’s something not complicated,
people die without insulin
so don’t intimate that this is negotiable,
don’t intimidate and call it consensual,
and don’t boast about what insurance has saved me
when it’s all Monopoly money.
I’ve spent way too many lunch breaks on hold
just to be told
I should’ve had an ailment that’s in-network.
My patience has met my out-of-pocket.
I just want it to make sense.
If an apple-a-day keeps the doctor away
then this system is an orchard
rotten to the core.
It has the bedside manner of a buzzsaw.
And no
I can’t tell you how to fix it
but that doesn’t make me or it less broke,
so if ya’ll keep blowing smoke
I’m going to keep pulling fire alarms
until the insulin runs out.

David Icenogle is a writer and mental health advocate from the Midwest. He has written nonfiction work for the University of Nebraska-Omaha and the National Alliance on Mental Illness, as well as poetry for Asylum Magazine, A Tether to this World, Main Street Rag, From Whispers and Roars, and others. He also produces a YouTube channel focused on addiction and mental health called “No Chaser with David Icenogle.”

Photo credit: Sy Clark via a Creative Commons license.

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