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Want to fix health care? Leverage clinics


“We’re already paying for it—it’s just hidden in your premiums.”

That’s what President Barack Obama told attendees of a town hall meeting last month in Green Bay, Wis., one of the stops on his traveling road show to sell his vision for healthcare reform to America.

I have said before that I am optimistic that we can fix what is wrong with health care without socializing medicine—a fear that seems to play like a broken record among echo chamber dissenters who attempt to compare health care in Canada and the United Kingdom to a Breshnev-era toilet paper line in the former Soviet Union. I have met people from these countries, including some pretty conservative types who will tell you that the kinds of stories folks like Sen. Lindsay Graham, R-S.C., tell about having to wait longer for care just aren’t true.

That also doesn’t mean that we should socialize medicine either. Because the last time I checked, the debate wasn’t about shifting 300 million Americans—including the 250 million of us who already have insurance—to a government-run program, it was about finding a way to mitigate the rising cost of health care and getting coverage for the 46 million or so that either don’t have insurance or don’t have enough of it.

But I do agree with Sen. Graham and others like him who believe that ultimately, these types of issues—namely, the question of whether or not to create a public option to compete with private insurers, and who is going to pay for all of this—have the potential to derail health reform entirely. In the course of the debate, there has been much consideration given to the idea of cutting back reimbursements to providers who participate in such programs as Medicare and Medicaid. This industry knows full well what stuff like that means.

Squeezing providers limits access to quality health care. If a pharmacy goes broke and shuts down because it can’t afford to serve Medicaid patients, that store is closed to everybody, not just to the Medicaid patients that used to shop there. When a third-year medical student decides to pursue a specialty rather than go into family practice, that is one less GP that is available to treat Americans. Penalizing providers isn’t the answer.

I am not an economist, and I don’t pretend to have an answer for how or where America is going to come up with $1 trillion to pay for health reform. But I am certain that figure could be reduced substantially if the plan to fix health care included a bigger role for retail clinics and worksite-based healthcare solutions.

I was reminded of this again last month during the “ABC News” live broadcast of the President’s healthcare forum, a program it called “Prescription for America,” when a Johns Hopkins nursing student named Hershaw Davis addressed the issue of a shortage of primary care providers and the overcrowding that impacts our nation’s emergency room and urgent care facilities as a result. His basic question was, how can we get nurse practitioners more involved at the community level?

The answer Obama should have given was to push for the expansion of the clinic model in every city and town in America. How much could we shave off that $1 trillion estimate if we were talking about utilizing the clinics to do acute care and even play a greater role in prevention and wellness for 46 million uninsured Americans instead of funneling them through the ER or trying to come up with imaginary physicians that don’t exist to provide this kind of care?

Why do I believe this kind of care provides more answers than questions? Just take a look at the Big Three U.S. Automakers versus their top competitors in Japan and Europe. It is estimated that the cost of every car produced by Ford, GM and Chrysler includes about $1,500 to fund the price of health care; BMW is spending about $450 per car, while Honda spends about $150. One reason, though certainly not the only one, is that here in this country, Honda and BMW are utilizing worksite-based solutions to provide care for the people who build their cars and their families. The Big Three do not.

Editor’s Note: A headline for a story that appeared in the June 29 issue of Drug Store News (p. 12) regarding industry reaction to the Affordable Health Choices Act, commonly referred to as the Kennedy health plan, suggested that the National Association of Chain Drug Stores and the National Community Pharmacists Association fully endorsed the plan. To clarify, the groups support certain provisions of the bill, particularly a proposed grant program to implement medication therapy management services for people with chronic conditions. The groups do not patently support all aspects of the proposed legislation.

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