US Pharm . 2006;3:1.

I don't particularly like it when someone uses the expression, "I told you so," but when it comes to Medicare Part D, I must say, I did tell you so ... and I have the proof. It was exactly one year ago that I wrote an editorial entitled, "What Was Congress Thinking?" I wrote the column in reaction to an announcement that Congress had passed a $400 billion drug aid bill called the Medicare Prescription Drug, Improvement and Modernization Act of 2003, better known today as MMA or Medicare Part D. As I write this editorial, Medicare recipients, state governments, and the Feds are scrambling to make an ill-conceived and poorly executed law work the way it was supposed to.

At the time, I questioned why Congress was rushing this bill into law, and the only three answers I could come up with were votes, votes, and votes. I do think that the politicians who voted in favor of this law had good intentions of delivering quality health care to the millions of Medicare beneficiaries who did not have prescription benefits. My biggest fear then, as it is today, is that the pharmacist would get financially squeezed even further, and how prophetic I was.

Since I live and work in New Jersey, which is also one of the states where I hold a license as a registered pharmacist, I am naturally more in tune with what is going on in my own backyard, even though this law has prompted disgruntled pharmacists from all over the country to contact me. At one point, New Jersey Governor Corzine said his state is spending $1.3 million a day buying drugs that should be covered under the new law, but because of glitches in MMA, they weren't. While the dollar amounts are different, other states were claiming the same thing, which prompted the federal government to say it would reimburse the states but declined to say just how much.

I think President Bush, his entire cabinet, and every member of Congress who voted for the MMA debacle should be made to join the plan, just to see how complicated and unfair it is to pharmacists. They should visit their local pharmacist and order their prescription medications, only to be told that their information is not in the system and that their lifesaving medication could not be dispensed. Then, maybe they would get the message ... then again, maybe not.

I know that I am preaching to the choir, but at the same time, the choir has to become vocal and start complaining to their elected local and state government officials. Not that I condoned the recent transit strike in New York, but you have to admit, it got the attention of every citizen and government official in the tristate area who depends on the New York transit system. If the government continues to pick the pockets of pharmacists with costly programs without properly reimbursing them, we could see pharmacies closing their doors in record numbers. When the American public can no longer get their prescriptions filled in what I consider one of the best drug distribution networks in the world, you can bet that will get their attention. But unlike the case of the transit workers, once those doors shut, most will not be able to be reopened. It won't be like the transit workers going back to work and starting up the trains.

What a mess! What has happened to our health care system over the years is a disgrace. Who really knows how many lives are being lost because of greedy third parties who only care about their bottom lines and satisfying their stockholders? Instead of passing small-minded, politically motivated laws, Congress should start thinking about its actions and properly reward pharmacists financially for their years of education, dedicated service, and their valuable role in the health care system.

Harold E. Cohen, R. Ph.
Editor-in-Chief

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