Hey! I know....let's increase the co-pays for Medicare recipients, Part D, and the (pretend, funded by US tax payers $$ at administrative rates of 15-20% versus Medicare's less than 5%) Medicare 'Advantage' companies ---------and let's do it AFTER the period of time during which Medicare recipients can ENROLL or change their enrollment for the year (every year between Nov 15 thru Dec 31 people can change their Medicare company) so that the Medicare recipient, and the mental health provider, cannot discern what they are going to be charged or paid because dontchaknow, the likes of Humana, having farmed out their various contracts, can't tell you if a particular outpatient CPT code associated with an outpatient mental health service is going to be PAID FOR or NOT---like it was LAST year.
Today I have a patient going into a local psychiatric unit, charging Medicare literally thousands of $$ because she cannot afford a $3 co pay for additional medication which her psychiatrist prescribed (no, he did not have any of that med in his little stash in his office given the kind of drug it was and there was no substitute, really, and the client merely needed to double up on what she was already taking because she was early-waking, like really depressed people do, and could not go back to sleep after 3 am every night).
Last week, I called up the county DSS office related to another client whom, dontchaknow, could not discern (as in, cannot look into a crystal ball) the how much more her co-pays were going to be come January 15th of the new year. So, she has to choose between FOOD or MEDS. Inquiries to the local DSS indicated that though she is a 'catastrophic coverage' CAP patient, which means that she receives one-on-one services from a care-taker from 9 to 2 everyday---due to the extent of her disability-------- she may or may not be able to obtain some additional Food Stamps which she uses very very carefully.
This is dumb management and as Krugman said yesterday in the New York Times, it is merely a foolhardy policy of 'EATING THE FUTURE':
http://krugman.blogs.nytimes.com/2011/02/12/eat-the-future/
"February 12, 2011, 10:10 am
Eat the Future
The public says it wants to see government spending cut — and the Tea Partiers really, really want spending cut — but people don’t want to cut any program they like; and they like almost everything. What’s a conservative to do?
The obvious answer, once you think about it, is to eat the future: to cut spending in a way that undermines the nation’s long-run prospects, but doesn’t impose all that much pain on voters right now.
And that, as best as I can tell, is the running theme in the cuts proposed by House Republicans.
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