Tuesday, March 21, 2006

Thank You Medicare Part D!

I M Sick N NC
100 Any Street
Small Town, NC 2xxxxx-xxxx

Dear Senators and Representatives,

My name is I M Sick. I am xx years old and HIV positive. I live on $900 a month from my Social Security Disability. I am also enrolled in the new Medicare Part D. I am studying in preparation for graduate school, and my church, a small, very conservative Baptist church in Small Town, is full of members who have supported you.

I would like to thank you all in Congress and the NC General Assembly for Medicare Part D. Persons who were unable to afford their HIV medications in North Carolina and were part of the state’s Purchase of Care program and receiving Medicare were told that our participation in Medicare Part D was not, as the federal government had originally said, voluntary. No, for us, this was mandatory. This has proven to be a great blessing!

Most of you voted for this program. I would like to thank you for single-handedly raising the cost of HIV medications for those who were unable to pay for them from the beginning from $0 to, for me today, $175.00 per month until I reach the $3600 limit. I have to say that I really appreciate now having to spend almost $2000 a year on my HIV medications and knowing this will recur annually makes me giggle with anticipation. Yes, truly persons with HIV are better off today than they were just a year ago here in the great state of North Carolina. Ah well, I suppose it could be worse. We could have bird flu too, right?

Truly, this is a “safety net” for persons with high cost drugs. Oh yes, our drugs are much more affordable now that we pay $2000 a year instead of $0! I especially want to thank all the legislators in the NC General Assembly and especially the administrators of the Purchase of Care program at NC Department of Health and Human Resources! I know it makes them sleep much easier at night knowing that those entrusted to their care are getting affordable HIV medications after mandating that they join Medicare Part D. I know I would! I must say this safety net functions exactly the way it was designed to work. Truly, this is a marvelous example of the efficiency and compassion of our American government. I’m sure many seniors and persons with catastrophic illnesses and their families will be thinking of you all when they go to the polls in November and then again in 2008. I know I will!

I would also like to thank the drug companies. Thank you for producing your medications at such affordable prices. Yes, I know we could get them from Canada if we lived along the border states, but, alas, we do not. At least I can say that I’m helping grow a North Carolina business. Thanks, Glaxo-Welcome!

I’m sure my church will thank you all when they find out that I am no longer able to tithe, since I now have to divert this much money to my medications. I’m sure our pastor will appreciate this as well. We’re a new church and would like to have a full time pastor. We had hoped to be able to pay him full time by the end of the year. Ah well, what do we really need with a full-time pastor, right? We're praying about finding a building too. Ah well, who needs a regular meeting house. I would also like to thank you all personally for taking $2000 from my savings each year. I had been thinking recently that I might save some money to return to graduate school next year or the year after so I could return to work and teach history. Boy, I'm looking forward to Christmas this year and all the gifts I'll be able to buy for my family with the money I'm saving! Thank you so very much for helping me do that. Thank you, all of you, each and every one, for this great blessing. It’s wonderful to know that you care. May God deal as magnanimously with you all as you have done to me and the others living with HIV in North Carolina this most blessed day.


Sincerely,
IM Sick N NC

Proverbs 29:7
The righteous is concerned for the rights of the poor,
The wicked does not understand such concern.

4 comments:

  1. Dear Gene,

    As one of your biggest fans, I am extremely disappointed in your poor understanding of this issue.

    CAVEAT: I am sure that dealing with HIV is more distressing than I can imagine---physically, emotionally, socially, and financially. I suppose that some Christians see you with a big red AIDS stamped on your forehead, or at least with an asterisk by your name. I am not one of them, however. I admired your scholarly approach to theological issues before I ever read your profile and learned of your HIV. When I did read it, I just admired you more, for doing such great work even while enduring such a major a "thorn in the flesh." So please don't take what I have written as having come from bigotry.

    As far as I can tell from your post, you believe it is the government's responsibility to:

    1. pay for your medicine
    2. have compassion on you
    3. make sure you have enough money to tithe with
    4. contribute to your church's building fund
    5. pay part of your pastor's salary
    6. help you pay for graduate school
    7. pay for your family's Christmas presents
    8. pay for the health care of many seniors and others with large medical expenses

    Gene, it is not the government's responsibility to do any of these things. The person who is able to work is to provide for his own needs. The person who is not able to work is to be provided for by his family. The person who is not able to work, and has no family to care for him, is 'truly in need," and is to be cared for by the church.

    You have quoted a proverb in your post. Yes, the righteous man is concerned that the poor's right's are not infringed. But what are the poor man's rights in regards to money? Does he have the right to be given expensive medical treatment for free? No, he has no right to this. Here are the rights of the poor man, which the righteous man must make sure are not infringed:

    1. the right not to be stolen from
    2. the right not to be taken advantage of in court by the rich

    Gene, God does not want to provide for your through your government. He will provide for you through his blessings on your own abilities, your family, and/or your church.

    Evidently you are badly mistaken in this area of thought, my dear brother. Please take another long look at this issue.

    Love in Christ,

    Jeff

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  2. >>>As one of your biggest fans, I am extremely disappointed in your poor understanding of this issue.

    I agree, I'm am extremely disappointed in your poor understanding of this issue.

    >>>CAVEAT: I am sure that dealing with HIV is more distressing than I can imagine---physically, emotionally, socially, and financially. I suppose that some Christians see you with a big red AIDS stamped on your forehead, or at least with an asterisk by your name. I am not one of them, however. I admired your scholarly approach to theological issues before I ever read your profile and learned of your HIV. When I did read it, I just admired you more, for doing such great work even while enduring such a major a "thorn in the flesh." So please don't take what I have written as having come from bigotry.

    No, I think it comes from ignorance about all the issues.

    >>>As far as I can tell from your post, you believe it is the government's responsibility to:

    You'd have a point if (a) the Government hadn't already decided to try to make it their responsibility and (b) if Medicare, SSD, and Medicare Part D were entitlement programs (they are not) and (c) if I was advocating a re-distribution of wealth (which I am not).

    >>>1. pay for your medicine

    Actually, they have *already* declared they want those on Medicare to include prescription drug coverage. In NC, we have a Purchase of Care program to help those under a certain income level pay for their HIV medicines. Prior to Medicare Part D, we paid $0. I'm paying $177 a month now. Others are paying far more. How is this beneficial to us? We were not given the option to join or not join this "voluntary" program. We further were told it was a "safety net." It's hard to see how paying several thousand dollars a year is a greater "safety net" than our previous coverage. It would make far more sense if (a) they had phased the program in to work out the kinks, (b) had considered the PoC''s, and (c) the state had been more reasonable and figured out a way to help ease the cost of medicines to those for whom it would increase. In point of fact, I'd be happy to pay some of the cost. I was looking forward to paying a 30.00 copay today, which is what I paid last month, until I got the $177.00 bill for this month because I've hit "the gap" so quickly.

    >>>2. have compassion on you

    I have a hard time believing you believe that government, which is instituted by God, should not have compassion on its citizens, regardless of social rank or economic status.God has made us for community, to depend on each other, and God has given mankind poverty so that we might learn beneficence and gratitude in relationship to each other. Numerous laws command Israelites to deal hospitably, compassionately,and generously with widows, orphans, strangers, and sojourners.

    >>3. make sure you have enough money to tithe with
    >>>4. contribute to your church's building fund
    >>>5. pay part of your pastor's salary
    >>>6. help you pay for graduate school
    >>>7. pay for your family's Christmas presents

    My only income is from SSD at present. SSD is an insurance benefit into which I paid in good faith through Social Security taxes, not a welfare program. I pay all of the above items myself. However, what is the source of the income? These activities are only cited because these activities are directly affected by what happens when they tinker with Medicare and HIV Services. My ability to do these things is directly affected by their actions. That's the reality.


    SSD is not a wealth redistribution program, unless you view Social Security taxes as illicit government wealth redistribution. It's an insurance program into which I paid from the time I began working when I was fifteen. Medicare coverage is offered to persons on SSD to help them pay for their healthcare. We pay an insurance premium for that too. It is *not* free. The issue here, however, is that I have no other choice. Have you seen the prices for private health insurance for persons with HIV? I *also* pay a premium for prescription drug coverage. This is not a case of complaining about government entitlements. Oh no, Jeff, I pay an insurance premium on all of these items, and I paid an insurance premium for my disability coverage. The only difference here is that the US Government administers SSD and Medicare, not Blue Cross/Blue Shield. In fact, they contract, in my state to Palmetto in SC to handle it for them. Medicare Part D is a contracted program, not a single-payer system.Frankly, Jeff, if I was writing this to Partners Health or Blue Cross or Eetna or another private insurer, I know you wouldn't have a problem, unless you have a problem with insurance.

    HIV Purchase of Care programs exist, because the cost of these medicines is catastrophic. They exist in order to keep the cost of sick care for PWA's down. Sick care for a Person with AIDS is approximately $100k / year. What NC would pay in medication costs per person would be approximately 20 percent ($20k/ year) of the cost of sick care for that same Person With AIDS, which, if s/he had no insurance at all, would drive the overall cost of health care up for you. NC Purchase of Care decided that it would exceed the Federal Government's own rules and make the voluntary program (Medicare Part D) mandatory for persons with HIV on Medicare. We had no choice in this matter. None, zero, nada, zip, nil. Thanks to this, NC raised my cost for medicine from $0 to up to $3600. On top of this, seniors all over the country are learning, much to their surprise, that the insurance programs for which they signed up aren't covering their medicines at all in many cases. My own pharmacist told me that "These programs are changing every day." I haven't gotten a formulary for my medication yet. Medicare Supplements won't help with prescriptions. I'm simply asking NC's General Assembly and the US House and Senate to explain to me how I am better off today than I was 2 months ago. That's exactly what we were told when they sold us this program. I don't expect the government to give me a handout, Jeff; I expect them provide coverage when they say they wish to do so and honor their obligations within the contract in which we are engaged.
    >>>8. pay for the health care of many seniors and others with large medical expenses.

    >>>Gene, it is not the government's responsibility to do any of these things.

    If Medicare, et.al were entitlement programs you'd have a point, they are not. SSD is an insurance program administered by the Government into which I paid. Ditto with Medicare. Part D is privately contracted. Persons pay insurance premiums for Medicare and Part D.

    >>>The person who is able to work is to provide for his own needs. The person who is not able to work is to be provided for by his family. The person who is not able to work, and has no family to care for him, is 'truly in need," and is to be cared for by the church.

    Please do not to act as if I believe that Medicare and Purchase of Care are entitlements. I do not. However, I'm thinking you may. Let's make this clear. When we could work, we paid into Social Security. This included disability coverage. If I could work, I would. In fact, all the persons living with HIV in this state would do so, if they could, if they could get affordable health insurance. However, in my particular case, I am in the process of losing my right ear thanks to a staph infection I have had for 4 years now. Almost 1/2 of it is gone. I have lost my hearing once, and I had major eye surgury last year because I nearly went blind when it started growing in my retina. Then there was the fungal infection that caused me to lose 40 pounds. I couldn't walk. Oh, and I've had 2 episodes of pneumonia. I write and study because, at present, that's what I *can* do. If I can't work, I can use my time to prepare to go back to school if and when my health stabilizes. I *must* wait until this ear has healed. This is a drug resistant MRSA infection...you know "the flesh eating bacteria." My contact with others is limited to my church and my family, and I occasionally go out to eat, where I always eat alone and study.

    My family consists of my Mom. She is single and retired and on a fixed income herself. She qualifies for the list of widows.

    My church has 15 families in it and is brand new.

    My medicine bill alone is $2243.56 / month. That's $27,000 a year. Tell me, if a church can't pay its pastor, from where does the money to help with medicine come? Moreover, the churches here won't get together to form a new AIDS Service Organization, which we desperately need. The one I founded here in the mid-90's closed a few years ago, leaving only a housing agency to help. Apparently, the conservative churches, which are the majority, with the exception of one PCA church, don't want to cooperate with the liberal churches because they view them as apostate. In NC, we're also on a consortium system, and the largest ASO in NC is one county away...but the dividing line for that Consortium is the county line. It is illegal for them to serve clients in this county.

    >>>You have quoted a proverb in your post. Yes, the righteous man is concerned that the poor's right's are not infringed. But what are the poor man's rights in regards to money? Does he have the right to be given expensive medical treatment for free? No, he has no right to this.

    A. I pay an insurance premium for both my prescriptions and my medical care. It's not "free." You see, we're told that this program will make us better off. Please, how are we better off?

    B. Biblically, no, but the Bible is not a manual for economics or drafting civil social contracts for a 21st century industrial society. That "right" would, in fact, vary from nation to nation from a purely civil perspective.

    >>> Here are the rights of the poor man, which the righteous man must make sure are not infringed:

    1. the right not to be stolen from
    2. the right not to be taken advantage of in court by the rich

    I think that's a facile look at poverty in Scripture and the cause of the poor. What is the conclusion to the observation that there will always be poor people in the land? “Therefore, I command you to be openhanded toward your brothers and toward the poor and needy in your land” (Deut. 15:11b). The right not be stolen from applies to both the rich and the poor. However, we're not discussing wealth redistribution, which steals from the rich and disrespects property. We're talking about contractual obligations which *presently* exist in our society. In Leviticus 27:30 we find that the tithe provided funds both for the church and for the poor.The tithe was also divided between the Levites and the poor, with the Levites assisting those in great need. The tithe amounted to a tax. Then there was the gleaning law, but we're not discussing those who are able to work but do not do so here. So those injunctions don't readily apply. Those discussing the role of the church and family are also in view. It seems Scripture actually discusses an integrated approach in which the church leads the way. However, in our day, the churches have abdicated that role. These verses concerning the gleaning laws and the tithe seem to indicate that both the government and the church should be involved in helping the poor, and the poor, if they can work, should do what they can. Ideally, the church should lead. Unfortunately, the church has neglected its responsibility, and government is now heavily involved in poverty relief.

    I'd ask, what are those who are *not* in churches (and with respect to those living with HIV there are lots of them) supposed to do to pay their medical bills in our society if they can't work? This wouldn't apply to just persons with HIV either. This would apply to many others. The right not to be stolen from implies that the poor need to have property of their own, so one could take that and ask how does moving from $0 to $2000 or more a year help the disabled person have property? Remember, this isn't wealth redistribution here, Medicare, SSD, et. al. are insurance programs into which we pay a tax when we work (SSD) and an insurance premium if we use, not entitlements.

    >>>Gene, God does not want to provide for your through your government.

    Where does Scripture prohibit government from providing for its poor citizens when they are catastrophically ill?

    >>He will provide for you through his blessings on your own abilities, your family, and/or your church.

    As if I deny this?

    I do not deny these things, but I *also* live with certain realities. This includes living in a nation that gives HIV medication away to Africa while persons living in its borders have to go without. There are Purchase of Care Programs in this nation that have waiting lists. The churches, from my perspective have abdicated their responsibility. The biggest SBC church here, with over 5000 members, I know for a fact that many of them still think AIDS is a gay disease and you can get it from swimming pools. This is no exagerration. I've heard it in person.

    >>>Evidently you are badly mistaken in this area of thought, my dear brother. Please take another long look at this issue.

    I agree, Jeff, you are mistaken. Please tell me, if the Government did none of this at all, and you were disabled with a catastrophic illness in a new church with a handful of families, and single, how would you pay $27,000 in medicine alone, not counting the doctor's visits every 3 months for your HIV, labs, etc. and the monthly visit to the Wound Clinic and the medical supplies for your infected ear?

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  3. Dear Gene,

    I am doing exactly what I asked you to do, taking another long look at this issue. I'm willing to learn, and do not want to speak/write in ignorance.

    Love in Christ,

    Jeff

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  4. Michael Borne4/01/2006 6:45 PM

    GeneMBridges said:

    "I live on $900 a month from my Social Security Disability. I am also enrolled in the new Medicare Part D. I am studying in preparation for graduate school"

    Does SSD know how much time you spend blogging? If so, would they consider you disabled?

    Anyone who spends as much time blogging as you do is probably not disabled. You could maybe get a job as a writer or copy editor. Many jobs now can be done over the Internet. Have you contacted The Founders or R. C. Sproul's organization? What about your local newspaper?

    I disagree that SSD is the same as insurance. Insurance is a contract. If the insurance company fails to pay a valid claim you can sue them in court.

    SSD is whatever the government wants it to be at the moment. We pay into it and the laws change every year. If the government wants to change benefits it is their right, or should I say, our right as citizens, to do so.

    AIDS is a disease which is largely contracted by ungodly sexual behavior. The cure for AIDS is simple: live by biblical standards of sexual morality. I realize that there are also innocent ways of getting the disease but sex is the primary method.

    You are saying it is the government's problem, and therefore my problem, if an AIDS patient cannot pay for his government funded medicine because his government check is too small. I disagree with you.

    Michael Borne

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