There was an article in the Wall Street Journal about how Walgreen's will pull its Delaware pharmacies from the provider list for Delaware Medicaid. When reimbursement rates from the state are so bad that a chain pharmacy will not take the loss for thousands of prescriptions for the destitute to receive medicine we have a serious problem.
I see several causes of this problem:
1. Contrary to popular belief, wholesale drug costs do go up just like the cost of things like food every year.
2. Companies who use pharmacy as a loss leader for their business allow lawmakers to operate under the false assumption that all pharmacies can afford $4 prescriptions and thus lower reimbursement rates should be acceptable.
3. Increasing numbers of people on welfare stretch the money further and further to the point where states like California will probably go bankrupt.
4. Reimbursement rates from all insurance and welfare providers keep decreasing as copays increase to the point where many can no longer afford medications thus fewer prescriptions are being filled which can result in an increase of hospital stays and complications from people who should be taking maintenance meds but see the need to eat and have a roof over their heads as a higher priority, because it is...
I really hate the current medical system we have in the US today. The entire system is broken and there is no way our government will be able to fix it without a complete overhaul. Don't be fooled and think there is a solution out there. Ours is a profit based system and that will never change. There are way too many hands in the cookie jar that love love love those cookies. This means that no American will ever be sure that they have appropriate or adequate care unless they are a member of Congress and get a sweet sweet deal with their health plan or move to Canada, England, France, etc. and marry into citizenship.
The whole point to this rant is that even with pharmacies refusing to take state plans the system will not get better. It just makes it harder for people dependent on the state to get their treatment. Crap, I have just ruined my whole day thinking about it. Time for Chinese take out and Vodka, my meds for the day...
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12 comments:
You're right.
Consider my side of the fence. I've stopped seeing Medicaid patients becasue of high no-show rates and low reimbursement, and will likely ditch Medicare the next time it gets cut.
And I'm just one. Many docs are doing this.
System needs to be gutted. And there are no easy answers.
Here's an idea. Why don't we make Walmart the new Medicaid and Medicare? Here are the guidelines:
1) If you live within driving distance of a Wally World, THAT is your formulary. $4 list.
2) If no Walmart is around (what's that like 5% of the population or something) you get traditional pharmacy benefits.
Walmart wants these people. Let them have them. Someone crunch the numbers. What would that plan save the country each year?
In the UK, you don't have to have citizenship - as long as you're a legal resident, you get free NHS care. Something like 90% of prescriptions are free, and if you don't get free prescriptions, you can buy a prepayment card that gives you all your prescriptions for about £100 per year.
Actually, it's worth taking a look at Thailand's health care system. They did a combo of a number of nation's system to get what works best for them. And I'm jealous a place like Thailand can pull it off and we can't!
"Ours is a profit based system and that will never change. There are way too many hands in the cookie jar that love love love those cookies."
Well worded. the economic crisis is inherently caused by the exact same reason (even beyond the subprime failure, etc).
Wow.....what a glorious day it would be to not have ANY Medicaid patients come in....
I don't know about other pharmacies, but they BY FAR cause the most problems here.
This is absolutely true that the drug prices are going up by the day...and we should raise a voice against this basic need for health care.
now if cvs would have the balls in ny to do it, then we would be all set.
The headline in the Delaware paper was; State urges workers not to use Walgreens. Now that someone has had the balls to stand up to the Medicare reimbursement issue the state is threatening to pull the contract for all state employees also. What does one contract have to do with the other? DE Medicare is asking Walgreens to "stand by them in their time of need" and " the most needy and helpless population". Does anyone remember that pharmacy is a business? A for PROFIT business! I applaud Walgreens for standing up to the state and taking a public beating. I would like to see the state tell any other contractor that they will pay less then your cost and we will pay a year later. Its only pharmacy that will bend over and take this crap. Hooray for Walgreens!
Agree. Somewhere along the line "profit" became a 4-letter word in healthcare.
I got into this business to help people. But I can't help anyone if I can't provide for my family and meet office overhead.
Good article.
Let's not go trotting off to Canada just yet. What's the wait for your rotting tonsils to be removed? How about six months. I just filled rxs for Canadians who came to the states and paid cash money to have surgery here. Guess it's not all that great if there's no money in it. Look, as healthcare professionals we are trained beyond the masses. What is wrong with getting paid beyond the masses? I'm not being greedy here, I'm just saying that socialization of U.S. medicine will be a complete failure. If there's no money in it, there won't be any practitioners and you will be on a 17 year waiting list to have a hangnail looked at. Oh, and as for Thiland - how the fuck is that even close to our population and/or fat asses? WTF? Let's look at something that works - don't they still cane people?
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