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A Medicaid Tale

By Jeralyn, Section Social Justice
Posted on Tue Jul 19, 2005 at 04:08:30 PM EST
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This is a little off topic for me, but I got this e-mail, and wanted to share it. Just another reason the Republicans should not be in charge.

My 20 year old was diagnosed with Manic-Depression at the age of 8 years old. For the past 12 years he had been on 9 medications a day to maintain a reasonable level of stability. In June of 2005 his Doctor placed him on a new anti-convulsant/mood stabilizer along with an atypical antipsychotic that achieved a level of stability and functioning we had not seen in the last 12 years.

I went to refill his medication on July 19 , 2005 and much to my surprise, dismay and disbelief Medicaid refused to cover this Medically necessary drug , which by the way ran $130.00 for a 20 day supply. I spoke to our pharmacist, and my son's doctor, only to find out that even they had no for warning as to this Medication being on the list of No Longer Covered medications with Medicaid....

My son's doctor even applied for Medicaid authorization as Medically necessary for my son. He was promptly refused by Medicaid. It absolutely amazes me that a politician can make medical decisions of such proportions that can and will affect many people in a very negative way.

My son has gone from 9 medications a day down to 2 a day with the most impressive results and increase of functioning we have seen. I am totally in shock. This new medication has made it possible for my son to become a productive functioning member of society.

(continued below)

I am a registered voter, and have missed only three elections since I turned 18. It is also amazing that our Governor's Drug Addicted Daughter can commit prescription fraud be placed in a Mental Health/ Addiction Center, which by the way has at least a 6 month waiting list for the mere mortals of Central Fla., not be charged for a felony, had drugs found on her person while in treatment and never was held accountable for any of her actions.

Is Bush looking to let the ill and infirm wonder the Streets to be beaten to death or abused at societies whims or because a group of teens were bored or thought it was fun to torture someone to death ? I am sorry I am just irate at the idiocy of the Bush Regime`......

Thanks for allowing me to Vent and to share.

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    A Medicaid Tale | 12 comments (12 topical)
    Re: A Medicaid Tale (none / 0) (#11)
    by Che's Lounge on Sat Dec 17, 2005 at 12:59:41 PM EST
    It's very simple: If you're poor, you take 9 pills a day. If you're rich, you take two.

    Re: A Medicaid Tale (none / 0) (#1)
    by Talkleft Visitor on Sat Dec 17, 2005 at 01:01:25 PM EST
    I forgot to mention the cost of the 20 day supply of the one medication is equal to 1/4 of my sons' monthly income...A 30 day supply will be equal to or a bit more than 1/3 of his monthly income... The out of pocket cost for the second medication would(if it weren't covered) would total 2/3 his monthly income...

    Re: A Medicaid Tale (none / 0) (#3)
    by jen on Sat Dec 17, 2005 at 01:01:25 PM EST
    I keep remembering Bush during the election warning us that if the democrats won we would have government beaurocrats dictating our health care. Gee, we wouldn't want THAT

    Re: A Medicaid Tale (none / 0) (#4)
    by ppjakajim on Sat Dec 17, 2005 at 01:01:25 PM EST
    Jen - The problem is that Bush got a Rx insurance plan for seniors through Medicare, which will help me greatly, as well as my Mom. And the Demos fought it. So, tell me why?

    Re: A Medicaid Tale (none / 0) (#5)
    by Talkleft Visitor on Sat Dec 17, 2005 at 01:01:25 PM EST
    Medicare is a workers contribution based program paid into from Social Security witholdings from working.... Medicaid is not contribution based program but is a welfare program set in place for those who have developmental disibilities and physical impairments that limit or prevent gainful employment and have not been able to work due to disabilities... In Florida Mental Illness falls into the Drug/Alcohol/Addiction category so monies are spread very thin with addiction taking the lead in recieving monies... Funny thing is from my experiences with my son , Mental Illness is a developmental disability and not an Addiction issue.... His development has been and can be very much disabled when he is not stable and due to medications to control the symptoms....

    Re: A Medicaid Tale (none / 0) (#6)
    by sarcastic unnamed one on Sat Dec 17, 2005 at 01:01:25 PM EST
    Interesting article in the most recent Nat Geo about psych problems - some of them, like bi-polar, may be caused by viruses. Anyway, lilone, my mother's bi-polar and, bluntly, a complete mess when she's manic and not much better when she's not. There are some charitable organizations who may be able to help with your situation. I wish you and your son all the best.

    Re: A Medicaid Tale (none / 0) (#8)
    by Richard Aubrey on Sat Dec 17, 2005 at 01:01:27 PM EST
    When talking about reducing the cost of healthcare, most folks forget that means reducing health care. Other than price regs for consumables like meds, unit costs for doctor visits, or hospital stays, seem pretty much fixed. That being the case, controlling health care costs means controlling health care utilization. Like the old HMO concept. The tightening up was going to happen to somebody else. No problem. But when one of those controlled upon is you, or gets some ink, IT'S A PROBLEM.

    Re: A Medicaid Tale (none / 0) (#9)
    by Talkleft Visitor on Sat Dec 17, 2005 at 01:01:27 PM EST
    Like the old HMO concept. The tightening up was going to happen to somebody else. No problem. But when one of those controlled upon is you, or gets some ink, IT'S A PROBLEM....
    Let Medicaid stop allowing certain medications to save money and watch the rise of in patient treatment begin... I see in the next 14-90 days there will be an extremely sharp rise in admissions for psychiatric patients alone , not to mention patients with other health issues, who are placed on ineffective medications or those their bodies have built a tolerance to because of long term usage... What an effective way to Save money.. Hospitilization costs vs Medication costs , hhhhmmmmmmm where is the logic here?????? Average medication cost of $130.oo for a 1 month supply of medication vs. (est.) 500.00-1000.00 per inpatient day... I must have learned math on venus because it is far different than the equations I am seeing in the Medicaid cuts for Medication..... Richard the Mediciad Cuts have effected more underage children and adults than you may be able to fathom... There is a 10 yr.old cancer patient in Volusia County who needs Zofran for his severe nausea that is a direct result of the Chemo-Therapy that he needs to battle his illness and become a survivor...Medicaid Cut this Medication... The Medical Cost reduction needs to start with a way to minimize erroneous visits to the Emergency Rooms for such things as a hang nail , allergy symptoms , and such... When is an Emergency An Emergency ? Asthma Attack , Heart Attack symptoms , Severe Bleeding , Open wounds , broken bones , Car accident victims , Assault Victims ,Dog Bites etc... I have on numerous occasions witnessed first hand people in the ER seeking treatment for blisters from new shoes , the flu , colds , etc... ER's cannot turn away those seeking Medical Attention however minor.. Some ER's have Fast Track clinics that are attended by physicians asst. who determine the best course of treatment for minor inflictions , with the guidance of Drs'... There needs to be more of these programs available outside the Hospital ERs that are run by an Administrating Hospital fFacility... Do yourself a favor and visit this site to read a few stories on what parents , patients and Drs. alike are encountering.....Do some research Because these Cuts affect us all in the lonf run...

    Re: A Medicaid Tale (none / 0) (#10)
    by soccerdad on Sat Dec 17, 2005 at 01:01:27 PM EST
    Jen - The problem is that Bush got a Rx insurance plan for seniors through Medicare, which will help me greatly, as well as my Mom. And the Demos fought it. So, tell me why?
    1. its going to bankrupt the country. The projected cost makes SS look like chump change 2. Noncompetative, it forbade groups from negotiating lower prices. 3. too many give aways and protection for the corps. so great idea, bad bill

    Re: A Medicaid Tale (none / 0) (#12)
    by Talkleft Visitor on Sat Dec 17, 2005 at 01:01:28 PM EST
    Che Lounge In your world that may be a reality..... In the world of Medicines and Illnesses it isnt a REALITY....

    Re: A Medicaid Tale (none / 0) (#13)
    by Talkleft Visitor on Sat Dec 17, 2005 at 01:01:30 PM EST
    Dear Jim, Kerry and Edwards talked a lot about America's health care last year! The voters by a small margin (in fact) were more attentive to threats of terrorism, also labeled demagoguery (the threats). G

    Re: A Medicaid Tale (none / 0) (#14)
    by Talkleft Visitor on Sat Dec 17, 2005 at 01:01:30 PM EST
    Thank You, G

    A Medicaid Tale | 12 comments (12 topical)