Sheila Anderson doesn?t have a family doctor.
She doesn?t have an HMO advice line to call.
When her grandchildren have problems with asthma or act up in school because of ADHD, she reaches into her bag of tricks. Anderson is signed up with Maryland Primary Care, a free program for people receiving Maryland Pharmacy Assistance, or she visits the St. Joseph?s Outreach Van when it visits her neighborhood. For the youngsters, she also relies on the state?s Children?s Health Insurance Program.
In short, Sheila contends with a patchwork of free or discount insurance programs, drug handouts and brand-name drug limitations. “These are my grandkids. They have a lot of health issues,” she says.
They are also her responsibility.
In Baltimore, patients like Anderson who are not insured pay out of pocket, at rates 62 percent higher than those the government pays for Medicare and Medicaid recipients, according to a study released by the Maryland Public Interest Research Group Tuesday.”When 46 million uninsured Americans go it alone at the pharmacy, they pay the price,” said MaryPIRG spokeswoman Johanna Neumann.
According to the study of the costs of 10 common prescription drugs at 600 pharmacies in 35 cities, Baltimore ranked 14th most expensive. The federal government negotiates lower prices for people receiving its health benefits, as do some insurance companies.
“Shifting the high cost of medication to the most vulnerable members of society, the uninsured, is the wrong prescription, because when medications are not accessible, people suffer and may even die,” said Janet Selway, a nurse and spokeswoman for the Maryland Nurses Association.
Drug prices for the uninsured are rising faster than inflation, according to MaryPIRG research. Compared to a 2004 study, drug prices have risen by 10 percent for uninsured patients.
Immediate solutions
Maryland Gov. Robert Ehrlich has not done enough to secure prescription drug price waiver from the federal government that would lower drug prices for state residents, health care advocates said.
“Last year, the General Assembly passed a new law that lowered prescription drug prices for low income Marylanders,” said Vincent DeMarco, president of the Maryland Citizen?s Health Initiative. “The Bush administration has been dragging its feet on the necessary federal waivers to allow this law to take effect.”
He challenged Ehrlich, saying, “If you really have a close relationship with President [George W.] Bush, call him.”
S. Anthony McCann, secretary for the Department of Health and Mental Hygiene, said he could not answer for Ehrlich?s relationship with the president, but he did not think the waiver program would get federal approval. We may “have to go back to the legislature again,” he said.
He has not received an official answer, but said federal health officials had objections to the waiver formula.
The government should also make cheaper generic drugs more available by closing loopholes that allow pharmaceutical companies to hold onto their patents, Neumann said. Drug buying pools at the state level would also allow individuals, businesses and governments to combine their buying power to negotiate lower prices.
