Let me share with you what I
learned about Medicaid while working at CVS/Pharmacy. First a little background, I spent over eight
years at CVS/Pharmacy. During my time at
CVS, I spent a couple of years in an underprivileged area, where Medicaid is
the predominate form of insurance (if we can call it insurance). This was a life changing experience for me in
several ways. First, I realized I
definitely did not want to become a retail pharmacist. Second, I grew to despise all “poor” welfare
recipients. Now at first, this may make
me sound like an insensitive jerk, but let me explain. These so called “poor” people that frequented
my store brought with them their unrivaled feeling of entitlement. They truly believed everything was to be hand
fed to them on their schedule and according to their needs. Honestly, I cannot say this is entirely their
fault. Nonetheless when I say they felt
entitled, I do not just mean to free drugs.
These people felt entitled to have their scripts filled in thirty
seconds.
Medicaid customers would show up
without their card having never been to a CVS before and expect me to have some
magical way of handing them a free prescription in a matter of seconds. They were not responsible for keeping track
of their own Medicaid information and if you ask them for it, they reply with “isn’t
there a number you can call?” I think
they truly believe that I had some kind of insurance white pages and I just
wasn’t willing to search for their name.
What are worse are the things that Medicaid would
cover. For instance, Georgia Medicaid
covers a drug called Accutane. Accutane
is the last measure of treatment for acne.
Yes acne!! The cash price of this
drug is over $500/month. Most real
insurances charge a co-pay of at least $50.
Yet Medicaid customers get it for "free". This is a crime in my opinion. Another example, Methergine is a drug which
is almost always used after an abortion in which case it is taken alongside doxycycline
and ibuprofen. I used to fill these
medications at least once a week. For
those of us who don't want to fund abortion this is a problem. I can't speak as to who paid for the actual
abortion, but I know we are funding the pills after the abortion.
What can be done?
Here is my three-fold solution:
- First we need to cut down what drugs are covered
for Medicaid patients, $500/month for an acne medication that is unnecessary
and ridiculous. Acne is a part of life,
and most middle class kids deal with it because their parents will not be
paying a $50 co-pay just for acne.
Methergine would also fall in this category of drugs that should never
be covered at the taxpayers’ expense.
- We must instigate real co-pays for Medicaid
customers. Believe me when I tell you most
of these customers had enough money to pay regular co-pays like the rest of us
(see point 3). The argument made for
Medicaid was that poor people cannot afford insurance. Fine give them Medicaid,
call it insurance, and let them have all the co-pays that come along with real
insurance. This will help keep them away
from the doctor for every sniffle they get.
While I struggled through college on Mac & Cheese, I didn’t visit
the doctor unless it was important because I could barely afford the co-pay.
- We must cut down the number of people on
Medicaid. We must find a way to prevent
Medicaid fraud. We had two customers
which I distinctly remember because their situation was so exaggerated and they
visited once a week. I assure you more
like them exist and often stopped by. Of
the two customers I speak, one drove a new blue Hummer H2 and one drove a new
black BMW. Both were on Medicaid. Now I don't know if they drove these to the
Medicaid office when they applied, but they certainly pulled through my drive-thru
once a week. This is insane. Stricter rules need to be put on the application
process for Medicaid. With as much as
our government loves to create new regulations you would think this would an
easy reform to pass, but instead they are too busy regulating the “rich” small
business owners.
What are your thoughts on my solutions, and what else could
be done to reign in this Medicaid money sink?
