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Rx limits bring tough choice

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Under some pressure from disability and senior advocates, the Utah Department of Health will take a more surgical approach to a proposal to limit monthly Medicaid prescription reimbursements.

Exemptions have been granted to the chronically ill patients, children and pregnant women. Instead of hard and fast limit to to seven prescriptions per month, the agency will conduct individual reviews to ascertain whether certain patients require the many prescription medications they have been taking. Then, determinations will be made whether exemptions should be granted and to what degree. This is a better course than across-the-board reductions, but it is not without its own set of problems concerning equal treatment and whether this review will result in the cost savings some officials have envisioned. If not, where will health department budget cutters turn next?

From a sterile, arm's-length perspective, this page sees no inherent problem with reviewing Medicaid patient expenses. Some Medicaid recipients are over prescribed. When some people enter nursing homes and do not see their primary care physicians as often as they are accustomed, prescriptions can add up absent a holistic look at the patient's care. It is prudent that Medicaid recipients also explore alternatives to their prescribed medications such as generic drugs or even over-the-counter preparations.

While this page understands that all departments of state government are expected to bear a portion of the state's anticipated $200 million budget shortfall this fiscal year, legislators must be mindful of the very needy people served by Medicaid and work to limit the impacts in what portends to be an extremely tight budget year.

The Legislature has a number of options. It can work to achieve budget cuts elsewhere. It can impose hiring freezes, which proved to be a successful tactic in Salt Lake County's budget crunch. Another option is, of course, to raise taxes. We are not necessarily endorsing a tax hike, but it follows that the Legislature must carefully consider every option when very needy people's physical and mental wellbeing may hang in the balance.

It is true that individuals and health-care providers can share in the responsibility of cutting these costs. Yet, it is vital that a broad spectrum of human ramifications are understood before the final reductions are handed down.