Prescription for disaster: city says no to senior citizens' drugs | Neighborhood News | Chicago Reader

Prescription for disaster: city says no to senior citizens' drugs 

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For the last dozen years Mary Krcmar filled her prescriptions free of charge at the city's southwest-side health clinic not far from her house in Gage Park. But a few months ago the city announced that sometime in 1994 it would stop providing free medication to seniors who visit the clinic, now called the Southwest Community Family Wellness Center.

Krcmar says she will have to do without many of the drugs and vitamins her doctor recommends. "I take six to seven pills a day, including pills for high blood pressure and diabetes and potassium," she says. "Now I'll have to make choices. Forget the vitamins and forget the potassium. It's really hard. I don't know why they would do this to old people."

Krcmar's not alone. Without the city program, at least 500 low-income seniors on the southwest side cant get such invaluable drugs as insulin for diabetes or pills that combat hypertension and high cholesterol. Some of this medicine costs $50 a month or more.

City officials say the program was abolished to save money, but some health officials predict grave consequences. "Medicare doesn't cover the cost of these drugs, which in some cases people need to stay alive," says Jennifer Artis, executive director of the Wellness Center. "We're very concerned."

The center, at 4150 W. 55th St., was built in the 1970s as part of Mayor Richard J. Daley's ambitious plan to provide free drop-in health facilities throughout the city. Several doctors were on duty, offering a wide range of services for people of all ages. But by early 1993 the clinic was seeing fewer patients in a month than clinics in other parts of the city saw every week. Moreover, for the last couple years the clinic had been used exclusively by senior citizens, as families and younger residents went to other, privately operated clinics in the area.

"When it was originally established there wasn't as much access to other outpatient clinics in the area as there is now," says Tim Hadac, a spokesman for the city's Health Department. "Since then Mercy Hospital has opened a big outpatient clinic at 56th and Pulaski, and there are two others in the area. There's a lot more access, and that's why the [Wellness Center's] patient roster has gone down."

Because of the falling patient load, the city cut back the services offered at the clinic and laid off some of its staff. "You used to be able to get a chest X ray there, but no more," says Krcmar. "It was always run with a little dignity. It went down a lot." Then last year Health Department commissioner Sheila Lyne proposed ending city funding and turning the clinic over to a new, locally run not-for-profit. It was part of her larger plan, supported by Mayor Daley, to privatize some of the clinics the mayor's father had built. Lyne argues that not-for-profit organizations run by local leaders can often provide better, less costly services than the city. "When some people say privatize they try to conjure up negative connotations, which aren't accurate," says Hadac. "Our view is that it, doesn't matter who provides the care, so long as it's quality care accessible to people with limited ability to pay."

In the case of the southwest-side facility, a board of local bankers, merchants, residents, and activists was formed to oversee the clinic. Most of its support now comes from Holy Cross Hospital, which staffs the facility with doctors. The clinic was refurbished and painted, and a wider range of services was offered. A grand opening was held in December.

But amid the hoopla came a directive from Lyne that the city would discontinue the free-medication program as of January 1. Hadac doesnt know how much money cutting the program saves, and Lyne could not be reached for comment.

The reaction at the clinic was shock and fear. One longtime patient, a widow, cried; others pleaded for help. The patients at the clinic were much more dependent on the program than the policymakers at City Hall might have imagined. Many politicians and bureaucrats apparently view the southwest side as a solid mass of middle-income wage earners who abhor all social programs. In fact, the population in many of these communities is rapidly aging. The sons and daughters have moved to the suburbs, and many of the parents left behind are retirees struggling to make do on fixed pension plans. The widow of a retired assembly-line worker, for instance, might make $550 a month. After rent, heat, phone, and food, there isn't much left for anything else.

"Widows have it the worst," says Elizabeth Ferraro, a nurse at the clinic who makes regular home visits throughout the southwest side. "Some of them have no children. Or maybe they're estranged from their kids. They might be living in a small apartment. You go into the home and you see an old rotary phone, which they're renting from the phone company. I tell them, 'Buy a new one--it's cheaper.' But they don't have the cash."

Ferraro and her colleague Susan La Valle regularly see patients who are malnourished. "We have patients who only eat one meal a day," says La Valle. "A woman was eating cat food. It only costs 19 cents a can."

Most of these seniors pay their medical bills through medicare. But medicare only pays for 80 percent of any health bill and doesn't cover most drugs. "You can scrape together enough money to pay for supplemental insurance, but that only pays for a portion of the bill that medicare doesn't cover," says Joseph Ramski, a retired factory worker and member of the Wellness Center's board. "No matter how you look at it, you still have to pay for more."

Ramski's medical needs are partly covered by a health-insurance plan he received after years of working at the International Harvester factory on the southwest side. "When I retired I had it in writing from the company that my wife and I would receive health care for the rest of our lives," he says. "Then last year I got a letter from the company saying my coverage had been discontinued. I wrote them a letter asking what had happened to all the money I had contributed to the policy over the years."

Ramski's protests finally persuaded the company to continue the plan. But he has to pay $68 a month in premiums, and he no longer gets many services, including dental care. But Ramski is luckier than many retirees. Under his plan he can obtain generic drugs for $7 per prescription and name brands for $8 through the mail. "It takes seven to ten days to receive the drugs from the company, so it better not be something I need in a hurry. Some people are paying $ 1.10 for a pill. We said to one guy, 'Jerry, why don't you go to Mexico?' You try to laugh, but it's not really funny."

Some of these seniors could apply for public assistance to pay for their drugs, but that's a time-consuming, arduous process. "These are proud people who have worked hard all of their lives, and now suddenly they're supposed to apply for public aid?" says Ferraro. "It's not going to happen. It wouldn't even be worth it. They'd have to sit in a public-aid office for hours, waiting to be served. Then they'd have to answer a bunch of questions like, Do you own a house? Do you have a checking account? Where's the support document? Now you tell me, where is someone born 80 years ago in Poland going to get her birth certificate?

Ferraro and other nurses acknowledge that better diets and regular exercise might help some of their patients' health problems. "I used to think that hypertension was a disease of black folk," says Artis, who for years has worked in health centers in black neighborhoods. "I used to tell black people not to eat so much salt and pork and fatty food. Then I come over here and see all the eating habits that these people brought over from the old country: Polish sausage, cooking with lard, you name it. There's a lot more in common between the black and white communities than I ever imagined."

In the last few weeks several southwest-side seniors have started demanding that their local political leaders pressure the city into continuing the program. "Some of the politicians will take some convincing," says Ramski. "They think that everybody out here has enough money to take care of themselves. I was at this meeting where Congressman William Lipinski spoke. And one lady said, 'I want the same health plan you got' which is the free coverage that a congressman gets. Lipinski took the mike and said, 'Let's go on to the next subject.' Boy, did he get the booing. It was embarrassing. But these politicians have to learn how tough it is for some of the seniors out here."

Art accompanying story in printed newspaper (not available in this archive): photo/Lloyd DeGrane.

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