Health care reform

Well, we may, or may not have some kind of health care reform passed in Congress now that may or may not be amended to death in the next few months, but hopefully we will have some kind of change for the better. I have nothing witty or interesting to say, but I can say that we have had a lot of patients being admitted recently who have Medicare and have hit the "doughnut hole" already and are falling apart because many of the generic medications available in psychiatry are in no way related to the newer, name brand ones. Even some of the second generation medications that have come out in generic are still running in the several hundred dollar range a month. Somehow I do not see that the prescription drug benefit program for seniors and the disabled has done what it is supposed to and it does not make a lot of fiscal sense. Sure, Seroquel can run around $1000 a month, but a patient who decompensated and ends up on the psych unit for seven days costs the taxpayer $7000. I would not worry about us having enough patients to keep us busy on the psych units. The drug dealers will always make more. This reform bill is supposed to closed the so-called doughnut hole, but it is going to take years, and I fear that partisan bickering is going to whittle the bill into some worthless piece of bureaucratic nonsense and the Medicare patients will fall by the wayside. I hope for the best. My patients do not have much time to wait.