Medicarelessness

Today our R.N., who cares for all our patients as if they're her own family members, reached into her purse and handed me her personal VISA card. Out of frustration, she decided to pay for a patient's Plavix because he's run out of pills and he's run out of money...and Medicare won't pay for his meds now. Remember that darn Medicare doughnut hole? The one you sink or swim in when you've spent x-amount of dollars on medications in a given year? When it's your time to swim in the doughnut hole, you have to pay 100% out-of-pocket for awhile. Otherwise, you sink.

Sammy, who has been a patient of ours for 30 years, is in his 60's. He lives with his mom, Gladdy, who is in her 90's. She keeps calling us crying because she can't find a way to pay for Sammy's pills. Safeway Pharmacy already called us that he owes them $400. Who knew Safeway took pity on poor people and allowed them some slack paying for their meds. Sammy is out of slack. The R.N. is desperate to find him some medication. She calls his cardiologist and begs for samples. (They’re rationing.) They reluctantly allow one week's worth. They, in turn, promise to apply for Plavix assistance through the generous folks at Bristol Myers. I agree to try to apply for emergency assistance from Medicare...on Monday.

I take the R.N.'s VISA card and click on the link to my favorite Canadian pharmacy and order 3 months worth of Clopidogrel, generic Plavix, which isn't even available in the United States. It's $77.00. In the U.S., the brand name stuff would have cost Sammy about $270. Eventually, the medical practice will end up reimbursing the R.N. and paying for Sammy's Clopidogrel because we don't want him to die.

Lately, we've been paying for some patient lab tests and not charging the health care workers who come in to see us because they work hard and take care of our patients in the nursing homes. Most of them are overworked, underpaid, and underinsured. So, we try to take care of them when they ask, so they are healthy enough to take care of our Medicare and Medicaid patients who reside in those pathetic warehouses that you never want to send your family member to if you can possibly avoid it.

Anyhow, Sammy needs more than Plavix. His mother needs her medications too.

There are a lot of Sammy's and Gladdy's now. Many are just not getting their medications...and ending up in the E.R., where they get meds for a while and recover, which Medicare will pay for. Then they're discharged.

Once back home, some still won't have found a way to pay for their medications and will just sink down into the doughnut hole...never to come up.

MediCARE? or Medicarelessness?