11/08/2008

Socialized Medicine Vs. Whatever

I can't help but recall a quote by a voter during the election that Barack Obama would usher in an era of "socialized medicine" that would mean if she needed an organ transplant she would be denied.

socialized-medicine As most folks who have been through such a process can tell you there is much more likelihood that private insurers will deny you a transplant than the "socialized" programs we have now such as Medicaid or Medicare.

I received my transplant after my private insurer dropped me once I became very sick. I had to wait until I was eligible for Social Security Disability and as an offshoot, Medicaid to finally be allowed to be listed for transplant.

The process, once the process was approved and I had the magic card in hand was seamless. I did not have to worry over bills and co-pays. I received my post-transplant medications quickly and without trying to come up with extra money for "upper tier" co-pays and such.

Then, Medicare kicked in with it's attendant Republican backed "prescription drug benefit". This boondoggle and pork barrel project to shore up friends in the insurance industry has proved a disaster for me.

For the first time since my transplant I do not have the anti-rejection drugs that keep me from rejecting my new liver. This past week, I took my prescriptions in to be filled for the first time since my "drug benefit" kicked in only to find the company I have does not cover one of the drugs at all. The other drug is an "upper tier" drug and they cover only 75% of it. If it were something that was $100 a month, that wouldn't be too bad. But, this drug runs almost $1200 a month. That means I'm looking at $300 for this drug and $1300 for the other. That's $1600 a month which is twice what I make a month.

Without these two drugs I will die. It's quite simple, they keep my body from destroying my new liver and without them my body is beginning to attack my liver and it's only a matter of time before it's destroyed and I die a very painful death.

When I had the truly "socialized" system of Medicaid I did not have to worry. Now that I am on the program that the Republicans have "privatized" I cannot the medication I need to survive despite their trumpeting of how much they have helped people.

On Thursday, I called the private insurance company who provides drug coverage for Medicare recipients. I spoke to a very chirpy and upbeat young woman who explained the situation. I explained the gravity of the situation and received the sentiment: "Oh, I'm really sorry about that. If there's nothing else I can do, have a nice day!"

Have a nice day? How am I supposed to have a nice day?

I called my new doctors at UMC here in Tucson to see if there was someone there who might be able to help me. They didn't know. Back at my old facility in South Carolina they have a person who does nothing but help post-transplant patients find ways to pay for medication or have it provided through the drug companies. Here in Arizona there is no such person. No one knew what to do.

I called Medicare and spoke to someone there. She told me my drugs were covered under "Part B" of the program and I just needed to give the pharmacy my Medicare card and it would be no problem.

Relieved, I ran to my local Walgreen's up the street and gave them the card. The woman at the counter took it and my "Prescription Drug Plan" card and typed and typed.

As she worked I noted her angle pin, her cross, and other religious insignia on her frock. Finally, she turned to me and said, "Well, these have to be pre-approved."

"What does that mean?"

"Well, I'm not really sure. But it says in the computer it has to be 'pre-approved'. We'll have to call Medicare and see what we have to do."

Expecting her to pick up a phone I waited. She just looked at me, her little angel pin glittering in the fluorescent lighting.

"Well, do you do that or do I have to?"

"Oh, I can do it. But it usually takes a week or so for them to give us the approval."

Stunned, I said "I have enough medicine for another day and half."

"Oh, I'm sorry." she replied.

"Do you know what happens if I run out of this medicine? I reject my liver and I die."

"That's so sad. But, it'll be at least end of next week before we hear anything. Is there anything else I can help you with?"

The drug companies (those supposedly evil entities) do provide this life saving medication free of charge. The problem is, they only do it if you don't have Medicare, Medicaid, or private insurance. If you have any of those, you're out of luck even if you can't afford Co-Pays or "top tier" premiums.

So, today I run out of one of the drugs completely. I have enough of the other to make it till Monday. After that, I'm done.

If we had a single payer AND single provider system in this country, perhaps I would not be an emotional mess right now. If everything was handled by people using one single system there would be no need to coordinate back and forth with private companies either insurance or provider all trying to protect their bottom line profit.

With a single provider and single payer system she would have been able to type in the information and find out that, yes, I had a transplant and was not seeking to cadge immunosuppressants because I thought it'd be fun to take them. As it is, I now am out of medication for all intents and purposes and just have to wait for a private pharmacy looking to make a profit to decide to give me the medication. I have to wait on an employee at a government office to look at my medical records online and see "yeah, this guy needs these to live" and then call back a private company to OK the deal. Unfortunately, that can take days or weeks.

So, for all those who whine and cry about "socialized" medicine, I say "screw you." If I hit the lottery and can afford medicine that runs almost $2800 a month without blinking then I suppose I won't worry either.

No, that's the difference. I would worry, because I worry about the health and well-being of others as much as myself. Maybe that's why I'm a Democrat and not a Republican.

In the meantime... I wait and hope somebody approves this before I start rejecting.

So, President-Elect Obama, despite what the Republicans whine and cry about, PLEASE fix this system. Your people are hurting and dying.

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