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thejunipertreeAN IMPORTANT MESSAGE TO OUR PATIENTS FROM THE CENTER FOR CANCER AND HEMATOLOGIC DISEASE- JANUARY 2004
Last month, the Federal Government passed the Medicare Prescription Drug Bill. The primary purpose of this bill was to provide assistance to our elderly and disabled in obtaining and affording prescription drugs. While the plan is designed to help the neediest of patients in giving them the access they need to necessary medications, the method of payment chosen by this new government entitlement is less than desirable for cancer care. The "Bill" significantly decreases payments to community cancer care clinics such as The Center.
As a result of the passage of this Bill, oncologists all over the country have been scrambling to find a way to make ends meet in 2004. In many instances, the payment we receive from CMS (The Center for Medicare and Medicaid) is less than our actual cost to purchase the drugs. As a participating provider in the Medicare program, we are obligated to accept Medicare rates as payment in full. In almost all instance, failure to collect the 20% copay from you, the Medicare patient, will result in a significant loss to this practice; one which we cannot afford to continually sustain and yet remain a viable community oncology clinic.
Additionally, some of the Medicare Managed Care Programs, such as Aetna US Healthcare Medicare, have added additional financial burdens to both physician and patient alike. A new injectable program has been instituted whereby many of the drugs administered to you, such as Procrit, Aranesp, Neupogen, Neulasta, and several others, will now carry an additional $45 copay over and above the normal office visit copay. This amount will be deducted directly from our Aetna reimbursement and now becomes an additional financial burden for you, our patient.
These facts and many other distress us greatly, as we feel that we are being hampered from providing you with the many services that have become the standard of care at The Center. The environment that we created was one of going the extra mile for each and every patient, meeting the needs of all with whom we come in contact. We have genuine concerns about our ability to continue that tradition in light of the serious cuts that are being thrust upon us in the years ahead.
You will be asked for copay and deductible payments at the time of your visit. No patient will be seen without a referral if you are part of a managed care plan. All patients without a medigap or secondary insurance will be expected to remit any and all balances due. While we realise that this practice is somewhat different than what you have been accustomed to, it is, in fact, a change we find imperative in order to continue providing you with the best in care without interruption.
Please be assured that we will do everything within our power to continue to provide all of our patients with excellent care, utilizing prescription plans, pharmaceutical assistance programs, clinical trials, and state and federal programs. Realise, however, that we cannot do this without your help.
What can you do to help? Please ask at our front door for a legislative contact sheet. Your voice can and will make change happen.
---
What does all of this mean?
I'll break it down for you:
Basically, it's a bunch of bullshit that has been masqueraded as an effort to help the elderly and disabled get the medication they need. I'd really like to know who wrote this bill and why they thought it was a good fucking idea.
To pay for the medications, this Bill has deemed it necessary to decrease payments from Medicare and Medicaid to places like the Center. Because of this decrease, places like the Center are now receiving payments from Medicare and Medicaid that are actually LESS than the money they are putting out for drugs. And because they are participating provider in Medicare, they have to accept the rates as payment in full.
Places like the Center used to allow patients to not pay their copay, if they couldn't. They were billed for it and this was frequently used in the decision making process of whether or not the patient could go on permanent disability. Now however, because of this bill, places like the Center CAN'T bill for a copay. They have to have it up front, unless they want to incur a serious financial loss. And serious financial loss will result in being unable to run their practice the way it needs to be run.
Not only all of this, but because of this bill, patients receiving specific injectable drugs are now subject to an additional payment of $45 because the Aetna reimbursement to the practice for these drugs has been taken away.
What does all of this mean to me (other then a scathing round of profanity that I am currently holding in)?
It means that my mother, who needs to go back for a second round of chemotherapy, will most likely NOT BE ABLE TO RECEIVE HER TREATMENT because she can't afford to pay the copay. She received a treatment today, but is probably not going to be able to get any more of them because before all of this, she was just being billed for the copay. $15 an office visit.
Doesn't sound like much, does it?
Now take into account that she's unable to even pay her FUCKING RENT RIGHT NOW because her STUPID GODDAMN EMPLOYER FORGOT TO SEND IN THE DISABILITY PAPERWORK LAST MONTH. And we have NO IDEA when she's going to start receiving disability checks. Even after she starts to receive her disability checks, this is going to severely fuck up her finances because $15 every single office visit when you're visiting the office SEVERAL TIMES IN A MONTH is going to add right the fuck up.
In other news, I received an email from a potential job opportunity telling me that the salary is $10 an hour. I wrote back and told them this was acceptable (even though it actually really isn't) because since the sixth of November, I have put in 23 online job applications [**EDIT** actually it was way more than 23 because I just realised I deleted everything from my sent folder in my email program in the beginning of November] and barely heard back from ANY of them (this does not include the amount of job applications and resumes I have sent out in meatspace, I'm not sure of that total at the moment but it's comparable). I also asked them in the same email if they would be interested in setting up an appointment for an interview, but I've yet to hear back about that.
I'm trying very hard to not be negative about this, because if I succumb to that temptation I will most likely jinx the fuck out of myself. And with things getting as desperate as they are, I can't afford to do that (literally and metaphorically).
I wish I had a slingshot.
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(no subject)
Date: 2004-01-05 02:29 pm (UTC)the.
shit.
>=O
(no subject)
Date: 2004-01-05 04:08 pm (UTC)(no subject)
Date: 2004-01-05 03:48 pm (UTC)The good news is ... Battle Royale came today. Silly me didn't read the auction correctly. I thought it was a special 2-DVD set (which I now found out doesn't actually exist). What I actually bid on was 2 complete DVDs.. so 1 for you, 1 for me.
(no subject)
Date: 2004-01-05 04:05 pm (UTC)Woo hoo!
Want to come over tonight and watch it?
Fucking Asshats
Date: 2004-01-05 06:31 pm (UTC)Robin, how much didja pay for Battle Royale?
(no subject)
Date: 2004-01-05 03:53 pm (UTC)i hope this job comes through for you...at least it will be more money than you have now, and it would be great to have something work out for your family.
i'll be thinking good thoughts for your mom, too.
(no subject)
Date: 2004-01-06 12:55 pm (UTC)Thank you, lady.
I do certainly appreciate all the good thoughts
you can possibly send.
(no subject)
Date: 2004-01-05 05:31 pm (UTC)dude.
okay, so I'm thinking half brick in a sock should suffice instead of the slingshot. Or I can lend you an old bra to use as a slingshot.
Who can we write the Nasty Letters to? I want the heads of the responsible parties on a plate.
Also, I miss the shit out of you. When are you on AIM these days? In addition/alternately, email me yo number & I can give you a call sometime soon.
(no subject)
Date: 2004-01-05 09:04 pm (UTC)I'm guessing state representatives or suchlike. Senators or something would probably be effective.
ARRRRRRRRR!
Date: 2004-01-05 05:35 pm (UTC)Re: ARRRRRRRRR!
Date: 2004-01-06 01:01 pm (UTC)That comment gave me my first smile of the day. :)
(no subject)
Date: 2004-01-05 08:08 pm (UTC)(yuck!)
(no subject)
Date: 2004-01-06 01:01 pm (UTC)Yeah.
I wish that every single person who's got their
thumb in the healthcare pie for bad reasons would
go through the things that my mother has during
her bout with cancer/chemo. Just so they fucking
know what it's like. And the extra special shitty
people should also go through it while having
no money to buy food and pay rent/bills/car payments.
(no subject)
Date: 2004-01-06 12:09 am (UTC);(
did you know its ILLEGAL for a naturopath
to treat certain kinds of cancer?!?! its the
fucking drug companies going hand in hand
with our government and the slimeball drs
who are already in their pockets. its disgusting
& im truly sorry for you guys.
as someone whos had to deal with SSI, disability
claims, medicare, medicaid & the like for FAR too
long, i totally understand what youre going thru &
i sympathize.
i despise our health care system, our government
& the corporations that have their dirty fucking hands
in every bit of it. i will be keeping you & your mom in
my thoughts & my fingers crossed for something good
to happen for you both.
in the meantime, here is a link you might find helpful:
http://covertheuninsuredweek.org/
&
if youre interested in any info on natural meds,
please let me know. (by no means would i ever
suggest herbal remedies as a substitute for
proven treatments but it is something else to
consider.)
*hug*
:)
elisavet
(no subject)
Date: 2004-01-06 12:58 pm (UTC)on natural medications. At this point, my mother
has already started to look in that direction
but hasn't come up with much of anything that is
terribly useful.
One question though, since you seem to have
a little bit of experience with the
disability stuffs:
Have you ever applied for (and received) welfare
while on temporary disability? She's got an
appointment, next week I think, to speak to
someone about receiving welfare while waiting
for her disability to finally come through.
(no subject)
Date: 2004-01-12 12:55 pm (UTC)im sorry it took so long to get back to you.
i just got laid off & im losing my fucking mind.
as far as getting temporary welfare while
waiting for SSI, it CAN happen altho i do
know every state is different. the one thing
i can tell you for sure so you guys dont get
discouraged is that nearly everyone who
applies for SSI gets turned down @ least
the first time, if not more. you just have to
keep applying.
my sister, who was in a wheelchair &
weighed about 80 lbs when she went in
for her first SSI application, was turned
down twice b4 they approved her claim!!!!!
even WITH all the dr's info backing her up!!!
so dont just give up if that happens,
apply again & again til it goes thru.
it will eventually.
my mom gets both SSI & some form of welfare,
but its not too terribly much (like $10 a month in
food stamps - seriously). she doesnt really have
medical bills tho so that might make a difference.
your mom might be eligible for more.
far as i know, theres no reason your mom
shouldnt be able to get both...altho like i said,
it might be different in your state.
you also need to check & see if there are any
cancer aid societies in your state. here in MI,
there is the barbara karmanos foundation -
they help ppl with bills & other stuff while they
go thru chemo. it might be a good place for you
to contact & see if they know of one in your state.
good luck!
*hug*
:)
elisavet