is the way prescriptions are handled. No, I am not talking about Medicare Part D and the donut hole, or the ban against negotiation of prices or of reimportation, all of which are important issues.
I am talking about the tilting of the playing field against independent pharmacies.
This is from personal experience, twice in recent months, first with my wife and then with me.
Under her federal employee health insurance we have full coverage on prescriptions, which given some of our medications and the official prices is critical.
We first encountered it with one of the medicines for her cancer.
This week I encountered it with one of the medicines from my psoriasis.
Our independent local pharmacy cannot get them. The prescription plan for the federal employees is managed by CAREMARK which is CVS and the only place we can obtain those prescriptions apparently is CVS. The wholesaler for our wonderful local independent is not given access.
Please keep reading.
There is no logical reason for this to occur, other than it becomes a cash cow for some major drug chains / distributors. I was told by one local pharmacist that they even in some case pay kickbacks in order to obtain exclusives.
Yes, there is a desire to control costs.
But there is no reason that ongoing medications should therefore have to be routed through large chains without the kind of ties to the local community, which oh by the way also tend not to pay their employees as well.
We have seen big box stores destroying local mom and pop stores for years.
I can remember when we first got prescription coverage with a local government employer that we were told all maintenance prescriptions had to be through one mail-order company (which btw is a good reason to maintain Saturday mail delivery, particularly in communities where the package delivery companies do not go).
In the case of my wife's medication, there is supposed to be special care taken in handling it, and she must appear, show ID and sign for it. But the special handling is that the overnight package delivery sits at the pharmacist's station unopened until we show up, and then the paperwork is executed by a clerk.
We already have too much of what we have to deal with being centralized in large corporations. This is true in banking, in health insurance, in so many other areas.
Given the importance that independent business have played in American communities, one would hope that the Congress might address this issue so that small businesses are not so disadvantaged.