nyrxman's blog
Harold Cohen blogs from his office and home in New Jersey.
Ben Franklin's Health Care Reform Program
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In the early 18th century, before he served on a committee of five who drafted the Declaration of Independence in 1776, Ben Franklin already had the solution to health care reform in America when he proclaimed, “An ounce of prevention is worth a pound of cure.”
If only the legislators who came after him had listened to his wisdom, perhaps this country would not be in the health care mess we find ourselves in today. Common sense would dictate that preventing an illness is far better and less expensive than treating it. Yet, our antiquated and greedy health insurance system seems to prefer following the oftentimes disastrous and measurably more expensive practice of treating an illness instead of preventing it.
It would appear from a recent article in the New York Times that our government's approach to health care is not much better than that of the private sector. The article centered on a 31-year-old San Diego woman who was afflicted with Alport's syndrome, a genetic disease that causes kidney failure. Because of her devastating illness, she needed dialysis and eventually, at the age of 14, a new kidney. Her treatments and transplant cost Medicare hundreds of thousands of dollars. Following her operation, she was in need of immunosuppressant drugs so that her new kidney would not be rejected. However, federal law limits Medicare reimbursements for these life-sustaining drugs to 36 months. As you might expect, paying for the drugs to maintain the kidney from her own savings once the Medicare limit expired proved to be impossible, and the woman's transplanted kidney failed. Medicare then paid for a second transplant, which cost the system $125,000, as well as another 36-month round of antirejection drugs, thus perpetuating the costly cycle of health care.
This is a perfect example of why our health care system doesn't work. Our current system is based on reimbursement for costly medical procedures rather than upfront payment for far less expensive preventive care. It is based on fixing what is broken, not protecting what is already working. It's like not getting the fluids changed regularly in your car and then having to pay for a new engine or transmission.
Pharmacists could save this country millions of dollars while getting paid for their services if we took a page out of Ben Franklin's playbook on staying healthy. While many in our government pay only lip service to pharmacists who practice medication therapy management, they need to dig deeper into their pockets and pay real money for the consultative services that pharmacists can and should perform. And insurance companies aren't alone in bearing responsibility for the failure of our health care system. Chain and independent pharmacies must also embrace this preventive system of health care in order for it to be successful. Pharmacists are well trained to perform these services, but their store management must allow them to get out from behind the prescription counter to play an integral part in any new health care reform. In fact, pharmacists should be lobbying for that kind of activity in their stores. It will not only drive traffic and eventually increase their bottom lines, but more important, it will elevate the profession and allow pharmacists to practice pharmacy the way it was meant to be.
Some people might consider Ben Franklin an eccentric character in history, but there is no question that he was prophetic in declaring that an ounce of prevention is worth a pound of cure because that is exactly the doctrine our lawmakers need to espouse if health care reform is to be successful.


Comments
Location: New Albany, IN
Posts: 181
I know that you are old enough to remember the 70's when there was a big push for preventative care and HMO's.. cheaper to prevent than to treat. Amazingly many of us baby boomers were entering their 20's.. the typical person's "immortal period". Now that the baby boomers are moving into their 60's we are now all about disease management... few signed on to preventative care... so here we are... trying to manage what we didn't prevent.
Medicare was established as a catastrophic program... the only part that is provided at no charge is Part A - basically hospitalization and home nursing.
Part B is an optional charge - which basically covers docs,labs, HME. Until a few years ago, Part B only covered blood glucose meter/supplies for Type I.. if you had Type-2 .. you were on your own.
Until 2006, with the implementation of Part D. Medicare folks were on their own to treat with medications any disease that Medicare would pay to have diagnosed.
The insurance industry is quite myopic on preventative care. With a annual open enrollment period for most/all group policies. The insurance industry has no assurance that they will recoup any of their expenditures paid out for preventative care. Since the vast majority of health insurers are now for-profit - public traded companies with all the pressures from "the market" on growth of both revenues and especially profits.. their incentives do not link up with preventative care ideals.