Presentation: Medicare and Medications – What’s new and why you should care

When I took my seat at Monday’s meeting, I chided Jay Zenner because I hadn’t received his usual reminder that it was my turn to write up the program for the bulletin. He replied, “Well, we only have one more meeting after this, and it’s the holiday music program, so I thought you would figure it out.” As our speaker began to wrap up her presentation and I was scribbling frantically in my notebook, trying to make sense of the convoluted scenario she was explaining, Guy Solie leaned over my shoulder and said, “I can’t wait to see how you write this up. This topic is incredibly complex!” To which I responded, “Yep, I probably should have gone with the holiday music write-up.” 

My usual practice is to email a draft of my article to the speaker for editing prior to submitting it for publication – thank goodness. My journalistic skills are insufficient to even scratch the surface of the topics that were covered, but I can assure readers of one thing: Senior PharmAssist is an incredibly valuable resource in our community and provides services that need to be scaled to serve all Americans, because negotiating our current system of Medicare and Medicaid  is amazingly complicated and are only getting more so.  

Monday’s speaker, Gina Upchurch RPh, MPH is the Executive Director of Senior PharmAssist, a Durham-based nonprofit organization helping older adults with limited incomes improve the quality of their lives by streamlining drug regimens, helping them pay for medications, and connecting them to other services and resources to help them live well and independently. Upchurch pointed out that the U.S. is one of only two countries that allows consumer drug advertising, resulting in Americans that take more medications yet are less healthy than comparable populations worldwide.  

She presented data showing how, as our population is aging, larger percentages of seniors’ personal incomes are being spent on medical expenses. Less attention is paid to improving socioeconomic influencers of our health such as the level of education, access to fresh and nutritious food, income levels etc. while more money is being spent on clinical care. Meanwhile, the cost of prescription drugs spirals higher each year.  

A major concern that Senior PharmAssist tries to address are the over-, under-, and inappropriate use of pharmaceuticals. A graphic on their brochure stresses, “Know your meds. Know your coverage. Know your rights.” Their approach is working, and working well – after two years in the program, they’ve seen a 36 percent decrease in visits to the Emergency Department and a 29 percent reduction in hospital stays. Upchurch recalled former Rotarian and Senior PharmAssist board president Andy Barada as someone who always touted the program’s impact.  

Another critical service that the organization provides is helping individuals wade through the confusing maze of Medicare coverage and approved health plans and assist them in making informed choices about other health insurance coverage. Upchurch’s staff consists of six full-time and five part-time employees; volunteers supply additional support when possible, but as health care legislation becomes increasingly multifaceted, it gets harder to find and train qualified volunteers. Staff are specifically trained to address the needs of older patients. Oddly enough, as Upchurch pointed out, neither medical schools nor pharmacy schools require specialized training in the treatment of our geriatric population.  

The bottom line, Upchurch stressed, is that our country’s health care system is ridiculously complicated, or in the words of one of her clients, “What a racket!” The elephant in the room that no one is addressing is how to better manage long-term care that currently focuses on expensive institutional care. We’re simply not doing enough to help aging citizens live well and independently in the community. Rather, we strip them of their financial assets and then place them in facilities. Upchurch feels strongly that universal access to health care is badly needed and she questions whether having insurance companies (like Medicare Advantage plans) be the ones deciding who has access to services such as dental care, transportation, and nutritious food is the most effective way of supporting our health.  

After fellow Rotarian and long-time Senior PharmAssist supporter Kay Gresham introduced the speaker, Upchurch joked that she didn’t know if she would be recognizable as the photo of her that was in the bulletin was at least 15 years old. “Every one of these grey hairs was caused by Medicare,” she said ruefully, tugging at her silvery locks. I’m just glad there are people like Gina and her staff out there looking after the best interests of the rest of us grey-haired folks when it comes to making informed health care decisions. For more information, visit www.seniorpharmassist.org 

Submitted by Carver Weaver

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