Cover the Uninsured Week March 10-16

[Sally_ICURN]

As some may have heard or read or seen on TV in the form of informational commercials, in the United States, there are 41+ million people who are not covered by health insurance. As the commercial goes, 8 out of 10 of those uninsured are people who are employed.

Cover the Uninsured Week is "an effort to sensitize the public and opinion leaders to the plight of the more than 41 million Americans who lack health insurance."

About Cover the Uninsured Week

Cover the Uninsured Week is an effort to bring this important and ignored issue to the forefront by an impressively large group of partners, patrons, benefactors, sponsors, and supporters which include the ANA to the YMCA and many reputable groups in-between. AND by individuals like you and me.

http://covertheuninsuredweek.org/involved/

Some facts:

*The uninsured represent 14.6 percent of the population.

*Uninsured Americans come from every race, age and ethnic group.

*Nearly a quarter of them are children."

More facts

As nurses, we have the opportunity to help. Help individuals by learning what resources are available to them.

Find out more about the legislation that is being proposed by Congress and the administration of our current President:

Legislation.

This IS NOT about a Single Payer healthcare system or Universal Healthcare, this IS about adressing the very serious healthcare crisis that is happening NOW in this country.

"The Covering The Uninsured Campaign does not endorse a particular solution to the problem of the uninsured, but it invites you to join the national discussion so that practical solutions can be found."

Get involved. Sign the proclamation! When you do it is forwarded to a company called GMMB, an advocacy agency who is uniting the voices into one large ROAR! Print it, take it to work, collect signatures and mail it to Sarah Moss c/o GMMB 1010 Wisconsin Ave NW Suite 800, Washington DC, 20007 . That's my plan.

It's the least we can do to try and make a contribution for the better.

[MelRN13]

Signed. Thanks for the info.

[Gardengal]

Sally_ICURN,

Thanks for posting the topic with links-esp to the ama one. When i first encountered this thread I recognized that the links were some I would want to take the time to read, so chose to leave the thread to return to later. Lo an behold I had to come back to a thread which apparantly has generated some controversy. I'm sorry that happened to detract from a good topic.

I find it interesting that the AMA is so strongly behind this, I believe they were one of the big detractors when the issue of catastrophic illness insurance was a hot topic in the late 70s early 80s. (kind of a similar concept) Maybe this time around with the collective support of so many there will be more progress. I seem to remember a lot of concern regarding decreased general quality and socialized medicine last time I got involved in looking at this to any extent.

I think that many people now are agreed that our health care system is broken and needs to be fixed. Maybe that opens our minds a little more.

I frequently feel that open hearts are not really that uncommon...it's when we add open minds and try to open pocket books and wallets to support the ideas that we run into trouble.

By the way- I too carry my own professional Liability Insurance, but not on a separate policy. i include it with my homeowners for better coverage at a lower cost.

[Brownms46]

Originally posted by maureeno

The Bush administration has suggested a Medicaid reform plan, front loaded with money which is to be paid back after several years, with the supposed "savings" states are to find by redesigning their benefit programs. Oregon already received a Medicaid waiver from the federal government to devise its own healthcare plan. The plan is now in total crisis. 500,000 people with no coverage at all.

From The Oregonian

Man's state points to crisis

03/09/03

PATRICK O'NEILL

A disabled Portland man is unconscious and in critical condition at Legacy Good Samaritan Hospital & Medical Center after losing state pharmaceutical benefits for low-income people.

Douglas K. Schmidt, 36, apparently suffered a massive seizure about eight days after his supply of anti-seizure medication ran out.

Family members said Saturday that Schmidt was still waiting for an application to arrive so he could get onto one of the interim prescription programs being offered as backup by pharmaceutical companies.

Oregon's budgetary problems have forced the state to drop coverage for some people on the Oregon Health Plan, the state's health insurance program for the poor. In Schmidt's case, it was a cut in the state's medically needy program.

Jean Thorne, director of the Oregon Department of Human Services, called Schmidt's hospitalization "a tragic circumstance."

"But as we cut back the safety net, we're going to see similar cases," she said Saturday.

Thorne said 8,500 people lost pharmaceutical coverage when the medically needy program was cut. "But beyond that we have another 100,000 who are going to lose their coverage on July 1," she said.

That's the date the Oregon Health Plan eliminates coverage for the state's working poor.

Maureeno,

I'm glad you posted this story, as I'm here in Oregon, working with this area's unemployed, disabled and working poor. I have seen first hand, the distress the people in this area are going thru. I see providers desperately searching for ways to help those who are losing their benefits here. In fact one 17 yr old student work a letter to the editor about this horrible problem to the newspaper here, about his mother losing her coverage.

Just last week we were calling around trying to find meds for a newly dx young woman with seizures. We have been frantic calling the insulin drug company for insulin, and have other offices calling for their pts.

Before last week when some people received a temporary restoration of their benefits, there was a group home, that was going to have to get rid of their residents. Why?? Because the group home was told, that it didn't matter if their residents couldn't afford their meds, that they would have to provide them, because if they got sick ...it would be the group homes fault!!! And so the group home will have to stop caring for them!!!!

So what good does it do to have benefits to allow you to go to see a doctor, if you can't pay for th medication???

There are some programs with the drug companies, such as twelve dollar co-pays. But that does nothing to help those who can bearly afford to pay rent, and eat. There are those who are having to chose between having a place to live, or eating, and having their meds!

We have a samples cabinet and even though the drug reps are leaving us more and more samples, it only touches the surface. There are also programs with the drug companies, that will give the pt. drugs but it depends on what kind their are taking, and they can't be receiving help from any other source in order to get that help. Plus it takes from 6-10 weeks to get started receving the meds from the drug companies once they qualfy. After 6 months, they have to apply all over again!

I think this will soon show up in the hospitals with more and more pts, being more acutely ill, with mulitiple admissions, if they'e lucky! This is a very sad time...in more ways then one!

[kids]

originally posted by maureeno

from the oregonian

man's state points to crisis

03/09/03

patrick o'neill

a disabled portland man is unconscious and in critical condition at legacy good samaritan hospital & medical center after losing state pharmaceutical benefits for low-income people.

douglas k. schmidt, 36, apparently suffered a massive seizure about eight days after his supply of anti-seizure medication ran out.

family members said saturday that schmidt was still waiting for an application to arrive so he could get onto one of the interim prescription programs being offered as backup by pharmaceutical companies. ...

(edited down article to save space as it appears twice previously-kids-)

i have never been a fan or defender of ohp (oregon health plan)...and i am not going to start now, however, i live

the drug that was no longer approved is lamictal.

2 statements i heard/saw his mother make on local tv news:

(he was) was notified on the first of january that the medication would not be covered after march first.

(and she said) "if he had told me he had run out i would have found a way to pay for it".

the agency that i left in january also has 2 oregon offices. the neuros on their cases were also notified that it would not be covered, they neuros and their patients were given 60 days notice so that attempts could be made to wean the patients on to other drugs or to document unsuccessful attempts. when this story broke i spoke with a former co-worker about it: 3 cases had obtained waivers from the ohp for the med because of unsuccessful weaning, a 4th is paying for it out of pocket and pursueing assistance from the manufacturers program.

i am not sure what is meant by the statement "family members said saturday that schmidt was still waiting for an application to arrive so he could get onto one of the interim prescription programs being offered as backup by pharmaceutical companies".

the manufacturers program (copied from: http://www.needymeds.com and pasted below) does seem to be somewhat of a pita but it does not appear to me to be anything that could not be acomplished in a 60 day period especially if you consider that neuros all over the state of or (had to be) scrambling to get people enrolled in the program.

pharmaceutical company glaxo wellcome inc.

program address glaxo wellcome, inc.

patient assistance program

po box 52185

phoenix, az 85072-9711

toll free phone number 800-722-9294

fax number 800-750-9832

guidelines and notes: this continues to be a complicated and tedious program for advocates who do not have regular consistent contact with patients because of the extent of provider involvement required -- patient advocate must be the liason between the program and the patient. . even though glaxo wellcome merged with smith kline beecham to form glaxo smith kline, they continue to maintain this program under this name for now. call monday through friday 8 am to 8 pm eastern time. program is designed to provide short-term assistance. patient eligibility depends on patient's household size, income and medical expenses.

initiating enrollment: patient advocate must call to register as advocate and to pre-enroll patient. patient advocate can be any professional willing to serve as liaison with company on behalf of patient on a regular basis. they will send forms that cannot be copied, but advocate must call to register every patient if patient is eligible they will activate card on second page of form so patient can obtain an immediate 30-day supply of medication and then send in form.

health provider's role: doctor completes, signs the form. gives patient 30 day prescription to take to the pharmacy with card. for subsequent supply,

patient's role: patient signature required. income and financial information also needed on form. company will request proof of income and copy of picture id after initial application received. patient needs to complete and mail form after initial telephone enrollment and doctor's signature and portion are completed.

how dispensed: patient uses card along with prescription and $5 or $10 co-pay to obtain medication at the pharmacy. advocate must call before each prescription will be filled.

amount dispensed: 30 days, then two additional 30 day supplies of the product. patient must submit additional income and insurance information to be approved for additional 90 day increments.

refills: company requires additional written documentation of financial status and a follow up call from designated advocate before they will authorize refills. .

limit: indefinitely

i do not want to come off sounding unsympathetic to the uninsured in any way. my children and i were uninsured for 4 years because dispite making an rns wages, affordable insurance was not available from my employer. we got by, but only because i had a good relationship with my kids doctors and dentist and when i made payment arrangements i kept them. somehow i managed to pay for well child visits, preventitive dentistry, sick visits & abx, 3 broken arms (2 in the same week) and a 4 day hospitialization for pneumonia.

[RNforLongTime]

Well Susy, Sally may not have said that (about the virtual posse) but she agreed with the person who did.

[NRSKarenRN, BSN, RN]

Please keep this thread on the topic addressed. Thanks.

[Sally_ICURN]

Wednesday

3/12/2003

"Dr. James Dwyer, a professor at the Center for Bioethics and Health Law and the associate director of the Consortium Ethics Program, used his time to discuss the moral and ethical case of the uninsured dilemma. He said as a society which values justice, America needs to provide healthcare opportunities for everybody. He added that Americans should re-evaluate their sense of responsibility to improving society.

'We live in a society that overemphasizes individual responsibility and underemphasizes social responsibility,' he said."

http://www.pittnews.com/vnews/display.v/ART/2003/03/12/3e6ed3c687149

It strikes me that of the list of organizations, etc. that are supporting attention to finding solutions to covering the uninsured, that noticibly missing from the list are pharmaceutical companies, HMO and Managed Care companies, and health equipment companies. What does this say about the priorities of this country's money making businesses that are, in large part, the suppliers of our care?

[Sally_ICURN]

Originally posted by Gardengal

I find it interesting that the AMA is so strongly behind this, I believe they were one of the big detractors when the issue of catastrophic illness insurance was a hot topic in the late 70s early 80s. (kind of a similar concept) Maybe this time around with the collective support of so many there will be more progress. I seem to remember a lot of concern regarding decreased general quality and socialized medicine last time I got involved in looking at this to any extent.

Gardengal, you may find this interesting:

"1940's

Truman's plan is denounced by the American Medical Association (AMA) , and is called a Communist plot by a House subcommittee."

http://www.pbs.org/healthcarecrisis/history.htm

Everyone read...it's an easy to read timeline from PBS of the developing insurance crisis in healthcare from 1900 - today.

[sixes]

Iwas shocked to read AMA is behind this also. All our papers etc. state otherwise.

I would see why they wouldn't support it. Illness is big business, with big dollars. Everything I have read lead me to believe that most health care is privatized.

I wish I was more educated in these matters

[CountrifiedRN]

Signed and emailed to my friends!

[sanakruz, ADN]

Kids-

I work with mentally ill clients and have accessed indigent pt. programs. Each manufacturer is different and there are different hops to jump through. Long waits also.

It's easy for ill and /or low functioning people to get discouraged and give up in the middle of the process. You are right these folks need advocates- Thast would be WE NURSES.

Go to nursingdrugguide.com There is a list of drug companies. With some perusal you can find the product you are looking for.If anybody wants some tips send me a pm- I ve got some experience with this

Fight the good fight.

[Gardengal]

Sally-

I found the timeline for the healthcare crisis fascinating. I think one of the interesting pieces is the effect of international war on the issues. I hope that the issues with Iraq are settled rapidly to allow attention to be continued on this important issue.

Julie