US Pharm. 2009;34(10):2.

In the early 18th century, before he served on a committee of five who drafted the Declaration of Independence in 1776, Ben Franklin already had the solution to health care reform in America when he proclaimed, “An ounce of prevention is worth a pound of cure.”

If only the legislators who came after him had listened to his wisdom, perhaps this country would not be in the health care mess we find ourselves in today. Common sense would dictate that preventing an illness is far better and less expensive than treating it. Yet, our antiquated and greedy health insurance system seems to prefer following the oftentimes disastrous and measurably more expensive practice of treating an illness instead of preventing it.

It would appear from a recent article in the New York Times that our government's approach to health care is not much better than that of the private sector. The article centered on a 31-year-old San Diego woman who was afflicted with Alport's syndrome, a genetic disease that causes kidney failure. Because of her devastating illness, she needed dialysis and eventually, at the age of 14, a new kidney. Her treatments and transplant cost Medicare hundreds of thousands of dollars. Following her operation, she was in need of immunosuppressant drugs so that her new kidney would not be rejected. However, federal law limits Medicare reimbursements for these life-sustaining drugs to 36 months. As you might expect, paying for the drugs to maintain the kidney from her own savings once the Medicare limit expired proved to be impossible, and the woman's transplanted kidney failed. Medicare then paid for a second transplant, which cost the system $125,000, as well as another 36-month round of antirejection drugs, thus perpetuating the costly cycle of health care.

This is a perfect example of why our health care system doesn't work. Our current system is based on reimbursement for costly medical procedures rather than upfront payment for far less expensive preventive care. It is based on fixing what is broken, not protecting what is already working. It's like not getting the fluids changed regularly in your car and then having to pay for a new engine or transmission.

Pharmacists could save this country millions of dollars while getting paid for their services if we took a page out of Ben Franklin's playbook on staying healthy. While many in our government pay only lip service to pharmacists who practice medication therapy management, they need to dig deeper into their pockets and pay real money for the consultative services that pharmacists can and should perform. And insurance companies aren't alone in bearing responsibility for the failure of our health care system. Chain and independent pharmacies must also embrace this preventive system of health care in order for it to be successful. Pharmacists are well trained to perform these services, but their store management must allow them to get out from behind the prescription counter to play an integral part in any new health care reform. In fact, pharmacists should be lobbying for that kind of activity in their stores. It will not only drive traffic and eventually increase their bottom lines, but more important, it will elevate the profession and allow pharmacists to practice pharmacy the way it was meant to be.

Some people might consider Ben Franklin an eccentric character in history, but there is no question that he was prophetic in declaring that an ounce of prevention is worth a pound of cure because that is exactly the doctrine our lawmakers need to espouse if health care reform is to be successful. 

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