Shawn sighs tiredly, just a few months ago his life was going great: He was thriving at his job and had a bright future ahead of him. Shawn wonders what could he be right now if he followed the suggested treatment right away. He remembers the days where everything started to head downhill:

The year is 2013, Shawn is excited, he recently got his bachelor’s degree from college and it is his official first day of work at the company he interned for in the previous year. Although the pay isn’t that high, around $70,000 annually, Shawn is glad to have a job that could support himself. His work is not too demanding, reviewing data on spreadsheets and organizing it. Shawn is ambitious, often working hours overtime to show his value, hoping that his efforts will pay off in the future.

One afternoon on Friday, Shawn looks down at his phone, seeing that his friend is calling.

“Hey Shawn, you open over the weekend? Want to go hiking with us?” invited Andrew

“Sorry, I have a bit of work to finish.” replied Shawn

“Come on, you haven’t done anything but work for the last few weeks! You need a break and plus it’ll be more fun with you” stated Andrew

Realizing that he hasn’t done much other than work, Shawn replied “You know what, sure, I’ll join in. I’m getting a bit tired of working; a break might help me keep motivated”

            On Saturday Andrew and Jackson picks up Shawn and heads to the mountains.

“This spot is great, there’s quite a nice view on the top and the hike itself is quite fun” states Jackson, “There might be a few parts that involves climbing”

“Sounds great! Hope we don’t get hurt though” says Shawn.

“Yeah, it recently rained so I’d assume the climbing parts may get a little slippery” Andrew added on.

“It won’t be a problem; I’ve done it once and it wasn’t that bad. If I can do it you should too” replies Jackson, laughing off the worries.

            As they traversed up the mountain, Shawn’s worries about the possible dangers dissipated. The recent rain caused a nice earthy smell as the climbed accompanied with the view of a giant lake formed by melted winter snow provided an enticing experience.

            “You’re right! This hike is great, want to go swim in the lake when we get down there?” commented Shawn.

            “You betcha, lets race to see who gets there first” challenged Jackson, swiftly running ahead.

            Both Shawn and Andrew didn’t want to lose the race so they followed, hastily descending the other side of the mountain to the lake. As they ran downwards, they saw someone lying down, clutching their leg. It was Jackson! He ended up falling down and breaking a leg. Due to this, the adventure screeched to a halt, Shawn and Andrew helped carry him back to the car and quickly went to the hospital to get checked up. Luckily, the injury was not fatal and only needed to get a cast and let it heal for a few days. As they were checking out of the hospital, the bill shocked them.

            “What the ****, just a cast for my leg costs 2,000? This is a scam!” exclaimed Jackson

            “Unfortunately, you don’t have health insurance so the price is $2,000” replied the receptionist “This is just standard pricing.”

            Reflecting on this incident, Shawn wonders to himself, “should I get health insurance, it’ll help cover the cost if I ever need it.” Fortunately, in 2014, the affordable care act has been updated, making it cover more people and Shawn perfectly fell in the bracket. Thus, Shawn as the cautious man he is, decides to purchase health insurance.

            It just seems like fate that Shawn falls ill shortly after the purchase of health insurance. Initially Shawn believes it to just be a cold, the incident during the trip made him extremely worried, not resting properly, which he believes to be the root cause. As time dragged on, the uncomfortable feeling still resets within him, however, Shawn already took a few days off of work and decides it is time to go back.

            “Hey Shawn, nice to see you back at work again. You feeling better now?” asked his coworker.

            “I’m still not feeling too well, I don’t know why but my stomach has been hurting recently. Not sure if I should go check in with doctors” replied Shawn, uncertain if he should spend a couple hundred dollars visiting the doctor.

            “If you’re still feeling bad and it’s getting worse, I think you should visit the doctor to get it checked out” suggested his coworker, “it’s better to be safe than sorry”

            Following the suggestion of his coworker, Shawn decides it is a good idea to visit the doctor. Although he at first was optimistic about his condition, what the doctor told him devastated him. The doctor tells him that he has ulcerative colitis, an inflammatory bowel disease that causes inflammation in the digestive track. Although there are no cures other than removing the colon, the doctor suggested biologic therapy, a method that targets the inflammation and slows the development of the inflammation. However, there is a high price tag for using it, costing over $10,000 annually but the pay-off of using it could be lifesaving. Shawn knew that he should follow the doctor’s instructions so his disease doesn’t get any worse. However, with the high price, he isn’t able to pay for it, forcing him to rely on his health insurance. The health insurance does cover these costs but due to their “step therapy protocol”, it requires Shawn to try cheaper alternatives for 3 months before moving onto the prescribed option. These alternatives do include drugs that help with inflammation such as the use of Aminosalicylates, a drug that helps with inflammation, but is much weaker than the doctor’s suggestion.

            In the first month of using these drugs, Shawn doesn’t feel much of a change. He still has pain in the abdomen but it is bearable. He assumed that the drug is working, not letting the inflammation develop further meanwhile also saving him a lot of money from purchasing expensive alternatives. However, as time progressed, the symptoms started to worsen, abdominal pain and cramps became frequent and fatigue has become constant. By the 2nd month, Shawn is in dire need for a different treatment, the pain became unbearable, causing him to stay at home.

            With only 2 weeks left of the 3 months step therapy protocol, Shawn couldn’t keep waiting, his current medications did nothing to relieve him of his pain. The pain has increased by so much, that it felt like a blade is stuck in his stomach. As the pain got worse and worse, he had difficulty completing daily tasks, often being chained to his bed by the cramps. Yet, when he contacts his health insurance to move onto biological therapy, he is swiftly denied, asserting that their protocol refuses further treatment coverage without going through their process. With no choice, Shawn has to wait out the two weeks, with each day the blade sinks deeper into his stomach.

            As the process of step therapy ended, he is finally approved of biological therapy. But, by the time it was approved, the damage done on Shawn’s colon is irreversible. The doctor informed him that the growth of the inflammation requires him to have his colon surgically removed. While the disease is solved, the process also caused irreversible damage to his life. Due to being bound to his house during the step therapy process, he could not spend time on his work, leading to Shawn getting fired. Losing his job puts Shawn under financial distress, but it is only part of his worries. The surgery ended up costing much more than what the biological therapy suggestion costed, spending what he has left of his savings.