With Gov. Chris Gregoire’s budget, the state is considering cutting access to medicines for low-income families to save money. I have a cautionary tale about the impacts of such a drastic move.
For more than a decade, I have been a pharmacist/ manager serving low-income patients – patients who have little or no political influence with local, state and federal entities. If we ignore them today, however, we will end up dealing with the results very soon.
For the last three years, I have worked primarily with mental health patients in an outpatient setting, and have continually observed the results of my patients’ lack of compliance with their medication regimens. When patients don’t have access to their medicines, the problems and costs begin to emerge almost immediately.
Within 72 hours, I have observed my patients’ symptoms of schizophrenia, bipolar disorders and depression, as well as many other disorders, begin to re-manifest themselves. Many times, the situation escalates into a crisis. Among the results I have observed are hospitalizations (short and long term), incarcerations and suicide – all of which are much more expensive than the costs of the medications my patients take for their mental conditions.
Although the focus these days is on the fiscal cost of these programs, we should also not forget the human cost of cutting people off. The lives of many of my patients are dramatically better when they have their medicines. They can be productive, hold jobs, enjoy their families and live something like a normal life.
Without their medicines, many lose all of those things.
Seeing those impacts firsthand has been a powerful lesson. Every day, my primary goal is to ensure that my patients stay on their medication to prevent the results I have mentioned.
Now, the state of Washington is about to make my job much more difficult.
The state claims it can save millions of dollars by limiting access to medicines, affecting families who have no other health care options. Those savings simply will not appear.
Restricting access further would prevent half of my patients from receiving the medicines they need. Half. These patients will end up in hospitals or jail, and will simply be an expense shifted to another portion of the Washington state budget. This would be a lose-lose for everyone. The state would spend more on patients, and the lives of individuals would be thrown into chaos.
Washington is not the only state to consider this. Attempts to restrict Medicaid drug coverage have been dismal failures in other states. State policymakers certainly understand this. I fail to understand why Washington state officials believe that we would be any different. Our financial situation is certainly difficult. But difficult times require that we are more honest about the impacts of our decisions.
We should not allow the vain hope that everything will work out to supersede the experiences that those of us in health care see every day.