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
  • Another Jesus

    If you follow the logic of Jason Rapert and his supporters, God is very pleased so many have donated money to rebuild a giant stone slab with some rules on it. A few minutes on Rapert's Facebook page (if he hasn't blocked you yet) also shows his supporters believe that Jesus wants us to lock up more people in prison, close our borders to those in need and let poor Americans fend for themselves for food and health care.
    • Jul 20, 2017

Most Shared

Latest in Guest Writer

  • Banned in 2018

    Here's some arcana reeking of 2017 that I'm banning from consideration, attention, even out-loud mention in 2018. I'm unfriending all this 2017-reminding shit. It's dead to me in 2018.
    • Jan 11, 2018
  • Paternalism

    I cannot count the number of times that more established people have told me how I should think, how I should dress, how I should get my hair cut and when it is my time to place my name in the proverbial election hat.
    • Dec 21, 2017
  • Gratitude

    Now, more than ever, I find myself thankful for those who resist. Those who remind us of our higher common values. The fact-checkers and truth-tellers. Those who build bridges in communities instead of walls to segregate. The ones who stand up and speak out against injustice.
    • Dec 14, 2017
  • More »

Event Calendar

« »

January

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 Viewed

  • Will Arkansas join the red state revolt? Part II

    Looking ahead to state Senate elections.
  • The Oval outhouse

    One thing all Americans finally can agree upon is that public discourse has coarsened irretrievably in the era of Donald Trump and largely at his instance.
  • Sex crusaders

    Some years ago, a married woman of my acquaintance confided that a locally famous physician kept squeezing her thigh under the table at a dinner party. Actually, the fellow was famous for that, too. Removing his hand hadn't worked. She'd thought about stabbing him with a fork, but hadn't wanted to make a scene.
  • Trump's 'Actual malice'

    While his words away from cameras in the Oval Office the following morning will have a more immediate impact on the futures of DACA recipients and America's reputation around the globe, President Trump's statement on libel law in the United States last week represents a more thorough assault on the country's fundamental values through its disrespect for the rule of law and lack of understanding of the nation's history.
  • Along the civil rights trail

    A convergence of events in recent days signaled again how far we have come and how far we have yet to go in civil rights.

Most Recent Comments

  • Re: Banned in 2018

    • I thought Faulkner said "The past is never dead. It's not even past."

    • on January 17, 2018
  • Re: Playing to a crowd

    • Somebody said 'WOKE' and ' Hilary Clinton was by and far the best candidate we…

    • on January 16, 2018
  • Re: Banned in 2018

    • By God, I think Bob covered every goddam one of 'em! Thanks.

    • on January 16, 2018
 

© 2018 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation