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The Road to Health Care Reform

Harold E. Cohen, RPh
Editor-in-Chief

3/19/2010
US Pharm. 2010;35(3):1.

With all the political posturing and the inaccurate information being disseminated on health care reform, I'm afraid most Americans have lost sight of the primary reasons we need to overhaul our current health care system. Without getting into the minutiae of the House and Senate bills, I think most legislators from both sides of the aisle agree on the same basic tenets of health care reform. These are a desire to reduce inflated costs in today's health care system; to make health insurance available to millions of Americans who currently have none; and, finally, to assure that Americans are never without health insurance as a result of losing their job or having a preexisting health condition. While these issues are not being contested, there is still no consensus as to how we are going to accomplish them.

The road to health care reform is full of potholes and other obstacles, making it onerous for all sides to agree on how best to fix the system. I know that one way is by involving pharmacists. Pharmacists have been, and will continue to be, an integral part of the U.S. health care delivery system. Because pharmacists see patients more often than any other health professionals outside of an institutional setting, it only makes sense that pharmacists play a major role in any future health care reform.

And that means that pharmacists have to take on more consultative responsibilities. There has been much talk about medication therapy management (MTM) services, and while there are geographic pockets where pharmacists are practicing MTM on a regular basis, the concept has still not been widely adopted by most chains and independents. There are many reasons for this, but primarily it is because they've had little or no financial incentive to perform these duties from either insurers or the state and federal governments. I really don't understand why. There is solid evidence that performing these kinds of consultative services could save our health care system billions of dollars, which of course is one of the goals of health care reform. In a recently published article in Population Health Management, researchers pointed out that there are some 23.6 million undiagnosed cases of diabetes in the U.S.; the researchers estimate that diagnosed cases of diabetes cost the nation $174 billion per year in higher medical costs due to lost productivity. Just imagine what the health care bill for diabetes would be if even a fraction of the 24 million undiagnosed cases were discovered.

I am not suggesting that pharmacists diagnose cases of diabetes, but they can help keep it under control and possibly reduce the $174 billion it costs to treat the disease by consulting with their patients with diabetes to make sure they are compliant and that they recognize the signs and symptoms of taking their medication incorrectly. Diabetes is only one chronic disorder adding billions to this nation's health care costs.

Pharmacists and their employers have to become proactive if they are going to get involved in health care reform. Until now the excuse was that there were not enough pharmacists. Today, more pharmacy schools are graduating PharmDs who want to go into retail and wrap their arms around more than just filling prescriptions. They want to serve the health care marketplace in a way that really makes a difference, both financially and professionally.

Pharmacists should pave the way to health care reform. Pharmacists need to get more vocal about their desire to add value to our health care system. If not, the road to health care may end up just being a dead end.  
 
To comment on this article, contact editor@uspharmacist.com.
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