Thursday, February 08, 2007


HMSA reimbursement cuts threaten to close rural pharmacies

It's not a question of "may", but of "will." Unlike Longs Drugs in Ala Moana or other Longs on Oahu, a rural pharmacy serving its local community can't make up for cuts in insurance company reimbursements by selling more sundries. People in rural Maui or the Big Island, for example, can use only so many calendars, slippas, or cans of roach spray. When reimbursements drop below costs, the business will shut down. It's a fact of life.

Local communities depend more on their pharmacies and their pharmacists than do big city folks. They can't drive for dozens of miles to get to big town that has a Longs. They also consult more with the pharmacist on the medications they are taking. It's often a very close and very important relationship.

For older folks or those who are not able to travel, the closure of a nearby rural pharmacy can be a matter of life and death.

Yet this is the prescription that HMSA is writing for its rural policyholders.

HMSA not only increases premiums to employers and individual policyholders, it has cut reimbursements to doctors so drastically that several specialties are getting scarce on Neighbor Islands. There have been op-ed articles in the newspapers. I've written that the scarcity of specialists threatens not just Hawaii's day-to-day health care, but our preparedness in the event of a storm, tsunami or other disaster:
Well, Hawaii is losing its doctors and it's no laughing matter. Insurance companies raise premium rates when they can, they also cut payments to doctors while building obscene reserves and paying large executive salaries. Why not fix this? We're not afraid to regulate insurance companies. We should deal with this problem in 2007, before a natural disaster strikes and finds hospitals unprepared.
The legislature is in session. Now's the time to call your own legislators and ask them to do something about rising HMSA premiums and plummeting reimbursements to doctors and pharmacies.

Pharmacies have only a few days to sign new suicidal contracts to be HMSA providers. If they are not HMSA providers, patients won't be able to get their prescriptions filled or renewed near their homes. The pharmacy will have to close, because HMSA has a near-monopoly in Hawaii. The decline of rural health care will accelerate.

It will be too late for rural areas when their local pharmacist moves away. No one in their right mind will open a new rural pharmacy under the current circumstances. So call your legislators today and let's get HMSA (whose reserves have burgeoned to around $700 million) under control, while the Legislature is still in session and can do something about it.

You can also check with your pharmacist to see if they have a copy of the petition that has been circulating to request the Insurance Commissioner to intervene. If they do, read it and sign it.

No one can save your neighborhood pharmacy but you.


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