Gloria Ferris

Yesterday Christine came by for a cup of coffee, and this is how the conversation started. “I thought my pharmacy bag seemed awfully light when I picked it up.” Over the years, she and I have formed this little charade on how we handle these conversations about Medicaid. It’s kind of like a comedian and his straight man trying to make it in The Berkshires while knowing that the material just isn’t too funny. But how else do you deal with this reality played over and over and over? So knowing my part well, I ask “Why was it so light?” And her reply, “Medicaid has disallowed four of my medications.” The straight man had no line to deliver. She asked me, “What am I to do now?” The straight man still didn’t know what to say, so she said “Punt?” Christine said, “I’m not ready to do that.”

I knew that but I truly am out of options of what to say. I don’t know how many times her doctor can act more like a magician than a physician and pull a rabbit out of her hat finding another medication, a new combination that works, a referral to a specialist that turns into a miracle too good to believe. We hear story after story of the doctors who scam Medicaid for millions of dollars, but we seldom hear of the doctors that still take Medicaid patients and work through and around a bureaucratic system that has long forgotten why it was formed but rather is more interested in its own survival than for the vulnerable people it was formed to serve. These doctors are unsung heroes.

Twice a year, Medicaid revisits the approved drug list for the patients under their care. In January, these very drugs now pulled off the list were put on the approved list. Doctors breathed a sigh of relief and began prescribing them for patients that needed these drugs for a better quality of life. Now, five months later, the drugs are gone, the patients have lost faith and neither have any hope for an answer coming from a huge bureaucratic mess.

You see, I think that the problem is that late last year, a new use for Cymbalta was found. It not only was a useful medication for depression, but it was found that it also helped people with extreme nerve pain. This fact would open the door for doctors to prescribe the drug to people with neurological disorders, neuropathy from diabetes, and other conditions. The other medications I didn’t even try to figure out the why or wherefore. It boggles my mind when I hear people my age talking about “Medicaid ” planning for their parents. I can only assume that they have had no firsthand knowledge on working with this agency. Single-payer insurance plan for the nation! I can think of nothing more horrific if it turns out to be administered like Medicaid has been for the poor. I realize there are no easy answers for any of these things, but I can only believe if we try to switch our thinking from a sickness viewpoint to one of wellness, we may begin to turn this elephant around. Christine feels that had she had more preventative care when she was a child that her illness would not be as advanced today. That may or may not be the case and in regards to her, we will never know, but don’t the children of today deserve a better outlook, and how can promoting good health be wrong?
So yesterday was a day that was pretty bleak, but today was a day that again saw Christine looking for answers on how to cope with the extreme nerve pain that would make a lesser person knuckle under. Her latest goal is to score a muscle stimulating machine she was denied last January, causing the doctor to prescribe medication to cope with the pain rather than muscle stimulation. So, she asks me, the straight man, what do I think? Do I think that we can find a way to get one? And me, who am I to rain on her parade? I say, “yeah, yeah, we could try that.”