After a six year mission to see the adoption of much needed Medicaid savings measures, the Senate finally supported our efforts to remove the “carve outs” restricting the utilization of prior authorizations for prescriptions.

Earlier this year, Governor Haley made in her state-of-the-state address. Here’s what she said:

The majority of prescription drugs issued by Medicaid are generic, with three large exceptions: AIDS, cancer, and mental health. We propose, following the lead of Senator Kevin Bryant, a pharmacist himself, that we remove the proviso prohibiting the use of generic medications to treat those three afflictions. I realize that this may sting pharmaceutical companies, and some lobbyists, but it is an option that will allow us to realize real savings without compromising the quality of care for our patients.

 

I met with Gov. Haley recently, and stressed the potential savings if we make this change. As a pharmacist, I witness wasted taxpayer money on prescription drugs on a daily basis.Currently, Medicaid has a process called prior authorization or PA. This process is applied to some medications. In these situations, generic alternatives must be used first, and in the instance that the generic drug does not work; the more expensive medication may be dispensed. In no way is quality of care in jeopardy. If a consumer is paying cash for a product, naturally, they will try the least expensive option first. When the taxpayer is required to pay for medications covered by Medicaid, I believe we should take the same approach.

Prior Authorization is applied to many life threatening therapeutic classes with little or no problems, yet with exponential savings of the taxpayers’ money. We apply the PA’s to medications treating diabetes, blood pressure, esophageal reflux, and many, many more.

I am confident that there is much room for savings in the mental health, aids, and chemotherapy areas. Currently, the legislature has banned the Pharmacy and Therapeutics Committee from even considering utilizing the PA in these three categories.

For example, in 2010 Medicaid spent $23.7 million on 3 drugs (Zyprexa, Seroquel, & Abilify). Applying a prior authorization mechanism on these drugs would only mean that less expensive alternatives be tried first. Even though many patients may still qualify for these meds, the PA possibility will still save money as drug manufacturers are more cooperative with negotiations on rebates when the prior authorization is a possibility.

Adding prior authorizations to Aids and Chemotherapy drugs may not save much, but there is still merit in expanding the PA to these categories. As you know, the hiv virus in a constantly changing organism and cancerous conditions are ever-changing, so therapies are constantly changing. But remember, the PA possibility does increase the rebate negotiating factor.

South Carolina Government: Now is the Time for Historic Reforms

Restructuring our state government will result in a more efficient, more effective, and more accountable government. A government that is more efficient will free up additional resources to more adequately serve those who need government help. A government that is more effective will better serve those who need government’s services. And a government that is more accountable will allow voters – and The Legislature – to hold future governors responsible for our state’s results.

One of the many benefits of greater accountability would be an increased diversity in government leadership. For example, over the past ten years:

African-Americans have led 26% of agencies when the governor makes the appointment, yet 0% of agencies under Constitutional Officers (for the past 130 years!)

Women have led 30% of agencies when the governor makes the appointments, yet only 6% of the agencies under Constitutional Officers

African-Americans currently hold 23% of the top deputy positions under gubernatorial appointees, yet 0% of the top deputy positions under Constitutional Officers

Many leaders – have publicly called for a much needed restructuring of government.
• “The reason to do it, I believe, it makes for a much more effective government.” former Governor Jim Hodges1
• “The 1895 constitution was ‘done poorly and for the wrong reasons,’ said former Governor Dick Riley…He agreed with a previous comment by (former) Gov. Mark Sanford that the constitution was meant to keep liquor out and black men down.”1
• Representative Chris Hart “dismisses the fears of diminished legislative power, noting that the Legislature and governor can – and should – both be strong…‘In civics class, you learn about the three branches of government…We don’t have that here.’”2
• “He demonstrated his ability to do with DPS what we could not have done in the Legislature…That just illustrated what the potential impact of a governor who can be held accountable would be…That’s a benefit that I think some of us may have missed.” Representative Joe Neal2
• “(Senator John) Scott boasts that he voted this spring to create a new Department of Administration that the governor would control, to let the governor hire and fire the director of a merged Department of Mental Health and Alcohol and Other Drug Abuse Services, and to ask voters to let the governor name the education superintendent, secretary of state and lieutenant governor.” 2
• Senator Darrell Jackson “now says he’s back to supporting the idea (restructuring), specifically mentioning (former) Gov. Mark Sanford’s argument that letting the governor appoint constitutional officers is ‘the only way we’ll get an African-American in a high position.’”2
• “If you have accountability to where the people can have some input to it, they can get the services they deserve…In those areas that you don’t have oversight by the governor, those people are not accountable.” Representative Joe McEachern2
• “It is a constitution born in sin.” Senator Tom Davis1
• Governor Ben Tillman’s goal was “the elimination of black Carolinians from the political process….black disenfranchisement was the primary goal of the new constitution.” Walter Edgar, The History of South Carolina
Sources:
1. State senator says S.C. Constitution ‘born in Sin’” Charleston Regional Business Journal 1/19/09
2. “Are black legislators becoming the best advocates of restructuring,” Cindi Ross Scoppe, The State 5/20/08
If passed by The General Assembly this session, the referendum to change the Constitution could be put before voters in 2012 and therefore will not take effect until January of 2015.
This session is the time to act since we don’t know what governor will be in office when the change is made. It is also unlikely to impact any of our current statewide constitutional officers. And, perhaps most importantly,
Isn’t 120 years long enough to spend under the shadow of Ben Tillman’s pitchfork?

“I believe Jesus was a great moral teacher, but I can’t accept His claim to be God.” Have you ever heard a statement like that…or perhaps said something similar yourself?
C.S. Lewis probes the greatest decision of life:

A man who was merely a man and said the sort of things Jesus said would not be a great moral teacher. He would either be a lunatic – on the level of a man who says he is a poached egg – or else he would be the Devil of Hell. You must make your choice. Either this man was, and is, the Son of God: Or else He is a madman…or something worse. You can shut Him up for a fool; you can spit at Him and kill Him as a demon; or you can fall at His feet and call Him Lord and God. But let us not come with any patronizing nonsense about His being a great human teacher. He has not left that open to us.

Liar: Jesus knew he wasn’t God, but said so
Lord: Jesus Christ is everything he says he is
Lunatic: Jesus thought he was God, and pretended to be so

Who is the living Son of God to you?

Here’s a very good illustration of our Country’s financial mess