From the Publisher: Health Care Reform: Less Gain and More Pain?

Pharmacy TimesApril 2010 Allergy & Asthma
Volume 76
Issue 4

It has been a strange calm after the storm as the health care reform bill was debated, dissected, and finally passed, but now comes the real reckoning as each interested party takes a closer look at the immediate outcomes and what lies ahead. Are pharmacists comfortable with the bill, and will it serve them well?

I have expressed my opinion about the health care reform bill in my blog at (see “Ignoring the Message, Loud and Clear”), where I outlined the pitfalls of a government in a period of unchecked and unsustainable growth. Now we have to live with the results, and health care professionals across the country are reacting. One pharmacist sent us a message listing his fears—“In order to cover an estimated 32 million people, many of whom cannot afford to pay high premiums for their insurance, it will require massive across-the-board cuts in the cost of health care delivery in this country,” he wrote. He went on to say that pharmacists should expect less job security, not more, with the implementation of this bill, despite the fact that the role of the pharmacist continues to expand. Many others share that view.

Our online polls of pharmacists are also very revealing: fully 63% of pharmacists thought the health care reform bill would not pass. Now that the bill is a reality, our follow-up poll reveals that 44% of pharmacists believe it will have a negative impact on health care, 22% think it is too early to tell, and 33% think the new bill will have an overall positive effect on health care in this country.

The public has also weighed in. A Washington Post poll revealed that 55% of Americans expect their own costs for health care to be higher because of the reforms, and 60% say that the nation’s overall health tab will rise. The bill was touted as a major cost-savings policy, but only 16% of Americans predict that medical spending in the United States will be much lower. A USA Today poll revealed that the public sees “less gain and more pain.”

Many physicians, too, are viewing the health care reform bill as the final straw in a decades-long process that has eroded physicians’ decision-making authority. One eyeopening survey of physicians before the bill passed showed that nearly one third of the respondents said they would consider leaving the practice of medicine if the bill became law. One only has to look at blogs, comments, columns, and posts—many of which we have run on—to see what other health care professionals are thinking now.

We need only to look at Massachusetts, which covers 97% of its residents (the highest in the country), to see where this may all go. Pharmacists will bear the burden as the front-line health care professional and medication experts. In Massachusetts, the primary care system was unable to handle the 500,000 newly insured patients looking for a regular doctor (in a state that has the highest number of physicians per capita). According to the Massachusetts Medical Society, a primary care internist had an average wait time of 50 days for new patients, with almost half refusing to accept new patients. Even before reform, reports projected a shortfall of 40,000 primary care physicians over the next decade nationwide. Thirty-two million newly insured Americans, plus the millions of baby boomers reaching Medicare age, will only make this shortfall worse.

Where this all will end and what it will ultimately mean for the entire health care professional community and patients is yet to be determined, but the early signs are far from promising. For pharmacists, the impacts are not yet fully known. We will be monitoring it closely in the months and years to come.

Thank you for reading.

Mike Hennessy

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