Universal Healthcare?

[Marlin300]

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So with the State of the Union Address tonight, universal healthcare was mentioned quite a bit. In your opinion, what kind of impact do you believe this would have on pharmacy?

 

[Artful Dodger]

As long as it helps people, what can go wrong? Regardless, the whole healthcare industry is quite understaffed. It should be more accessible in my honest opinion, but cost is the controversy, and I honestly don't know much should be spent when it comes to that. I've always been an advocate of more money into healthcare, because we have so many people using it, but very little funds to operate on. Anyway, the effect it will have on the pharmacy profession...it might have little or no impact depending on what measures are taken to provide people with healthcare. It also depends what type of work you will do as a pharmacist. Most work at chain pharmacies, so it won't hit them that hard at the moment (no details have emerged yet - in the readings I have done thus far). I think the strain or anger rests with those pursuing medicine as a career. they're duking that one out on SDN as we speak lol. but also, fro ma broad stance, why do we all want to go into healthcare? the phrase that has been beaten to death applies here "to help people". That's why we go back to what is the real ethical issue for why we're in this...the reason that we should all hold in our hearts...to support any cause that helps people live better lives. Healthcare professionals should really stand up for that. Don't let insurance dictate the way you should think about patients. Whatever...that's my take. Now don't beat me on the head. I'm the most neutral person you will ever meet.

 

[OperatingThetan]

Millions of Americans are uninsured and not receiving the drugs they need to live a better life. Once UH is implemented, many more scripts will need to be filled. The demand for pharmacists will increase thus pushing their salaries higher.

This holds true until CVS cashiers begin demanding more "responsibility".

 

[confettiflyer]

Millions of Americans are uninsured and not receiving the drugs they need to live a better life. Once UH is implemented, many more scripts will need to be filled. The demand for pharmacists will increase thus pushing their salaries higher.

This holds true until CVS cashiers begin demanding more "responsibility".

Ah but if you have single payer national insurance, reimbursements can be dismally low thus driving down salaries paid to pharmacists. Ever see a physician's office that takes state medicaid/other gov't programs? They need to put pt's in the revolving door (15mins a visit) just to break even, this is why a lot of MD's refuse to take it or limit the # of pt's they'll accept on the program.

 

[Tatodotcom]

why put yet another responsibility on the gov't? they havn't gotten one thing right yet...and I don't care if you're republican or democrat, the govt screws up just about everything they are fiscally and finacially responsible for....look how they run their budget....it may benefit people temporarily, but as a country it will just be another problem that future generations will have to deal with

 

[117296]

So with the State of the Union Address tonight, universal healthcare was mentioned quite a bit. In your opinion, what kind of impact do you believe this would have on pharmacy?

I may want to point out that it was a speech to a joint session of Congress and not the State of the Union. But that is splitting hairs. It seems that many people on this board aren't that against universal healthcare, as long as it does not affect their salaries and the reimbursement rates are fair.

I'm not sure that Thetan's statement is correct, though. There is too much variability in the economy right now to say that pharmacist salaries will rise. One could make a very good case that the salaries could fall in the short term.

And how exactly would CVS cashiers demand responsibility...I'm not sure I follow.

 

[Thovkhaws]

In healthcare there's the Iron Triangle: Cost, Quality, and Access.
The theory goes that increasing emphasis on one of the three might decrease the out-come of the other two. If you increase healthcare access then costs go up (on taxpayers if UH or on indviduals) and quality goes down (more load placed on system that can't handle it). If you improve quality (better rx formularies, better diagnostic testing, etc.)then costs (more expensive procedures) go up and access (due to costs) go down. If you decrease costs (opt for less expensive insurance bennefits) then access goes up and again quality is down. You get the point.
Healthcare is a $2.26 trillion dollar industry or roughly 16% of the GDP. The U.S. has a higher % of GDP dedicated to its healthcare system than countries with UH. But the system allows for more freedom in selection of your healthcare which freedom you might not get in other places ergo the increased U.S.'s increase cost leads to assumed increased quality. So will UH health work in the U.S.? It will lead to decreased quality and decreased revenue for healthcare sectors. I'm not thinking about the money alone but UH will have a negative influence for everyone. Another thing is that I don't think that it has worked anywhere yet.
I think the most important thing we need to do is not worry about enrolling the country in a UH policy but focus on the preventitive health measures that will drive down costs in the long run. We should focus more on preventing chronic diseases which account for the majority of the revenue in the healthcare system. Keep the system the way it is, and one last thing: allow medicare D to subsidize and negotiate prices with drug manufacturers, that will reduce the coverage gap hypothetically.

 

[chibipinkbunny]

Ah but if you have single payer national insurance, reimbursements can be dismally low thus driving down salaries paid to pharmacists. Ever see a physician's office that takes state medicaid/other gov't programs? They need to put pt's in the revolving door (15mins a visit) just to break even, this is why a lot of MD's refuse to take it or limit the # of pt's they'll accept on the program.

Ha, ha, that's what they did to California pharmacies recently. The government became short on money so they cut reimbursement to pharmacies 10% for Medicaid patients. I know that pharmacists were fighting this because they were losing money on many Medicaid patients. I think they got it down to a 5% decrease, but that's still very hard on independent pharmacies that don't use drugs as a lost leader. In read somewhere that doctors get reimbursed 70% less for Medicare patients when compared to patients on private insurance. If we had a single payer system I don't see how this is going to change. I don't think doctors make as much money in other countries, nor do pharmacists. Once again, I'm not sure about that, but that seemed to be my general impression of things. Ha, ha, though doctors would get screwed a lot more than pharmacists by a single payer system. If you're a top neurologist making about $600,000 a year, the government won't stand for that. The government simply can't afford it. I think another misconception that people have is that if we switch to a single payer system we're going to give everyone the best treatment that money can buy. That simply isn't true. The government doesn't have enough money for that. People will be getting pills instead of surgery a lot more often, like they do in other countries, which may or may not be a bad thing. We're not going to be able to afford the fancy smancy top of the line medications for everyone. Anyway, I was informed that Obama wanted employer mandated insurance vs. a single payer system, which I'm less against.

 

[WVUPharm2007]

They would never have a single payer system in the US. I'd think that they will just have employer mandated/govt subsidized third party insurance. If they do that, it's gold. Job security up the wazoo. Taxes would be higher, but with all of these new schools opening up for no damn reason at all, we need the increase in demand before they start spitting out people to man all of the Rite Aids...

 

[confettiflyer]

I'm personally a fan of the way Germany runs things...you have the option of opting out if you can afford it. The MD unions all negotiate with payors set prices while there are multiple "insurance companies" if you will that you can choose from. Something like that, I'm obviously simplifying things. If you're ever bored, read into it...people seem to be satisfied there.

 

[thephoenician88]

because it's not enough to deal with medicaid in retail right now, just add on universal for everyone.

that way i can tell everyone that they all require PA's.

 

[cemented]

The reason that medicaid is so complicated is because we as a nation have made it so complicated. In the UK for example, regardless of income, everyone gets drugs at a simple fee. The US has this ethos that makes it very complicated. If we just said its a flat rate for everyone regardless of income the system would run alot smoother. I am not saying that the UK's system is the best, but remember all the struplations with medicaid, if you make this amount then you don't qualify and if you make this must, you pay up to this amount and then we pay the bill. If we were to truly adopt Uni Healthcare our whole system of healthcare would need to be restructured.
Food for thought.

 

[Transformer]

The reason that medicaid is so complicated is because we as a nation have made it so complicated. In the UK for example, regardless of income, everyone gets drugs at a simple fee. The US has this ethos that makes it very complicated. If we just said its a flat rate for everyone regardless of income the system would run alot smoother. I am not saying that the UK's system is the best, but remember all the struplations with medicaid, if you make this amount then you don't qualify and if you make this must, you pay up to this amount and then we pay the bill. If we were to truly adopt Uni Healthcare our whole system of healthcare would need to be restructured.
Food for thought.

I'm not sure how smooth thing will run in both cases but for sure, universal health care will drive down the quality of health care in the U.S. If everyone was getting the same quality of heath care, and health care providers are getting reimbursed the same amount of money, then there is little incentive to work harder and provide the best care for our patients when health care businesses are loosing money.

The only way we are going to restructure into a Universal health care system is to start adopting socialism and partially ditch capitalism.

Keep in mind the drug business is profit driven and adopting an universal health care system will potentially drive down their competition, profits, salaries (this includes the pay of health care professionals, including pharmacists), and the quality of health care in the United States.

 

[cemented]

I disagree respectfully. In Great Britain (and I use this only because it is the system I am more knowledgable about), inefficent hospitals are closed down and CEO of government run hospitals are given bonuses if they are able to run the hospital effentictly. For example, in Britian hospitals are paid X amount of money per patient. If the hospital is a good one, then that hostipal receieves more pateints and therefore is considered viable as a healthcare institution. If a hospital is considered "bad" then less people go there and the government will cut funding and the hospital will go belly up. Also, British doctors make good money, compreable to their US counterparts, so I don't think they will be really affected all that much. Also in England, Private insurance is avalible but you have to pay for it and it is ALOT MORE AFFORDABLE because there is a safety net to catch everyone. Personally, I don't care if we as a country adopt some form of socialism in this aspect because it would benifit everyone and I personally believe that if government can tape our phone and read our personal e-mails, then why not give us afforable healthcare. Just my opinion and not meant to start any drama on SDN.

 

[fhx06]

Regardless of any change, we need several parties to be on the same page and agreeing with each other in order to implement any type of universal healthcare. The system in the US is not just limited to the government, healthcare providers, and people, but also insurance and drug companies. To have the most efficient system, we'd have to have all these groups of people agree to a system that can benefit everyone. If we force drastic change that severely hurts any one of these groups, we may be in for devastating consequences in the future.

My biggest concern is that if we rush the implementation of a universal healthcare system without addressing loopholes, gaps, and corruption, we may very well be making this situation worse than it already is.

Cemented: this is a legitimate topic for debate since it applies to all of us as healthcare providers and receivers, so I see no harm in bringing it up.

 

[Artful Dodger]

I disagree respectfully. In Great Britain (and I use this only because it is the system I am more knowledgable about), inefficent hospitals are closed down and CEO of government run hospitals are given bonuses if they are able to run the hospital effentictly. For example, in Britian hospitals are paid X amount of money per patient. If the hospital is a good one, then that hostipal receieves more pateints and therefore is considered viable as a healthcare institution. If a hospital is considered "bad" then less people go there and the government will cut funding and the hospital will go belly up. Also, British doctors make good money, compreable to their US counterparts, so I don't think they will be really affected all that much. Also in England, Private insurance is avalible but you have to pay for it and it is ALOT MORE AFFORDABLE because there is a safety net to catch everyone. Personally, I don't care if we as a country adopt some form of socialism in this aspect because it would benifit everyone and I personally believe that if government can tape our phone and read our personal e-mails, then why not give us afforable healthcare. Just my opinion and not meant to start any drama on SDN.

Yeah, I know about the British healthcare system. It's not in good shape. But I think the difference, with the readings I've done to educate myself, the US "Universal Healthcare" plan will be a little bit different. From what I understand, all insurance companies will be allowed to exist - and employers & employees will be able to keep the insurance they buy into. However, the government is going to start an insurance that will provide for those who can't get it...and you can buy into the government insurance plan if it's a better deal than your current insurance plan. That's my understanding of it at the very least...more people will be using healthcare services as it should be.