Inside This Issue - Opinion
No room for Rx at White House summit
March 16th, 2009
Community pharmacy found itself on the outside looking in as the White House Forum on Health Reform unfolded.
The policy summit convened by President Obama in the East Room earlier this month managed to accommodate a broad range of health care stakeholders, including legislators and other policy makers; representatives of the medical, pharmaceutical and insurance sectors; patient groups; labor unions; and “everyday Americans.” Conspicuous by their absence were individuals involved in retail pharmacy.
The omission was a regrettable oversight on the part of an administration that has vowed to avoid the pitfalls that scuttled President Clinton’s bid to reform the health care system in 1993 and 1994. In contrast to that effort, Obama had stated his intention to be inclusive and transparent in a process that, as he told a joint session of Congress in February, “we can no longer afford to put … on hold.” The exclusion of pharmacy from the forum was a troubling departure from that stance.
The profession plays an integral part in health care delivery, filling more than 3 billion prescriptions a year and helping ensure that patients use medications properly. In addition, many community pharmacies offer disease state management programs, operate walk-in clinics, provide immunizations and are primary outlets for over-the-counter medicines and health care supplies. The industry’s prowess in technology makes it a leader in an area that Obama has identified as essential to effective health care reform.
Had the administration seen fit to invite a pharmacy representative to the White House summit, it would have had a host of qualified candidates from which to choose. Two retail executives among many who come to mind are Tom Ryan, chairman, president and chief executive officer of CVS Caremark Corp., and John Agwunobi, senior vice president of health and wellness at Wal-Mart Stores Inc.
In recent years Ryan has emerged as a health care visionary, breaking down the silos in which different components of the system operate in order to strengthen the continuum of care and reduce overall expenditures.
Agunwobi — a physician who served as assistant secretary of health at the Department of Health and Human Services and as an admiral in the U.S. Public Health Service Commissioned Corps before joining Wal-Mart — presides over the pharmacy business at a retailer whose stock in trade is bringing down costs and saving consumers money. The company’s $4 generic drug program has not only benefited the chain’s customers but also prompted other pharmacy operators to develop ways to make prescription drug costs more manageable.
National Association of Chain Drug Stores president and chief executive officer Steve Anderson would have been another logical choice to speak for community pharmacy at the White House forum. The organization he leads is the advocate for companies that operate more than 39,000 pharmacies and have annual sales that top $750 billion. Anderson is an experienced association executive, one who is well versed in the political process and understands how business and public policy interact.
Inexplicably, none of them — or any other retail pharmacy leader — was asked by the White House to participate in an event intended to help put health care reform on the fast track.
Some will argue that the forum was largely symbolic and that the real work on the issue will get done during countless behind-the-scenes meetings in Congress and the executive branch. True, but symbols are important. The absence of pharmacy from the White House summit tends to reinforce the old perception that it is of secondary importance and members of the profession do little more than the modern equivalent of “lick, stick and pour.”
The industry has done much to change that view in Congress. NACDS and its allies have chalked up an impressive string of legislative victories over the past two years and developed a good working relationship with members in both houses, including Rep. Jo Ann Emerson (R., Mo.) and Sen. Max Baucus (D., Mont.), to cite just two examples.
Now it appears that the new administration needs to be won over. Pharmacy’s ability to improve patient outcomes by fostering greater adherence to medication regimens and, in the process, lower overall health care costs should make it a subject of great interest to the president and his advisers. Once the profession’s potential is brought into focus, it is very likely that pharmacy will represented the next time health care policy is discussed at the White House.