Weighing in on health reform

Rob Eder

Want to weigh in on healthcare reform? What do you think it weighs, anyway—Congress’ Patient Protection and Affordable Care Act? Drug Store News printed out the 2,400-plus page document, and with no binder clips big enough nor a stapler aggressive enough to contain it, we have kept it in a 9 in.-by-12 in. box that is roughly 10 in. deep—the pages overflow by about an inch.

I spot it at about 25 lbs. or so.

Indeed, the prospects for healthcare reform in America is a pretty heavy subject. I am still of the belief that by the time it is fully implemented, healthcare reform will look a lot different than the model contained in those 2,400 sheets of paper. I still believe that the final version, versions 2.0 and beyond, will favor more private sector-driven and consumer-directed solutions, and that the version of universalized care we end up with will be no more socialist than any of the existing federal entitlements—social security, Medicare and Medicaid—our taxes currently pay for.

I don’t think social security is socialism. I am inclined to believe that these types of expenditures really are investments in a more productive work force, which ultimately makes us a stronger economic force in the world.

I am certain that healthcare reform will change forms in the months and years ahead, and perhaps somewhat dramatically; to be sure, the legislation and the actions that led up to its signing into law will be a major factor in the next elections. There is a definitive fear rising among people who have insurance that their coverage will change, or cost them more. The polls indicated that most people who have insurance like what they have. I am one of those people. I like the insurance that I have very much. Could it be better? Sure. Was it once better? Absolutely, it was.

The reason it used to be better is because the cost of health care kept rising to the point where my employer could no longer afford to offer the same type of plan it once did without passing on considerable additional cost to the associate. Left unchecked, this trend will continue until a point where I will no longer like my insurance very much; and I am one of the “haves.” At the same time, under our existing system, the millions of uninsured will continue to ring up billions in otherwise avoidable upstream costs, because they have no access to preventive care and flood the emergency rooms when they are sick.

Do we have the money to pay for it? Not necessarily. But we have borrowed more than $1 trillion from the Chinese and the Saudis to pay for our military operations in Iraq and Afghanistan. The question of national security aside—because on some level, it is impossible to put a price tag on not being blown up in the middle of the night by our enemies—it appears that we actually could get a measurable return from health reform. The CBO believes it will chip away at the national deficit over the next 10 years, and for 10 years more after that. And if it made U.S. businesses stronger and more viable by containing one of our single biggest expenses, wouldn’t we actually have a better chance to one day pay off the Chinese and the Saudis—for everything?

If you can put your politics aside for a second, you have to admit that if nothing else, healthcare reform in its current form is at least good for retail pharmacy, and for that, the NACDS, the NCPA and the other members of the pro-pharmacy lobby deserve a lot of credit. The pharmacy-friendly provisions in healthcare reform—the new definition of AMP, strengthening of the MTM requirements under Part D, the DMEPOS accreditation exemption—are a major victory for the industry.

Want to weigh in on healthcare reform? Send me your thoughts and your best guess on the actual weight of legislation at reder@lf.com.

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