Magazine article Drug Topics

Health-Care Reform to Expand Competition for Customer Loyalty

Magazine article Drug Topics

Health-Care Reform to Expand Competition for Customer Loyalty

Article excerpt

The major players in the American health-care system are quickly falling into line behind President Clinton's proposal for a national solution to our health-care crisis.

Regardless of whether it will be a single-payer system or managed competition, most proposed solutions have much in common, including a basic benefits package mandated for all Americans, according to John Kralewski of the University of Minnesota School of Public Health. Prescription drug benefits are likely to be part of this package, he told a recent conference sponsored by the Institute of Pharmaceutical Economics in Philadelphia. For community pharmacists, the proposed reforms may herald a new era of sharp competition for customer loyalty, said Kralewski, a Congressional advisor on health-reform.

He feels that the long-standing debate between proponents of a national health-care system and supporters of the current fee-for-service model has virtually evaporated since President Clinton took office. The likelihood of a nationally integrated system of health care is "moving along faster than anyone could have expected." Businesses, labor unions, even insurance companies and the American Medical Association are supporting reform at a national level, said Kralewski.

Most parties agree that two of the reform proposals will directly affect prescription drug coverage: the formation of large purchasing groups to buy health-care coverage and the structuring of large integrated health-care provider groups to furnish the services. The aim of purchasing groups, he noted, is to provide to small businesses, the self-employed, and individuals the same advantages big companies have in buying volume health-care coverage--increased buying power, low administrative costs, and risk sharing.

Kralewski feels that a national minimum benefits package will be mandated or arise de facto. Because the federal government will buy in to the purchasing groups, and because the government already provides drug benefits to Medicaid recipients, drug benefits will probably be extended to all participants in purchasing groups, he said. The alternative would be a multitiered system in which low-income Medicaid recipients would receive drug benefits, while farmers and owners and employees of small businesses who subsidize Medicaid would not receive such benefits. Since that would be unacceptable to these groups, "I predict the mandated benefits package will be fairly liberal and will include prescription drugs," Kralewski said. …

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