Wednesday, July 22, 2009

First Person Account of California Budget Cuts

I am shocked to discover this morning I am a victim of the on-going budget cuts in California's MediCal system. It seems so simple on the surface but in reality is a life-threatening disaster.

I am a diabetic low-income senior. My health is dependent on testing my blood glucose levels to determine the dosages of insulin I require to maintain a normal life. This is achieved by pricking blood from a finger tip and applied to a test strip attached to an electronic monitoring devise.

As I discovered today, MediCal no longer offers a copay of $3.10 for the test strips. In stead, I must pay $40 retail for a box of 25 strips directly to the pharmacy. It is mandatory to test four to five times a day. I did the math. It amounts to an average of $240 a month.

But, here's the big picture. Between Medicare Part D, Health Net's HMO Seniority Plus insurance and MediCal, all other medical drugs are covered with a minimal or no copay and almost all medical costs are covered with no copay. In fact, after paying my share of an initial cost of $787 for an insulin pump, all supplies and replacement parts are covered in full by Health Net -- except test strips and lancets.

In my case, the test strips are the fuel which drives the engine to a healthy life which I indeed cherish. Since acquiring the insulin pump the diabetes-related symptoms of heart, lung and kidney problems have diminished. My blood pressure is normal as is the lipid panel detecting cholesterol and triglycerides. In fact, the only concern my primary physician has is my tendency to become dehydrated.

In short, this approach to preventive medicine is saving the state, feds and private insurers thousands of dollars. Now that is questionable because some faceless bureaucrat in Sacramento drew the line in the sand over a measly box of test strips.

In the interest of clarity, MediCal stopped paying for test strips some weeks ago but I was never notified until I learned the hard way from the pharmacist when I ordered a refill today.

Paying full price for the test strips represents about 21% of my monthly income, pushing all medical costs to almost a quarter of my income. Perhaps on a national average that's not so bad for an old man with diabetes. But it robs other areas that contribute to a quality of life.

They say health care reform involves a series of tough decisions. I fear in my case it was a stupid decision. It defies logic. It reminds me of my grandmother's admonition of "being penny wise and pound foolish."

I confess we low-income seniors in California may have been coddled by our state and federal governments in terms of casting safety nets in our direction. Oh, I will find a way to pay for the test strips in my meager budget. I'm old enough to go with the flow.

But it would be easier to reconcile this dilemma if it made any sense.

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