One pharmacy to rule them all…









Just a thought I had.  Continue your discussions.

69 thoughts on “One pharmacy to rule them all…”

  1. A perfect world! Government negotiating drug prices. Wait….how did this go when they created Part D? Oh yeah, it’s all politics.

    Getting rid of drug reps is probably your best idea. They “educate” on new, brand-name drugs while doling out all the goodies to the docs, and pull in $90K+ a year. Boy they did a good job educating on Vioxx, Vytorin, and the OTHER purple pill ($220/month as opposed to Prilosec–the same drug–at about $20/month). Guess who pays for that? You, me, and your grandmother just making it on her social security. Get rid of these cheerleaders, create an EVIDENCE-based formulary, and watch health outcomes improve and costs go down. Then we can pay for more prescriptions for you to fill, TAP. You’ll love it.

  2. My comment to the previous post had something to do with inequitable enrollment in health insurance programs, not purveyance of ‘socialized’ medicine.

    Get the health insurer scoundrels out of the picture and the payments for health care on a more even footing, then the bulk of health care reform falls in place. As it is now, many folks cannot afford the premiums. It may be hard to realize this for pharmacy students that first lived off their parents’ policies when going through school, then could afford the health care coverage when their jobs pay the big bucks, but from my point of view as an RPH with a non-traditional pharmacy education, I would have to say the present muddle of a variety of insurers ramrodded into the workforce provide uneven and many-headed medea (or whoever that ancient greek myth–maybe a hydra) that is impossible for anyone to get standard care at a fair price if there are pre-existing health conditions (and, I’m not saying DM2 or HTN from underlying OBESITY!!!), but family-economy breaking health matters such as genetic conditions, cancers, diseases that come in like an elliptical orbit from the atmosphere and hit the household on its tangential path.

    This current state of the having insurance business plopped into the basic societal fabric of health care provision to ‘run’ the mess into the ground has provoked the realization that even though Wal-mart’s $4/Rx is unfair to pharmacists, it’s fair to the patients that NEED the drugs! (Are there any drugs on that $4 Rx list that are NOT regularly used maintenance drugs? Sure, this kind of practice brings in the unsavory aspect of using Ranbaxy and other questionable generic suppliers, but it IS fair to patients.)

    I never said anything about supporting ‘socialized’ medicine. Unequivocally, it’s a matter of getting the insurance straight. President Obama has made it very clear that there needs to be other options than the present insurance muddle.

    Many pharmacists may not understand this as they’ve been students on their parents’ policies, then were able to afford whatever exorbitant fees that insurance set when subsidized by their job (but, inevitably by others that pay for the general availability of insurance through access to government programs such as Medicare that base the bulk of their payment arrangements on WHATEVER the commercial insurance will pay. As a non-traditional PharmD, I know what the effect of working three part-time jobs to support my family while going through school, WITHOUT health insurance does! I’m not saying all those without health insurance ARE working but, the present system DOES not encourage enrollment in any affordable commercial health care coverage plans, especially IF there are pre-existing health issues, as well as unavailabilty of general well-care plans to EVERYONE. My present insurance plan stinks, but at least it covers something, sort of like catastrophic coverage, and I know if my husband needs emergent care, at least I can work extra hours every week to help pay for it! Because, as pharmacist, I know what procedures, tests, drugs, etc. are necessary, and I am getting paid the big bucks.

    1. “Sure, this kind of practice brings in the unsavory aspect of using Ranbaxy and other questionable generic suppliers”

      That is a myth. All generic medications must undergo very strict testing to prove that they are bioequivalent , AB rated, to the overpriced brand name medication. There are manufacturer defect recalls on brand name and generic drugs. The funny thing is, many generics are made in the same machine and in the same factories as the brand. The company just puts a different imprint on it and sells it to the distributor to sell to the wholesaler. There are very few instances where an AB rated medication should not be automatically switched to, i.e. narrow therapeutic index drugs like warfarin, theophylline, lithium, etc. I frequently change the manufacturer that I stock if it is a lower cost on the FSS. I do not get reimbursed by insurance, all of my meds are paid for by all of you, so you’re welcome for keeping costs as low as possible without compromising patient care. 🙂

  3. Have you seen Michael Moore’s “Sicko”? It seems to shed some light on the possibilities of national health care and how it could benefit us all. The government is what we make of it. So it’ll be our own fault if it screws up. At least we have a say in the process. The private way is def screwed up now and they have way too much power and influence. They need to be taken down a couple notches.

    1. P&T this is about as stupid a post as anyone could care to read. The government is what we make of it. Yeah right. That’s why 70% of the country wants something done about illegal immigration, yeah like the kind that bankrupted California, but they never do anything about it. It’s called the government, industrial, media complex, and they appreciate your automoton vote once every four years, and then they go do what the want. Newsflash, the government screws up everything it runs. Try medicaid, medicare, and social security, they have 50 trillion in unsubsidized obligations OOOPS, why don’t you take control of that P&T I’m sure you can just right the check, or tell the government to. Or maybe they can just get the money for that and everything else that their brand new spending programs will cost from China, seeing as the great government we the people control seems to think when they run out our money they can just totally indebt the country for generation, because Hell, it feeeeeeels good. The private ways is screwed up and they have way to much power. You’re supposed to turn your car off when your in the garage. At least the private way you cand your employer can fire Aetna, BCBS, or whomever you have. The government, when they take over, will have unilateral power to do whatever they want, and you won’t be able to do Jack crap, but may since its what you make of it, they’ll cut you a special deal.

  4. You left out one thing, however. Pharmacy itself needs to change our view of what we charge for. True, we could get drug costs down, but we must start actually charging for our cognitive services. Every time a PA or NP orders mg of levothyroxine instead of mcg, we save a life. Every time a patient sees multiple doctors and gets, as an extreme example that doesn’t happen much anymore, erythromycin from one doctor and cisapride from another. Our service is not to count and dispense pills but to protect patients and ensure optimal pharmacotherapy at the lowest cost. Why would someone write an Rx for Cozaar ($$$$) instead of lisinopril($) unless the patient has had a reaction to ACE-I? It doesn’t make any sense and is not supported by JNC 7 or any PRCT.

    1. Cisapride was taken off the American market several years ago. It’s still available through veterinarians; it was returned to this market because there were just enough cats that needed it and nothing else worked.

      1. It was just an example. I should have said that it doesn’t happen anymore instead of doesn’t happen much anymore. Fact is, pharmacists save lives. We should be paid for our knowledge and unique clinical expertise not our dexterity with a counting tray and spatula, a machine can do that.

  5. Mail order? Please, God no. Where does personal patient care go? Come on, mail order doesn’t help patients. Mail order = lower adhereance. Let’s save them $ and take worse care of them, costing us more healthcare dollars.

  6. Yes, the government should start their own federal mail order pharmacy and put all these other pharmacies out of business. After all, we don’t need the CEO’s of Walgreen’s, CVS, and etc making all those big salaries…it is just out right \immoral\. Lets put all these pharmacists out of work, because they are making too much money already and that money could go toward covering these poor folks that have no insurance. While we are at it, lets just take over FORD motor company and have the government provide cheaper autos for everyone. Lets not stop at this. Lets put the government into housing(of course they have meddled in that for years…remember all those multistory big block buildings that housed people like rats). What about FREE houses for everyone!!!! Of course, the government can do things better than free enterprise….they can build roads and bridges to no where(but, it puts people to work). What about FREE tv’s? I think that would be a great idea. Oh…I want a new computer…why doesn’t the government give me a FREE, new computer. Oh…by the way…I need a new girl friend….do you think the government could furnish me one?

  7. To further expound on your excellent idea….drug reps *Jell-O wrestling* to determine whose PPI is formulary. That’s f*cking brilliant, TAP.

  8. Clearly I would have to be a non-traditional student to even fathom the idea of what insurance premiums are like. I am sure there were a lot of students that sucked it up for a few years in college and didn’t have coverage for themselves or their families, or I’m wrong and you were the only one who had it hard while going to college. Maybe that’s why they went to school is to afford a certain lifestyle for their family, this including insurance, house, etc…
    Obama has only made clear that there is ONE OPTION (not options plural) for healthcare today, GOVERNMENT-CONTROLLED HEALTHCARE and God-forbid someone (doctors, pharmacists,etc) make a living off of someone else (wait a minute, I guess its ok if you are receiving welfare to do this). So, they’ve taken the banks, transportation (all that’s left is the airlines, they have cars and trains), and now its gonna be healthcare. I am all for making it affordable but this plan is just another part of a government takeover. Imagine the VA formulary but worse! I wish doctors luck in practicing b/c the government will soon be worse than insurance companies and I guarantee the govt will be deciding what medications the patients will be receiving at a far worse level than current ins. companies. If this plan goes through, it should be called ChinaCare b/c they will be loaning us the money to pay for it and we will be paying them back for the next 100 years. We can thank our grandkids and their kids for having to pay for this at ten times the cost. If a socialized health system is more appealing to you by all means move to another country. The people (supposed to be controlling this nation, not politicians) can spend their money a hell of a lot better than the government can. I just hope that if this goes through, I can completeley opt out and not have to pay taxes on it. The whole reason I became a pharmacist was to actually EARN the things I wanted in life not earn things for other people. But that ideology is a thing of the past as our society is currenlty circling the drain.

    1. Thank you, Rx BRY, and to LD50Placebo_effect- Dude, get a job at Walgreens, they have good insurance and you do not have to work extra shifts if you do not want to.
      Now, I completely agree with a leader of discussion that if government is going to start paying for prescrioptions, we, as pharmacists, are pretty much, all screwed. Good bye, big bucks. Do not get me wrong. I like helping patients too, but I like to help for sufficient reimbersement. You can tell me I am cold-hearted and only care about money. But, how many of you would want to stand on your feet for 8 hours, get yealled at ( a lot) and would not want to get paid well, especcially, when you are used to certain life style? So, I think I am definately ok with Walgreens, CVS, Rite Aid, etc, making profit. (Oh, by the way, Walgreens does not charge $30 dollars for generics :), and that saving program does save money too sometimes)
      P.S. I did not have insurance in college, even though I am pretty traditional student. My parents could not afford me one.
      P.S.S. I do not have a solution to a problem, I just think that so many people in health care (and good luck with doctors)are going to be very opposed to government dependent health care that by the time they will approve it, we might retire already. So, just work some extra shifts and save up!!! 🙂

  9. “(because what private company can compete with the government? ”

    Ummm…FedEx and UPS seem to be doing pretty well. UPS is even unionized.

    1. to Eric, Umm, how many UPs or FedEx employees do you know that make more than 70K a year, or I know- about 5 to 7. It’s the people that are in the very top of the chain, like director, lead programmer, lead analyist. You need to work a while to get there. RPh right out of school is making at least 85+.So, yeah, I think I am still for private companies. They make us money

      1. Average UPS Driver makes about $25/hour:


        or $52,000/year.

        RPhs need to go through at least 6 years of school now for a graduate level education. If you’d like to compare grad. level educated individuals across the scale, i’d be glad to. The marketplace would look different with a public option for health care, but it’s not out of the question for an industry to work extremely efficiently with government competition. And really, is the system working so well now? Have costs not at least doubled for most people over the past 10 years? Not to mention the MILLIONS of people without insurance?

        1. 2 weeks late, I know… regardless:

          Ups employees universally hate their jobs. To make 50k a year as a driver you will need to work 50hr shifts. Want 60k? 60hr shifts.

          The guys I used to work with felt trapped. They were getting older and couldn’t do the job as their bodies broke down but only had high school diplomas so they kept at it to feed their families.

          Great example, please post more.

    2. People should have to pay for meds themselves and seek reimbursement through their major medical portion of the health insurance. If we had to pay for this out of pocket then this industry would truly be a free market enterprise and you would see prices drop immediately. As has been commented before many ways here, price drives people, nobody would spend 200 plus dollars a month on a ppi or bother to get a pre-auth for a non approved expensive as hell name brand when they only tried omeprazole 20 mg for a week and never took it right to begin with so they got no affect from it because the NP/PA told them to take it at bedtime with no regard to meals. Back in the day when I was in pharmacy school and working for a local chain store only about 5% of people had drug coverage, can you guess who? (i’ll give you a hint, they all worked for the government.) an almost non existent percentage of private employers offered a prescription option. Birth control cost 2.00/mo, Lanoxin was 1.75 for 100 tabs, I remember having to tell people that the Derm. had ordered Minocin for their childs acne and it was expensssive, running at around .40/capsule, How quickly all of these rxs were changed to tetracycline @ 3.00/mo. The Government started this shit pile and now all they want to do is blame the private sector for not holding costs down. They are the ones that were purveying this crap 25 years ago when they were handing out cards that covered anything at all for a mere .50 co-pay. Didn’t take long for big Pharma to see this cash cow building and so price changes started happening at least twice a year in the double digits instead of once a year. Way back then drug reps actually did something besides event planning, they SOLD drugs and forgive me for even bringing this up they did RETURNS.Free Market, Pay your own way out of pocket you would see things get cheap real fast. And don’t give any bullshit about R&D if all of that supposed money were really going to R&D than we wouldn’t Breast cancer walks, or Diabetes Walks (Juvenile) these things would be a part of our history not sapping every last bit out of us. The profit on the drugs used to treat BC could have alleviated alot diseases. No one gives a shit about how you or anyone else is doing unless they are profitting tremendously from it. Just my .02 from 30 yrs experience.

  10. RxBry:

    I didn’t need to hear a sarcastic personal commentary bringing up fly-by topics such as China, welfare, God, hell, and hundred-year loans, to refute the point that the present ‘insurance mess’ is a many-headed beast which is so out of control that it’s not clear to most folks what the problem is; not simply DTC advertising, poverty or living in a certain county or even region of the country, whether expensive brand name drugs were ordered by the physician, or number of health care providers –that certain medical specialties can attract doctors because they can command large fees or have Medicaid/Medicare subsidize their practices, or for the extremely wealthy it doesn’t matter at all, or whatever has been complained about e.g. obesity epidemic, lack of wellness care (availability of which was going to be the next big thing with establishment of HMOs in the 80’s).

    Heavens! I just pulled a FAX off the printer sent to our pharmacy about another major drug supplier whose shipment of expensive anti-organ rejection drugs was stolen. Thievery is running rampant which may be a sign of the times, or may be random, or may be the fallout from the deal Big Pharma is trying to broker with the White House about maintaing high costs for brand name drugs but making them available to Medicare recipients by tinkering with the doughnut hole.

    Fix the many-headed insurance beast, which confounds the process of reimbursement impacting all health care PROVIDERS/USERS/SPECULATORS, ETC, and put all the costs on the same playing field, instead of dribbling, dabbling, tinkering here, making a deal there, a little under the table over there. This idea that individual states can figure out what to do on their own bespeaks to gross corruptibility across individual state lines. See how well individual states do with their Medicaid programs.

    As for the personal ‘attack’, people become pharmacists for various reasons, and it’s usually a complex set, involving looking forward to a long and rewarding career choice, offering a great deal of flexibility–not one single reason. Surely, I’m not the only person in the US that worked many part-time jobs to support my family while going through pharmacy the long route, but I would venture to say that many folks might fail to recall how their situation is similar to those of their patietns and fellow Americans that barely make ends meet and each night pray that something doesn’t happen to them or their loved ones without health insurance, the modern day analogy to debtor’s prison–not that one is forestalled from leaving barred windows, but the issue of seeing a loved one’s health care denied because of THE INABILITY TO PAY.

    President Obama has made it quite clear that several options are out on the table. Maybe this is what is upsetting to some folks, that there is an incorrect assumption only one option is available to pick over.

    Certainly, in a free marketplace, when several options are available, and advantages seem unfairly to favor just a few of them, then there is reason to quibble. As a quick fur’instance, to throw off the argument from the pharmaceutical industry for a minute, simply examine how the sugar beet industry in Wyoming and mid-eastern/-western corn growers received government subsidies to grow as much as possible, and in so doing oversupplied the US with corn syrup and granulated sugar. The stuff was sold and marketed to those of us with sweet tooths, and provided future income to the dentists, diabetologists, soda makers, etc. Why, a whole culture has grown up around supersweetness. Or, look at the subsidies provided to tobacco farmers, which support an industry with its roots stemming from industrialist strongholds dependent on the slave trade along the eastern coastal areas.

    As for ‘earning’ what I want in life–I suppose it doesn’t bring out the squeamishness enought in our pharmacist mindset to realize that though we work the nubbins off our feet, it’s Medicare reimbursement (a government subsidized program in bed with private insurers that artificially ‘sets’ fees we’ll be paid from the private insurers). Although some docs bill their patients strictly on a cash basis, one would presume to dare the individual pharmacy company to operate on strictly a cash basis as well. How many customers?

    Take a look at the health industry situation from a new and more reaslistic angle, please.


      Quick lesson in recent history of pharmacy.

      It has not been until the very recent past that pharmacy stopped being a cash only venture. Up until the 1980’s and 1900’s prescription drug coverage was all but unheard of. If you got a prescription, you paid cash for it. Interesting how with the advent of prescription drug coverage plans the dramatic increase in costs for out-patient prescription medications. In my years prior to returing to school for my pharmacy degree I don’t think a job ever offered me prescription insurance benefits. The best I remember was in pharmacy school with the grad student insurance I was able to submit my receipts and get re-imbursed, after I had already paid cash out of pocket though.

      To be honest, however, I think the only prescription I had ever gotten filled was for Hismanal (remember that one?). I think a 30 day supply was going to cost me $60, so I just filled 5 pills and used them only when my allergies were unbearable. I was only making around $20K a year at that time so $60 was my grocery budget for the entire month.

      1. Hismanal. Boy I haven’t heard that name in ages. Remember that weird dose-counter cap it came with, that incremented every time you opened the bottle?

        The odd thing about Hismanal was that it didn’t work on a PRN basis; you had to take it for 14 days before it started having any effect (and this despite achieving adequate blood levels after the first 8 hours, nobody ever figured out why) so taking only five tablets probably didn’t do you all that much good…

    2. Sorry, so much offense was taken by my comments. Everyone is saying how terrible our healthcare system just b/c every single person doesn’t have insurance. I can’t stand to hear that people get turned down for healthcare…YOU CANNOT TURN LIFESAVING CARE AWAY from patients in an ER. Sorry if Mrs. Jones can’t get her precious bunion removed from her foot (is it life-threatening?) My problem with all of this is the amount of people with their hands out for freebies. Welfare is a joke b/c its not a crutch anymore, its a way of life. U.S. citizen? come get your healthcare. When did healthcare become an entitlement? Do we need to feed everyone too? How many millions of people are on the streets in America starving then end up in hospitals? If you think are health care is so terrible, go check out how wonderful Canada, Great Britain, Australia etc. is working for them. Great Britain’s parliament members are warning us not to do this b/c we will bankrupt ourselves (I guess technically we are already bankrupt since Obama admin. has put us into the trillion mark for a deficit, sorry if you don’t like the China comment but its a fact, where do you think this money will come from? wake up!)but nobody is listening! I had a friend in Britain go to the clinic b/c she was getting a UTI. She went in for lab tests and they sent her on her way with no medication. A week later she got a letter in the mail from the clinic that told her she didn’t have chlamydia. I can’t wait to have health care to their standards. By the way, please tell me where in the constitution it says that the government is to provide healthcare? or education for that matter? Another step in the wrong direction. I just can’t wait til the honeymoon phase is over with the celebrity (sorry, meant president who clearly is running this country from experience, ha) that is running this country. There are many better ways to help this “crisis” first there was global warming, then the economy and now “healthcare”. Funny how all of these are pushed by the very left wing folks. Hopefully some other “crisis” comes along before our country is ruined by this socialist attitude that b/c I am a citizen the govt should take care of me and provide me with everything I need to survive. Our future is really looking good. Maybe we could encourage businesses in the US (tax breaks!!!) to stay here and this will create jobs, tax breaks will mean cheaper production costs–>lower consumer costs!! This is a very difficult idea, but bare with me. Many ways to lower costs without full govt intervention. Doesn’t matter, its not like the people have a say its up to the geniuses in the House and Senate and once again, its Barack in a hard place. Good Luck, I hope I am dead wrong and this country prospers once again!

  11. ……”the massive amount of medical data the government would be collecting from filling your prescriptions” ……that is the absolute scariest part of this post…..

  12. I’m frightened by the inefficiency and all the bureaucracy that would be involved in something like this.

    speaking of $4 prescriptions, anyone else read about how Walmart continues to buy drugs from a banned company in India.

      1. SRK,

        I think we get a bad rap in the government sector. People can bring up cases of errors in the private sector too. How about the HUGE heparin error with Dennis Quaid’s children, that was at a hospital that all the celebrities go to so money was no obstacle, yet an error almost killed his kids. The undiluted potassium debacle of a few years ago also happened at a private sector hospital. Most private sector errors never leave the M & M meetings. They are dealth with as they should be, as system errors, not personal errors.

        I have the responsibilty for denying or referring up non-formulary requests at my facility as well. I get to use my clinical pharmacy skills and knowledge far more as a federal pharmacist than the vast majority of private sector pharmacists. I am recognized and respected as the pharmacotherapy expert.

        I also have to get more CE hours each year than any state license requires to keep my commission, in addition to disaster response training and deployments I must maintain my physical fitness in order to retain my commission as well. My job requires much more from me than a private sector position, outside of just being a clinical pharmacist. But I reap the rewards in satisfaction and pride in serving my country.

        People can debate whether a government sponsored health care program will work, but they should not disparage any of us who dedicate ourselves to serving our country whether in a civil service or uniformed capacity.

  13. Well Angry Pharmacist, I haven’t read all the other comments, but you’ve almost described the New Zealand system! We have PHARMAC (which not everyone loves) which is a government agency which decides which medicines are funded nationally. There is a co-pay – most people now pay only $3/fully funded item. If you see a private specialist then it is $15 or less depending on age and income. Only particular meds and particular brands are funded. Some medicines require special authority to be funded for a particular patient – often more expensive medicines – and the patient is required to try the cheaper med in the class of drug first. PHARMAC liaise with drug companies to get cheap prices on meds – will tender for sole supply deals and lock in suppliers for longer periods (a pain if that drug goes out of stock). It’s not perfect, but it means that everyone has reasonable access to drugs they require.

    The difference is that the drugs are still dispensed at independent pharmacies, who are then reimbursed for the drugs they have dispensed. Patients can still get other meds, but they have to pay the full price for them. it’s not perfect, but from what I read about the American system I think I’d rather stick with my own.

    1. I know that the U.S. and New Zealand were the only countries that allowed direct to consumer prescription drug advertising. I had heard that New Zealand had banned them now, is that true? If so we must quickly follow suit. There is absolutely no reason to directly target non-medically educated consumers with this advertising, it just encourages companies to continue to spew out multiple drugs that do exactly the same thing and stifles any true improvement in the medication arsenal to treat disease.

      1. no, not true. NZ continues to have DTCA of prescription only meds. And then of course you get the people coming in after the latest bunch of ads wanting Reductil or that new asthma inhaler that’s better than all the others etc etc.

        I too wish NZ had the prepackaged meds like Australia – but unfortunately not. Still lots of counting here.

    2. I did a rotation in Australia, where the healthcare system is very much like New Zealand’s. I must say that I was very impressed with that system, because people may not always get what they want, they at least get what they need. I believe that if we can find a compromise between the American system, and socialized public option similar to Australia and New Zealand’s, we may have the solution to this ginormous problem. One more good thing about Australia’s system, it was MUCH easier to count the drugs, since they were prepackaged ;).

      1. I don’t really understand why they’re not anywhere else? They come in boxes that under normal circumstances would be a one months supply for your average joe. If they need a larger quantity than the packaged supply, the doctor gets an authority number (some drugs they don’t need to) and the person will get two boxes to last them a month etc. Makes sense to me. 😉

  14. Right. Because if the government implemented a plan like that, they wouldn’t, you know, HIRE PHARMACISTS to work for them.

    And please forgive me if I’m not crying for the drug reps who would be out of a job.

    If you, as a free-market pharmacist, offer a service worth paying for (such as prompt service, not having meds get lost in the mail, and a personal touch) people will pay for it. I know I would, for the same reason that I personally choose not to use mail-order pharmacies now. And I DO pay more to have a pharmacist right there that I can talk to.

    You can’t advocate a free market and then whine because your product isn’t one that people will line up to pay for.

    And, Peon, as usual, you fail to understand that we trust the government for:
    1) The military
    2) Police
    3) Fire department
    4) Infrastructure
    5) Utilities

    And yet, you wouldn’t trust them to run an insurance company?

    Good thing that for people like you, as in EVERY country with universal health care, you can still buy private insurance. Sorry that the rest of us don’t want to be forced to make the same decision with OUR hard earned cash and would rather not fund the summer homes of the insurance CEOs when we could be paying our own mortgages instead.

    You advocate the free market and then try to tell me that I have to make the same decisions YOU DO with my health care dollar and we should prevent new options from showing up. That is NOT the free market.

      1. If it’s got different plan types to choose from, I surely would, especially if it had no restriction on preexisting conditions, etc.

        If we can pay for a stupid war, we can pay for a better and more ethical health system than CIGNA’s. Crooks.

  15. Anna, it is the function of a government to have a military and police. The purpose of a government is to protect its citizens and to have a legal system where everyone is treated fairly. I don’t think we can make the case that the government is doing much a job with regard to our court system…..that is another government mess. The war in Iraq was a war where our military attacked a country that had not attacked us. The US has been the agressor, the tyrant there. So, I don’t think we can make the case that the government is doing the best job with regard to the military.

  16. The purpose of government may have originally been to serve the people, but now the purpose of government is to perpetuate more government (so they can help more people of course.) Government tries to fix/prevent “free market” failures so everyone will be happy and keep voting for those in power. However when the proverbial fecal matter hits the oscillating unit, government says it happened because there was not enough control, and thus perpetuating itself further by giving itself more power. More government is the answer to problems that were caused by government!
    The problem with the debate of Free market vs Government is that we’ve never truly had a free market society. There have always been regulations and stipulations that interfere with everything and prevent the free market from finding a balance.
    Take antibiotic resistance for example. Few drug companies still fight the good fight against our unicellular enemies, not because the bugs have gotten just too damn smart and it takes too much effort, but because it’s just not profitable to do so. It takes decades and millions to billions of dollars to get a drug to market, and all that time and money can be flushed down the toilet by one quick stroke of the FDA’s pen. The FDA forces pharma to prove the effectiveness of a drug through clinical trials. But its just not possible to enroll enough patients to make the trial statistically significant, especially for serious disease states like sepsis where most patients kick the bucket anyway. Pharma used to get around this by making trials for indications of benign disease states ( sinusitis, UTIs etc) and saying, “well if docs also use it to treat meningitis, so be it!” Well that doesn’t fly with the FDA anymore. They now require pharma to justify the breakpoints they use for all of the indications (not just the gimpy easy to do ones), and it’s up to them to do the neigh-impossible expensive clinical trials to get the data to prove it (where again, most of the patients will die anyway.) Instead of jumping through all these hoops, most companies are saying, “fuckit,” putting out another me-too statin, grabbing 2% of the market and making a few billion dollars. They don’t have optimal results because govt gets in the way of keeping staph from eventually killing us all.

    The same is true of insurance companies. Government makes them jump through so many hoops, which reduces competition because the companies that don’t aren’t allowed to do business, or they lose out on the government monopoly of patients. Walmart is only as big as it is because of govt subsidies, which enabled it to put Mom n Pop out of business. The examples from almost any industry are virtually endless of how govt fucks everything in the long run.

    And you can’t protest about your concerns, because that makes you a terrorist trying to incite terrorism which gets you gassed, tazed(to death), and shot in the face (because rubber bullets are harmless!) like what happened during the Republican National Convention protests last year(which is why I think its ironic the US govt condemns Iran for quelling protesters violently while the US govt has been doing the same thing since the civil rights movement back in the 60’s)

    1. Which ETHICAL loops does the government make private insurance companies jump through?

      Not nearly enough.

  17. Intern-ator…great post! Everyone looks at government for solutions to problems, when the problems are caused by government. Government propaganda is quite effective….all these folks in Congress talk about how they are working to HELP the citizens. Currently, the blame for our financial problems has been directed toward the big financial institutions. What they fail to tell us is that the FED, under Greenspan, is responsible for the two bubbles we have had in the past decade: the tech bubble and the housing bubble. The very people that failed to see the housing bubble coming are now in charge of solving the current mess. It is like putting the fox in charge of protecting the chicken house. These folks are clueless.


    We have been doing that for years at the VA, like you pointed out! All meds are $8/month, regardless if it’s aspirin or Enbrel. If a patient is getting a med for a condition that happened while in the service, or if they are low-income, it’s free. We have a national formulary and great guidance for non-formulary usage (and PHARMACISTS are the ones in charge of approving/denying requests on a pt-specific basis using this criteria). We have massive mail-out facilities to handle a good portion of our workload.

    That being said, where I work there’s probably a 1:1 pharmacist:tech ratio. Nowhere close to 1:50.

  19. SRK, the government pays for most of the drugs that VA patients get. This may work fine at a VA facility, but that does not mean it will work nationwide. I would not put the VA at the top of healthcare in this country. What about the recent botched colonoscopies that has potentially expoused hundreds of patients to HIV and hepatitis?

  20. If I thought TAP was even remotely serious, I’d genuinely be worried about his sanity. History has shown us that when you take any form of government, society or economic philosophy to the extreme that it ends up being corrupt and harmful to the population. This goes for being extremely liberal as well as being overly conservative (communism and fascism for example).

    The only way any changes like this work are if they are done gradually and the plans are moderate. A government health plan that everyone was eligble for would work. Make it like an HMO so it wouldn’t be as easily abused. Charge people a copay that is similar to what other similar policies charge, and the government pays for the rest.

    If anyone has questions about where the money would come from, there’s plenty of cash wasted in financing our military ventures in other countries. Just think of how much money we would have saved if we hadn’t invaded Iraq.

    1. What’s been spent on the entire Iraq (unnecessary IMO) and Afghanistan (necessarry IMO) wars wouldn’t fund the proposed health care takeover for 3 years, but thanks, for nothing, and the all consuming all enveloping program would be around for eterninty. Socialism is great until you run out of other people’s money.

      1. And capitalism is great until you run out of poor people to take advantage of. See, two people can play the pointless rhetoric card.
        I’m sure your Iraq figures are only taking into account the invasion, but there are a lot more costs associated with that soup sandwich.

        1. The cost of occupation
        2. The cost of rebuilding, which a certain company owned by a certain ex-vice president is getting a sweet deal to head. Please, try to tell me with a straight face that there aren’t any kick-backs being tossed around.
        3. The human cost. These people could be used in this country. Instead they are stuck in Iraq where they do NOTHING to improve the US economy, and these human resources can be lost forever when these people are killed.

        The US is much more wealthy than other countries that have socialized medicine. So, how exactly can’t we afford the program again? Oh right, because the greedy-ass people against it would lose money, and they’re trying to convice pharmacists, doctors, nurses etc. that they’ll lose money (when they really won’t) in order to gain their support.

        A little bit of socialism makes things better for the public as a whole (FDR knew it and proved it). Laissez-faire captialism only benefits the extremely wealthy. Read some US history, and look at how workers were taken advantage of during the gilded age up until the great depression.

        1. The US is much more wealthy than other countries that have socialized medicine.


          Think there’s a connection?

  21. Let me just definitively state that anyone who thinks nationalized healthcare is a good idea is an absolute moron, and cannot present one irrefutable fact for the government takeover of yet another private sector enterprise. I will enumerate why:

    1. Debt – The government is 10 trillion in debt. They are borrowing cash from China. With their current healthcare systems, Medicare and Medicaid they have trillions of dollars in unfunded obligations. They can’t afford it. Don’t tell me about wars and the military. The money spent on Afghanistan and Iraq wouldn’t fund the proposed healthcare system for 3 years. Wars are finite, government programs are not. The Military is a legitimate pursuit of the government enumerated in our founding documents, health care is not.

    2. Life expectancy vs. Per capita income – The current average life expectancy in the European Union (the Mecca of socialized medicine) is 78.8 years in the United States it is 78.1 years, a whopping difference of 0.8% as compared to the U.S. life expectancy. Don’t quote me individual small countries. The statistical outliers to observations ratio don’t line up and they favor the small European countries. France is the highest life expectancy at 81 years or 3.7% longer. As stated, it isn’t a fair comparison. Quite frankly, the whole argument is irrelevant, since life expectancy is based on infinite permutations of causal factors, of which, healthcare is only one. U.S. per capita GDP is $47,000, while the EU is $38,000, a difference of 23.7% uh wow. Guess what, I’ll take my healthcare system and the current state of economic affairs in the U.S. Yes, for you clueless statists, when the government absorbs a private industry, it leads to a decline in GDP.

    3. Options – The problem with the current system is the final consumer is not the payer. This frustrates since it limits your options. However, the solution is not to empower a health care oligarchy in the form of the Federal Government. At least now, if you don’t like your healthcare, you can complain to your employer and the healthcare system. Additionally, if something becomes bad enough your employer can change it, and you can effectively lobby for this change. You will have no such options under a federal healthcare system. They will do what they want.

    4. Free Healthcare – Baloney, period. It will not be free. Everyone will be taxed excessively to pay for it, and then, just like Medicaid and Medicare, they will realize they still don’t have enough money for it. They will begin to go further into debt, and then they will cut Healthcare employees wages and install price controls, and an innumerous list of Draconian measures in an attempt to hold down skyrocketing costs, due to abusive access of the system. Just like all the medicaiders who think the emergency room is where you get routine healthcare examinations and treatments. Eventually, you may even see measures, which are being considered in European countries to control costs, like deciding who lives and dies (oh your 80 and you have cancer; well your time was up anyway.) You think you can keep your current plan. Wrong. Remember when our newly elected king criticized McCain for wanting to tax healthcare benefits, during the elections (just 8 months ago). Well guess what his plan is to put National Healthcare, yep tax your current healthcare benefits. The government will out compete all private healthcare insurances except perhaps for those the super rich can afford. You’ll be stuck with them, and like always they’ll change the rules in the middle of the game.

    Competence – The government currently can’t locate 300 billion dollars in Tarp funds. They pay 1 million for hammers and screw drivers. They failed to uncover 9-11 due to a lack of communication between security agencies that was mandated by none other than the federal government. The Medicare, Medicaid, and Social Security systems are trillions in debt and on the verge of collapse. They are vastly incompetent in nearly every undertaking. Let’s give them something big and new to do. Brilliant.

    There are many other reasons, these are just a few.

  22. Someone should wake up The Drug Nazi. I’ve tried once and got called numerous names from the Nazi himself.

    “Anybody can refuse to pay any cost. But don’t be surprised if you get less when you pay less.”
    Thomas Sowell

    He said it well. To add, do you want the government to refuse any cost at your expense?

    There are very good points on this site and I applaud the reasoned arguments. For me it’s simple. How can I trust a government to correctly run an industry when it cannot correctly run itself?

  23. Why do people think the government could/would cut costs or run it any better. government officials get huge salaries/bonuses/pensions/benefits, and usually they will employ a comittee to do the job of one person.

    I heard a comedian put it very nicely on TV that if the government threw a childs birthday party, it would be years behind schedule, cost millions of pounds and result in a public enquiry to determine why the child didnt get the right present.

    1. You are knee jerk against government.

      Your own lack of a sense of responsibility, as with the rest of our lack, has lead to criminal private insurance companies. CRIMINAL.

      What are you doing to help uninsured people get coverage?

      Stand up for someone for once, and make it someone other than PRIVATE insurance crooks.

  24. To recap, the idea of putting healthcare in hands of government (i.e. taxpayers) means to remove the insurance industry middlemen who change insurance coverage, up premiums, and are generally given the upperhand in setting contracts and reimbursement rates to the people that PROVIDE the care. Providing national health insurance promotes reduction of redundancy (if not increasing bureaucracy), dissencentizes patients from overindulging just ’cause they can… while promoting access to all taxpayers (without consideration of pre-existing conditions to the extent that present conglomerate does). When mentioning the VA, don’t forget that it is funded in part by the national budget. When the US Gov’t doesn’t run well-balanced, then the VA isn’t funded, (recall 1988-89) but in essence–when national health insurance has a problem; it IS too big to fail. It’s called taking a pre-emptive and pro-active approach to provide for the healthcare needs of its citizens, because at present, there is too much disparity between providing for those that cannot access healthcare fairly to pay their dues for whatever reasons.

    1. Oh, sneaky. Single payor will promote access to, not just taxpayers, but people who don’t pay any taxes at all. The government is NOT the taxpayers, and that’s the problem. You see, it is the TAXPAYERS who pay the bills and the politician government officials and bureaucrats who spend all the money like they didn’t have to earn it. Cause they didn’t. All they have to do is force the working people to pay taxes, then give freebies to the people who have nothing better to do but vote themselves more freebies.
      We taxpayers–NOT the government–are fed up.
      And so, why should *I* bother to work if I can get free healthcare?

    2. Don’t you just love statists. In the name of going from a private system where they don’t like the policies, they want to go to a unilateral public system. What you don’t think they’ll have policies. The public system will instiute more and less fair policies. At least now, if you insurer violates your contract or denies you care you should get you can sue them. You can’t sue the government my friend unless they let you. Liberalism is a mental disorder it has no cause effect philosophy, it just meanders aimlessly towards oblivion.

  25. LD50placebo, government will not provide for the healthcare of its citizens…it is the citizens(taxpayers) that will do the providing for citizens(non-taxpayers). The taxpayer is funding two wars, Medicaid, Medicare, Social Security,bailout of the biggest financial institutions, GM, and a zillion other pet projects by Congress. Just how much burden can the taxpayer shoulder? How much debt can this country accumulate before it goes bankrupt? It is not a question of “helping” people or solving a healthcare problem; it is a question of whether this country can afford another massive government program at a time when this country is deep in debt.

  26. Government will run universal “healthcare” to not make profits, but to win votes. Those who “enjoy” the program are likely not the ones paying for it, but they are forever vote for the ones who gave them this “entitlement”. Just like Medi-Cal and MediCare, it will be a huge burden on those of us who pay. By the way, health coverage DOES NOT equal healthcare. We know it, they know it. The irony is I came to this country for the values and beliefs that Obama is seeking to abandon.

    1. As much as I despise obama and his retarded policies, the values that this country once stood for started going down the toilet in the Reagan years (and perhaps even earlier). He was the president that practically invented deficit spending. Ever since then, the American people’s debt has been growing exponentially and the gov’t has gotten larger and larger. For God’s sake, the largest building in Washington is named after Reagan. The only difference between obama and Reagan is that obama wants to the send the gov’t takeover in hyper-drive.

      We’ve been handing over our great country to outsiders for years now……….it’s estimated that $300 billion is spent directly and indirectly on illegal immigrants. The obligations only get larger and larger despite what our politicians promise us. Also, just observe half of the convenient stores you walk into; a lot of them are owned by indians……they are given tax exempt status for seven years; but the trick is that after seven years, they turn the business over to a relative, and the seven year cycle repeats over and over; if I opened up my own pharmacy, would the gov’t give me tax exempt status for being a full-blooded caucasian American……..fuck no; they would probably laugh at me……..alot of the people given citizenship in this country are put on welfare and get tons of free shit………I wonder if I went to Italy to live, would they give me this kind of entitlement?

      Just my 2 cents

  27. VA pharmacy is a joke. They, like what the Europeans do, only allow certain medicines to be given out and if they are to expensive they just refuse to provide them. For example, I have TBI from a few to many IED’s and am rated %100 and the VA would only provide the older seizures medications such as Tegretol, Dialantin, etc. They are older and cheaper but newer medications do a better job. At that time I was having on average 5 to 7 seizures a week, so I got tired of the VA mess of doctors (non neurologist because they just are not cheap) and went to a private Neurologist and he pretty much found my problem and offered a solution with in 2 hours while the VA and military doctors spent 7 months do nothing. He gave me a prescription of Kepra and my seizures went down to one a week. The problem was that this Kepra cost me around 375 dollars out of pocket and every time I went to the Pharmacy the tech expected me to yell at them because of the price. I just told them hey it is not pain meds I have no choice. I went back to the VA and tried to get my prescriptions filled through the VA but they will not because it is not one of their approved medications. So now I pay out of pocket for the medicine but hey I rather pay 80 per visit for a good doctor that treats me immediately and 385 out of pocket for working medication then deal with the government Bureaucracy. Luckily my VA compensation allows me to do just that. Problem is that a lot of guys are coming back from OIF/ OEF with similar problems but its just not politically correct to fund the VA as much as SSN. Now I do not blame the people at the VA just the system itself. It funny though seeing the system from the VA receiving end. I spent 10 years of my 15 year military career getting a doctorate in pharmacy and now I do not think I even want to put it to use if I were capable of after seeing the BS with the government system and the way things are heading.

  28. “Drug reps would be a thing of the past.”

    It would be really sad that all the young, hot looking drug reps no longer come into your store/hospital and give you their memorized speech as to why their drug is better.

    There would be no more drug dinners at posh places like Lawry’s Prime Rib.

    That’s why I vote no on a government run pharmacy.

  29. People go into pharmacy simply because it’s a relatively quick way to make good money, not because they think they will enjoy the career. Who says they want to be a pharmacist when they grow up? Most are not very satisfied when they realize all they do is fill pill bottles all day, and have to keep up with the trillions of new drugs coming out. If socialized health care is passed generic drugs will become more common, and as drug prices decline, so will the salaries of pharmacists. I can easily see them going from 100k a year to 50k, which is more what they deserve. I’m sorry, but I have a beef with them as they are not only overpaid, but now they want the title of doctor, which they don’t deserve. When they are required to get a phd, and defend a dissertation of a thesis that they created in front of a panel of experts in their field, then I will call them doctor. An English or History professor with a phd is much more of a real doctor than any pharmacist. If a physician’s assistant can’t be called doctor, no way should a pharmacist. I know a girl with half a brain that just got into pharmacy school and she’s only a sophomore in college. She won’t even have a real bachelors degree when she’s done but she’ll be a pharmacist! What a joke.

  30. You should know a little more about what pharmacy school entails before you make comments about my profession. Based on your user name, I am assuming you are some piece of shit lawyer who benefits society by playing the system to fatten you own pocket. Like your profession is so tough. I could kill 8 hours a day lying to strangers too. How in the hell is a History professor with a PhD more of a real doctor than PharmDs? Being a World War II expert is more deserving than someone who makes sure what you put in your body doesn’t harm or kill you? I personally prevented 3 possible deaths while I was a \stupid pharmacy student\ on rotations at a local hospital. Why did this happen? Because some \real doctors\ had no fucking clue how to properly dose medications. So next time you visit your nearby hospital, ask some \real doctors\ about how much of an asset we are to them and how much they rely upon us. So get a clue and go fuck yourself.

  31. Well, if the HuffPo [] has it right (and it seems that they do, for once) the “Big Pharma” companies have already lobbied with the whitehouse and sold us out in favor of socialized medicine, so you may very well see something like what you have described down the road if all this crap actually passes. Another terrible consequence of this (with the death of competition in healthcare) will be that the cute drug rep with the DDD cup who used to hand out samples and office supplies will now be replaced by a “Nurse Ratched” type who will just beat you about the head (much like an astroturf Obama-union thug would to a citizen attending a townhall to protest “Obamacare”.)


  33. I’ve always wanted a government run pharmacy to compete directly with the drug store chains that invented the pharmacy drive-thru and forced RPhs to work 12 hour shifts without breaks. Well said Angry Pharmacist.

  34. well, previously Sweden and Norway had socialized pharmacies that were all owned by the state, since the business was supposed to be for public health, not profit. It worked fine, but for whatever reason they de-regulated it and now it’s a free market unfortunately.

Leave a Reply to AnthonyRPH Cancel reply