President Clinton Addresses Health-System Pharmacists

In his keynote address at the ASHP Midyear Clinical Meeting and Exhibition, the former president discussed how to improve health care and the role that pharmacists can play in bringing about this improvement.

President Bill Clinton addressed more than 20,000 health-system pharmacists on December 3, 2012, as the keynote speaker at the opening session of the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting and Exhibition in Las Vegas. In his speech, Clinton discussed the challenge of improving health care in the developing and developed world as well as the role pharmacists can play in bringing this improvement about.

Clinton noted that he now spends much of his time in developing nations such as Haiti and Rwanda working on projects under the auspices of the William J. Clinton Foundation, which he launched after leaving office in 2001. “Poor countries need systems that have predictable results,” he explained. The challenge in developing countries is to establish systems that work smoothly and deliver services that we take for granted in the developed world—services such as electricity, climate control, plumbing, safe drinking water, and transportation. In Rwanda, he explained, there are currently just over 600 doctors serving a population of over 10 million. The country’s health minister has set a goal of establishing 3500 new health clinics in the countryside, which would put everyone in the country would be within a day’s walk of health care.

In developed nations such as the United States, Clinton explained, the challenge is to reform systems to ensure that they perform the functions for which they were designed. “Once you build systems,” he pointed out, “they reach a point where they become too rigid … because there are too many people benefitting from the way things are.” This sort of rigidity in our health care system, he argued, has helped send health care costs rising at such a rate that many American workers have seen their wages stagnate for years.

Clinton suggested that pharmacists, who “are trusted by both parties in Washington,” have a golden opportunity to help make health care reform as effective as possible. “It’s really important that this group do whatever you can to make sure that we implement the Affordable Care Act properly, and if there are things that are wrong with it, both with what the law says or how the regulations come out, that you move as swiftly and aggressively as you can,” Clinton said. He also called upon pharmacists to “make sure that these magnificent advances in pharmaceuticals actually work to make people healthier and are coupled with changes in lifestyle.”

At several points in his speech, Clinton touched on the problem of prescription drug abuse. He referred to a recent New York Times article that reported that life expectancy continues to rise among all groups in the United States except non-Hispanic whites with a high-school education or less. Among the causes for this group’s decline in life expectancy were increased rates of smoking and obesity and a larger than average increase in mortality from prescription drug overdoses. Later, he noted that in the space of 10 days in late 2011, the 30-year-old son of his neighbor and the 28-year-old son of his close friend died as a result of combining alcohol and oxycodone. “You can help with this,” he said. “We simply cannot afford to continue to do things which cause human loss with medications that are supposed to alleviate pain and suffering.”

At the close of Clinton’s speech, ASHP President Kathryn Schultz, PharmD, joined him on stage for a question-and-answer session. In response to a question regarding how pharmacists can ensure that their skills are better utilized, Clinton suggested that they perform an exercise similar to one he undertook upon leaving office: Make a list of all the things that you would like to change in the health care system—for example, reducing hospitalizations, readmissions, and hospital-acquired infections—then scratch off the things that you can’t have an effect on and pursue the rest.

For her last question, Dr. Schultz asked Clinton which health care provider he would turn to with questions about his medications: a nurse, a physician, or a pharmacist? “And before you answer, Mr. President, remember that there are over 20,000 pharmacists here today,” she added, inspiring laughter throughout the crowd.

Clinton responded that he tends to address questions about his heart medication to his cardiologist, but that he brings many other questions to his pharmacist, whom he described as “a really smart guy.” “I talk to my pharmacist all the time,” Clinton added, “particularly about the interface, if you take a bunch of pills you need to be careful that you aren’t cancelling out or creating a problem that didn’t exist before.”

“That’s the right answer,” Dr. Schultz said, inspiring more laughter.

“It has the virtue of truth,” Clinton replied.