CVS may be a leader in health-care transformation

Adapted from Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com

Woonsocket-based CVS’s purchase of Aetna, the huge insurance company, could at least start to make fragmented and exorbitantly expensive U.S. health care a bit more coherent as well as cutting costs for consumers, both in medical-visit bills and insurance premiums. (We’ll see if that happens in our profit-obsessed system.)

Of course, other pharmacy chains and insurers will also tie the knot.

By putting together the insurance function and the direct provision of care, the merger will help create better, more complete patient medical records, thus facilitating better, especially preventive, care. And by helping to make many CVS drugstores even more of the primary-care/preventive-care centers that they’ve been becoming the past few years, the merger should take the pressure off astronomically expensive hospital emergency rooms, whose overuse is one reason that America’s health-care system is so expensive and inefficient.

Much of the treatment in CVS’s Minute Clinics is provided by nurse practitioners and physician assistants, who are less expensive than U.S. physicians -- the world’s highest paid. The American Medical Association has opposed the merger in part because it fears that the competition will cut doctors’ pay.

Importantly, the merger will strengthen CVS in negotiating with drug makers, which, protected by massive lobbying operations in Washington, charge by far the highest prices in the world – indeed sometimes engage in price-gouging. Those prices are yet another reason why health-care costs threaten to bankrupt the country.

(Happily, Trump signed two bipartisan bills into law last week to ban so-called gag clauses at the pharmacy counter. The bills, the Patient Right to Know Act and the Know the Lowest Price Act, would let pharmacists tell patients that they could save money by paying cash for drugs or try a lower-cost alternative. The existence of gag clauses was an outrage.)

We won’t know for several years what the full effects of the CVS-Aetna merger will be but it’s obvious that this experiment could profoundly affect many millions of Americans.

Will consumers benefit, as well as CVS senior executives and other shareholders?

Healthcare industry protectionism

From Robert Whitcomb's "Digital Diary,'' in GoLocal24.com

Guild-like protectionism has always been very powerful in American health care, which partly explains why our health costs are the world’s highest.  I was reminded of this in reading the May 7  Providence Journal op-ed column “Protectionism only hurts Rhode Island,’’ by Saya Nagori, M.D., an ophthalmologist and medical director of an online app called Simple Contacts. It’s a telehealth technology for glasses and contact-lens users.

She asserts in her obviously very economically self-interested piece, that “79 percent of the time that a contact-lens user visits an optometrist to renew a prescription, they are reissued the  exact same prescription….{But} mobile app platforms like Simple Contacts use technology to administer a basic vision test….{which} is recorded and reviewed by a Rhode Island  licensed ophthalmologist who can renew the patient’s existing contact-lens prescription’’ at far less cost that visiting an optometrist.

Of course, the Rhode Island Optometric Association sees this as a serious threat to members’ revenue stream and has filed legislation to ban use of this technology. It reminds me of the strenuous attempts by some physicians to keep CVS’s Minute Clinics out of Rhode Island (where CVS is based).  Minute Clinics are staffed by nurses, nurse practitioners and physician assistants rather than by considerably more expensive physicians.

But the protectionists will fail in the end. American health care is just too damn expensive and so more and more patients demand new options.