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In her address to Amnesty International, Harvard graduate and award- winning author Margaret Atwood once warned, “Powerlessness and silence go together.”1 Likewise, President John F. Kennedy once stated, “There are risks and costs to a program of action. But they are far less than the long range risks of comfortable inaction.” If their assertions are correct, then why are so many of us content to sit back and let others carry the banner? Is it because we as pharmacists and healthcare providers are disinterested? Or do we think that the responsibility for change and advocacy rests with our employers or our professional associations? Perhaps we believe that the current status quo, including job security and a predictable paycheck, will continue to endure.
Team-Based Care is the type of fulfillment HR 592 set out to achieve, not technically increasing pharmacists’ scope of practice, but fulfilling it in a very curious way. Despite the extraordinary diversity in their makeup, all interprofessional provider teams share the quality of overcoming barriers to any provider’s scope of practice. Each team is defined by the patient’s needs.
HR 4190 is awaiting passage in Congress with importance to pharmacists, but not for its provisions, which would have little effect on most pharmacists. This segment addresses the strategic factors underlying the rhetoric about HR 4190. For it has been positioned by the American Pharmacists Association (APhA) and the Patient Access to Pharmacists’ Care Coalition (PAPCC), as part of an agenda of expanding pharmacists’ scope of practice, which merits keen understanding.
HR 4190 is a short legislative pharmacy bill that deserves a long look by retail pharmacists. Its significance rests not in its immediate provisions, but in what it is related to and what it suggests.
I recently attended the back-to-back American Pharmacists Association (APhA) and the Academy of Managed Care Pharmacy meetings. I was especially pleased to see the thousands of attendees, and encouraged by the energy and enthusiasm for the pharmacy profession at both meetings.
The US healthcare system is plagued by high costs, variable quality, and limited access to care. The passage and enactment of the Patient Protection and Affordable Care Act was facilitated by the transition of focus from quantity to the provision of high-quality, interdisciplinary care, and prevention of costly diseases. Prevention requires a focus on public health and population-based care. The Institute of Medicine defines public health as “fulfilling society’s interest in assuring conditions in which people can be healthy.”
In our last 2 issues, I focused on the turbulent times of health insurance coverage and the enormous impact it would have on the retail pharmacy landscape and the consumer. Indeed, the predicted difficulties did, in fact, happen.
In our inaugural issue, I talked about our US healthcare delivery system bracing for a sea change in 2014. Well, it turns out my column for this issue will be no different, except that more changes have now been implemented as a result of the rocky rollout of the Affordable Care Act (ACA).
According to the Centers for Medicare & Medicaid Services (CMS), about 1 in 5 patients receiving Medicare who are discharged from a hospital are readmitted within 30 days.
As the Wall Street Journal reported last month, Walgreens, the nation’s largest drugstore chain, in a drastic effort to curb the escalating costs of providing healthcare, plans to move more than 180,000 of its workers—and their families—into an online private insurance exchange.

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