Skip to comments.Denver boy, 9, died after state-benefits error denied him asthma medication
Posted on 02/04/2010 2:35:27 PM PST by Second Amendment First
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‘Ms. Lucero needs to be a little concerned as to why she couldnt provide for her son.’
And where is the child’s father.
I am very sorry for this boy, it must have been a horrible death.
But the responsibility for caring for him lay with his PARENTS. They are the ones who failed.
If his father is dead or somehow seriously disabled, my apologies in advance.
Advair 2x/day costs about $150/mo. If she worked, I’m sure she paid that much in taxes, but the gov’t of course knew how to spend her money better than she did. Even if she worked, $150/mo might have been out of reach for her. It is for a lot of people. For example, I couldn’t pay that on top of my minimal health insurance that I’ve managed to keep. That’s after my small business went belly-up, again largely thanks to taxes and gov’t stupidity wrecking my customer’s businesses. (Gee, for some reason that really seemed to start happening a lot in 2007 and got worse from there. It’s almost like something happened in late 2006 that was really bad for small businesses. Wonder what it was? /SPIT)
Why didn’t mom just buy the meds and try to get reimbursed? I’d do whatever I had to do to keep my child alive. There are parts of this story that don’t make any sense.
I’m on Symbicort, which is about $100 a month before insurance. My lovely insurance company insists that I order a 3 month supply at once. So now we’re at $300 before, around $125 after. Of course, that’s not considering that I’m on 5 such maintenance meds per month. Even after insurance, 5 x $125 is a good bit of change to pay all at once.
Amen. This story stinks from every angle. Too many lawyers, too many government boobs and too many agendas to figure out where the truth lies.
I agree, I’d sell everything I owned for Rx for my son.
Nobody denied the boy this medicine. They just didn’t pay for it. Big difference.
Of course, it may still be a problem.
“This woman just sat around waiting for the government to do something.”
Yup, just as she’s been taught she was entitled to do by the govt run schools, the media, our culture, and now these lawyers.
Socialism kills, first the spirit and eventually the bodies. Death is the inevitable result. Lots of death. The sadest thing? Socialism is often self-inflicted suicide-by-government...
She got samples. Just not in time. My two had to take Advair along with a nebulizer when the inhaler wasn’t doing enough.
The story doesn’t tell enough to determine just how many ways this child was failed by adults. Not being able to get a human on the phone but once...she should have gone in person.
I think there is some missing info in this piece.
First, why didn’t she keep going to the doctor if this was such a long standing problem? The doc could have done something different. Daily Prednisone perhaps? Not ideal, but it would have managed the inflammation, and once the problem with his benefits was cleared up, he could have gotten back on Advair.
Second, she called every three days for months? That doesn’t seem right; you would think that someone would have done something. And she only spoke with his caseworker once?
Third, why didn’t she go elsewhere? A state or US Rep or Senator? The local newspaper?
The problem is that people dependent on the government think that everything will be done for them, and when it’s time for them to take the initiative, many don’t bother. And when something like this happens, they push the blame on others.
I feel for this mother, as this most likely was a preventable death. But if you bring a child into the world, take some responsibility to do what’s needed to be done.
Y'know, that's the point. The bureaucracy constantly works to dehumanize the process, because actually dealing with people is expensive, time-consuming, and interferes with the actual work of the bureaucrat - wallpapering the bureaucratic maze. People can not live their lives waiting in line for the next bureaucrat to forward them around the circle - thusly the bureaucracy evades responsibility.
You are right, this kid was failed by many adults. It doesn’t make sense. If the doc knew the kid didn’t have the medicine or couldn’t afford it, the doc could have given them samples months earlier. My kid’s doc did that with medicine that wasn’t covered or was expensive. The pharma reps love to have the Dr’s pass out the samples.
I find it hard to believe that the doctor DIDN’T step in. Which causes me to ask; did the mother tell the doc what was going on?
Paraprofessional is a fancy term for teacher’s aide. Low pay (because it’s a position that doesn’t require a college degree) and usually no benefits.
I would not have just done the calling every few days and watch my child deteriorate. I would have been on the phone to every charity agency, news, school officials. Everyone.
You can always pay cash and submit the claim yourself.
There doesn’t seem to be a father around anywhere to help her with her children — and pay for medicine.
Yeah, there is more to this story.
The dr,as i’m reading the comments,would seem to be the link that should have held it together. A family dr will get you the medicine,especially where a child is concerned,and put the bill in for whatever.
That being said never have been stuck in a situation where the govt was paying for me i can’t say she had a family dr or had to run to the emergency room every time something went wrong. If the latter then she might be seeing someone different all the time and not have established the patient dr bond. One would hope the drs in the emergency room would treat everyone the same but you hear so many horror stories about those places. So sad and tragic.
If she was this concerned about him why didn’t she take some of her cash benefits and buy some of his medication rather than make him go without? Get off your butts and quit thinking big daddy gob’mint is going to care for you, do for yourself! There are going to be piles and piles of bodies everywhere if the checks quit coming one day!
Its damn frustrating dealing with any govt agency. They like it like that of course.
IMO, your assessment is justified.
So? She goes back to the doctor for another prescription. Or just calls like I do and has one sent to the Pharmacy. Easy as pie.
Not only will the problem get worse for many Asthmatics it already has.
The EPA declared the original delivery medium, for asthma medicine, a pollutant.
You cannot buy the original formula and have not been able to for over a year.
Why is this a big deal? Many Asthmatics do not respond well to the “New” less polluting formula and many don’t respond AT ALL!
Having asthma is similar to taking a fish out of water. The asthmatic drowns from a lack of open and free breathing lungs.
Many have been forced to buy the original formula underground, online or even traveling internationally, where you can receive the original formula but not the new formula.
The EPA ruling is killing people left and right.
IIRC, the medicine is $130 bucks per tube. That can be a lot of money to low income family.
Still, relying on the government/taxpayer for picking up the tab when a life is on the line is just .....
If you go running around changing your prescription venders you will run afoul of the same sort of thing that hit Rush Limbaugh.
I seriously doubt this mother has the resources to challenge the bureaucracy, nor are the solutions to her problem all that obvious. Remember, she was told MORE THAN ONCE by people in authority that the problem was fixed. Obviously they lied, or, they, themselves, the system experts, didn't know and were unable to find out that they didn't know.
BTW, regarding the particular medicine I had trouble obtaining, I've been using it for 5 years. it works. I have no complaints nor do I suffer any negative side effects. Except for that one instance where I needed an emergency supply somewhere else hundreds of miles away, I have had to check with my physician every time I try to refill the prescription.
The reason is that it is authorized 5 refills, each for 90 days. That exceeds some "standard" in a piece of government software and effectively cancels my prescription every time anyway. This latest one had "1 refill" so I figured I was home free ~ but fool me!
Look, this poor woman got the flimflam from people running a system they can't control.
For instance, if you start a therapy under Medicare, they will only authorize a “Standard of Care” deliverable.
If you go outside the system they will bill you for everything and you will lose benefits.
The Doctor is restricted by law from going outside the system once a patient is in the system. PERIOD.
Her real recourse would have been in the emergency room where he would have been rushed to the front of any line and given a nebulizer.
Would she get a bill? Yes and it would be a big one. But they would have nebulized him and he would have walked out with a new nebulizer.
Depending on the city, the fire department even carries nebulizers and spares. There is no charge for this.
You only get charged when you enter the ambulance or the emergency room.
At Walgreens, pro’ly about $275
I just explained this in a post and totally agree. When you are on Medicare your Doctor, pharmacy and you are all under very strict rules which have severe limitations and real risks if anyone goes outside the system.
If you are on Medicaid you cannot purchase the medicine out of your own pocket. It is not like having private insurance and deciding, out of expediency, to pay for it your self and deal with the insurance company later.
Under Medicare the Dr., Pharmacy and you become part of their system and rules.
Is Primatene OTC? If it is, I am going to add it to my first aid kit. I have several friends who are asthmatic and it may be their hope, in a pinch.
Agree, sad and unavoidable. Do have to wonder how much the Dr. knew?
sorry, AVOIDABLE is what I meant.
>Im 51, almost died from my asthma a couple of times in my youth. I survived and managed before Advair was even invented.
I say this, because I think theres a lot more to this story than is being reported.<
You said it. This just doesn’t add up, not to mention I believe I’d have personally done without to buy my child’s meds if necessary. There are cheaper steroid inhalers out there. Prednisone tablets aren’t all that expensive for that matter. Advair and Symbicort are amazingly effective and the drugs of choice.
I wonder if this kid was a preemie and had damaged lungs from neonatal care, as opposed to a typical case of asthma?
Odd... I love Symbicort.
“Andrew Lieber was Zumante’s physician since birth.”
I agree with you re the doctor, they get all kinds of freebies. Some is screwed up in the story.
Zumante had struggled with asthma since he was 3 months old. But when he was 6, the condition became serious enough for his mother to apply for benefits under Social Security, which also entitles him to Medicaid.
That means he was on permanent disability through social security. Since his mother didn’t make alot of money it would be SSI/SSP. They should have also been receiving a cash payment for him.
My mother was medi/medi here in California and they NEVER pd for her Advair, either she did or if she didn’t have the $ I did.
>The Symbicort I just started is almost as bad, though. lol
Odd... I love Symbicort. <
Symbicort is great stuff. I originally got put on plain Foradil with a steroid inhaler. I HATE that stuff. Those stupid capsules get stuck in the inhaler and it takes up too much room in the refrigerator. Symbicort is just so much simpler.
Now that is just not true. My mother was medicare/medicaid here in California. She was prescribed Advair which was never covered. When I went to pick up her meds every mnth they would tell me the Advair isn’t covered and I would shell out the dollars. They would ring it up and I would walk off with the scrip.....every mnth.....til she died.
I take care of a 99 year old every day and have for three years. My experience has been her procidures are stopped at a certain point and her drugs are controlled under medicare.
She was in a procedure and the nurse told the doctor he had reached the limit. I asked what limit and the doctor explained Medicare regulations.
My immediate response was “So I will pay for the rest of the procedure”.
He said he can’t.
Twice I tried to pick up meds and there was some sort of issue and I offered to just pay for it. I was told can’t, as there are Medicaid restrictions. They assured me the problem would be ironed out the next day and I could pick up the prescriptions.
The pharmacist explanation similar to the Doctor explanation.
You may have had different experiences but, that is my experience.
Oh, thus far I really love what Symbicort is doing for me. It’s that awful taste! lol, that’s to what I was referring. I’ve only been on it 1 month.
They originally put me on Pulmicort until I began having one of the side effects — psychosis. Symbicort is MUCH better.
one puff twice a day is a lot easier than two inhalers four times a day (two puffs Albuterol, two to four puffs Azmacort is what I take during Asthma season...)
But I know from experience the salbutamol in Advir gives a steady relief of wheezing, while the twice daily dosages allows both relief from asthma and a good dose of local steroids is also in the inhaler to stop the wheezing. You can forget you have asthma most of the time.
Indeed, steroids alone will work, with "as needed" Albuterol...but you get lazy and forget to take all those doses.
I believe the drug company has programs to help you pay for the medicine, however...LINK
the bad news is that there is a lot of paper work.
As for getting money for the medicine: Lots of folks can't afford it, but when you get dependent on the government, doing things like asking relatives for money, or asking your church to help you pay the bill, or the Salvation army, or using the money for medicine instead of karate lessons, all these ideas disappear, and only BIG GOVERNMENT (meaning a clerk makes the decision) is left.
Yep, all I had to do was mention to the assistant at the pulmonologist’s office that my meds were really costing a chunk and she gave me several full size samples. Came out to a couple hundred dollars worth of meds.
Tragic asthma ping.
Oh, don’t EVEN get me started on that! I KNOW that my rescue inhaler is nowhere near as effective as my old ones. I used that last of the albuterols I’d squirreled away just last week. Now I’m on the stupid new ventolin. If I traveled out of the country, you bet your sweet bippy I’d stock up on the old formula inhalers.
No information about the child’s father, though.