Pharmacy/Medical – 2015
by – Sheri de Grom
A rural pharmacy, along with a bank, grocery combination dry goods store and post office anchored small towns that were the backbone of America for decades.
Four-hundred-ninety rural pharmacies closed their doors forever between the years 2003 and 2013. This is a significant loss considering the average age of a farmer/rancher today is 65 and over.
There are approximately 6,700 independently owned rural pharmacies operating today. In addition to providing prescription and over-the-counter medications and consulting about their proper use, these pharmacies offer other essential health care essentials. These include: blood pressure checks, diabetes counseling and immunizations.
Often, these rural pharmacies serve as a gathering place for community citizens to meet and chat. Local news is discussed and the drugstore (as it’s often called) is the only social contact for many rural and small town residents. These individuals do not, as a rule, depend on social programs or government programs to provide their needs. They find out what their neighbors (30 and 60 miles apart) need help with, and that help is provided with nothing asked in return. This may include nourishing meals provided, fences mended and providing rides to wherever the individual may need to go. Normally, these rural communities make every effort to take care of their own.
Medicare Part D makes it more and more difficult for the independent rural pharmacist across our nation to serve the customers who’ve always depended on have coverage of some kind. This population is proud. They grew up and moved into adulthood during the great depression and they made it ‘then’ and they are determined to make it ‘now.’
Rural independent pharmacies have been at the mercy of two major Medicare policies related to payment for prescription medications.
The Medicare prescription drug discount cards (introduced January 1, 2004) were offered by Medicare-approved private companies (primarily large pharmacy chains and insurance groups).
The Medicare prescription drug benefit introduced (Medicare Part D, began January 1, 2006) and makes prescription drug coverage available to everyone with Medicare. [This statement is true if the individual can afford the premiums for Medicare Part D, have the income to cover the co-payments for prescriptions and are able to survive the doughnut hole when the insured must pay the full price of their prescription.
With the implementation of Medicare Part D came increased administrative efforts, payment timeliness and low reimbursement levels. Independent pharmacies cannot compete with the large chain stores.
Residents of communities that have lost their only pharmacy may adapt by driving farther to another pharmacy, using mail order, or obtaining courier service from another location, but access is always a concern for anyone with limited mobility.
With the advanced aging of rural America exacerbating the gutting of downtown America by Wal-Mart, independent pharmacies have rapidly become just another empty storefront town.