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Paying People To Take Their Medications

From a wildly approving New York Times:

For Forgetful, Cash Helps the Medicine Go Down

By PAM BELLUCK

June 13, 2010

It has long been one of the most vexing causes of America’s skyrocketing health costs: people not taking their medicine.

One-third to one-half of all patients do not take medication as prescribed, and up to one-quarter never fill prescriptions at all, experts say. Such lapses fuel more than $100 billion dollars in health costs annually because those patients often get sicker.

And, no, The Times didn’t just make up that $100 billion dollars. That is exactly what it turns out to cost based on very scientific calculations.

(Just kidding.)

Now, a controversial, and seemingly counterintuitive, effort to tackle the problem is gaining ground: paying people money to take medicine or to comply with prescribed treatment.

It’s not “counterintuitive.” It is just ridiculous and wrong. It is also never going to work, since they have found that these programs never work. Such as Mr. Bloomberg’s efforts to pay kids to go to school and get better grades.

You can’t buy off stupidity.

The idea, which is being embraced by doctors, pharmacy companies, insurers and researchers, is that paying modest financial incentives up front can save much larger costs of hospitalization

In a Philadelphia program people prescribed warfarin, an anti-blood-clot medication, can win $10 or $100 each day they take the drug — a kind of lottery using a computerized pillbox to record if they took the medicine and whether they won that day.

Before the program, Chiquita Parker [photo at right], a 25-year-old single mother with lupus, too ill to continue her job with special needs children, repeatedly made medication mistakes, although she knows she depends on warfarin to prevent clots than can cause strokes, paralysis, or death.

“I would forget to take it,” and feel “like I couldn’t breathe,” she said. Or she would “take two in a day,” and develop bruises from uncontrolled internal bleeding.

But in the six-month lottery program, she pocketed about $300. “You got something for taking it,” Ms. Parker said. Suddenly, she said, “I was taking it regularly, I was doing so good.”

Her health – being able to breath — wasn’t motivation enough. She needed a $300 incentive.

And she was teaching “special needs children”?

[W]ith patients forgetting medication, finding it inconvenient, fearing side effects, or considering it unnecessary if they feel better, important players are turning to financial rewards. Aetna, the insurer, helped pay for part of the Philadelphia experiment, and is considering using that or another method…

‘Big Insurance’ is doing this? Then it must be some conspiracy to kill off poor people.

Aetna has begun paying doctors bonuses for prescribing medication likely to prevent problems: beta blockers to prevent heart attacks, statins for diabetes sufferers. Currently, 93,000 doctors are in Aetna’s “pay for performance” program; bonuses average three percent to five percent of a practice’s base income

Even the new federal health care overhaul includes incentives, expanding a program paying pharmacists extra for helping some Medicare patients learn to take pills correctly.

Notice how far down in the article this bit of news is buried. Did you know that Obama-care included this?

Of course, in time, it will be expanded to pay every ‘poor’ person to take their free medicine. That is only ‘social justice,’ since our evil society made them ill in the first place.

Experts say the psychological effect is more important than the dollar amount, which is usually just enough to seem significant.

Expecting failure, the Traumatic Brain Injury Network, a Columbus, Ohio, clinic for brain-injured patients with substance abuse problems, tried paying $20, in gift cards to grocery stores or restaurants, if patients completed their first treatment phase in 30 days. The one-time payment not only improved initial compliance, but “they actually scheduled more appointments” and stayed enrolled, said Dr. John Corrigan, the clinic’s director. “I didn’t start as a believer,” he said.

The $20 helped propel Damand, 30, who had quit the program twice, to attend, even walking when he lacked bus fare. “I’ve been taking my meds like I’m supposed to,” said Damand, who took the card “straight to the store,” buying soap, tissues, chips. (The clinic insisted that patients’ last names be withheld.)..

Yes, we must reward those “brain injured substance abuse” patients even more.

Even severely mentally ill patients respond to small payments. A British study in which patients are paid about $22 for regular injections of antipsychotics has kept some of them from being recommitted to psychiatric hospitals.

“We’ve had a least one patient say, ‘Now I see the benefit of medication and take it regularly,’” said Dr. Stefan Priebe, a psychiatry professor at Queen Mary, University of London. But for most, he said, “you would probably have to keep the incentive going.”

And keeping this going is what it is all about.

The Philadelphia lottery project has worked with patients of varying income…

Dr. Kimmel said patients win $90-a-month on average, reduced from $150-a-month because less money worked equally well. That $90 “will pay for itself” if it prevents two emergency clinic visits, he said. “Prevent a cerebral hemorrhage or major clot, we save tens of thousands of dollars,” he said.

Ever notice how we are always told that income redistribution will “pay for itself”? And somehow it never does.

Still, as we have noted before, the New York Times has been pushing for this program for some time now.

And why not? It’s yet another form of wealth redistribution. And like ‘healthcare reform,’ it can be disguised as being in the interest of public health.

This article was posted by Steve on Monday, June 14th, 2010. Comments are currently closed.

15 Responses to “Paying People To Take Their Medications”

  1. GetBackJack says:

    “Money is the rich man’s magic”

    It can make anything appear you seek. It can make anyone bow to your will. Money can produce any result you want. Money can woo any mate, change any vote and/or cure any sickness. It can build anything you want and answer any dream.

    Bow down and worship Man’s god, or face the fire like Shadrach, Meshach, and Abednego.

  2. proreason says:

    “a program paying pharmacists extra for helping some Medicare patients learn to take pills correctly.”

    uuuuuuh

  3. BannedbytheTaliban says:

    “That $90 “will pay for itself” if it prevents two emergency clinic visits”

    Two emergency clinic visits = $90. That is pretty affordable healthcare. I pay more than that for one visit with insurance.

  4. Right of the People says:

    Where do I sign up? I have to take both oral and injected meds daily and never forget because I don’t know, maybe I want to be healthy and live. If they’d pay me I know I’d never forget, I could use some more pocket money.

    Oh wait, I’m not a minority and I actually work for a living. Never mind, what was I thinking?

  5. untrainable says:

    Dr. Kimmel said patients win $90-a-month on average…

    Is that Dr. Jimmy Kimmel? and is this another late night joke? They can’t be serious, can they? :-/

    Seems to me that if they don’t take their meds, they’ll be dead sooner and, in the long run, they’ll cost the taxpayer less in freebies. Isn’t that how we calculate healthcare these days? Oh, sorry, that doesn’t start until 2014… guess we’re just in the warm-up phase now huh?

  6. wardmama4 says:

    I can’t imagine having a life threatening illness – and not being able to ‘remember’ to take my med correctly – I kind of have gotten to like living and I can read beyond a 3rd grade level. It is just getting to the point that Uncle Obama will have to go to where they stay and set the pills out for them.

    Talk about stupidity. And a program paying pharmacists extra to help some Medicare patients take their pills correctly – just more money from hard working, educated people to hand carry the lazy and ignorant along for free.

    God Help America.

    • MrBill says:

      If we’re talking about patients who are sick but mentally competent, I agree 100%. Wanting to stay alive and healthy ought to be incentive enough.

      I’m not ready to dismiss this outright with respect to mental patients, however. The mentally ill are notoriously bad at taking their medication. Oftentimes they’re in denial about their condition and don’t feel they need meds. Others are just so whacked out that their ability to care for themselves is compromised. For the severely psychotic I doubt that a financial incentive will make a bit of difference. However, for those who still have some grasp on reality, I can see how a chance to win some money might encourage them to be more conscientious; and, for those who don’t believe they have a problem, it might persuade them that there’s no harm in taking a few pills if there’s a chance of getting some money out of the deal. I’m not saying this will work – the “evidence” cited in the article sounds anecdotal – but if there are anecdotal success stories, it may be worth a properly-designed scientific study to see if it really does work. If there’s a chance this could help stabilize mentally ill folks to the point that they stay employed, or at least keeps them out of homeless shelters and/or prison, it may be worth looking into.

  7. TwilightZoned says:

    I just keep sinking deeper and deeper into the…twilight zone.

  8. Reality Bytes says:

    Hey! I like it when somebody buys me a drink. What’s wrong it other than you have to be stoned to come up with such an idea!

  9. Liberals Make Great Speedbumps says:

    “Her health – being able to breath — wasn’t motivation enough. She needed a $300 incentive.”

    Someone tell this stupid b*tch that I’ll send her a check for $500 if she’ll stop taking her Warfarin! What a useless POS!

  10. Mithrandir says:

    It’s A LOT CHEAPER to let these people die from their own stupidity. . .

  11. fallingpianos says:

    Doesn’t surprise me that Obama voters would need financial incentive to take their meds.

    • Mithrandir says:

      I used the make the “joke” (not a joke anymore) that the liberal voting blocks are so dependent on government that they can’t even wipe their own arse without a panel of social workers, and an entire bureaucratic apparatus to help them do it!

      Are their voting blocks so completely socially retarded that we have to give them:
      ~free medical care
      ~free housing
      ~guaranteed graduation and employment
      ~free school breakfast/lunch/dinner
      ~NOW paying them to take their own medicine that they get for free anyway?

      Oh my god……how in the world did we ever become a great country with all this mess?

  12. proreason says:

    “how in the world did we ever become a great country with all this mess?”

    It really is an important question. Because when we lock these criminals away for life, we have to fix the underlying problem.

    And the problem isn’t stupidity, or the people, or the system, or modernity, or bad luck.

    The problem is a deliberate and long-lasting alliance of political criminals and marxists, who have schemed and worked for 60 years to undermine everything in the greatest country that ever existed.

    We have to take back, not just the government, but the media and the schools. Failing that, they will be back in 10 or 20 years, because their lust for power is so great that they will never go away.


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