Insurance Changes Create Issues for Everyone

    After working for a couple years in a retail pharmacy, one of the most common issues I see that creates a barrier to care is insurance changes. Anyone who has worked in a retail pharmacy can easily identify the beginning of the year as being the most challenging when it comes to getting prescriptions covered for patients. This barrier can be seen in many different forms. For example, at the beginning of the year many people get new insurance plans, but don’t always have the processing numbers needed in order to bill the insurance for a prescription. In other cases, they might keep the same insurance or switch to a new one but a drug they consistently take is no longer covered. Even if a patient has the correct numbers and their medication is on the formulary, sometimes the deductible at the beginning of the year is so high that they are unable to afford their medications. This is further complicated in young adults who may still be on their parent’s insurance plan but are now responsible for taking care of their own health. Oftentimes changes in their access to medications aren't always communicated to them, so they are at a loss when it comes to how to get their prescriptions. These issues and others can also arise throughout the year especially since insurance is tied to employment for many people. When the insurance holder of the family loses their job, the entire family can face the consequences because they all will lose their coverage. This can be recovered if someone else in the family can provide coverage, but this again creates an insurance change. These issues create barriers for the patient to access care as well as creates stress on the health system because more time is spent on resolving issues.

Universal healthcare and a single payer system, or at least reducing the differences in insurances, may improve access to care and simplify processes in healthcare (at least in retail pharmacies). Reducing differences between insurances to any degree could prevent extreme unexpected changes that prevent care. If this progresses further so there is only a single payer, then everyone can know what to expect and there wouldn’t be changes in care. This would also be beneficial because insurance wouldn’t be tied to employment so everyone can have access. This change would of course create new problems for the healthcare system. If everyone now has access to care and financial burden isn’t an issue, the system may be overwhelmed with needs. Maybe this would put patients and the health system back to where we started with barriers and stress or maybe this would allow for new job opportunities and technology advancements to make up for the extra needs. Either way, we know that the current system doesn’t work as well as it should, so it wouldn’t hurt too much to make changes.