I wish we had a separate drug assistance program. Something like if you are making less than 200 or 300% poverty[1] the government will pay the full cost[2] and then just pro-rate it from there. Since we are talking long term drugs, its by definition something that would be applicable to preexisting conditions. I worry that it will not take the steps necessary to control fraud or run out of money like IHS.
1) http://familiesusa.org/product/federal-poverty-guidelines
2) obviously some upper limits apply https://www.medicaid.gov/medicaid/prescription-drugs/pharmac...
Already exists.
https://www.medicaid.gov/medicaid/prescription-drugs/index.h...
http://insulinnation.com/treatment/why-walmart-insulins-aren...
In the US of all places, there isn't a good argument for the very, very slightly modified newer insulins to cost so much more.
(these points are alluded to in the article, just want to mention them here, as well)
Welcome to America. Land of the free.
Another example involving insulin: The client got free insulin but did not pick it up. It was only after a social worker dug into the issue found out the client did not have a fridge and so when picking up the insulin the pharmacist said "do you have a fridge", they said "no" and walked away. The social worker found a program with home depot to get a free mini fridge.
From what I understand, much of the medical world feels the same way. That's one thing I would certainly add to Canadian health care -- some kind of minimum of public mental health and social work. There are a lot of programs already that don't attach a fee for the patient/subject, but they're not necessarily common knowledge or accessible to people as a "walk in and book" sort of service.
edit: To wit, I think the reasons social programs don't work is inaccessibility to those who really need them, lack of familiarity with them, and taboo (but this last one is probably another discussion). I think right now we need more of them, and they need to have access to proper resources and that their end benefit to society would be substantial. I'd be interested in seeing some projections surrounding that to be sure.
Their biggest clients are hospitals and insurers. There are people called "frequent flyers" who come to the emergency room frequently and while they might only be 2% of clients they account for a huge share of costs. It's actually cheaper to hire social workers to provide these people with the things they actually need (i.e. treating the causes) instead of the symptoms.
Here's an example. Guy is low income. Cannot afford food & insulin for diabetes. So he chooses to not buy insulin and the food he does buy is high in sugar (think cheap whitebread). Goes into diabetic shock and gets sent to the emergency room. Instead it's much cheaper for everyone involved if a social worker finds out the problem, helps him research some foodbanks to cover his nutritional needs or gets him on a discount insulin program. It's not free, but it's much cheaper than trying to clean up a mess after the fact.