On the seventh day of George Bush's new Medicare drug benefit, Stephen Starnes began hearing voices again, and he started to beg for the medications he had been taking for 10 years. But his pharmacy could not get approval from his Medicare drug plan, so Mr. Starnes was forced to be admitted to a hospital for treatment of paranoid schizophrenia. Mr. Starnes, 49, lives in Dayspring Village, an assisted living center for people with mental illness. When he gets his medications, he is stable.
Mix-ups in the first weeks of the Medicare drug benefit have vexed many beneficiaries and pharmacists. Dr. Steven S. Sharfstein, president of the American Psychiatric Association, said the transition from Medicaid to Medicare had had a particularly severe impact on low-income patients with serious, persistent mental illnesses.
"Relapse, rehospitalization and disruption of essential treatment are some of the consequences," Dr. Sharfstein said.
Dr. Jacqueline M. Feldman, a professor of psychiatry at the University of Alabama, said that two of her patients with schizophrenia had gone to a hospital emergency room because they could not get their medications. Dr. Feldman, who is also the director of a community mental health center, said "relapse is becoming more frequent" among her low-income Medicare patients.
At Dayspring Village, the 80 residents depend heavily on medications. Most of the residents are on Medicare, because they have disabilities, and Medicaid, because they have low incomes. Before Jan. 1, the state's Medicaid program covered their drugs at no charge. Since then, the residents have been covered by a private insurance company under contract to Medicare.
For the first time, residents of Dayspring Village found this month that they were being charged co-payments for their drugs, typically $3 for each prescription. The residents take an average of eight or nine drugs, so the co-payments can take a large share of their cash allowance, which is $54 a month.
Under the Medicare law, low-income people entitled to both Medicare and Medicaid are exempted from all co-payments if they live in a nursing home. But the exemption does not apply to people in assisted living centers like Dayspring Village.
Douglas D. Adkins, executive director of Dayspring Village, said: "Some of the pharmacists have been saying, 'No pills unless we get a co-payment.' Well, how are these people going to get the money for a co-payment? They don't have it."
Maybe George Bush's rich, republican friends can donate some of the billions they stole. Or even better, let's wrest control of our country from the republicans and give it back to the Democrats so we can begin to repair the damage caused by George Bush and his mob.