Editor's Note: Health Care Reform—Be Part of the Process

Mr. Eckel is professor and director ofthe Office of Practice Development andEducation at the School of Pharmacy,University of North Carolina at ChapelHill.

As elections approach, one thingis clear: health care reform willbe on politicians' agendas for2009. That means that each of us needsto be prepared to participate in the process,to ensure that any future healthcare system represents our interests.

Recent years have shown how hard itcan be to make sure pharmacy's needsare heard in Congress. We have seensome glimmers of hope, such as therecent success with the passage of HR6331 in averting Medicare cuts. This isan unusual case, because we had strongallies in the other medical professions. Ithas demonstrated that we can succeedwhen we work together, however.

As budgets tighten even further,we can expect increasing pressure toreduce reimbursements. This will resultin a continuing series of battles at stateand federal levels and ultimately in proposalsfor more fundamental change toour health care system.

If change is inevitable, we must playa role in determining what that changewill be. This means more than just fightingproposed reimbursement cuts—itmeans helping to define a new systemthat recognizes and rewards our professionalknowledge and skills.

Pharmacy associations have begun toaddress this. The National Associationof Chain Drug Stores issued a set ofbroad principles for health care reformearlier this year, covering most areasthat directly affect us. The Association ofCommunity Pharmacists CongressionalNetwork has come up with much morespecific proposals with the potential todefine new ways that pharmacists canbe reimbursed. These include a "PBM[pharmacy benefit manager]-less" system,in which reimbursements would begiven at retail landed cost, plus a professionalservices fee. The group says thatit has been asked by Rep John Conyers(D, MI), chairman of the House JudiciaryCommittee, to meet with other pharmacygroups to build consensus for thepharmacy provisions in any 2009 healthcare reform bill.

The statements emerging from pharmacyassociations can help us focus onthe issues, consider the options, andformulateour own position. Ultimately,it is up to each of us to identify what wewant, then commit to helping shape thefuture—making sure that politicians hearour views. A successful health care programneeds to support pharmacy—toensure that happens, we must committo being part of the process.