Posts tagged 'medication'
When you have one pot of money and it is finite, it can be hard to split it up in a way that makes everyone happy. Let's take what the government is going through with the budget right now. It would be great if they had unlimited amounts of money, if the automakers and banks weren't in big trouble and if Medicare/Medicaid and Social Security were at least stable.
But the picture isn't that pretty, and the fact that we are in the middle of a recession doesn't help either. Add to that bad mortgages, foreclosures all over the place and handing over money to the banks without an accounting of where it has gone and the picture gets worse.
As to the banks supposedly showing profits recently from the bailouts, take a look at Dr. Martin Weiss’ article, Big bank profits are bogus! Massive public deception! He writes, “Was the bad-debt disease magically cured? Did the economy miraculously turn around? Not quite. In fact, we have overwhelming evidence that the condition of the nation’s banks has deteriorated massively since then.
“How can our trusted authorities be so blatantly deceptive and still keep their jobs? Perhaps you should ask Fed Chairman Ben Bernanke. Not long ago, for example, he declared that the total losses from the debt crisis would not exceed $100 billion, while conveying the hope that most of those losses could be soon written off. Also around that time, the International Monetary Fund (IMF) estimated the losses would be $1 trillion, with only a small percentage written off. The IMF’s latest estimate: $4 trillion in losses, with only one-third of those written off so far. Bernanke’s error factor: He was 4,000 percent off the mark, in a world where 50 percent errors can be lethal.”
And the critics talk of Medicare’s $1 trillion in costs last year to cover 42.5 million seniors. This cost was inflated by the privatized HMOs, PPOs inserted into Medicare along with the rule that Medicare could not bargain with Big Pharma on drug pricing as does Medicaid. These are a few of the negative impacts inflicted on Medicare by the Bush administration and others. In fact, Medicare began in 1964 under Lyndon Johnson as a classic single-payer health insurer. Listen closely, President Obama. It was only later that the privateers were ushered in to gobble up 12.6 percent of its premium revenue for “administration.” What if Medicare got some of that bank bailout money?
Yet the Times reports, “as a result, the administration said, the Medicare fund that pays hospital bills for older Americans is expected to run out of money in 2017, two years sooner than projected last year. The Social Security trust fund will be exhausted in 2037, four years earlier than predicted, it said.” The question is to whom will that money run out to?
Though there are many priorities here, this is a country that touts taking care of the neediest among us first. "Give me your poor...your huddled masses..." The country was founded on these ideas. All of the rest of this stuff we are dealing with now came later and some of it did not have to come at all.
The new president has said that this is our time, this is the time for change. It seems that he and lawmakers are trying to figure out what to change first and how to do it so that everyone comes out at least somewhat stable. I wouldn't want to be in their position - the president and lawmakers were left with quite a mess to clean up and figure out and it hit them all at once. It doesn't matter who is or was to blame. The blame game can go back decades and waste time that we don't have. It is time to fix things once and for all, and it is time for everyone to stop whining and get the job done.
This is a story about a man named Don. It really happened, and it really happened to Don.
Don really enjoys playing his guitar.
Tuning it, he says, is so much easier than getting into tune with his Medicare prescription provider, called Medco, (one of the largest Medicare medication distributors), which kept telling pharmacies Don's benefits had ended.
He recalls his first trip to the pharmacy this year.
"I gave them my card, they looked it up and they said that's been terminated."
Since Don needs seven different prescriptions every month for his heart, blood pressure, and diabeties, he started getting concerned, as those bottles were nearly empty. Many of us can relate to that situation. I get nervous when the number of pills I have left gets low , especially if my doctor is out of town, I don't have a new prescription or my check hasn't arrived. I take 6 different pills every day for heart, blood pressure and a few other issues.
Back to Don. He kept calling Medco. Over and over until it was ridiculous.
"I probably made 35 calls to them."
Medco kept telling Don he wasn't covered, while Medicare kept telling him he was.
"I was getting really frustrated about it."
Then he thought the frustration would finally end, when he got this letter from Medco, which said he was covered.
But despite that letter, the pharmacist said his records showed Don still wasn't.
"I call Medco and I fight with them on the phone about it, they keep telling me I'm terminated."
Now, Don really started getting worried. When you are in a situation like this it seems like you get stuck in the middle and everybody is going back and forth with no end in sight.
He says he certainly can't afford the $700 it would take every month to buy his meds without Medicare's help.
"I just figured I'm going to have to quit taking them and take my chances, whatever."
Most local news channels in every city and state have some sort of consumer problem solvers segment where the news channel will help you with your problem. Don definitely had a problem and it could have turned out to be fatal for him. With his pills running out, Don finally called the 2News problem solvers, and they contacted both Medicare and Medco.
Later that very same day, Medco called Don, to clear up his situation.
"They just wanted me to know that they had updated everything in my file and the card is now working and I could go pick up my prescriptions anytime I wanted to."
Finally, Don finds himself in perfect harmony, with his music, and his meds. If you find yourself in a similar situation, don't give up. Keep trying to deal directly with your drug company, medicare and your pharmacy. If that doesn't work, do what Don did and get extra help. There is usually a way to work it all out.
For years we have heard about the plight of seniors on very meager incomes who have to rely on Medicare and Social Security to survive and who have had to buy second-rate food – or even dog/cat food – so they can eat.
Medicare has been designed to help seniors with their medical expenses, especially prescriptions. The prescription drug coverage, a supplement to Medicare, is essential to seniors, as much of their ongoing healthcare is dependent on their medication.
This part of the Medicare coverage available should actually be the easiest to deal with. No doctor, no hospitals, no tests, just medicine. However, with the changes to Medicare, especially with Medicare Advantage on the scene, things have gotten somewhat dicey in the area of seniors and prescriptions.
On the surface, Medicare Advantage is a good idea, but once you look into it, there re dangers lurking just a little below the surface. These dangers can leave seniors extremely vulnerable, because once seniors have reached a particular amount of coverage/paid claims for prescriptions, the bottom drops out.
What happens is that if a senior has a Medicare Advantage plan that pays up to $2500 in prescriptions, once they hit that amount, they must pay for further prescriptions out of their pocket – often to the tune of thousands of dollars. Once they reach the next plateau, coverage kicks in again.
The problem with this situation is that if a senior on Medicare Advantage has spent the initial allotment of coverage for prescriptions in the month of August, they will be paying for medication out of pocket possibly for the rest of the year. Many times, the cost of medication is more than their entire Social Security check or entire income that month.
Because of this, too many seniors are simply going without medicine. Imagine being on insulin or heart medication. How long could a senior with diabetes or a history of heart disease go without their medication before there are serious complications, or even fatal ones?
Lawmakers are trying to fix Medicare. This is one area where they have to pay close attention. In the meantime, physicians can try to work with their patients on Medicare to prescribe generics – especially those that are $4 on many pharmacy plans – so that seniors don’t have to risk their health and their lives by going without.
Lately there has been a rush to access various personal and confidential medical records for research purposes. The latest information being requested is Medicare prescription drug benefit claims.
The Centers for Medicare and Medicaid Services (CMS) has issued a ruling allowing researchers access to records for only specific purposes. They will be able to study the effectiveness and safety of medication used by elderly and disabled Medicare recipients.
One of the reasons that researchers want to try to explore this information is that elderly and chronically ill patients are often not included in clinical trials and the information that can be obtained through Medicare could help study results of specific medications.
CMS has stated that under the rules, the information regarding the individuals and the identities of prescription drug plans will not be accessible and will remain encrypted. CMS will also combine cost information for Medicare prescription drug plans because not doing so “could negatively affect the ability of plans to negotiate medications, favorable to Medicare beneficiaries and taxpayers.”
There will also be regulations to guide research in what they can do and what they cannot when it comes to the research they are working on. The Kaiser Family Foundation has said that the release of this information is a good thing. Researchers will not have the ability to access certain claims data, nor will it be able to discover the amount of rebates that Medicare prescription drug plans receive from pharmaceutical companies and the amount they charge beneficiaries.
One important part of the research will be allowing researches to determine how many beneficiaries reach the “donut hole” amount where there is a gap in prescription coverage, but they will not be able to identify which plan they are enrolled in. Determining the gap in coverage at the “donut hole” may help many avoid financial traps in the future by identifying a way to avoid that trap.
In some respects, if handled appropriately, this research can certainly be helpful to many parties involved.
Most of us live our lives without too many emergencies to interrupt us. As a result, we have a tendency to get pretty comfortable and not be totally prepared in the event of certain emergencies – especially medical emergencies.
This can put us in a mess if we are suddenly faced with a medical situation where people – such as our doctors or hospital – need pertinent information from us to treat us. For example, we might break our leg, which in and of itself seems simple to deal with.
However, what if we are taking medicine for blood pressure, diabetes, heart issues or blood thinners? All of these medications can have an effect on how the doctors in the emergency room choose to treat us. They can also have a huge effect on our health.
If the doctors don’t know what medicines we are taking or how much, they could possibly give us conflicting medicine which could cause serious health issues.
There is an easy solution to this issue. Write it all down. A great suggestion is for you or a friend/family member to write down all your medications, the doses, and the times you take them. Include over-the-counter medicines, such as Tylenol or allergy medication. In addition, write down your blood type, religious preference, doctor’s name and phone number and an emergency name and phone number plus any allergies you might have. Put all of this information on one sheet of paper and fold it and put it in your wallet. In addition, give an extra copy to a friend or relative, as well as keeping one copy on a magnet on your refrigerator so it will be easy to find in an emergency.
Chances are that you won’t need to use this handy little paper, but in the event that it is necessary, it will keep your doctors informed and will keep you safe.
There are numerous complaints about government agencies not communicating with one another and not working together. Some of these complaints make it clear that because of this lack of communication people have been hurt or killed, lost money or property and have often ended up in crisis.
There is some good news for Medicare recipients. The Food and Drug Administration (FDA) and Medicare will be working together to help keep recipients safer. Both the FDA and Medicare have huge databases. Medicare’s databases contain a tremendous amount of information regarding claims, which include medication. The agencies have determined how they can use the databases to explore and address problems with medications and medical devices and equipment that are discovered while they are new on the market. This computerized early-warning system is being designed to keep people healthy and save lives. In addition, the system will save money by recognizing negative reactions quickly, look at patterns that lead to hospitalizations and work to isolate medications that are causing or increasing health problems. With all this at work together, this should eliminate some hospitalizations and other medical expenses, saving money for recipients, for Medicare and for all involved in the system that tries to keep people well.
This new system will keep individual records private. Only information regarding medical issues will be shared, but the identity of the individual will be kept private. The FDA has a current early warning system, but it relies on self-reporting by patients and doctors, which is not accurate, and which also does not capture a high percentage of information, since many people don’t report for many reasons.
This system has taken years to devise, and is important because it could shorten the time it takes to detect drug safety issues and bring it don from years to months. This is good news, not only for Medicare recipients, but for all of us.
