Medicaid

Somehow forgotten in the debate for and against universal health care is the fact that since 1965, the US has had some semblance of coverage for its low-income and impoverished citizens. It's probably one of the few successes reaped from LBJ's Great Society.

The program is called Medicaid. Ever since I have been back home in Alabama, I've had to rely on Medicaid to provide prescription drugs for my bipolar disorder. The problem with Medicaid is that it takes a very intelligent person to cut through the red tape and successfully obtain it. Another key problem with Medicaid is that it is lacks many of the amenities that a Blue Cross/Blue Shield excellent quality insurance provides. Medicaid will only fill 30 days worth of prescription drugs at a time. Additionally, as a cost-cutting measure, two of my medication, Effexor and Strattera, are placed on Physician Advisory (PA) status. This means that my physician has to go to the trouble of stating firmly why I should specifically be prescribed these particular meds rather than a lower cost alternative.

But even so, it's absolutely ridiculous how much a 30 day supply of medication costs without insurance. Effexor would cost upwards of $500 a bottle. Strattera would cost $400. This is an excellent example of unbridled greed. The pharmaceutical industry has milked so many people dry that many ailing individuals have been forced to not be able to afford to take their medication. That is a total travesty. Mental illness, in particular, is endemic among the homeless and the drug addicted. I have no doubt that we could prevent many crimes of property and illegal drug offenses if we ensured prescription drugs would cost less than street drugs.

Medicaid works fairly well for just prescription drugs alone, but fat chance getting it to work for anything beyond that. Therapy, a crucial element along with pharmaceuticals in successful treatment of mental illness is an impossibility so long as one only has Medicaid. Few therapists will take it because it a) pays out at such a low rate and b) often pays out delinquently, months behind when it is supposed to.

The point of this post is to recommend strongly that if baseline universal coverage comes to these shores, we would be wise to avoid the pitfalls of Medicaid.