Managed Care - November 2008 - (Page 10)

LETTERS Nationalize it Re: “Reform — Does It Just Mean More Regulation,” October 2008. Milton Friedman said long ago, if health care is a right, it must be nationalized. It is a right. Ask any ER doctor. So a single-payer system will come. Thomas Allen Barley, MD North Vernon, Ind. Watch out for lawsuits! In your June 2008 interview with Barbara Starfield, MD, she forgets to mention the detrimental effects of lawsuits on our health care system. Any system avoiding lawsuits will be more efficient and resource-rich than ones possessing them. Yet beyond the efficiency argument is the fact that the lawsuits assaulting our system create exorbitant malpractice insurance costs. Sadly, areas of this country are left without health care because these prohibitive costs drive away the providers. This phenomenon is uniquely American, I believe, but alas I do not know for sure. Eugene Bigelow, MBA, RPh Clinical Staff Pharmacist Memorial Health System Colorado Springs, Colo. in the rates of office visits and telephone calls might occur. Yi Yvonne Zhou, PhD Manager, Analytics & Evaluation Kaiser Permanente Portland, Ore. Ask the pharmacist I am very tired of reading how prices will rise or fall because of a behind-the-counter drug class. Where are the articles about the patient being better served by such a class? How about the best outcome for the dollar and time invested for the patient? How about pharmacoeconomics? How about just plain health care efficiency? I have been out of pharmacy school for over 30 years, and I can still do a good job at what I studied and trained for — selecting the best drug for the patient. Who better to select the appropriate dose, strength, and mode of action than a pharmacist? The word art is significant, as it involves information gathering, interpretation, com mun ication, and decision making between the pharmacist and the patient. If only physicians knew how many times their prescriptions are not filled because the patient cannot afford it, the patient does not “feel” bad with high blood pressure or high cholesterol, the patient cannot take specific medications while on the job. Pharmacists have these discussions daily. We are here, patients have access to us, they trust us, and we have the knowledge. Use us. I have worked almost every aspect of pharmacy: in a large teaching/research hospital, in chains, in my own store, in a Two sides of coin Re: “It’s Time To Ask More of Utilization Management,” October 2008. I think the article is right on the money. Utilization management and quality improvement should function like two sides of the same coin, but they rarely do. Lori Stephenson, RN Director of Quality Improvement Rocky Mountain Health Plans Grand Junction, Colo. More data needed Re: “Help Members To Avoid a Part D Doughnut Hole Crisis,” October 2008. It would be helpful to know the profit margins, in percentage and actual dollars, for branded and generic drugs. Furthermore, members should know the administrative costs and the hassles with prior authorization. Subodh Kumar Mehra, MD St. Louis, Mo. E-mail advantage Thank you for the article “Kaiser’s EMR Push Pays Off ” in the June 2008 issue. This article describes the incredible EMR accomplishment Kaiser has achieved, and more importantly, it presents some impressive benefits of the EMR. In the article, you stated the 7 percent to 10 percent reduction in office visit utilization by using secure e-mail between patients and their doctors, which is one of the findings in a published study. I would like to underscore that the reduction in utilization occurred even though 63 percent of doctors were lowlevel adopters with fewer than 15 e-mail encounters a month. If more doctors encouraged their patients to use secure e-mail, even further reductions Issue gets complicated Re: “Plans Feel the Pressure to Vaccinate More Adults,” August 2008. Once again an issue as straightforward as preventing diseases through vaccines is complicated by the fragmented health care delivery system with complete lack of focus on the patient. Albert Durant Mims, MD Lake City, S.C. 10 MANAGED CARE / NOVEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - November 2008

Managed Care - November 2008 Editor’s Memo Contents News and Commentary Legislation & Regulation Letters Medication Management Compensation Monitor Do It Yourself for Less Biomarkers Promise, but Do They Deliver? Oncologists Complain About Drug Payment Consider Blood Pressure Self-Monitoring Q&A: Keep Industry in the Game Formulary Files Plan Watch Tomorrow’s Medicine Outlook Respiratory Syncytial Virus Managed Care Considerations Contents Continuing Education Objectives RSV Disease in the Pediatric Population In the Trenches RSV Infection in the Adult Population Health Plan Medical Director Health Plan Pharmacy Director RSV Issues and Solutions Assessment/Evaluation/Certificate Request Post-Test

Managed Care - November 2008

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