NEW YORK After decades of fruitless efforts, activist lawmakers in a Democratically controlled Congress finally may be on the verge of pushing through one of the most elusive policy goals of the past half-century: a massive reform of the U.S. healthcare system that aims to extend health coverage to most Americans and put a clamp on federal healthcare spending.
That bill, the Affordable Health Care Choice Act of 2009, is a long way from passage. Republicans on the Senate HELP Committee object to several key provisions in the bill – including language that would impose higher taxes on the wealthiest Americans to help pay the bill’s estimated trillion-dollar 10-year tab, a new government-run insurance provider to compete with private-sector insurers and a provision that would penalize employers who don’t offer health benefits to their workers – and that opposition is sure to play out when the House of Representatives and the full Senate debate the measure in coming days.
Nevertheless, even staunch conservative lawmakers acknowledged that the climate for health reform is ripe. Spurred by public alarm over the rising cost of health care and dire projections about the future of Medicare and Medicaid, the Obama administration and the President’s allies in Congress have made overhauling the healthcare system a top legislative priority, and are pushing for fast-track passage of a bill before the end of the current session.
It’s too soon to tell just what impact the bill would have on some of the biggest issues of concern to retail pharmacy, such as Medicaid reimbursement. But concerns over costs and employer mandates aside, chain and independent pharmacy advocates have found much to like in the Affordable Health Care Choice Act.
As envisioned by HELP Committee chairman Sen. Edward Kennedy, the bill, if passed in its current form, would advance the concept of pharmacy care, elevate the role of pharmacists as patient-focused community health practitioners and exempt retail pharmacies from accreditation requirements for the sale of durable medical equipment, a cause long sought by pharmacy leaders.
Needless to say, the bill also would swell the roles of prescription drug customers by expanding affordable coverage to most of the estimated 45 million to 50 million uninsured Americans.
Among the pharmacy-friendly provisions championed by Kennedy and other supporters of the bill:
- The establishment of community health teams to set up the “medical home” model of individualized health care for patients – a model that could include retail pharmacies as “homes;”
- Funding of a pioneering grant program to implement medication therapy management for the treatment of chronic diseases;
- Greater incentives to spur generic drug switching and the adoption of health information technology;
- A greater emphasis on disease prevention through healthier lifestyle and nutrition, and closer coordination between health counselors (including pharmacists, presumably) and patients; and
- The creation of an approval pathway for biogenerics at the Food and Drug Administration.