Want to fix health care? Leverage clinics
“We’re already paying for it—it’s just hidden in your premiums.”
That’s what President Barack Obama told attendees of a town hall meeting last month in Green Bay, Wis., one of the stops on his traveling road show to sell his vision for healthcare reform to America.
I have said before that I am optimistic that we can fix what is wrong with health care without socializing medicine—a fear that seems to play like a broken record among echo chamber dissenters who attempt to compare health care in Canada and the United Kingdom to a Breshnev-era toilet paper line in the former Soviet Union. I have met people from these countries, including some pretty conservative types who will tell you that the kinds of stories folks like Sen. Lindsay Graham, R-S.C., tell about having to wait longer for care just aren’t true.
That also doesn’t mean that we should socialize medicine either. Because the last time I checked, the debate wasn’t about shifting 300 million Americans—including the 250 million of us who already have insurance—to a government-run program, it was about finding a way to mitigate the rising cost of health care and getting coverage for the 46 million or so that either don’t have insurance or don’t have enough of it.
But I do agree with Sen. Graham and others like him who believe that ultimately, these types of issues—namely, the question of whether or not to create a public option to compete with private insurers, and who is going to pay for all of this—have the potential to derail health reform entirely. In the course of the debate, there has been much consideration given to the idea of cutting back reimbursements to providers who participate in such programs as Medicare and Medicaid. This industry knows full well what stuff like that means.
Squeezing providers limits access to quality health care. If a pharmacy goes broke and shuts down because it can’t afford to serve Medicaid patients, that store is closed to everybody, not just to the Medicaid patients that used to shop there. When a third-year medical student decides to pursue a specialty rather than go into family practice, that is one less GP that is available to treat Americans. Penalizing providers isn’t the answer.
I am not an economist, and I don’t pretend to have an answer for how or where America is going to come up with $1 trillion to pay for health reform. But I am certain that figure could be reduced substantially if the plan to fix health care included a bigger role for retail clinics and worksite-based healthcare solutions.
I was reminded of this again last month during the “ABC News” live broadcast of the President’s healthcare forum, a program it called “Prescription for America,” when a Johns Hopkins nursing student named Hershaw Davis addressed the issue of a shortage of primary care providers and the overcrowding that impacts our nation’s emergency room and urgent care facilities as a result. His basic question was, how can we get nurse practitioners more involved at the community level?
The answer Obama should have given was to push for the expansion of the clinic model in every city and town in America. How much could we shave off that $1 trillion estimate if we were talking about utilizing the clinics to do acute care and even play a greater role in prevention and wellness for 46 million uninsured Americans instead of funneling them through the ER or trying to come up with imaginary physicians that don’t exist to provide this kind of care?
Why do I believe this kind of care provides more answers than questions? Just take a look at the Big Three U.S. Automakers versus their top competitors in Japan and Europe. It is estimated that the cost of every car produced by Ford, GM and Chrysler includes about $1,500 to fund the price of health care; BMW is spending about $450 per car, while Honda spends about $150. One reason, though certainly not the only one, is that here in this country, Honda and BMW are utilizing worksite-based solutions to provide care for the people who build their cars and their families. The Big Three do not.
Editor’s Note: A headline for a story that appeared in the June 29 issue of Drug Store News (p. 12) regarding industry reaction to the Affordable Health Choices Act, commonly referred to as the Kennedy health plan, suggested that the National Association of Chain Drug Stores and the National Community Pharmacists Association fully endorsed the plan. To clarify, the groups support certain provisions of the bill, particularly a proposed grant program to implement medication therapy management services for people with chronic conditions. The groups do not patently support all aspects of the proposed legislation.
Senate panel votes in favor of healthcare reform bill
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.
CVS Caremark to open Customer Care Center
NEW YORK Here’s a look at how the future of pharmacy is going to work …
The fact that CVS Caremark is preparing to open its first Pharmacy Customer Care Center is important because it appears as though the two biggest players in pharmacy — the other being Walgreens — are setting their sights on extracting much of the busy work out of the stores in an effort to free up the in-store pharmacy teams to perform more of the medication therapy management, disease management and other more high-touch services that will come to define pharmacy care in the future.
As explained by Larry Merlo, president of CVS/pharmacy, the Woonsocket, R.I.-based pharmacy retailer is opening the new facility and launching the new pharmacy service program to “enhance the service provided to individuals who call our pharmacies, as well as to provide more time for our pharmacy teams to spend serving customers in our stores.”
The move is in a similar vein to that of Walgreens’ “POWER” initiative. As previously reported by Drug Store News, POWER is aimed at offloading and centralizing some prescription dispensing duties in Walgreens’ pharmacies. The goal: to ease up pharmacists and workloads, reduce staffing costs and give its pharmacy professionals more time to consult with patients. The workload-balancing project offloads dispensing duties from individual Walgreens pharmacists to centralized processing centers. Company leaders predicted the project will free pharmacists and even pharmacy technicians from some of the mundane dispensing tasks so they can migrate to a broader role in patient oversight, clinical care and integrated health care alongside physicians, PBMs and corporate health plan sponsors.
As of late May, Walgreens’ POWER project had shifted script dispensing functions for more than half the company’s nearly 800 stores in Florida, and some 100 of its 238 stores in Arizona.
It is likely that this is just the tip of the iceberg and that the industry will see more of these types of programs and initiatives as retail pharmacy further digs its heels into the U.S. healthcare system and continues its evolution into a broad-reaching healthcare provider.