State Medicaid cuts

[JanS]

I’m sure there are quite a few people in the community that will be affected by this:

http://www.thenewstribune.com/2010/09/30/1362348/state-medicaid-cuts-devastating.html

I especially like the deep cuts in the pharmacy program. For those of you who have to pay, you all know what the prices of some of these drugs are, esp. if there’s no generic. Wonder how many people will simply stop taking medications?

And, they’re gonna make drastic cuts in the Apples for Kids program, just when Regence Blue Shield is pulling out of insuring children in separate policies without having to be in a family plan. How scary for those people. But, hey, the Steve Ballmers and the Jeff Besos’s of the world are against 1098..heaven forbid that anything ever be cut from their lives. These cuts will do a great deal of harm to the people of this state. I’m dumbfounded.

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[Escondido]

How does the saying go?…. a society is judged by how it treats its most vulnerable?

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[JoB]

we are each judged by how we treat the most vulnerable around us.

worth thinking about when you vote.

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[Carson]

WWJD. If I had to guess, he wouldn’t be voting for any republicans or tea baggers……shame on the wealthiest country on earth and they way they treat the vulnerable.

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[NicNDuB]

Ok I know I’m preaching to the choir, but as someone who worked at Harborview with the uninsured and later assisting HIV+ individuals to obtain insurance, I feel the need to point out that too often we frame the health coverage issue as an individual problem, instead of the public health issue it actually is. While I agree that we should be concerned about the most vulnerable populations in our society, not everyone shares this belief, but I haven’t met too many individuals who aren’t concerned about their own health and safety.

And this is where I believe the conversation needs to move away from “the most vulnerable” to “our collective well being”. Viruses and other communicable diseases love densely populated areas because their ability to live and “procreate” is dependent on hosts. When communities have a high percentage of individuals with compromised immune systems (e.g. children, elderly, and the disabled), diseases will setup residence in these hosts as they learn how to get around the immune systems of the healthy. If contagious individuals do not have access to healthcare, they essentially become a carrier which impacts everyone in the community.

This is where I like to use an actually case to illustrate. At Harborview I worked with an individual who was the sole supporter of their family of 4 (them-self, a spouse and two children). This individual worked as a cook in a nice restaurant that didn’t offer health benefits. Therefore, when they got sick, they continued to go to work since they couldn’t afford medical care or to take time off and still feed and shelter their family. This individual also expressed a strong value of being self sufficient versus being a “welfare family”. I met this individual when they were admitted to the hospital after being immobilized by tuberculosis. Moral of the story: If you think healthcare is an individual’s responsibility ask yourself how many others you encounter in your daily life and how strong your immune system really is.

Finally, this is how the proposed Medicaid cuts could impact all of us:

• Cuts to outpatient Rx benefits: MRSA and other diseases that are “highly resistant” have developed in big part because of a lack of adherence that allows disease strains to become immune to existing treatments. So we can expect to see a rise in “super-viruses” if individuals can’t afford to complete some Rx treatments

• On average Medicare takes two years to make a disability determination. In WA the Disability Lifeline (or GAU as I knew it) offered medical coverage during this determination process. So even if you’ve worked your whole life and believe you have a safety net should you develop a chronic condition or get seriously injured, ask yourself if you have saved enough to cover medical and living costs for 2 years while waiting for the government to process your claim.

• Hospice services and emergency medical funding: do we really want to stop providing emergency and end of life care? Because if so we’d all better get accustomed to watching individuals die on our streets.

Thanks for reading and now I’ll step off my soap box.

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[Jiggers]

The latest report by HarborView is that TB is up sharply among the homeless community this year because they are forced to sleep in cramped quarters in a shelter and breathe the same oxygenated air. There is a mandatory quaranteened period if one is symptomatic and will undergo numerous blood cultures in a 4 day holding period. Once determined if the individual has contracted T.B, they are given a prescripted medication(not A cure), to help combat their virus and let back out into the public. Most carriers of TB don’t give a damn about giving it to other people around them. The scary thing is that you don’t know who has it around you and hopes no one sneezes within fifteen feet from you. You can get TB just by breathing it in.

I personally have a rare auto-imnnuno deficiency illness which requires life-long infusions which isn’t A cure. I am very nervous being around dirty individuals with nasty habits. Thank gawd I am not on medicaid and have better insurance to pay for my $2,500 an infusion treatments. But one day soon, it will be cut too I’m afraid.

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[JoB]

NicNDuB

thank you for making your point so eloquently…

it’s too easy to think that these cuts only affect others when the truth is that they affect all of us one way or another.

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[HMC Rich]

First hand experience teaches us about reality and rhetoric. Thanks NicNDub

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[redblack]

hey, rich. you understand that nic-n-dub’s reality is imploring us to not cut a government-funded social medical plan for the poor simply because of anti-taxation rhetoric, right?

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[JoB]

and there’s the rub..

rhetoric translated into programs often kills people.

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[Dr.Moxie]

Well put, NicNDub! What bothers me the most about the cuts to pharmacy benefits is that they are supposed to save the state money, but I strongly believe that eliminating coverage for maintenance medications will end up costing DSHS much more in the long run than they realize. If people have to choose between food, shelter, or medications, most of them will choose the first two. DSHS might save a few hundred dollars a month by not covering a patient’s medications, but if that patient’s non-compliance puts them in the hospital, a 2-3 day stay could cost $10,000 or more.

I don’t really have a solution to this – the system is broken in many ways. We need more money for social programs, but where that money will come from is a mystery. The truth is even if prescriptions are covered by Medicaid, at the current reimbursement rates more and more pharmacies (especially independents) will follow Walgreen’s and Bartell’s lead and stop filling Medicaid patients’ presciptions. The state pays pharmacies far less than it actually costs to obtain a drug, to the tune that on average, each Medicaid Rx loses a pharmacy $20-$40 or more. If small pharmacies (or even big ones) continue to lose this much money, EVERYONE’S prescription prices will go up.

But again, although I wish I had the answer, I don’t. I just think it’s sad that the healthcare of our community is considered such a commodity, when it should be a basic human right.

/sorry for rambling!

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[JoB]

Dr Moxie..

rhetoric driven solutions are seldom cost effective…

this one is no exception

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