David DePalma

10/5/15
The Healthcare Conversation: Pharmacists vs. Politics
Pharmacists have evolved immensely from their original roles at the local apothecary.
Providing mysterious creams and elixirs under a shroud of witch-doctor type mystique, in
todays world, might arouse the attention of local authorities. Instead, todays professional
pharmacist may prepare medications in a hospital for patients in critical condition, fill retail
prescriptions for a whole community of good patients, or commit himself to research and
development as an integral part of a team of specialists. The options are limitless, yet
pharmacists must all rely on a community of professionals, providers, patients, and politicians in
their fight against disease. Community and communication are the ultimate factors in any
healthcare providers ability; no pharmacist would be able to provide adequate care without
reliable, peer reviewed knowledge from others. Furthermore, because pharmacists in the United
States operate under the supervision of the law, proper communication and interaction with
legislation is vital to the success of our healthcare efforts.
Before popping her fancy new pill or lathering her big toe in a pungent ointment, the
patient receives her strange drug from a pharmacist. Consequentially, the pharmacist is entrusted
with a certain duty to ensure the patient understands the medication she is using. For the field of
pharmacy, patient protection is of utmost value. Before this principle became the standard,
patients were sometimes subject to horrifying side effects from untested, dangerous medications.
Also for the patients betterment, an elegant, professional experience is an important component
of pharmacy. Professional behavior ensures the patient feels that his pharmacist is
knowledgeable, and cares for his well-being. Even the swirl in a jar of ointment shows the

patient that it was created with care. The prospect of discovering new knowledge is a principle
upheld by many, including myself. Although patient interaction remains a vital component of
healthcare, I am invigorated by the role of a pharmacist in a community of diverse scientists and
scholars, all dedicated to discovering new cures for the good of humanity. No matter what value
most motivates an individual, underlying each value is, ultimately, the life of a person; to defend
each patients life, pharmacists must be bold, scrutinous, and courageous on the patients behalf.
Yet while the recipe may call for a lion, often pharmacists play the part of a lamb. All too
often, pharmacists seem to fall into a quiet, complacent role. Perhaps quiet characteristics result
from the introverted nature of those who pursue a career in pharmacy, or perhaps complacency is
bought by high-paying retail pharmacies such as CVS/pharmacy. Retail pharmacists, a major
player and participant in the field, are often silenced by their corporate overlords with nontransparent corporate policies, and are unable to speak about on-the-job errors, as well as unfair
hours and policies. For whatever reason, the pharmacist has become the whipping-boy in many
respects. Although researchers and developers may not face the same issues from their superiors,
at the end of the day they must answer to their shareholders. Though no morally sound healthcare
professional would want the price of a drug to treat infections in HIV patients increased by
5,000%, Martin Shkreli, the CEO of Turing Pharma, did just that (Herper, 2015). The
pharmaceutical industry reserves, and practices, the right to increase their prices by arbitrary and
near-infinite amounts. As a future pharmacist, I feel motivated to be an advocate for issues such
as this. Examining the community of people involving healthcare, it is apparent that it will take
more than just pharmacists and healthcare providers to protect the well-being of patients. It is
even more important, then, that pharmacists must have a distinct voice in the healthcare

community so that they may provide their important perspective on the controversial issues that
permeate the field.
In terms of credibility, it is of the highest importance that those involved in pharmacy are
indeed experts in their field, that is, up-to-date on an ever evolving body of medical information
and discovery. For pharmacists per se, there are a variety of publications dedicated to addressing
issues that specifically involve pharmacy. The National Association of Boards of Pharmacy
(NABP) releases a brief monthly newsletter that strives to educate pharmacists on current issues.
Additionally, targeted at academic pharmacists is the American Journal of Pharmaceutical
Education (AJPE), a magazine outlining current research as well as other topics in their relation
to pharmacy education. Drug Topics, gives the reader a slightly broader view, and is targeted at a
broader audience, consisting of healthcare professionals involved in drug dispensing,
development, or pharmacy in some way. Databases too, such as AccessPharmacy provide an
even more in-depth, specific information, ranging from articles from peer-reviewed journals, to
published studies. Though these resources are all highly useful to professionals, one of the most
important participants in the field of healthcare, and specifically pharmacy, is the patient.
Not only is the patient the ultimate decider of what care he receives, but he is also a voter,
and a shaper of public policy. Therefore, any publication or piece of media that speaks to the
United States healthcare system is a player in pharmacys discourse community. From Fox News,
targeted at conservative Americans, to Time magazine, which could be read by anyone, it seems
that pharmacys discourse community is shaped by far more players than imagined.
One American business publication, Forbes magazine, is read by over 8.3 million people,
in addition to over 37.8 million unique website visitors each month (Forbes Media, 2015). It is
one of the most popular business publications in the country. Forbes magazine is a major

commentator on all things business, including the field of healthcare. With total United States
healthcare expenditure at 17.1%, or $2.86 trillion (GDP current US$, 2015), of our gross
domestic product, its no wonder that the Pharma and Healthcare section is a major section of
the publication.
Forbes.com is a cornucopia of articles and blurbs, with topics touching all facets of
business, including a section dedicated to Pharma and Healthcare. There is an abundance of
content, mostly written by contributors who have access to the same publishing platform as
Forbes's own journalists (Bartlett, 2013). Contributors are part of Forbes online platform. They
are not employed staff members, but are selected by Forbes to write for them. The vast majority
of articles on the website appears to be authored by contributors of variable background.
A search for the term single payer yielded many results including an article entitled
Single Payer Is Inevitably Hillary Clintons Unwise Fix For Healthcare. The author, Scott W.
Atlas, M.D., works as a researcher for the Hoover Institution of Stanford University on health
care policy and the roles of government versus the free market in access, pricing, and quality of
medical care, and served as Professor and Chief of Neuroradiology from 1998 until 2012 at
Stanford University Medical Center (2015). Dr. Atlas credentials are impressive, but his writing
seems to lack citation entirely. He claims that most Americans are opposed to [ObamaCare],
that ObamaCare is among the most expensive marketing campaigns in history, and that
Hillary Clinton thinks the authority in health care decisions should lie, all without citation of a
factual source. In Sally Pipes article Michael Moore Is Right: Obamacare Is Awful, But SinglePayer Would Be Much Worse (2014), she boldly states single-payer systems in other countries
arbitrarily ration care and yield health outcomes far worse than those in the United States,
without citing a source at all. Though it seems Forbes may have some level of scrutiny in

choosing their contributors, it appears that they offer a liberal amount of freedom as to the
statements contributors can make, a stark contrast to the standard level of scrutiny applied to
peer-reviewed medical journals, or other scholarly databases and sources.
Further scanning of the search results revealed a polarized body of opinions and little
diversity:
Single Payer Health Insurance: Why Bernie Sanders Just Doesn't Get It,
Obamacare's Lawless Rollout Cements Case Against Single Payer Health Care,
Michael Moore Is Right: Obamacare Is Awful, But Single-Payer Would Be Much Worse,
We Used To Call It Socialized Medicine (Conover, 2014; Goodman, 2014; Goodman,
2015; Pipes, 2014).
Buzzwords like cement, doomed, and socialized, stand out in the titles. While most of the
four articles listed were written by so-called contributors, one was written by a Forbes staff
member. Nearly all of the articles mention names of politicians. Many of the politicians listed are
2016 Presidential candidates. The language and tone of Forbes articles, even from the
beginning, paint a picture of the real views that the publication promotes.
The opinions of healthcare providers provide a distinct contrast from the predominating
opinions in Forbes. In a 2009 study of 1,675 randomly-selected physicians, only nine percent
preferred the current employer-based healthcare financing system. Forty-nine percent favored
either tax incentives or penalties to encourage the purchase of medical insurance, and [forty-two
percent] preferred a government-run, taxpayer-financed single-payer national health insurance
program (McCormick, 2009). In Drug Topics, articles predominantly support single-payer and
universal healthcare. An article entitled Why Pharmacists should endorse healthcare for all by
author Fred Mayer, RPh, MPH, provides a pharmacists personal viewpoint. In the brief article

he cites several statistics, and although he fails to include a complete list of sources, he does back
his claims up with real numbers and states he is motivated by healthcare for all citizens (2015).
Physicians, pharmacists, and many other caring healthcare providers, in general, see one thing
that Forbes seems to miss in almost every article; healthcare is about improving patient health,
and as a society, our system must revolve around healthcare for all of society.
Society, through pharmacy, needs free discussion and communication about the issues
that matter most in healthcare. Providers are limited in how much they can project their voices;
patients are vulnerable and need protection, and misinformation can be highly harmful.
Publications targeted at the public play a key role in the discourse community for pharmacy and
healthcare, as public policy is a key determinant of the abilities of healthcare professionals.
Countless pharmacists, healthcare providers, and simple concerned citizens want nothing more
than to protect the life of patients and people worldwide and will use all available information to
fight for that, but when money is involved, a greater crowd is drawn into the conversation, and
with that, a drone of questionable information.

References
McCormick, D., Woolhandler, S., Bose-Kolanu, A., Germann, A., Bor, D. H., & Himmelstein, D.
U. (2009). U.S. Physicians Views on Financing Options to Expand Health Insurance
Coverage: A National Survey. Journal of General Internal Medicine, 24(4), 526531.
http://doi.org/10.1007/s11606-009-0916-x
Atlas, S. (2014, March 28). Single Payer Is Inevitably Hillary Clinton's Unwise Fix For
Obamacare. Forbes.
Bartlett, R. (2013, September 26). The Forbes contributor model: Technology, feedback and
incentives. Retrieved September 28, 2015.
Conover, C. (2014, March 6). Obamacare's Lawless Rollout Cements Case Against Single Payer
Health Care. Forbes.
Forbes Media. (n.d.). Retrieved September 28, 2015, from http://www.forbesmedia.com/
GDP (current US$). (n.d.). Retrieved October 6, 2015, from
http://data.worldbank.org/indicator/NY.GDP.MKTP.CD/countries/US?display=graph
Goodman, J. (2014, December 29). We Used To Call It Socialized Medicine. Forbes.
Goodman, J. (2015, April 20). Single Payer Health Insurance: Why Bernie Sanders Just Doesn't
Get It. Forbes.
Herper, M. (2015, September 23). Even With Concessions, Martin Shkreli Still Gets A Massive
Price Hike For Daraprim. Forbes.
Mayer, F. (2015, May 10). Why pharmacists should endorse healthcare for all. Drug Topics.
Pipes, S. (2014, February 3). Michael Moore Is Right: Obamacare Is Awful, But Single-Payer
Would Be Much Worse. Forbes.