|
|
| The Pulitzer Prize-Winning Weekly Newspaper |
«
Go back |
| Pharmacy wrestles with budget cuts |
Clark Merrefield
2008-07-31 |
|
A state cut to a Medi-Cal reimbursement plan that took effect this month threatens to put the West Marin Pharmacy out of business.
The law, which was signed by the governor in February and enacted July 1, cuts by ten percent the reimbursement health care providers receive when they treat Medi-Cal patients.
"I am making up the difference (several hundreds of dollars per day) from my own pocket," owner Zsuzsanna Biran wrote to the Point Reyes Light last week. "Any help with this is and would be very much appreciated."
Faced with a $14.5 billion budget shortfall, the cut will save an estimated $610 million this year. Many other state agencies have also been asked to make cuts.
On a folding wooden table in front of the cash registers at the pharmacy in downtown Point Reyes Station, signatures are filling up a petition urging the state to repeal the cuts.
The pharmacy spends up to $10,000 daily on prescriptions and up to $300,000 per month, Biran said. She estimates that she is losing $300 to $350 per day because of the reimbursement cut, and since it took effect she has been paying more for Medi-Cal prescriptions than she gets back. About a third of her total prescriptions are from Medi-Cal patients.
"It breaks my heart but I have to send some people away," Biran said. "I can't really afford to take that kind of a hit."
But the pharmacy takes into account whether a customer will be able to get their prescription elsewhere, Biran added.
That is an important point for the pharmacy's local clientele. For customers like Kathleen O'Toole of Point Reyes Station, a Medi-Cal recipient who takes up to 18 medications every day and cannot drive because of recurrent seizures, the life of the pharmacy is linked to her own.
"It would just be devastating for me," O'Toole said. "I would possibly have a mental breakdown. It would be that powerful to me."
The pharmacy was bought by Biran more than a year ago following the death of former owner Dan Donovan. Before the purchase went through, O'Toole relied on volunteer aides to get her prescriptions from pharmacies in Petaluma.
Linda Sturdivant of Inverness Park has also depended on the pharmacy for years.
"She's paying for all of our medications out here," Sturdivant said. "She gave up a life to come here and help us, and she wants this to be her home. But she's got employees, rent, electricity."
Health care providers—including doctors, pharmacists and hospitals—have always helped cover Medi-Cal patients. The state pays a portion for routine visits and emergencies, and the provider is responsible the rest.
"The Medi-Cal cuts are going to affect the healthcare of all Californians," said Ned Wigglesworth, spokesperson for the California Medical Association. "The cuts are not only going to reduce the access to health care for medical beneficiaries, they are also going to undermine the access to emergency services that all Californians use."
While doctors tend to have a larger cushion of patients that have other types of insurance to help cover losses from Medi-Cal patients, pharmacists tend to rely more on Medi-Cal recipients, Wigglesworth said.
"Pharmacists have been continuing to pay the lost revenues out of their own pockets to cover the cost of the medications," said Lynn Rolston, chief executive officer of the
California Pharmacists Association. "That's been really difficult for them but they are a really dedicated bunch."
Several lawsuits have been filed seeking an injunction that would temporarily suspend the cuts. One injunction was denied in Los Angeles Superior Court last Friday, and this Friday another one will be heard in federal court.
"We do understand that there are difficult and painful reductions, but they're necessary in light of the state's fiscal situation," said Anthony Cava, spokesman for the California Department of Health Care Services.
"We're hoping providers will stick with us through these tough budget times," he added.
While the state department sends its hope, the petition in the West Marin Pharmacy grows by about thirty signatures daily and Biran continues to cover Medi-Cal losses from her own pocket.
"I pray every day, I pray on the rosary that she will stay in this area," O'Toole said. "We will support her no matter what the politicians put us through."
|
|
| |
|
