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Medi-Cal reimbursement cuts affect everyone

POSTED June 14, 2013 9:20 p.m.

Columbine, Sandy Hook Elementary, Aurora, Colo. These top headlines are some of the most recent and memorable stories we have seen in the news. But, yet, our government wants to see more!

Most people are looking at the money side of the [10 percent Medi-Cal reimbursement cut], but as a concerned citizen, I am going to take this to a place many are unaware of or simply don't want to discuss.

I am a local pharmacist/owner for a privately owned pharmacy in the Central Valley and we service the general public along with assisted living and foster care facilities. A great percentage of our patients are Medi-Cal patients that are taking two or more medications for a mental illness. With the 10 percent cuts we will no longer be able to provide these medications to our patients because the reimbursements are hundreds of dollars below what we can purchase the medications for. Sure, this cut will be devastating to my business along with many other healthcare facilities, but the more disturbing issue is if these Medi-Cal reimbursements take effect these patients will no longer be able to find: providers to prescribe their medications, laboratories to analyze blood results, pharmacies to fill their medications or facilities to provide care services.

Where will these people go for their healthcare needs? Where will they get their prescriptions filled, especially in rural areas? Now, with Obama Care going into effect soon, many new patients will fall under the Medi-Cal umbrella. Where will all these new patients seek medical care? Ponder that for a while. Government officials are saying reductions will not impact member access. Of course they will. No provider can afford to see these patients, and no pharmacy can afford to fill their prescriptions. They go on to say if problems occur they will quickly address the issues. How long does it take to get any issue resolved with the government? There is always a long drawn out process.

Now, you ask, how does this affect me? Well, the decision our government is about to make will greatly affect everyone in this country ...if these mentally ill patients are unable to receive the medications they need to function in society.

Imagine your child sitting in the local theater with a group of friends unaware that the individual sitting next to them has not taken their antipsychotic medication for a few days and something in the movie triggers their brain and sets them off. They may be sitting in a classroom and a child with severe depression who has been bullied one too many times just can't take it anymore and reacts violently. These are our headlines now without the cuts, so we know it's reality. We have seen mental illness at its worst in the past year or so. Let's not make it worse!

Just to get my point across and show the community the severity of this issue, I would like to use my local pharmacy as an example. We service around 20 plus foster care homes, ranging from five to 10 children per home and taking two to four medications each for severe mental illness — all of which are on Medi-Cal. If this cut is approved we will no longer be able to provide these homes with the necessary medications to care for these children's psychological needs. Now this is just one small town pharmacy. Think of the big picture. In turn, they will be forced out onto the streets in the general public, without medication! You think the streets are unsafe now? Just wait.

— Steve Stoll

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