MAINE VOICES: Jim Clair

Don't pile costs on druggists' backs

Copyright © 2004 Blethen Maine Newspapers Inc.

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ABOUT THE AUTHOR Jim Clair is vice president of Community Pharmacies L.P., a Maine chain headquartered in Augusta. To top of story

I read with dismay the Jan. 8. editorial entitled, "Cut in pharmacy fees better than alternative." It concludes that the only two options available to Gov. Baldacci are either to implement a 40 percent reduction in the MaineCare pharmacy dispensing fee or to raise state taxes. Fortunately, things are not that bleak.

I work for Community Pharmacies, L.P., a Maine-owned and Maine-operated retail pharmacy chain with 14 stores from Saco to Madawaska. We just completed our fifth year of operations and continue our struggle toward a fair profit on the slimmest of margins.

To suggest that we should accept this most recent reimbursement reduction as some sort of civic duty, lest state taxes be increased, is simplistic at best.

And to suggest, as the editorial does, that Rite Aid is being disingenuous about its plan to cut store hours or perhaps even close stores in response to this cut does a disservice to that chain. We are weighing those same options in order to survive.

There have been many studies that say that it costs a pharmacy approximately $6.75 to fill a prescription in Maine, yet the governor is proposing to reduce the dispensing fee, without consent by the Legislature, from $3.35 to $2. This will make Maine's Medicaid dispensing fee the lowest in the country.

Do Mainers know that this is the eighth decision made by the Department of Human Services over the last 18 months that have financially hurt their local pharmacy? We have become a convenient way to balance the state Medicaid budget as more and more people are added to the Medicaid program.

Over the last few years the Legislature has expanded eligibility significantly. The Legislative Office of Fiscal and Program Review recently published data that show that the number of people on MaineCare (Medicaid) has increased from approximately 180,000 in July 2001 to 242,000 at the end of December 2003.

That's an increase of 62,000 people, or 34 percent, in 30 months - an average of 2,000 people being added each month. And once Maine Rx Plus starts (a new MaineCare prescription drug discount card), the Department of Human Services estimates that another 80,000 residents (yes, you read that number correctly) will become eligible.

With 242,000 enrolled, Maine now has nearly one in five of our residents on MaineCare. Meanwhile, New Hampshire, with about the same population, has approximately 94,000 people on its Medicaid program, or approximately one in 13 residents.

How about bringing MaineCare eligibility back in line with reality? How about doing a true top-to-bottom review of state expenditures, and then have the Legislature set its priorities and make the tough choices?

Implementing this latest cut runs contrary to two principles that were said to guide this governor and his administration in their decision-making process: ensuring access to quality health care and building "public-private partnerships."

Access to quality health care can't continue when the pharmacy network in this state continues to erode.

Pharmacy customers will be met by reduced hours, fewer staff and, perhaps, fewer stores. Already, in response to this reduction, we have dropped out of the MaineCare Durable Medical Equipment program (incontinence, ostomy products, etc.); we have stopped our delivery services; we have stopped our special packaging for boarding homes; and we will most likely be withdrawing from the MaineCare program entirely at one of our stores.

This latest reduction removes $8 million from the Maine economy, including a 2-1 federal match for each state dollar expended.

That translates into fewer staff, reduced store hours and fewer sales that, in turn, will lower income and sales tax collections to the state.

If Mainers are at all concerned about how and where they will get their prescriptions filled in the near future, I encourage them to contact the governor's office as well as their local legislators and let them know that the MaineCare budget should not be balanced on the backs of Maine's retail pharmacies.

Accept this reimbursement reduction or endorse increased state taxes? Not as long as other, more fiscally sound options go unmentioned and untried.

- Special to the Press Herald

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