At PAC breakfast, Kondracke reviews health reform

WEST PALM BEACH, Fla. The ambitious agenda set by the new Obama administration and a Democratic Congress on health reform and other issues is running into some bitter opposition from Republicans.

But the White House likely is to emerge with some form of expanded health coverage for Americans and an overhaul of the healthcare network that could thrust community pharmacies into a more prominent role as local centers for prevention, wellness and patient intervention. That was the prediction from political analyst and journalist Morton Kondracke at Monday morning’s NACDS Political Action Committee breakfast meeting.

Kondracke, executive editor and columnist for the Capitol Hill newspaper Roll Call and a regular commentator for "Fox News," gave a wide-ranging talk that addressed the current polarized political landscape and the changing healthcare system.

“Except for the Tea Party crowd, Obama is enjoying fairly high popularity ratings,” said Kondracke, with an average approval rating of 61%. What’s more, he opined, “The mainstream media has gone gaga over the president.”

However, added the "Fox News" pundit, the president’s activist agenda and aggressive efforts to stimulate the economy through massive federal outlays have angered many right-leaning voters and opened a wide rift between Republicans and Democrats. “Since 1994, we have not had an all-Democratic government,” said Kondracke.

The strong Democratic majorities, particularly in the House of Representatives, are fueling the very activist tone apparent in the early days of the Obama administration, as Congress and the White House tackle health reform, the budget, education, the environment and other issues, Kondracke added. But they’ve also spawned a vocal and determined backlash on the smaller-government side of the political divide. “The Republicans cannot stop the House from doing anything, but they can make a lot of noise about what the Democrats are doing — and they are doing that,” Kondracke said.

The resulting polarization, he said, likely will slow many White House initiatives — including moves to overhaul health care, cut out-of-control health spending and broaden health coverage to the more than 45 million uninsured Americans. “The noise out of Washington — and it’s not just from Rush Limbaugh and Sean Hannity — is that a lot of Republicans are branding a lot of what Obama is doing as socialism, or at least European social democracy. So even though Obama said we were going to move into a post-partisan era … everything of importance that Congress has passed so far … [has] all passed on a strict party-line vote.”

In addition, the gap between Democrats’ and Republicans’ approval of the president is now the largest in history at this stage in a new administration, Kondracke said. “That’s the heavily polarized partisan climate that Obama … has not been able to overcome,” he added.

Nevertheless, Kondracke predicted that the movement for health reform and expanded coverage of the uninsured this year will be almost unstoppable. “The Obama administration and the Democrats want to pass a healthcare reform bill this year so badly,” he said, that they may be willing to compromise on issues of concern to Republicans, who consider a single-payer, government-run health plan anathema, and who insist that the White House must get a grip on rising Medicare and Medicaid costs.

Employers also continue to raise concerns about the insurance costs they could incur under any health system overhaul. Nevertheless, Kondracke told NACDS PAC contributors, both Democrats and Republicans generally do agree on some elements of health reform. “One is investment in health [information technology]. And it’s broadly agreed to that we should move from ‘paid from procedure’ medicine, where doctors get reimbursed on the basis of how long they spent with a patient … to being paid for performance and keeping the patient healthy. How we’re going to get to that nobody has quite figured out, but somehow everybody agrees that that’s the way to go,” he said.

With roughly 70% of all healthcare expenses going to the care of chronic diseases, said Kondracke, a broad consensus also has emerged on the importance of preventing and managing chronic disease, rather than simply treating illness and critical conditions after they’ve occurred. Given that shift in emphasis from critical care to prevention, he added, “There’s a real chance for drug stores to be at the center of healthcare reform … and for drug stores and pharmacists to be ‘medical homes’ for health care. “Somebody needs to be responsible for organizing [patients’] meds and their treatment, and drug stores would be an ideal place to participate in that kind of system,” he noted, particularly if another 45 million patients end up with health coverage and overwhelm the nation’s primary care physicians.

Opening the PAC event, NACDS chairman Andy Giancamilli and president Steve Anderson recapped the highlights of recent fundraising activities undertaken on behalf of the NACDS membership. “We achieved the goals that were set,” said Giancamilli. “The NACDS PAC contributed $325,000 to the campaigns of more than 100 candidates. We also were effective in raising an additional $200,000 through fundraising. Sixty percent of the money went to the Democratic candidates and 40% went to the Republicans,” continued NACDS’ chairman, adding, “96% of the candidates that we supported are today serving in office: 115 of 120.”

Giancamilli renewed his call for continued activism and support from chain pharmacy leaders as NACDS goes back to Congress this year to lobby for a seat at the healthcare reform table. “It’s important that our story be told, and that we have the resources to do this,” he said.

The need is made more acute, added Anderson, by the lack of expertise about healthcare issues among most lawmakers on Capitol Hill. “Even though there are 535 members of Congress … there are only a few people who really understand health care in Congress and take the lead.” Among them, he said, are Senate Finance Committee chairman Max Baucus, D-Mont., and Rep. Frank Pallone, D-N.J., who chairs the House Energy and Commerce Subcommittee on Health. Pallone, who Anderson said “has become a great friend over the last few years of NACDS,” will make an unscheduled, but welcome, appearance at the final NACDS Annual meeting business program Tuesday morning, the chairman revealed, to discuss health reform efforts and legislation affecting retail pharmacy. The business session will be followed by a private discussion between Pallone and NACDS retail members.

“We need you to be there,” Anderson admonished members at the PAC breakfast. “It will be extremely helpful in what we do as we move forward.”