The American business model has long protected and promoted the role of the middleman. If there’s one thing we learned from “Office Space,” it’s that the middlemen often have the “people skills.” They make the deals happen; they keep commerce humming, right? Middlemen keep the relationships between Joe Consumer and Big Corporations in good shape, and ensure that everyone stays happy…right? Well, not always.
As we all know, in this economy, the emphasis must be placed on job creation and the health and success of American small businesses. Main Street jobs are the ones in most need of both new creation and our continued protection, if the economy will ever recover. In some instances, middlemen are creating a crunch for small business owners – which could result in reduced consumer competition and fewer jobs. Specifically, I’m referring to pharmacy benefit managers (PBMs), and the impact they have on independent pharmacy owners, particularly in rural areas.
Simply put, a PBM is the middleman between you, your pharmacist and your health insurance provider. They are a powerful part of the health care industry, making it disturbing that most patients are probably unaware they exist, beyond a liner note on their insurance card. PBMs set the contracts and reimbursement levels between health insurance companies and pharmacies, making plenty of competition between them a very good thing for consumers and pharmacy owners, particularly independent community pharmacists.
A proposed merger between Express Scripts Inc. and Medco Health Solutions Inc. would threaten the competitive marketplace, essentially creating a “mega-PBM.” A consolidated PBM of this size would control a large share of the supply line of brand-name and generic drugs, thereby raising the prices of prescription medications and leaving employer health care plans and patients with few remedies outside of absorbing the cost increases. The results could be disastrous, particularly in underserved communities where independent pharmacists would find their businesses threatened. To prevent these anti-competitive effects in the health care delivery system, the consumers, pharmacists and small businesses that make up the Preserve Community Pharmacy NOW! coalition (PCPAN) are working to stop this planned merger. The bottom line is clear: the merger between Express Scripts and Medco is not in the best interest of patients, employers or health care in America. It must not be allowed to move forward. Please join us and make your voice heard today, and stand up for Main Street jobs!
About the author: Betty Streckfuss is a retired Registered Nurse. She is Speaker Pro Tem of the Texas Silver Haired Legislature, a non-partisan organization dedicated to educating and providing opportunities for Texas seniors to involve themselves with the legislative process. She was appointed by Gov. Rick Perry (R-TX) to the Joint Legislative Committee on Aging, addressing issues relating to the senior community.