Since everyone else and their pet dog gets to sound off on what is the best plan to overhaul the United States healthcare system, I thought I'd put forth a few of my own.

(Note: anyone who has been following this blog knows my reasons for advocating a single-payer system, so the following remarks are meant to be as an alternate to that most desired of solutions.)

  • Lacking any real reform, which indeed seems now to be the resultant predicament we find ourselves in, we could save millions just by having one uniform billing form, and one uniform insurance card. I have seen insurance cards without any ID number, group number, processor number, or even a logo to let us know whom to bill. Honest.
  • Give pharmacists the power of therapeutic substitution. If your insurance wants you on Prilosec OTC instead of Aciphex I could switch you to that drug without having to fax or call the office and wait the three days to hear back from them. They're only going to say switch it anyway.
  • Advocate the use of free discount cards. We switched a patient taking generic Topamax to the generic saving quite a lot, but then we tried on a lark to send the claim to a free discount program. The price went from about $240 to $28! We use it a lot on the phentermine drugs which are never covered on insurance, causing the price to go from $30 to $12.
  • Reimburse pharmacists to review patient medication profiles with the physician. I could save people—and insurance companies!—thousands, maybe millions, if I could afford to go over profiles. But I now do not have the time and no one can afford to not fill prescriptions in place of examining profiles. This would also probably prevent many unnecessary hospital visits due to adverse effects and interactions.
  • Set up a regional or state-wide pharmacy ad-hoc committee every couple of years to go over ideas to send to government boards and insurance oversight committees. Pharmacists have a lot of great ideas for saving money.

Take away Sen. Chuck Grassley's insurance. See, if he didn't have insurance like the 50 million other Americans you'd have real reform, saving the country, oh, about a trillion dollars a year. Probably the best idea I've ever come up with.


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