Maddening Medicaid Massacre

There are a few universal truths in the pharmacy world.  Some apply to patients.  There is one that applies to pharmacy staff: we hate medicaid people.

Now, I know what you're thinking.  Why just pharmacy staff?  Why can't I hate medicaid people?  Good news, my friend.  You can!  After reading this, you will.  Well, you should.

Medicaid is a federally funded program that provides health care for people who cannot afford it by their own means.  If you make under X dollars annually (this differs per state) your entire medical bill will be paid for by Uncle Sam.  You all know where Uncle Sam gets his dough.

Sounds great, right?  If people can't afford health care, they should get some help from the government.  Right?  Many Americans believe that health care is a right.  Once you get a little exposure working within our health care system, you may start to think differently.  Come work in a pharmacy for a week.  I don't know many pharmacy people who feel that health care is a right.  You start to feel differently when you see the way people are spending your money, the way they are abusing the privilege of health care.

A perfect example of this abuse occurred last night in my pharmacy.  A night time regular came back to the pharmacy at about 1:45.  He had a friend with him that I'd never seen before.  Each of them had 4 prescriptions from the local emergency room.  All the scripts were for medication to treat breathing problems.

Ready for the kick in the nuts?  I am, because I get it every day I go to work.  My nuts are like hard, unfeeling wood by now.  Even if you don't think about things like this, you pay for it with every tax deduction from your precious little paycheck.

Both of these guys reeked like smoke.  The regular guy does every time he comes in.  I imagine him rolling around in a big fucking ashtray before he comes to the pharmacy.  You've smelled someone like that before.  Don't you wonder how they could possibly smell that bad?  I guess they smoke A LOT.  This is your first clue that he has medicaid.  They are usually a little stinky.

Here's a list of the medications he gets, every single month, to treat his breathing problems:

1. Mucinex: $31.49

2. Fluticasone: $68

3. Albuterol nebs: $17.59

4. Advair: $302

5. Combivent: $125

Total Cost: $544.08

So we're all clear, you're paying for that.  You and the rest of America that works, that is.  Medicaid patients usually have a copay ranging from 1$-3$, which as you can see compared to the overall medication cost is exactly jack shit.  Now, to smell as bad as this asshole does, he's probably smoking around 2 packs every day.  Let's say $3 per pack, so $180 per month.  He's paying $180 a month to kill himself, and you're paying $544 a month to keep him alive.  How do your nuts feel?  

Did I mention he visits the ER at least once a month for whatever reason?  I can tell you it's not emergent, because whenever he's in the pharmacy he's just hunky-fucking-dory.  Do you know why medicaid patients go to the ER so much?  Here's an idea.

1.  They've got shit-one to do.  They don't have jobs.  The bingo parlor is closed after hours.

2.  There's no difference in cost to them between an ER visit and a general practitioner visit, although the bill to us is 5-10 times higher for the ER.  I guess at the ER they don't have to make an appointment to fit their busy schedule.  That's convenient.

This is the problem with medicaid.  Anybody who's poor can get it.  You can stop down the pill room to get your $100/month cholesterol medication, then waddle to MacDonald's to see how many Big Macs you can squeeze in before Oprah.  Medicaid patients can shit out as many kids as they want, they'll be covered too.  Think there are any coverage restrictions based on how you've got the condition you need treated?  Think about the guy I started this post off with.

Think about this, America.  Better yet, impart the damage on yourself physically.  Every time you pay for a medicaid patients medication, it's a moral kick in the junk.  Why not make it a literal kick in the junk?  Next time you see a medicaid patient huffing on their ProAir or selling their Vicodin to your teenage child (score!), run up to the nearest person and have them kick you in the gonads.  It's already happening anyway.