Lee B. Tolbert, President & CEO
West Philadelphia Coalition of Neighborhoods & Businesses 

The health-care reform debate continues to focus on improved access to care and providing the highest quality care at the lowest price. In tough economic times, many ideas that appear to save money in the short term may reduce the quality of care and lead to sicker people and greater costs in the long run.

Case in point: the state Department of Public Welfare plan that would "carve out" pharmacy services from the managed-care organizations and take over providing benefits for about 1.2 million Medicaid patients enrolled in these managed-care plans, almost half of them children.

This proposal, which the Legislature has already defeated three times, could reduce access to care while taxing our already overburdened system. Although DPW claims it can provide the same level of care while saving taxpayer dollars, until I hear some details, I'm not convinced.

DPW will have to address some critical issues if it plans to assume this "new" responsibility. Will focusing only on saving money negatively affect the quality of care these clients receive? Will DPW hire enough people to do the job right? How will these inexperienced employees deal with the often complex medical needs of the Medicaid population?

The managed-care organizations provide a continuum of care in a comprehensive and coordinated system that would be badly fragmented by carving out pharmacy services.

They also save tax dollars through a greater use of generic drugs and, because patients are healthier, they require fewer overall prescriptions. And the reason for the carve-out may be moot by fall since President Obama is proposing to let Medicaid plans get the same drug rebates that state-run programs do.

This proposal has already gotten three strikes from the General Assembly. Clearly, there are others who have unanswered questions.

Philadelphia Daily News