Senator seeks advice from pharmacy students, faculty concerning RI health care

04/21/09 - One of the many hot button issues facing the presidential administration is the health care system. With millions of Americans remaining uninsured, the problem of restructuring the broken system has fallen upon United States senators, including Rhode Island's Sheldon Whitehouse (D-RI).On Friday afternoon, Whitehouse came to seek advice from University of Rhode Island pharmacy students about the ongoing health care reform.

"We're headed for a pretty significant meltdown," Whitehouse said to the roundtable of 12 students and professors. "Health care is the biggest concern by far. It is a really, really grave situation."

He described the system as a "toolbox." The "toolbox" that needs to be created, Whitehouse explained, is one that builds an informational infrastructure, and focuses on quality improvement, interventions and wellness. The current American health care system, he said, is a "bloody, old toolbox."

In an eight to 10 year range, Whitehouse describes a "tsunami" of impending health care problems, with baby-boomers aging in significant numbers. With this oncoming wave of Americans needing health care, it is uncertain if the infrastructure of the current health care system will be able to handle this.

However, the government is looking into changing these outdated policies - a move which may create political strife.

"We're heading into the system, but we're going to relive all that political warfare," Whitehouse said. "Any time money is involved, politics is right behind."

Whitehouse is one of leaders working on the issue, along with a bipartisan group of fellow senators.

"He is actually involved in the debate as a role in the committee," Alex Swartsel, Whitehouse's spokeswoman, said. "He's held dozens of meetings with advocacy groups to talk about health care."

One of the first topics up for discussion between Whitehouse and the URI students was President Obama's summit, the White House Forum on Health Reform.

"I noticed there is an unfortunate absence of a voice from the pharmacy side," student Meaghan DeNobile said. "We can play a major role."

Professor Elaina Goldstein agreed. "It's critical to understand the pharmacist is part of the delivery team."

Whitehouse conceded that there was a lack of input from pharmacists concerning health care reform.

"The role of the pharmacy community in health care reform is nonexistent. Doctors aren't being listened to, either," he said. "If lawyers had as little a role in the decision, there would be fire and pitchforks."

The public's need for better education about health care was also a prime concern.

Whitehouse described a sliding scale of pharmaceutical use. Out of every person who leaves the doctor's office with a prescription, approximately 70 percent actually get the prescription filled at a pharmacy. Consequently, only about 44 percent will actually take the pill, and even a smaller percentage complete the full course of treatment.

This leads to the issue of pharmacists following up with patients, and potentially tracking the proper use of their pills.

"The public needs to be informed of the role of pharmacists," Dorich said.

The group also discussed the pros and cons of different states' health care plans. A model they agreed was worth looking into was North Carolina's, in which the pharmacists are closely involved in reporting information to patients. Ultimately, this lowers the cost and improves the quality of health care, Whitehouse said.

"Compared to the rest of the country, the northeast is far behind in pharmacy practice and, in some ways, health care," pharmacy student Nick Dorich said.

Whitehouse discussed some of the potential ideas put forth in the Senate about altering the system.

"An information technology platform is a given at this point," he said.

However, he warned the shift will not come easily.

"But the biggest and ugliest fight is going to be about the public option," Whitehouse said. This public option would be an insurance policy, financed by taxpayers but managed by the government, which would be open to everyone. "If that gets subsidized by the government, the insurance companies can't compete with it."

Overall, the URI College of Pharmacy seemed appreciative of Whitehouse's effort to hear their concerns about the reform.

"I thought he gave us a good understanding on where he was coming from, and open to hearing us," Goldstein said. "He was the one who called here, to come here. He's opened up the door for further discussion.