As another century was wending its way toward a happy ending at last, Samuel Clemens, aka Mark Twain, was said to have observed that history may not repeat itself, but it does rhyme. And in this century, Arkansas seems to be catching up, and catching onto, the danger that concentrations of economic power represent to democracy.
Those concentrations may have gone by various names over the years--from monopolies to trusts--but they all represent a common danger to consumers. And now they've reared their many-tentacled heads where prescription drugs are concerned. Both wide-awake legislators and this state's governor, the Honorable and honorable Asa Hutchinson, seem very much aware of the danger and just as determined to quash it. Good for them.
Michelle Gray, the Republican state representative from Melbourne, is taking the governor's word that he'll do something about this injustice at face value. "He looked me in the eyes," she says, "and I have to trust that. If I can't trust my governor to do what he says he will do, I might as well pack up and go home." Happily, she shows no sign of packing it in and heading back to Melbourne, for which all of us can be grateful. Her good faith effort should soon enough be reflected in the bill for all our prescription medications.
At last report, this much-needed reform is still "a work in progress," to use the governor's phrase, but it should be wrapped up by the end of this year's special fiscal session of the Ledge. "I expressed to Representative Gray," says the Guv, "that I'm committed to the pharmacy issue being resolved in the special session. Everybody is working in good faith to develop the language. Once consensus is reached on the language of the bill, we will know what's going to go on the call."
Here's hoping, though not necessarily believing, that the governor has summed up what's going on accurately. But for now it's not easy to see how the giant CVS chain of pharmacies would adopt policies that would provide "fair and sustainable reimbursement" to all pharmacies, instead of rigging the system to encourage one pharmacy in particular, namely CVS.
In a defense that has become all too familiar, a spokesperson for CVS Health pharmacies claimed that the proposal to reform the sale of prescription drugs "goes well beyond the regulation of [prescription drugs] and would eliminate the tools that help lower the cost of prescription drug benefits." It's remarkable how little the defense of monopoly power has changed since the 19th century, when trusts were all the rage. And yet reformers like the Arkansas Pharmacists Association CEO Scott Pace note that CVS Caremark's website shows that drug stores owned by its parent company, CVS Health, were shelling out some $60 more for each of about 270 common prescriptions sold customers.
Only after this discrepancy was brought to the attention of Arkansas Blue Cross and Blue Shield, says the CEO of the pharmacists' organization, did CVS cut its reimbursement rate. The catch, and there's always a catch where price-fixing is suspected, is that CVS still pays chain drugstores more than it does independent pharmacists. What's more, it's reported that CVS has sent out letters asking still-independent pharmacies to consider selling their little stores to the giant company.
We're hoping for the best but are regularly reminded to prepare for the worst, as the all too frequent prison terms meted out to bad apples in the ledge attest. But keep the faith, which good examples like state Representative Michelle Gray keep supplying, Lord bless and strengthen them. And us all.
Editorial on 02/26/2018