Good Press

The New York Times has a good article on the expanded role and opportunity for pharmacists to take in patients' health care. Not only is this good press for the pharmacy profession, but it can serve to inspire you to start or expand new areas in your practice. For example,

The idea of using pharmacists in this way began to gain popularity in 2006 when someMedicare plans started covering medication therapy management programs, paying $1 to $2 a minute to pharmacists to review patients’ medicines with them; this year, about one in four people covered by Medicare Part D prescription drug plans will be eligible, according to agency estimates. For example, a Medicare Part D plan covered Ms. Gelinas’s medication management session at Barney’s pharmacy.

More employers and insurers also pay for pharmacists to advise patients, a role that the new health care law encourages with potential grants for such programs. In Wisconsin, for example, community pharmacists and some health plans have banded together to create a joint program, the Wisconsin Pharmacy Quality Collaborative, to standardize medication therapy management and ensure quality care.

Meanwhile Humana, which first paid for pharmacists to work with Medicare patients, expanded its coverage a few years ago. About a third of the 62,000 pharmacies in its network offer these services, and the insurer says it is studying whether a pharmacist seeing a patient in person has more impact than a phone call.

Medicare Bust

Federal authorities cracked down on Medicare fraud nationwide today across 5 states. Eleven were arrested in Michigan and 94 were indicted nationwide.

The local health care companies were located in Detroit, Livonia, Southfield and Oak Park.

From the Detroit Free Press:

McQuade and Detroit FBI chief Andrew Arena said economically distressed areas like metro Detroit are hot spots for Medicare fraud, which prompted McQuade to assign more people to prosecute such cases.

From the Detroit News:

"They prey on people desperate for drugs," said Barbara McQuade, U.S. Attorney for the Eastern District of Michigan. "Prescription drugs often are the benefit provided. They exchange stats that allow false billing."

The American Workers, State, and Business Relief Act of 2010

The Senate passed the American Workers, State and Business Relief Act of 2010. If signed into law, this bill will extend Medicare reimbursement rates at their current level and extend for 6 months a temporary increase in the federal medical assistance percentage.

This bill will probably have effects on DME accreditation as well. I will link to information on that shortly.

Health Care

When I graduated from WSU College of Pharmacy, I was skeptical of the HMO concept and, in particular, the promise that a health insurance company would actually try to maintain health under a capitation system. I figured the insurance company would try to provide as little service as possible to the patients and increase profit to the maximum. In the transpiring years, I have seen nothing to dissuade me from that viewpoint.

When I graduated, national health care was pejoratively called "socialized medicine" and was portrayed as "un-American", or at the very least, "French".

It did not take me too many years as a lawyer and pharmacist to see that the United States of America should have established national health care under a single-payer model 40-years ago, based upon the Medicare system or VA.

We are long overdue to have national health care and I am afraid that it may be too late, even now. The Senate, in particular, is owned by insurance companies and drug makers. We will hear a lot of canards and scare talk about single-payer and the problems it will cause, but it is clearly a smoke screen to preserve the tremendous profits made by insurance companies.

The biggest canard is the claim that in a single-payer system, government bureaucrats will make health care decisions for individuals. This contrasts with our current system in which an insurance employee makes health care decision for individuals- with profit maximizing in mind.

As a pharmacist, who would not agree that having one claim form and only one payer to deal with is infinitely preferable to applying for, being audited by and verifying coverage with 70 or more private insurance companies.

There is no free market anywhere on the planet and there never was. The reality of the matter is an individual citizen has no bargaining power versus an insurance company. Currently, we use private health insurance companies as middlemen, creating huge profit centers. Would it not be much less costly to use a government agency, such as Medicare, administering the system with employees who are paid a fixed salary?

I think this is an excellent time to start downsizing our military and intelligence expenditures and start spending it on health care for all of us. We have passed the point of diminishing returns on national defense. Currently, 21% of the national budget goes to the military-industrial complex. Yet, we are no safer and our perception of power is a drug that encourages Presidents to inject our forces into regions and problems that are insolvable by force and extremely expensive.

The Medicare system and VA system can be improved and they are capable of providing excellent administration for a single-payer national health care system. Will it happen? I honestly don't think it will, even though it makes total sense and is really needed. I think a watered-down and consequently doomed bill will pass. And then, the opponents to national health care will say they were right when the doomed plan fails.

I sure hope I am wrong about this prediction.