Favorite

Druggist for public option 

I am a pharmacist and I am reminded daily of how our health care system is broken. Those who say we already have the best health care system in the world usually forget to add “if you can afford it.”  To me that implies a broken system.  Fixing it will take years, but we need to start now, and we need a government-funded public option to help do it.

 The free market has failed us in health care, and a public option would spur much needed competition in our system.  In 2006, Merck's cholesterol drug Zocor went generic. Merck reached a deal with United Health, the nation's largest insurer, to charge the lowest copay for the brand name drug, while charging the highest possible copay for the generic alternative.  The best part of this story is that Merck cut a deal with a generics company, and Merck actually manufactured the generic version and used the generics company to distribute it. I defy you to find a better example of market failure.  

Much in this debate has been said about patient choice and rationing of care. I will interject here to say that the phrase “rationing of care” is pretty ugly and emotionally charged. Perhaps a better term for some situations is “cost-control.”  At any rate, the notion that patients should be able to choose their caregivers and their form of treatment is certainly an ideal  for which we should strive. As it is now, only those fortunate enough to be able to pay for their care 100 percent out of pocket are the ones with true freedom of choice.  Those saying that a government funded public option would lead to rationing of care are ignorant at best, and dishonest at worst.  If you rely on an insurance company – or the government – to pay for your care, you are already subject to rationing and/or cost-control measures, and any appearance of free choice is an illusion.

I see examples of this every day at work. If your doctor writes you a prescription that your insurer deems too expensive and refuses to pay, your health care has been rationed.  Often times the insurer will recommend an alternative medication, and just as often the alternative is something that should be suitable for the patient, and is less expensive, but is not what the doctor ordered.  This is what I would call cost-control. It is different from rationing, in that care is not absolutely denied, and it is something from which a public option would not be immune. However, the practice of rationing or cutting costs in order to profit is exclusive to private insurers.

We must accept that cost-control will occur, but how would a government-funded plan do so equitably? For prescription drugs, Arkansas Medicaid contracts with EBRx, a company that runs two committees comprised of Arkansas doctors and pharmacists. These committees analyze safety and efficacy data from clinical trials to determine which medications will be on Medicaid's Preferred Drug List (PDL).  The committees' meetings are open to the public and comments from the public are welcomed.  Through the process the panels evaluate which drugs are most effective and reserve them  on the PDL.  If all drugs under consideration are found to be equally effective to treat a particular disease, then the least expensive ones are placed on the PDL. It's natural not to want bureaucrats and politicians deciding who and what is covered. That is why a strong government-funded public option should have a system like Arkansas Medicaid's in which costs are kept as low as possible while still having health care professionals call the shots. 

I have some other thoughts on how to help control costs for a public option.  First of all, the government must be allowed to negotiate drug prices with pharmaceutical companies. Second, many of the chronic diseases we all currently pay for (diabetes, hypertension, hyperlipidemia) could be prevented, or at least mitigated, through education on proper nutrition and healthy lifestyles.  One of President Obama's principles for health care reform includes nutrition counseling. This is great, and I find it hard to argue with the idea that preventing illness in the first place will save everybody money on emergency room visits and treatments later.

A third opportunity could be the creation of universal electronic medical records.  Transitioning to this system should save money in the long run by decreasing administrative costs, plus we get the bonus of increased safety for the patient by giving every professional involved in a patient's care access to the same information.

My hope is that my voice will help the case for a government-funded public option. There are many opportunities to save money with a public option, but from my perspective that is not the real issue. Even though good disease prevention measures and increased competition among insurers could do that, for me reform is really all about making sure every citizen has access to quality health care. The creation of a strong government-funded public option is the best way to make that happen.

Mike Clark, a pharmacist, lives in Fayetteville.

Favorite

From the ArkTimes store

Comments

Showing 1-1 of 1

Add a comment

 
Subscribe to this thread:
Showing 1-1 of 1

Add a comment

More by Guest

  • Climate action good for Arkansas

    Thirty-five Senate Republicans and three Democrats, including U.S. Sen. Blanche Lincoln, support Senate Resolution 26 to block the federal Environmental Protection Agency from reducing greenhouse gas emissions from large emitters like coal power plants.
    • Feb 11, 2010
  • No country for old country

    Jeff Bridges plays it broke-down in ‘Crazy Heart.’
    • Feb 4, 2010
  • Needed: Strong Estate Tax

    On New Year’s Day the estate tax, an essential part of the U.S. tax system for nearly 100 years, disappeared because Congress failed to act in December. Congressional leaders now are pledging to act in early 2010 to reinstate the federal estate tax retroactive to Jan. 1. In the meantime, rhetoric over the estate tax will heat up.
    • Feb 4, 2010
  • More »

Readers also liked…

  • Schlafly's influence

    Phyllis Schlafly, mother, attorney and longtime antifeminist, died recently. What Schlafly promoted was not novel or new. Men had been saying that men and women were not equal for years. However, anti-feminism, anti-women language had much more power coming from a woman who professed to be looking out for the good of all women and families.
    • Sep 15, 2016
  • Seven

    The controversy over the Ten Commandments monument on the Capitol lawn just won't go away.
    • Feb 9, 2017
  • Why a change of leadership at the LRSD now?

    Johnny Key's abrupt, unilateral decision to not renew Baker Kurrus' contract as superintendent strikes us as shortsighted, misguided and detrimental to the education of our children and the health of our community.
    • Apr 21, 2016

Most Shared

  • Guest Playlist: Flap Jones of "Not Necessarily Nashville" schools us on real country music

    "Not Necessarily Nashville," which airs on KUAR-FM 89.1 every Saturday, 7 p.m.-9 p.m., celebrates three decades of the "best of the rest of country music" Saturday, October 21 at the White Water Tavern with Brad Williams of The Salty Dogs & The Creek Rocks, and we asked host Flap Jones to curate a playlist for us ahead of that anniversary celebration.
  • Discussion: State killing of the mentally ill

    The Arkansas Coalition to Abolish the Death Penalty and others will have a forum on mental illness and the death penalty at 6:30 p.m. Monday at the Bowen School of Law's Friday Courtroom.

Latest in Guest Writer

  • Can't afford to gut ACA

    The Affordable Care Act was passed into law with the promise that it would make insurance affordable. Because of bipartisan leadership in Arkansas, we continue to strive to achieve that goal. While rhetoric abounds, it is important to understand the Arkansas experience.
    • Sep 21, 2017
  • Tipping point

    I was extremely cautious before engaging in the educational debate about the State Board of Education's decision to take over the Little Rock School District.
    • Sep 14, 2017
  • Left behind

    Arkansas is getting a lot of attention for our very low unemployment rate. If you look only at that number (3.4 percent), you would think workers here were doing quite well — better than surrounding states and even the nation as a whole. But that seemingly simple rate can hide some huge gaps in prosperity.
    • Sep 7, 2017
  • More »

Event Calendar

« »

October

S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31  

Most Recent Comments

  • Re: Caution: government at work

    • The people of Arkansas need to keep demanding that our state government be accountable to…

    • on October 21, 2017
  • Re: Cotton to CIA?

    • Watching C-Span last week, they were talking about Cotton for the head of the FBI…

    • on October 21, 2017
  • Re: The casting couch

    • sigh............ I would argue that the idea of 'freedom from fear' is part of the…

    • on October 19, 2017
 

© 2017 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation