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June 29, 2009 9:25 AM

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Equal, similar incomparable in health

News Channel 8, WTNH
Equal, similar incomparable in health

Monday, 15 Jun 2009

Hartford (WTNH) - Some in people Connecticut are concerned about their medical coverage. One of the Governor's proposed budget cuts could leave hundreds of thousands without the coverage they need.

All of this comes down to the definition of "equal" and "similar."

For example, if someone who has MS needs a wheelchair, under equal treatment, they would be covered to get a power wheelchair. If the state is only required to provide similar treatment, they could be given a manual wheelchair.

So this new proposal has those who rely on state help very upset.

For nearly 13 years, Karen Mayo has provided round-the-clock care for her daughter Lindsay.
Karen Mayo - North Branford

"The proper name of her disability is microcephalic encephalocele," Mayo said.

Lindsay's brain was not formed properly in the womb. She cannot walk or speak, has seizures and is blind.

"She's my child, I want her at home, I want to care for her, I can give her the best care she needs in my home," Mayo said.

Mayo's only been able to manage because medicaid provides the necessary medicine and supplies. If they didn't, she might have to institutionalize her which is far more expensive for the state.

But that could happen if the governor's budget cuts go through. Right now, medicaid provides the cheapest treatment that's equally effective. The state wants to change that to similarly effective.

"When they say similar, although it sounds good, it's really not the same," Mayo said.

Substituting cheaper or different treatments for things like supplies, professional help or medication will cut $.5 million in the first year, $9 million the next year. It could also adversely effect 420,000 people in the state.

"I'm scared to death," Kelly Phenix, of East Hartford, said.

Kelly Phenix currently takes 24 pills a day after being diagnosed with bipolar disorder in 2003. She was given zyprexa which had serious side-effects.

"Within four months, I was a type 2 diabetic with blood sugars over 500," Phenix said.

That, in turn, has caused a host of other health problems. The state now pays an extra $1,000 a month for all her medication. She says substituting is not cost-effective in the long run.

Those relying on the right treatments tell us they understand it's a bad economy. But it is for them too.

"They're trying to balance the budget on the backs of the elderly, the disabled, the chronically ill," Phenix said.

We contacted the Department of Social Services who said they would still provide reasonable, necessary and appropriate care and that Connecticut will be on a par with most public and commercial health care programs. The governor's budget, with this change in it, has not yet been passed.


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