Joe Ganley, McKesson's VP of Federal Government Affairs, shared his insights about the policy climate today with independent retail pharmacists at a customer event in July. His remarks have been edited here for clarity.
Willie Sutton, the prolific American bank robber, was quoted as saying: “I rob banks because that's where the money is.” Well, I am a health care lobbyist because that's where the government is.
We know the decisions made by policymakers in Washington and in state capitals across the country have a profound impact on our industry. The federal and state governments are perhaps the largest consumers of health care in the country and health care makes up nearly one quarter of U.S. federal spending, it's 17% of our GDP. So it's not hard to understand why policymakers devote so much attention to the health care industry.
There is the ongoing debate about whether the government is too involved in health care or not enough, about whether we spend too much on health care, or not enough. But that's not the point. The point is that the government is involved in health care and it's going to continue to be involved in health care.
We can choose not to be interested in government and politics, but government and politics are interested in us. Withdrawing, or being angry or frustrated won't make them go away.
Wayne Gretzky, hockey all-star, once said “I skate to where the puck is going to be, not where it has been”. Well I grew up as a hockey player and I can tell you that the only thing worse than skating to where the puck has been is to stand flat-footed and wait for the puck to come to you.
As business people, we can either passively accept the policy and regulatory climate that comes our way, or we can get involved and try to do something about it.
At McKesson, we track thousands of pieces of legislation, and regulations affecting our business and our customers. On pharmacy issues alone, we are working to implement the national traceability law, expand the scope of practice for pharmacists, support the “any willing provider” legislation and ensure that pharmacists are paid adequately and fairly for the drugs that they are dispensing.
Alone we can do so little, together we can do so much.
One of the remarkable things about health care is how often policy debates can devolve into a zero sum game pitting one part of the industry against the other. Payers vs. providers, doctors vs. pharmacists, payers vs. drug manufacturers, large hospitals vs. small hospitals, community pharmacists vs. retail chain pharmacies.
When we allow these siloed debates to divide us, not only does it mean somebody wins, and somebody loses but we all lose. The people who end up winning are the cynics who don't want to see any progress at all.
We have to rise above our narrow financial interests and work together to support each other and advocate for the policies that are good for the health care system as a whole, and good for patients.
Let me give you just two examples:
Scope of practice
We can argue that it's unfair that physicians are being overpaid for basic health care services that could easily be done by a pharmacist for less money, and more conveniently for patients.
But to make the argument that way is going to end up with the doctors being pitted against the pharmacists. Instead, we need to make the case that at a time when there is a significant shortage of primary care physicians, and dramatic expansion of coverage, we need to provide safe effective, convenient ways for patients to access care.
Pharmacists are some of the most well trained, yet underutilized professionals in the health care system, and we should be leveraging their expertise to help patients become healthier.
Controlled substance abuse
We know there is an epidemic in this country of substance abuse, and it's easy to say it's the doctor's fault or it's the pharmacists fault, the wholesaler, the manufacturers or maybe even the government. But wouldn't it be more productive to get together and work on a solution instead of being pitted against one another.
That's what's happening now. In Washington, community pharmacists' lobbyist, chain drugs stores' lobbyists, folks representing the chronic pain community and providers' representatives are making progress on legislation that will hopefully bring all of us together with the government to be better positioned to collaborate on a solution to this problem. It's only a first step, but we're making progress because we're engaged and working together.
So, what do Willie Sutton, Wayne Gretzky and Helen Keller have in common?
They teach us that the government is involved, that we need to be involved, and that if we're involved together, we can make a positive difference on the policy climate for our industry.