NYT: Medicare Woes Take High Toll on Mentally Ill

[DeepModem Mom]

Medicare Woes Take High Toll on Mentally Ill
By ROBERT PEAR
Published: January 21, 2006


HILLIARD, Fla., Jan. 16 - On the seventh day of the new Medicare drug benefit, Stephen Starnes began hearing voices again, ominous voices, and he started to beg for the medications he had been taking for 10 years. But his pharmacy could not get approval from his Medicare drug plan, so Mr. Starnes was admitted to a hospital here for treatment of paranoid schizophrenia.

Mr. Starnes, 49, lives in Dayspring Village, a former motel that is licensed by the State of Florida as an assisted living center for people with mental illness. When he gets his medications, he is stable.

"Without them," he said, "I get aggravated at myself, I have terrible pain in my gut, I feel as if I am freezing one moment and burning up the next moment. I go haywire, and I want to hurt myself."

Mix-ups in the first weeks of the Medicare drug benefit have vexed many beneficiaries and pharmacists. Dr. Steven S. Sharfstein, president of the American Psychiatric Association, said the transition from Medicaid to Medicare had had a particularly severe impact on low-income patients with serious, persistent mental illnesses.

"Relapse, rehospitalization and disruption of essential treatment are some of the consequences," Dr. Sharfstein said....


http://www.nytimes.com/2006/01/21/politics/21drug.html?hp&ex=1137819600&en=35febaf4c964dc52&ei=5094&partner=homepage

[DELUSIONAL]

1. An unknown number of people are going to die as a direct

result of greed and mismanagement.

We'll never know the exact numbers. My guess -- more people who died so dramatically in 9/11 -- but the ones who die from this current bushie terrorism won't die in a dramatic fashion -- but they will be dead none the less.

[aquart]

2. Yet even here at DU, we have people thinking terrorism is our worry.

Terrorism is a pin prick compared to what we are facing because of criminal George. A pin prick.

[rman]

32. DU's history explains that

In honor of DU's 5th Birthday: 7 DAYS UNDERGROUND
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=364x198270

My take on it is "they" never left DU.

[proud2BlibKansan]

3. My sister is on medicaid

and is also suffering from mental illness. Just yesterday, she was trying to explain to me how complicated it is to fill her prescriptions now. She got frustrated and said these new procedures are going to make her even crazier. She was crying by the time she was through explaining and I had no idea what she was talking about.

I asked her if she wants me to pick up her meds for her.

[mom cat]

11. I am so sorry for your sister and so glad that she has you. This

changeover has hurt so many people.

[DeepModem Mom]

13. Thank you for sharing your sister's experience, proud2Blib. I hope...

she gets the meds she needs.

[proud2BlibKansan]

18. She will get them.

We will make sure. But I can't help but worry about the mentally ill who don't have family and who are abandoned by our society. It is shameful.

[Skittles]

39. please go with her next time p2b

she needs you

[Mnemosyne]

4. Do you remember awhile back

when Fla. started making medicaid patients take cheaper meds and fail for three months a year before they could have drugs they had successfully used for years the rest of the year? Most states do this now to cut costs, only many patients never get to go back to the drug that is effective. I know this from close personal experience.

I am so sorry that Mr. Starnes is having to suffer like that. The suffering caused by this administration in this country and worldwide is reprehensible.

The new medicare benefits are just a continuation of weeding out the weak and poor. I truly believe they are counting on people dying and committing suicide from serious physical and mental medical conditions to cut costs in many ways long-term.

Yes, I believe this administration is capable of such cold and calculating evil. No tinfoil required.

Never in my life would I have expected to see an elderly person cry at a pharmacy. I have seen it now. And I had to cry when I left because there was no way for me to help.

This administration just gets more disgusting each moment.



Peace
V

:hi:

[DeepModem Mom]

14. I have tears welling up, just reading the responses in this thread.

What an outrage -- what cruelty -- is this dismissal of the weakest and poorest among us!

[Mnemosyne]

27. I know dear hearted one,

just when you think you can cry no more...

:hug:

[NMMNG]

5. If any nitwit Rethuglican dares to ask me, "Why do you hate America"

Atrocities such as this will be on my long list of answers.



It is criminal to treat sick people like this and get away with it. :grr:

[Hekate]

6. There will be deaths, both thru lack of meds and by suicide

Serious, life-threatening illnesses kept in check by appropriate medication, which is then interrupted and resumed only if the victim can pay an exorbitant price.

Government, for all its faults, is ultimately accountable to US, the people, the taxpayers. Corporations (which is what we get from privatization) are accountable only to the shareholders and the bottom line.

Damn them to Hell for their cruelty and greed, for their callous disregard of basic human decency.

Hekate

[Dulcinea]

29. My husband's aunt...

...takes 16 pills a day for various ailments. She has to drag an oxygen tank around with her everywhere she goes due to a bad heart. If she can't get her meds, I shudder to think what will happen.

She long ago signed all her assets (not that she had much) over to her kids so she could get on permanent SSDI & get her meds paid for. No doubt there are many people just like her who are in as much danger.

Does that mean her life is worth nothing?

[Kurovski]

7. This simply outrages me. Privatizing the system was an immoral,

idiotically hateful thing to do.

And remember that DeLay twisted arms, bribed and threatened folks on the floor when there were initially not enough votes to pass this corrupt boondoggle designed to pour money into the coffers of BushCo. contributers.

It is a medical and financial national disaster.

Pathetic. Disgusting. Criminal. These are incredibly dangerous people who have taken control over our lives.

[zippy890]

8. Horrible and typical -once again the most vulnerable in this

country are harmed, like in the Katrina disaster.

Outrageous that these disabled people must suffer because of this government's failures in governing.

Why didn't the Bush administration forsee that mentally disabled people would have a difficult time during this farce of a drug plan's transition period?

Because they are incompetant - and they just don't care about the american people's welfare.

:grr: absolutely infuriating

and I can hear the repubs blaming the states and the people themselves for the problem

[susu369]

9. This is a well-written article and is so important

Someone close to me suffers from paranoid schizophrenia and lives in a community home. He has improved and stablized so much that he could even work part time (for the first time in his 61 years). A few weeks ago I noticed he was not doing well at all (talking out of his head).

The reason? Lapse in his medications.

The community home was fighting to get the proper medications after the January 1st medicare change. It was/is a nightmare.

[DeepModem Mom]

15. That is awful, susu! Thank you for sharing this story. nt

[susu369]

17. Thank you for caring

:hug:

[kurth]

10. Don't forget the profit protection racket

The law the GOP pushed through in 2003 explicitly FORBIDS Medicare from NEGOTIATING with pharmaceutical companies for lower prescription drug prices. Freaking FORBIDS it.

[GCP]

12. This makes me so fucking mad I can hardly stand it

I want to kill someone when I hear stories like this. This country has gone so far down the dark path it makes me wonder if we'll ever get back to being a reasonable caring place again.

AARRRGGGHHH :banghead:

[SammyWinstonJack]

16. What a Great Fucking Country this is!

:sarcasm: :mad: Proud to be an American You betcha! :puke: All this so the Greed Pigs among us can have more tax cuts! Who the hell cares about the poor, the uninsured, the mentally ill and the infirm elderly, just so long as gays can't marry and the wealthiest 1% get to keep their fair share. And of course the middle class will pick up the tab when preventive care would have been cheaper than hospitalization. Damn repubs will trip over a dollar to pick up a penny.

[DeepModem Mom]

19. Note: This story appears on page one today in the print edition...

and is among the five most-emailed.

[sarcasmo]

20. This cabal does not care about the mentally ill, or the poor.

[Gregorian]

21. But there's lots of money for bombs and jails.

This isn't what the people want. So it shouldn't be this way. So why is it this way. Our suffering is not neccisary.

[zann725]

22. Not only waiting for med's...but waiting YEARS at times for SSDI or LTD

coverage lead to the homelessness and death of many truly ill (eventual Medicare recipients). The average waiting time for SSDI to start is 1-1/2 to 2 years (for someone long-term ill). May I say that during that LONG wait, not only are they in most cases living WITHOUT meds, but also without home.

And MOST who also have private Long Term Disability Plans (such as the UNUM/Providet Class Action)...wait THREE years or more for that "supplement" to their State Disability or SSDI which they PAID for to do so under ERISA law. I laugh every time I see that AFLAC ad, with that cute little duck, that says that "AFLAC will be there in times when you get ill and need it." SURE! You'll wait an average of THREE years (even with legal support) to receive your "support"...and maybe NEVER get it...particularly IF your illness is serious and truly long-term.

Part "D"'s SLIGHT DELAY and confusion of drug coverage only is but the "tip of the iceberg" in this National Medical Care crises...particularly sad in the case of the Elderly and Disabled, who most desparately, timely need the care, and can afford it the least...yet their meds alone are often priced two and three times the cost of the meds of those on "private" plans who earn full-time executive salaries.

We need to develop respect for the Elderly and Disabled NOW. Every government in the past who has not...has crumbled, for among other reasons, greed and arrogance and lack of conscience.

[pop goes the weasel]

24. there's the SSDI wait

and then there's the extra year they have to wait to be Medicare eligible. What could be stupider? People who have already been found too disabled to support themselves obviously need medical help now, not in another year!

[zann725]

36. Yep! The whole system's set up to make you get sicker while you wait

and wait and wait.

That's how a lot ultimately lose their SSDI cases first time, AND in one-year review. They CAN'T afford the meds for a winning file during their long wait, waiting for SSDI qualifications. THen most get a one-year review AFTER approval. And during that first year, MOST have no paid medical care, since they are waiting for Medicare to begin. Really quite clever of the Powers-that-be.

And people who haven't gone through the System, have NO IDEA how hard it is on someone already quite sick. My friends keep wondering why I'm still struggling. Daaaaa!

I've now waited over 3 years for a private LTD policy (and it's short term counterpart) which should've supplemented my State Disability AND SSDI for about 60% of my prior income. Want to talk about needless loss and compromise.

If I see that cute little AFLAC duck one more time...saying he's there in time of need!! Right!

[pop goes the weasel]

23. psych drugs

are the most delicate, difficult to get right. The supposedly same formularies will differ enough to cause one to be effective or at least not harmful while another is either ineffective or has bad side effects.

The cost to the individual and society of getting it wrong is enormous. I think that anyone should be able to get any prescribed psych drug on demand, with the bill picked up by the taxpayers. (I don't think that people should be forcibly drugged, but more people would be willing to take medication if they had the right to take the ones, and only the ones, that are helpful to them.)

[HockeyMom]

28. Having both a daughter who is BiPolar

and as a person who works with the mentally ill, this is a nightmare waiting to happen. I can tell you what my daughter is like when she doesn't take her meds, OR, if they need changing. It takes time for the adjustment. They cannot just be switched arbitrarily for the COST FACTOR.

Also, since I work in the mental health field, our agency sent out a letter to all employees urging us to contact our REPUBLICAN (yes, it said that) state representatives on the cutbacks to Medicaid. If the clients cannot get their proper meds, they will become a danger not only to themselves, but to all of us who work with them.

[newswolf56]

25. This is genocide, period -- not "incompetence":

What The Times reports is only the tip of an unspeakably hideous iceberg. I know this all too well: I write about this issue for an advocacy-and-information journal that serves elderly and disabled people.

The ugly and infinitely damning fact is that social-services bureaucrats and advocates for elderly, poor and disabled persons have been warning about these problems since BEFORE the Bush Medicare Prescription Drug Lord Benefit was enacted -- and the (many) Democrats who voted for it are therefore thoroughly compromised by their votes. The Bush Administration response -- other than to cackle at how once again the Democrats were thoughtlessly falling into another George-Bush-is-stupid trap -- was to viciously suppress bureaucratic critics, savagely belittle the few advocates who were able to circumvent the near-total media blackout to make themselves heard, and to ignore all the rest of us.

Which proves beyond any doubt the unspeakable truth of what the astute poster above said, that the Bush Administration and the oligarchy it represents "are counting on people dying and committing suicide from serious physical and mental medical conditions to cut costs" -- the final solution to the problem of low-income elderly persons, the poor and the disabled: among the latter category innumerable AIDS victims who are now denied the drugs that formerly kept them alive.

Why? In the case of AIDS victims, the answer is obvious: the Bush Administration's savage Christian-fundamentalist hatred of homosexuals has now officially turned murderous. In the more general sense, all such genocidal policies are rationalized by the fact that under capitalism, the ONLY value we have is the degree to which we are profitable -- either independently wealthy or exploitable for profit -- and those of us who are low-income elderly or disabled or simply poor are not profitable in any sense. Thus the plutocrats not only despise us but lust for all the money that could be redistributed into their already obscenely fat bank accounts if we were all exterminated: precisely -- and do not doubt it for even a second -- the Bush Administration's intent: and all the more shame on the Democrats who voted for it, whether because they are class-traitors or because they were merely duped (again).

Three points to remember: (1)-everyone who does not die beforehand will be elderly, including those of you who now think of yourselves as endlessly young; (2)-the Bush Medicare Prescription Drug Lord Benefit (for that is exactly what it should be called) is absolute proof that every Republican -- every member of the party that is now ever more brazenly the American vessel of fascism -- is the sworn enemy of each and every one of us who is not independently wealthy; (3)-here too -- not only in ever-more-openly genocidal corporate/Republican policies but in the nationally ruinous unwillingness of far too many Democrats to oppose them -- is horrific proof of the extent to which we are already enslaved, quite probably beyond any hope of liberation until the political makeup of the world itself changes.

(I am, of course, low-income and elderly myself, and what it says on my signature line is a bitter truth both personal and political: "In these times, mere survival is a revolutionary act.")

[DeepModem Mom]

26. Thank you for this incredible post, newswolf, and..

for sharing your knowledge.

[rman]

33. kick

[wiley]

30. Drown them in the bathtub.

This is the work of CORRUPT REPUBLICANS. I warned them this would happen,and fought against it. Hastert and Ney and DeLay must pay for this. Burns and Santorum must pay for this. Bush and Cheney and McClellan must pay for this.

It is sending the elderly into episodes of fear and hysteria and destroying nursing care institutions throughout the country

Instead of therapy, those with mental illness are being tied or restrained in their beds or rooms until "something" can be done

People with chronic illnesses - who also can't get their medications just to stay alive - are also suffering from the inability to access mental health meds

Parents who are otherwise stable and healthy are abusing their children.
It is severely affecting thousands of vets being treated for hepatitis C (taking SSRIs or anti-depressants is almost mandatory)

The tired and poor are no longer welcome at our nation's shores. Lady Liberty is watching them end their lives in desperation and hopelessness.

I can't even begin to describe the horrors in hospital emeregency rooms.

[brentspeak]

31. You could see this coming from a mile away

The Republicans will do anything and everything in their power to destroy Medicare, Medicaid, and Social Security. It's not just greed that motivates them, but power, as maintaining those programs is a major Democratic party platform, and a big reason why people vote for Democrats.

[newswolf56]

34. Unfortunately, the Democrats are as much to blame as Bush:

The Senate vote on the bill was 76-33, with decidedly bi-partisan oppossition. In other words, the Democrats, had they chosen to fight rather than cave in to Bush Administration pressure, could have stopped the Bush Medicare Prescription Drug Lord Benefit and prevented what is now occurring. Here in the Senate records is the ugly and bitter truth:

http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=108&session=1&vote=00262

Note that -- to his eternal credit (and one of the reasons I so fervently support his candidacy in 2008) -- John Edwards was one of the very few Democrats who had the huge courage to heed the measure's critics and vote NO.


Edit: addition of last paragraph.

[salin]

35. I believe this is the vote on the first bill

the one that went to the senate. After similar bills passed both the senate and the house a "conference committee" was set up with members from both houses and both parties to rewrite the bill - this is usually done as a form of compromise - as both houses then have to vote again and pass the bill in a single form. In this case (as has happened more regularly in recent times) the democrats were locked out of the negotiations - and whole parts of the bill were rewritten and items that had not been included in either original bill were suddenly inserted.

Am guessing that this is not the final vote because that vote gave many hoosiers a big surprise - we all assumed that Bayh, who gets a lot of pharma $ through Lilly (located in Indianapolis), would vote for the final passage. But he didn't. In the end he voted against it.

In the vote you have linked above Bayh votes in favor of the bill - thus I am surmising that the linked vote might be to the original... the original was a bad bill (not nearly as bad as the house version, however) - but the bill that came out of conference (and eventually became the law) was ten-fold times more horrendous.

[newswolf56]

37. According to the Senate website...

which is the most deliberately user-UNfriendly online research facility I have ever encountered (you have to know the year and the bill's number -- even the exact proper name won't suffice -- to track legislation, which is why it took me nearly two hours to find this tabulation), this was indeed the "final" vote. If you can find a later vote, please do -- I surely won't be in the slightest bit offended, because my whole effort is to make known the ugly facts that are being deliberately suppressed by corporate media in service to the Bush agenda.

Also, this was THE enabling vote, the vote during which the Democrats not only ignored an opportunity to stop the legislation but made its passage a certainty. And even given a subsequent vote, this vote is not only profoundly damning but indicative of the truly embittering extent to which the party has abandoned its former New Deal values; debate on the measure, with the now-totally-confirmed negative input from social-service people, had begun at least a year earlier.

More explicitly, all the subsequent vote would show is the extent to which the clamor of protest had frightened some senators into actually listening to their constituents -- or at least reconsidering the positions they had made public by their original vote.


Edit: for clarity and completness. (Sorry; I am posting here while at work on another project.)

[salin]

40. I wouldn't disagree with your 'enabling' comment

esp given that the repubs had already started doing the lock the dems out of the conference committee and insert whole new parts to the law that benefits corporate buddies act prior to this bill.

I was just commenting on my memory per my surprise at Bayh's vote - it stunned a whole lot of hoosier dems and thus locked into my memory. (I am not a big Bayh fan, esp for national office - but I also know that in Indiana when we elect repubs - we elect some real wackos.)

[newswolf56]

41. Your recollection was right, but just as you acknowledge, the

irreparable damage was done by the enabling vote I reported above; from its very beginning this law was written by and for the pharmaceutical companies.

Here are the 11 Democratic senators who voted for the bill's final version:

Baucus (D-MT), one of four prime sponsors (the other three were Republicans); Breaux (D-LA): Carper (D-DE); Conrad (D-ND); Dorgan (D-ND); Feinstein (D-CA); Landrieu (D-LA); Lincoln (D-AR); Miller (D-GA); Nelson (D-NE); Wyden (D-OR).

I am delighted to see my own senators (Patty Murray and Maria Cantwell) reversed their votes on the final tally: advocates in Washington state were truly relentless in their protests, and both senators -- Murray especially -- have been doing help-the-victims penance for their original pro-Bush/Prescription Drug Lord votes ever since. But exactly like the flurry of gunshots that kill an innocent bystander, once launched by the initial vote, the measure became a fatal volley that could never be called back, and shame on Murray and Cantwell -- and everyone else who voted "yes" on S-1 -- for not recognizing this fact (or assuming we the people would be too stupid to recognize it).
_________
Footnote for would-be activists:

For those unfamiliar with the deliberately perplexing federal legislative process, there are typically at least two versions of any bill: a Senate version and a House version. Each has its own number -- an S-prefix designating the Senate version, an H-prefix for the House -- and each bill may have content that differs from the content of its companion measure in the other house. Once these bills have passed, their differences are reconciled by a House/Senate Conference Committee, and the reconciled form is then also voted on; assuming approval, it is sent to the president for signature or veto. But there may be any quantity of resolutions relating to such a bill, each too with its own separate number, and the bill may also be absorbed into another measure. Here of course is where the process gets muddy and profoundly difficult to track: an obstruction that is not only obviously intentional but -- when contrasted to other systems -- proves beyond any doubt Congress is doing everything in its power to discourage public scrutiny: note for example the easy-public-access numbering system used in the Washington state legislature, where a bill (and everything related to it) retains the same number from start to finish. Federal governance is allegedly a public process, but once you have worked in a genuine public-disclosure state like Washington, you can see what an absolute lie this is: the entire federal system is designed not only to make public participation impossibly difficult, but to enable politicians (and the plutocrats they represent) to pass sneak legislation without public detection.

In the case of what should properly be called the Bush Medicare Prescription Drug Lord Benefit, the Senate version was S-1; a House version, introduced the same day the Senate version was approved, was HR-1. There were eight related bills: H.RES.299, H.RES.463, HR-1382, HR-2409, HR-2473, HR-2596, S-1, S-1195. To arrive at the decisive votes, I had to track each of these measures to their conclusions -- a task made monumentally more difficult by the fact the corporate media effectively downplayed the entire story, thereby completely silencing the protests of advocates for persons elderly, disabled and generally poor. (In fact I had never heard of these protests until 2004, when I returned to journalism after an 18-year absence, and as a consequence began reading advocacy newsletters and related e-mail alerts firsthand.) Since you cannot find a vote in Congress without knowing both the date of the vote and the bill number, the near-total media embargo made the task especially difficult: counting the time it took me to find the second vote, I put at least five hours into this project, more likely seven.

For the sake of contrast, note that under the Washington state system -- designed to facilitate public participation rather than exclude it -- House and Senate always use different sets of numbers, for example 1000 to 2000 for the House, 5000 to 6000 for the Senate. And a given measure will never have more than two numbers: say SB-5000 and HB-1000; everything else would be in the form of amendments, which would merely add additional prefixes to the number: for example SHB-1000 (Substitute House Bill, i.e., the amended version). Thus the number itself is what is vital: request HB-1000 and you automatically get all its variants too -- which (as I can attest from many years of working with this system while covering the legislature) makes tracking infinitely easier, even in the pre-computer days when "request" meant driving to the capitol and perusing the printed records page-by-page. A comparable bill-search using today's electorate-friendly Washington state computer system -- I did at least a dozen such searches just last week -- takes about 10 minutes max.


Edit: restructuring a muddled sentence.

[newswolf56]

38. When I have time -- early tomorrow -- I'll honor your recollection:

It'll probably take another hour or two because I'll have to go back and do a top-to-bottom article search looking for some later-dated version of the "Senate Approves Drug Benefit" story I finally used to find the Senate bill-number necessary to dig up the vote on it. If I do -- all I will need is the relevant date -- I'll be able go back into the Senate archives and search further. If I find anything I'll write a summary and post the relevant link.

Internet records are fine as they go, but they are NEVER complete -- and they are a million times more difficult to find your way around in than a good card file, primarily because card-files were kept by trained and reasonably well-educated acquisitions clerks, while Internet data is most often tagged by hopelessly ignorant minimum-wage exploitees slaving in what they know are dead-end jobs. Hence -- for example -- a large regional library that (until I discovered the error and sent a very irate letter to its management) had all references to the Central Intelligence Agency computer-filed under "Vietnam War": a true story. At least they didn't have CIA filed under "Psychology" -- which I heard actually happened elsewhere.

[newswolf56]

42. Kick n/t

:kick: