Yesterday the California Medicaid system (Medi-Cal) cut reimbursements by 10% across the boards for Doctors, Dentists and Pharmacies. For pharmacies this was both the dispensing fee AND the drug cost reimbursement.
Yesterday is also the day where if your MediCal Rx costs over $150, pharmacies will lose money due to the state reimbursing below the dead net cost. See that Risperdal prescription that cost the pharmacy $200? The pharmacy lost $30 on that deal (reimbursed $170). What makes this obvious clusterfuck more amusing, is that the state has under the table “rebates” ie: kickbacks that mandate certain trade drugs. See generic prilosec? The state only reimburses for Nexium and Prevacid (now at $30 BELOW NET COST per Rx!). If the state and Big Pharma would stop space-docking (go look that one up), maybe the state would not be in such a money-hole. Wait, that makes sense. What also would of made sense is a 5% cut on trade name drugs and a 15% cut on generics. Hold on, does the state have any actual “real” pharmacists working for them or are they just “advisors” (ie: couldnt cut it in the ‘real world’ so they had to ‘advise’) who shake hands at the APhA meetings while giving back-room handjobs. Was this 10% cut just an arbitrary figure by some suit in Sacramento who obviously doesn’t have to deal the fallout? Sure is. Again, retail pharmacy is the human shield for the idiots in power.
No doubt that California is in a money-hole, but instead of sucking up some form of balls and a backbone and kicking people OFF of the welfare system who obviously should be out working (and contributing to the society that they gleefully suck the life out of (and make more babies for)), they just cut the reimbursement to the people who actually take care of them. Is there a real legit reason why the 27 year old male who walks into my store should be on the state system with his car stereo blaring the bass out in front?
The state probably thinks that pharmacists and doctors are all rich, they can just work for free! Yeah, fuck you. I didn’t put the time and effort to go to school and make something of myself to work for free. At this rate I should of just been on welfare like everyone else. California’s tried-and-true idea of a “solution” is to just throw money at the problem and hope it goes away. Well, I’m sorry, it didn’t and now people EXPECT the state to hold their cock while they pee, wipe their asses when they shit, and $0 copays for everything! You created this situation and now you expect US to take it in the ass for you. Again, fuck you. Its common knowledge that you don’t shit in your own bed, and you dont cut down the trees that provide you with food.
Oh, and because shitting in the faces of the working professionals wasn’t enough, the other insurance companies will look at us and say “Well, if the State can pay you shit, and you deal, then WE can pay you shit and you can also deal”. Can you all see where this is going?
Heres something else that the State obviously didn’t consider. What are the highest dollar medications we have. Ones that there are next to zero generics and people obviously cant switch to something else:
- Retrovirals (HIV baby!)
- Atypical Antipsychotics (sorta, haldol is always an option. We can always bring back Clozeril! heh)
So the state now have put pharmacies in a very very tough spot. Does the pharmacy lose $100 on that $700 HIV medication for their patient, or do they tell the patient “sorry bud, you up shit creek”. Do those fucked up politicians need to look at that patient in the eyes and tell him/her “Sorry. You cannot get your medications to prolong your existance because the store cant afford to lose $300 on your 4 HIV meds”. No, they dont. Maybe they should though. Pharmacies (and their patients) that do a ton of mental health/HIV/Chemo drugs are absolutely fucked beyond belief. Not just a little fucked, but full-on bend-over-bubba fucked.
So to the California representives who made this clusterfuck:
I refuse to fill an Rx for below cost. You know those expensive psych meds like Risperdal, Zyprexa, etc? Those aren’t going to get filled. Maybe you should use your powers of penile stimulation on Big Pharma or just grow a pair of balls and start booting people off of the system. Doctors aren’t going to take MediCal anymore, pharmacies are going to refuse to fill (ie: not stock) expensive trade name drugs and these people are going to go to their nearest ER at $500/visit to get care. You shit in your bed, YOU think of a different way to fix it other than letting the shit roll downhill on retail pharmacy.
I forsee many MediCal patients not recieving their medications unless the State pulls their collective heads out of their asses and do something. Stay tuned for more F-Bombs directed at the People’s Republic of Kalifornia.
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- Trying to not kill your patients.
- An open letter to my patients.
- The FDA obviously hates the public and needs to lay off the crack pipe.
- How to make your pharmacy career less painful.