Are the FEDS laying the ground work for Obamacare?

For decades… BTC (Behind the counter) class of drugs … or Pharmacist only class of drugs.. have been discussed. It is being thrown out there again… We all know that gross expenditures are going to go thru the roof… if Obamacare is implemented… and while the idea of “death panels” have been toss around… and of course denied… it is hard to deny that some sort of rationing of care and/or long waits to get medical care.

If Obamacare is rejected by the Supreme Court… I think that we will see Congress move toward lowering the Medicare age where people can “buy in” to Medicare A/B/D. With some sort of premium supplementation for “low income” families… and/or could we see a increase in the income to become eligible for Medicaid … or create some sort of  “buy in” or “spend-down” to participate in Medicaid.

In this author’s opinion… we are headed toward some sort of “national coverage”… more of a piecemeal structure… rather than a monolith like Obamacare

The list of drugs that are being tossed about for the BTC status.. is quite extensive… Could the FEDS and the insurance industry trying to address the above issues about rationing , gross expenditures and long waits…

Are we moving to a more patient centric self-care model… expecting the patient to be more self-reliant and more self funding… In all likelihood the BTC drugs will not be covered by insurance…. Could the new Walgreens format – “Pharmacist out front” be a prototype for where we could be going… Looking at the pictures of such configuration… how is a Pharmacist going to observe HIPAA compliance?

There was a recent study where patients with chronic conditions – like HTN … where normally only 33% are complaint three years after being diagnosed… this study… provided the pts with the medication for these chronic conditions at NOT CHARGE — NO COPAY… while compliance did increase… BUT… 50% still remained non-compliant.

Whose believes that making the patient more responsible for self-care… is going to do much positive in disease prevention or disease management. Could we actually cause the system higher cost for acute critical care… because pts have failed to “get on board”.

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