The law of unintended consequences strikes again

One hopes this will be a cruel April Fools’ joke, but for many on the Eastern Shore it may only be a cruel reality.

Delegate Christopher Adams shared the bad news:

United Health Care has decided to dramatically narrow their network of pharmacies on the Eastern Shore effective April 1st. This new decision will cause residents to drive upwards of 30 miles to get a prescription filled and be the end of the local pharmacy.

It appears that this is another one of those “hidden” consequences of OBAMACARE and Gov. O’Malley’s decision to make Maryland first with implementing OBAMACARE.

Nevertheless, driving 30 miles to get a prescription filled by one of the State’s “favored” pharmacists is wholly unacceptable. I am meeting with United Health Care tomorrow in a first step to ultimately reverse or greatly modify this decision.

According to a source in the know, the Maryland Department of Health and Mental Hygiene sets the criteria for considering a patient to be “covered” and it depends on their location, stating,”as long as pharmacies are within 10 miles in urban, 20 miles in suburban and 30 miles of patients in rural communities the standards for access to care are met.” So if you are in a town like Crisfield, where the nearest “chain” drugstore is the Rite Aid in Princess Anne or Pocomoke City – each about 20 miles away – you are “covered” but it’s not nearly as convenient as a local independent pharmacy. On the Lower Shore stores of the big three chains (CVS, Rite Aid, and Walgreens) are only found in Berlin, Cambridge, Delmar, Ocean City, Pocomoke City, Princess Anne, and Salisbury. It leaves large coverage gaps in rural areas which may have a pharmacy no longer used for the Medicare programs.

Obviously United Healthcare can choose whoever they want to be in their networks. But the problem with the health care system we are slowly, surely, and not necessarily willingly adopting is that cost is the primary consideration, not patient care. It’s been true ever since we’ve had a third party paying for our medical expenses, but it wasn’t so long ago that we had many more options for our care. Those days are now over as some former providers have left the state, leaving us with fewer from which to choose.

What Adams points out is that Martin O’Malley’s decision to jump right ahead with a fairly restrictive state exchange is now making life more difficult for the people it was supposed to help. Obviously there’s a lot of recovery needed on a national scale just to get back to a system which most were satisfied with, even though some chose not to participate by not purchasing health insurance and some could not afford it. Now while everyone is supposed to have health insurance (or pay a tax penalty) we find that care is even more expensive and difficult to obtain.

Chris isn’t going to get a lot of answers, I’m afraid, because it appears the die has been cast. And as a state legislator his impact on the national argument is small. But even if some of the independent pharmacies in under-served areas are added back in, it would be a step in the right direction. There may be a chain drugstore on every corner in Salisbury, but some of the smaller towns still cling to their local drugstore because it’s a sufficient size to cover the small market of a little village.

Thirty miles is a long way to go to get a prescription. That may be necessary for a need late at night or on a weekend, but for most refills and common items it shouldn’t be a requirement.