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March 14, 2007
Well, folks, the Hawaii Medical Service Association (HMSA) is at it again. It’s that sweet time of year when drug costs for the individual consumer are skyrocketing. That should be old news, of course. State regulation of health care rates ceased to exist in June of 2006 when the bill to extend oversight failed in the Legislature.
But a more dire threat to rural Hawaii is the sharp reduction in the rates at which Hawaii BlueCross Blue Shield reimburse pharmacies for prescriptions. For Maui’s branches of the Wal-Mart corporation or Longs Drugs (where they reel in enough cash from mac-nuts, slippahs, and sunblock to absorb the losses), this is not the end of the world.
But for small, independently owned pharmacies, the new HMSA contract is a slap in the face. “Every time I fill a prescription, I lose money,” says Tom Jones of Haiku Pharmacy, a 1400 square foot store that opened in 1996. Presently, it is the nearest pharmacy to Hana and Kipahulu.
There is talk of up to a 30 percent reduction in the amount of money Hawaii’s Blue Cross Blue Shield program will pay to pharmacists for the prescriptions they fill.
And once pharmacists agree to sign the new contract that has been drafted, there’s not much they can do to curb the losses. So why sign a contract that only hurts you? Arleen Jousxson-Meyers, Hawaii Coalition for Health president, put it plainly in an interview with The Star-Bulletin:
“HMSA is the 700-pound gorilla in Hawaii health insurance. It is impossible to make a living without cooperating with HMSA.” According to the HMSA website, over half of Hawaii residents are covered under their health care plans. Without signing onto HMSA’s coverage, the pharmacies could only fill prescriptions at full price for these customers.
So what does this mean for you, the consumer? According to Larry Geller writing in Disappeared News, “It’s not a matter of if rural pharmacies will begin closing, but when. And customers and employees may begin to feel the squeeze sooner than that.
One small Maui pharmacy owner described the new pressures this will put on the entire system:
“The issue is that we are going to be put into a position that is going to be difficult to maintain adequate staff and pay our bills.”
The cuts will put more pressure on fewer employees, and more pressure can lead to more errors. Wait times will inevitably increase, and it will become more difficult and time-consuming for doctors to put in orders.
For the 700,000 Hawaii residents who are covered by HMSA’s insurance policies, this could mean things are about to become a lot less convenient.
Because, your insurance provider, HMSA, will no longer be paying your local pharmacy a reasonable compensation for the medicine they fill for you, you may have to begin going elswhere. Meaning that instead of driving (or, for those unable to drive, being driven) just down the road to get medicine, you and all the other residents in your neighborhood will need to commute to Kahului (probably battling traffic and long lines) to patronize Safeway or Wal-Mart.
But pharmacies and their patrons aren’t the only ones suffering. Doctors are migrating to the mainland in large numbers. Rising insurance premiums and reduced reimbursement rates create an unfavorable environment for doctors, pharmacists and patients alike.
According to the HMSA, hiked premiums and lowered reimbursements are the fault of the drug companies. Cliff Cisco, HMSA senior vice president, cites the rising costs of the drugs as the root of their new policies.
And while the HMSA’s complaint is certainly valid in the face of the outrageous profits and political sway of giant pharmaceutical manufacturers, it does not seem unreasonable to expect insurance companies to demand a level of accountability from the industry--to confront the manufacturers themselves instead of passing off the costs to ailing Hawaiians.
If things are allowed to progress unchecked, the HMSA will be successfully affecting our healthcare more significantly than our precious healthcare professionals. And I don’t know about you, but I would much prefer my doctor or pharmacist assisting me in the maintenance of my health than my insurance agent.
Take Action: Contact your legislator!
Rosalyn H. Baker (Hawaii State
Legislature Health Committee)
From Maui, 808-984-2400 + 66070
e-mail: senbaker@Capitol.hawaii.gov
David Y. Ige (Health Committe Chair): 808-586-6230
e-mail: sendige@Capitol.hawaii.gov
Mele Carroll (Rep. District 13):
Phone 808-586-6790
e-mail: repcarroll@Capitol.hawaii.gov
J.P. Schmidt (State Insurance Commissioner) Phone 808-586-2799
Amanda Li Wilson
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