Will health plan squeeze out pharmacists?

Drug Store News, April 5, 1993 by Ken Rankin

Hillary Clinton's White House task force on health care reform is closing in on a series of proposals that are likely to rely on direct federal price controls to reduce spiraling costs.

Pharmacy leaders here in Washington recognize this and appear ready to help the Administration hammer out the details of a new system of health care price controls that now appears to be all but inevitable.

A few years ago, the specter of outright government price controls on pharmacy products and services would have prompted howls of protest from drug chains, independents, hospital pharmacists and other practitioner groups.

Today, pharmacy leaders have an even more important worry: the prospect that pharmacy services may not be included in the new federal health plan - at all!

Incredible as it sounds, top policy officials at APhA, NACDS and other groups believe that Hilary's task force just may come up with a plan to reform the nation's health care delivery system that excludes coverage of prescription drugs.

If that happens - if Washington chooses to ignore the role that pharmacists can play in improving patient care and reducing health costs - the objective of health care reform will be undermined.

For pharmacists, the consequences could be even more serious. To be left out of the first meaningful reform of American health care in generations would be an ominous turning point for the profession.

Virtually every segment of pharmacy now recognizes this danger.

The No. 1 recommendation to the Clinton Administration from the newly forged NARD-NACDS |Health Care Reform Coalition' emphasizes "the necessity of including pharmacists' services in any health care plan."

A separate and even more broadly based coalition of national pharmacy organizations assembled by APhA delivered a similar message during recent meetings with White House health reformers.

Speaking on behalf of hospital and consultant pharmacists as well as academics and pharmacy regulators, APhA's coalition said that prescription drugs and pharmacists' services "should be a core benefit under health care reform."

To be sure, not all segments of pharmacy agree on all aspects of health reform.

Retail pharmacy groups maintain that the focus of prescription cost containment by federal health reformers should be on eliminating the multi-tier pricing practices of pharmaceutical manufacturers.

Representatives of institutional pharmacy - a prime beneficiary of these unfair and discriminatory pricing practices - would like the government's cost control emphasis to be placed elsewhere.

It's important that disagreements over cost containment issues don't undercut pharmacy's consensus on the most significant issue of all - ensuring that pharmacy practitioners play a role in the emerging health reform program.