Mom received another letter from Governor Doyle touting the success of Wisconsin's SeniorCare prescription drug program for senior citizens. She got it on the same day that SeniorCare denied coverage for another one of her medications. That is how they save money: they decide that the medicines that your doctor has prescribed are too expensive, so go suck an egg.
Mom is 88. She fell and shattered a hip three years ago. After the surgery, her doctor prescribed Boniva, a medication for the management of postmenopausal osteoporosis. She received that for a month or two, then SeniorCare decided that was too expensive and they wouldn't cover it. So her doctor had to find an alternative. He then prescribed Fosamax, which essentially does what Boniva did, but it has to be taken more often. She's been doing OK on that for a couple of years. Now SeniorCare has decided that Fosamax is too expensive, too. So we're back to playing the find a less expensive (and often less effective) alternative game.
This has not happened with only one medication. It has occured with her acid reflux meds, pain meds, and heart meds. Her doctors prescribe something, the insurance says no, and she is left without medication while SeniorCare, pharmaceutical companies and the doctors slug it out. She once was transported to the ER because they thought she was having a heart attack. It turned out to be the under-treated acid reflux disease - under-treated because SeniorCare (NOT a medical doctor) demanded that she take a useless over-the-counter alternative. A trip to the ER is more economical than a pill?
It's quite obvious that the care of seniors is the last thing SeniorCare is concerned with. As always, money is more important than people. And as always, people who worked their entire life take it in the ass while Medicaid provides cradle to grave coverage for those who leeched off of them.
Screw you, Doyle.
Subscribe to:
Post Comments (Atom)
Posts
11 comments:
The pharmacy said that they faxed all the information to mom's doctor's office on Saturday. I called the doctor's office this morning, and they said they received nothing. I called the pharmacy again and they said that they did fax the information and they re-faxed it today. I again called the doctor's office, and, of course, they've still received nothing. Meanwhile, the doctor's office says they can prescribe an alternative if they know what the "approved" (read: paid off the right people) alternatives are from SeniorCare. The pharmacy, of course, does not have this information, so now we must contact SeniorCare.
This is how I spend my time. It's a full time job wading through the bureaucracy surrounding mom's and my health care. It can take days to resolve these things. In the meantime, someone might die, but that's OK, too, because then SeniorCare saves even more money.
But Orbs, according to the Rush Limbaughs of the world, we don't need health care reform in America. Most of us are happy with our health care. Personally, I don't know what world he is living in; maybe the rich white mans world.
According to Kaiser Family Foundation a company provided family health insurance plan rose from $5,791 in 1999 to $13,375 a 131% jump.
Do you realize that we have more options for bread than we have health insurers in America?
Here in Oklahoma, teachers were just informed their co-pays are going from $25 to $50 per visit.
As for the slackers, don't get me started. I have a friend who has a family member that has been in the welfare system a long time. She recently lost weight and guess what we paid for - surgery to get rid of the excess skin.
Meanwhile I have to pay almost 100% to get at colonoscopy because prevention is not covered. And I ask, why are we paying $850 a month for insurance?
Something has got to be done about this.
I agree that something has to be done, but SeniorCare is touted as health care reform. Wisconsin is the only state that is allowed an alternative to Medicare Part D prescription drug coverage, and SeniorCare is it. They say that other states are studying our system as a model. A model of what? Government incompetence?
We subsidize a permanent underclass with food, shelter, education, medical care, legal care, everything care, while people who worked and contributed to society their entire lives are punished for their contributions. The subsidized people commit crime after crime after crime, costing us billions and billions and billions of dollars, while those who abide by the law are treated like dirt for working hard.
Our government represents only special interests. It needs to be taken back by the people.
You are so right Orbs. One question I would love to have answered is this:
How much does it cost us to keep providing insurance coverage for single women who keep having babies? It's 2009 and there are countless forms of birth control but yet we keep rewarding those who will not take responsibility for their actions. (Both men and women).
Personally, and I say this as a liberal, if we have to pay for these irresponsible people, then we should be able to say "fine we'll pay for this but you will have to get the new birth control that will prevent pregnancies for up to 5 years". Why not?
Yes?? no kidding..
I think this thing with health care is a very tricky situation. I am a receiver of universal health care here in Sweden and I have no complaints of it. To have my 2 babies it cost me (out of pocket of course I know it costs) nothing, not a dime. I dont know what people are used to there in The States. I did the most of my "adult" years here in Sweden and have not much experience of what it is like there as my parents hated going to the doctor. I was the youngest of 4 children so by the time I came around they knew how to take care of the most.
I do know that I took my two daughter to a walk in clinic just days before we had to leave to go back to Sweden. The visit was probably 10 minutes total for the two girls. He checked their ears, nose and throat. They had a bacterial infection and prescribed antibiotics. We recently got those bills. For the oldest Mina that 5-10 minute visit cost 203 dollars and for Maia it cost 156 dollars. so for 10 minutes time it cost over 350 dollars. Thats just crazy. I am sorry. Maybe I am just ignorant to what costs there actually is when dealing with clinics but there is nothing I could see that would cost so much.
I dont expect The States to adopt a system like we have here in Sweden but something has to be done to make it affordable. We luckily bought insurance here in Sweden so that we can take them to the doctor, but for those that cannot get health insurance, dont have the money for it, I can imagine a lot is left for later. The problem is sometimes if you leave your health for later it can get worse and even more costly.
The Swedes are a very healthy people. Have a high life expectancy, high birth weights, low infant mortality and high quality of life. I can find those statistics for you later. It's late and I can't think too clearly to actually find them right now. I do believe it is because we all have access to health care. If something is bothering us we can go and get it checked out before it becomes a bigger problem. Babies are born healthy because it doesn't cost anything and is accessible to all.
I know I am very one sided about this, but with all of the positives I see from it they far outweigh the negatives (the biggest of those is yes, sometimes you may have to wait awhile to actually get care that is seen more as elective). I can live with those but I cannot live with fearing that my children are going to get sick cause how will I pay or worrying that my insurance company will finally decide that something is too expensive that they will not cover it.
don't know why my comment was posted twice so I removed one of them, that's what I deleted.
It is a complicated problem. The high costs, at least much of it, are the result of us covering for those who are not insured, on Medicare or Medicaid.
The $10.00 aspirin you get in the hospital is the same issue. A doctor bills $3500.00 for an MRI. Medicare pays them $300.00. For a doctor or hospital to accept medicare patients, they have to accept assignment (that is whatever medicare decides is fair to pay.) Everyone gets billed an inflated price to cover that difference.
Medication is outrageous. The enormous costs and the exclusivity length before generics are allowed to be manufactured are sickening in themselves. I do realize there should be some compensation for the research that it takes to develop new meds; however, they milk it to death. $600. for a lipitor prescription is unethical.
When I was taking care of my mom, her health, her medical issues, nursing homes, bills, medicare, medicaid, wheelchair transportation to dr. offices, her medications... I thought I was going to lose my mind.
The mess and the lack of professionalism in doing the right thing the first time is rampant. It was a full time job just to watch over everything and make sure people were doing their jobs.
An elderly person could never handle it themselves. It is criminal how the elderly and sick are actually preyed upon. I could hardly take it and I think I have my wits intact... well, most of the time!
Gosh I feel very fortunate. I go to Lakeview Pharmacy and they give me 4 of my medications for 13.50 each for a 90 day supply. I go to K-Mart pharmacy for sleeping meds and they check into it and gave it to me for 19.00 for 1 month supply. It is supposed to cost $35. The pharmisist did this on his own for me. Everytime I buy ANYTHING I always use the 'I am old and poor.' Works 90% of the time.
I believe that whatever "health reform" we get in the US will be a Frankenstein monster of pork for the special interests, notably the insurance and pharmaceutical companies (who I believe ruined health care in the US in the first place). Check out Medicare options since the "reform" of that a number of years ago and Medicare prescription drug coverage options. Both of these are now a melding of government and private insurance that are almost indecipherable to the average person, but are ALL weighted to the insurer's advantage. You and your doctor may think you are making your health care decisions, but they are subject to the insurer's approval.
After the "reform," will Congress still have a better health plan than the average US citizen? You betcha! And that's all that's really important, anyway.
Just saw a segment last week on ABC about "The Office of the Attending Physician"...which provides primary care for members of Congress for a premium of about $500 per year. This is not part of their federal employee health care, but a supplemental perk. Great deal I'd say.
There is ABSOLUTELY no excuse for Congress to have a better plan than the rest of the taxpayers. NONE...except they make the rules.
Post a Comment