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Tallahassee Democrat: In saving money, state hurts pharmacies and customers

Saturday, June 11, 2011

My husband, Charles, and I have owned and operated Jackson’s Drug Store in Monticello since 1966. For a small community drug store like ours, a lot has changed since then.

Independent pharmacies are the backbone of small communities, but recent efforts by the Florida Legislature have taken more and more prescriptions out of the hands of local pharmacies, instead putting them in the hands of huge mail-order houses.

This hurts patients, and it hurts small-business owners.

I believe in pharmacy choice and access for Floridians. While I’ve yet to meet a patient who prefers national mail-order prescription houses to the in-store service provided by community pharmacies, I respect every patient’s decision to do what’s best for them.

Our location in North Florida makes our business particularly vulnerable to the drastic mandates from Tallahassee that require more than 100,000 state employees and retirees to order prescriptions via mail and from out of state.

I know from experience that elected officials are never short of language and rhetoric aimed at assisting small-business owners in the free market, but this Legislature knowingly failed to include language allowing local pharmacies to participate.

I’m still stunned.

Many of my customers have been coming to our store for decades. Now, with one swipe of the pen, they have been denied a choice to receive our community-based service.

Restricting choice, as opposed to allowing employees the option to order by mail, removes access to quality care. It also removed a large portion of my customers, which are critical to our business’ viability. Small businesses without customers aren’t businesses for long.

And it may soon get even worse.

The Legislature approved another bill that will shift nearly 3 million Medicaid recipients into a managed-care framework. The change away from a fee-for-service system is designed to save the state money, beginning in July 2012.

Our business can’t afford for another huge portion of our customers being taken away from us, shifted from community pharmacies toward national mail-order houses.

This isn’t like buying books online; these are vital medical prescriptions that require consultation.

Medicaid patients must be able to access the pharmacy provider of their choice, just as they have always done, and critical medical services should be paid in a timely fashion.

One of the by-products of this legislation is the added threat that reimbursement rates for local pharmacies will continue to fall. Florida’s rates already are among the lowest in the nation.

By making sure Floridians can continue to access community pharmacies within managed care, and promptly and fairly reimbursing for us for our services, the Legislature can ensure that the level of care in our state does not deteriorate.

Many of my customers have very serious illnesses, and by severing their relationships with local pharmacists, Florida is doing a huge disservice to our entire health care system. In cutting community pharmacies such as Jackson’s Drug Store out of the process and instituting an outof-
state, mail-order system, the Legislature is threatening our livelihood, as well as the care my customers both need and deserve.

There are more than 10,000 community pharmacies in Florida that employ about 235,000 full and part-time workers. This will soon change for the worse.

We all agree that Medicaid needs to be reformed, but we must not sacrifice jobs and quality care for the most vulnerable Floridians in the process. Community-based pharmacies have been and must remain a critical element in the health care solution.

Gov. Rick Scott and the Florida Legislature, please support community pharmacies like ours.

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