Core Policy Analysis - Essay Example

Providing quality healthcare for the elderly has always been an important aspect of social justice in the The task of the government to care for its citizens, particularly the aging population, establishes the commitment to look out for their welfare. This is important especially since most of those who belong to this age group have little to no resources for them to be able to afford expensive medicines. In lieu with this, the State of New York through the Department of Health has implemented The Elderly Pharmaceutical Insurance Coverage program or more commonly known as EPIC. This expands the coverage of prescription drugs and excluded drugs for Medicare Part D for senior citizens. This is available to New York State residents aged 65 and older whose annual income is up to $35, 000 is single and if married is $50, 000. The eligible seniors must be a Medicaid member. The program is basically a co-payment between the government and the member with the latter paying an annual fee graduated on their income. If a member’s annual income is below $23,000 for single or $29,000 for married, EPIC will pay their premiums for Medicare Part D while those with higher income shall shoulder their own plan premiums. Those enjoying Medicaid with full benefits shall have this fee waived. On its part, EPIC will be able to co-pay the cost of the drug ranging from $3-$20 depending on its actual value. EPIC is part of the State Pharmaceutical Assistance Program which in addition enable its members to join Part D plan or allow changes in their Medicare membership upon enrollment in the program (EPIC New York State Department of Health). The program was introduced to aid senior citizens in their regular purchase of medicines. Clearly, people in this age commonly have maintenance drugs as well as other needs that their insurance programs may not cover. Enforcing government intervention to finance their healthcare requirements and integrating a co-payment scheme establishes a sense of multi-sectorial responsibility. Funding has become a major issue for this project. In 2012, devastating budget cuts led to the lowered funding for EPIC reducing the coverage that its members enjoyed. The budget was cut by roughly $12 million to sustain the shortage of $10 billion in the state’s budget. Prior to this, around 190,000 senior citizens of New York enjoyed the privileges introduced by EPIC. The changes last year meant that it had been limited to low-income earners and EPIC will not contribute until there had been at least $2,930 spent for prescriptions by the Medicare holder and his insurer. This took a toll to the senior citizens whose medicine expenditures increased tremendously because of the implemented changes (YU, 2013). Fortunately, at least for the first quarter of 2013, the Elderly Pharmaceutical Insurance Coverage as it had been conceived will revert to its original scope to the benefit of the New Yorkers enjoying this program. Jeffrey Keimer and Shaker Mousa delved on the necessity of community pharmacy programs to help in lowering drug prices and providing available healthcare to a greater portion of the population. This is the very same purpose of EPIC which envisions the assistance of the state to low-income senior citizens in the state. EPIC has reported on the most frequently prescribed medicines such as Clopidogrel, Hydrochlorothiazide, Omeprazole, Furosemide and Amlodipine to top the list. Community pharmacies help patients by providing improved access to less expensive medicines. Patients need to be educated on the value of available programs that will be good for them (2012). Margaret Davis, on her report ‘Strengthening New York’s EPIC program: Options for improving drug coverage for Medicare beneficiaries,’ analyzed the coverage of Medicare in New York in comparison with other programs of similar goals in other states. She cites that New York City has one of the highest Medicare costs in the country and that the managed care plans “receive Medicare’s highest per-enrollee rates” (2003, p. 28). EPIC is distinctive in its co-sharing of payment policy where an enrollee who has shelled out a specific amount of payment will enjoy the benefit of receiving his drugs at no additional fee. This would permit the member to keep out of his mind the exorbitant cost of medicines and thus empowering him instead to spend his money in other basic necessities such as food and other costs of living. Davis further suggests that federal money should be earmarked by legislators to finance this program. Another viable option is to open intrastate and multiagency purchasing pools. This could lead to the lobbying for the reduction of medicine prices to provide wider coverage to enrollees (ibid.). More than change the policy needs sustenance, as it stands right now, the EPIC program is implemented to its full only up to the end of this month and there is yet to be any clear indication that it will withstand the future. Outstanding fiscal deficiencies necessitate budget cutbacks and legislature will often find it easier to target programs such as EPIC to contribute to the crisis despite how little or how much it will add to the deficit. The senior citizens who enjoy this program cannot be left in the dark and simply wait for the time when they may again have to tighten the belt somewhere just to be able to afford their prescriptions. The enactment of EPIC is an ideal solution to provide for this often forgotten percentage of the community. “The cost of prescription drugs is rising at an unsustainable rate for individuals as well as for private and public health care programs” (Hunger Action Network of New York State). Without EPIC, these low-income seniors may resort to drastic measures such as cutting back on their doses or basically foregoing their drug intake because of monetary issues. Bibliography Davis, M.H. (2003). Strengthening New York’s EPIC program: Options for improving drug coverage for medicare beneficiaries. Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/Publications/Fund-Reports/2003/Sep/Strengthening-New-Yorks-EPIC-Program--Options-for-Improving-Drug-Coverage-for-Medicare-Beneficiaries.aspx EPIC New York State Department of Health. (January, 2013). Retrieved from www.health.ny.gov/forms/doh-3409.pdf Hunger Action Network of New York State. (n.d.). Retrieved from http://www.hungeractionnys.org/health8.htm Keimer, J. C., & Mousa, S. A. (2012). Expanding the role of community pharmacy: An evaluation of generic drug discount programs, pharmacy based immunization services and convenient care clinics. International Journal of Pharmacy 2(1), 1-7 . Retrieved from http://www.pharmascholars.com/admin1/files/21001.pdf Yu, W. (2012). Funding for EPIC returns, briefly. Retrieved from AARP website: http://www.aarp.org/health/medicare-insurance/info-12-2012/funding-for-epic-returns-briefly-ny.html Read More