Lest We Forget

Thomas Ricketts Newfoundland War Hero - Pharmacist

 Read some of the history PRESS HERE  and HERE and HERE
 

Please take the time to remember those who fought for our freedom.

Please take the time to remember they fought without thought for themselves.

Please take the time to remember those who serve our country now.

Please take the time to remember all who have sacrificed for us.

Please take the time to remember - take the time to stop and reflect - take the time for them.

Lest We Forget

Deceptions of the Dunderdale Government - an Example

As complicated as the pharmaceutical business is - there are some very simple concepts.

Unlike Doctors who have a billing code a pharmacist does not.

The pharmacy - the business - has the billing code for community pharmacy services.

The government is one of many insurers that offers its clients a card to use at a pharmacy.

A pharmacy can choose to accept or reject any insurance card.

The pharmacist does not decide that administrative and business decision.

CICPO is a duly incorporated not-for-profit trade organization that represents its member companies.

As such the CICPO negotiates on behalf of its businesses with insurance companies.

When a tentative agreement has been reached - the members of the CICPO vote on the agreement.

If a majority of members vote in favour of the tentative deal - then each corporation must separately sign an agreement with the insurer. This is a tariff agreement which outlines the amounts that will be paid to the pharmacy for acceptance of that particular drug card. Amounts include a dispensing fee, any specialty fees, mark-ups etc.

At all times the agreement reached is between the insurer and corporation - not a pharmacist.

In Newfoundland and Labrador you DO NOT have to be a pharmacist to own a pharmacy. Wal-Mart, Lawton's, Shoppers, and independent pharmacies can be owned by shareholders who are not pharmacists.

A pharmacy must employ a pharmacist as part of a staff in order that the pharmacy can conduct business.

A Pharmacy has the following expenditures:

1. salaries; CPP - EI - Workers Compensation - Benefits Package,
2. mortgage, lease payments, building maintenance,
3. light and power, Oil, or other energy,
4. taxation - federal, provincial, municipal,
5. security systems,
6. refrigeration,
7.specialized computers - software,
8. consumables such as pill bottles, special packaging, paper,
9. communications, telephone, facsimile, and other,
10. shipping - delivery costs,
11. inventory - medications - both prescription and over the counter drugs,
12. accounting - legal - professional services,
13. snow clearing, paving, property external maintenance,
14. carrying costs (significant when you accept an insurance card and wait up to two weeks for payment),
15. working capital,
16. operating licences,
17. garbage storage and removal,
18. delivery - vehicle maintenance - gas,
19. banking fees,
20. and other normal expenditures of businesses in the service and retail sector.

Not one of the above is the responsibility of a pharmacist.
The pharmacist is an employee of the pharmacy.
If a pharmacist is not working in a pharmacy, they work for Universities, Governments, Hospitals, insurance companies and pharmaceutical manufacturers.

The pharmacist is an employee.

The government of Newfoundland and Labrador wants pharmacies in the province to administer the provincial drug card. It like all other insurers is asking that their clients have the convenience of simply presenting an insurance card for payment of prescriptions drugs.

The pharmacy has the right to accept that card for payment or to reject it - in preference to immediate payment by the customer. This is the same for all businesses - including other essential goods such as groceries, furnace oil, light and power, or telephone.

The government of Newfoundland and Labrador chooses to negotiate with the Pharmacists Association of Newfoundland and Labrador - an organization that is responsible to represent all pharmacists - regardless of where they are employed. The organization is NOT a trade body and pharmacists not pharmacies are the only entities eligible to vote.

Therefore the government of Newfoundland and Labrador is negotiating with employees not the corporations it wishes to conduct trade with.

The CICPO members - all corporate - are not willing to have employee pharmacists negotiate a corporate contract on behalf of the company. The CEO's of the corporations represent the business interests - not the pharmacists - not the employees.

Making matters worse the vast majority of pharmacists in PANL do not have a shareholder interest in private sector pharmacies be they publicly traded or private.

The vast majority of voting members of PANL are employees and have nothing whatsoever to do with running a business or any responsibility for paying the bills of a corporation.

Pharmacists receive a paycheck and benefits from their employer - the pharmacy.

How can this professional organization (PANL) that has the mandate to represent pharmacists as employees also represent the employer - the corporation? How can this same organization claim to represent business when the business has not given express written permission to negotiate anything on the companys' behalf?

Is PANL going to go to the bank for these corporations and seek an interest rate for borrowing? Are they going to negotiate with wholesalers and manufacturers on their behalf? No they cannot and do not. Why then does this organization continue to claim to represent business? That is ethically wrong. It is materially wrong. PANL can say that government is negotiating with them - but PANL cannot claim to be negotiating for any business without the express written permission from the corporation.

The Government chooses to negotiate with PANL - when they have no authority to make decisions on behalf of the business. PANL does not bind a corporation.

Even under the farcical negotiation process with PANL - a "deal" was reached with government which is not binding on pharmacy - and not one corporation was asked to ratify such a "deal".

The CICPO pharmacies were not satisfied with a process which could bankrupt them - without a say - without any control - so they sent a formal notice to the Minister of Health that they would no longer accept the drug card for payment. This is a normal right of all businesses.

The notice was filed in accordance with the Provider Agreement between each pharmacy and government. All insurance companies and pharmacies operate under a "provider agreement" which outlines the rights and responsibilities of both parties.

The provider agreement between government and pharmacies required a 30 day notice for withdrawal of acceptance of the "card" as payment.

Upon that proper notification which was signed and delivered by over 60 individual corporations - the government decided to change the rules. The Government unilaterally changed the 30 day notice to 120 days and also added a condition that all patients that have been in the pharmacy within the past year were to be notified in writing - individually.

Further our members were threatened with disciplinary action and summary convictions if the "new" "immediate" changes to law were not followed.

We remain in the courts with that issue.

Now let's take the absurdity a step further - PANL which is supposed to represent pharmacists as a profession regardless of where they are employed do not actually negotiate any contracts for pharmacists!

The hospital pharmacists are represented by their union.
The University pharmacists are represented by MUNFA.
The government pharmacists are represented by their union.
Private sector pharmacists negotiate with their employer - the private pharmacy, drug manufacturer, insurance company etc.

All of the above pharmacists are voting members of PANL who are then trying to negotiate on behalf of private sector corporations!

We have a total conflict of interest. We have employees through PANL negotiating on behalf of businesses - most of whom have no risk whatsoever.

If a pharmacist has a problem with their working conditions or scope of practice or workplace health and safety - PANL is their representative. How then does PANL represent the employer?

There are no examples of this in any other sector.

The government is simply trying to force business to administer their social program at whatever they deem fit to pay for that administration. They can in fact put the business out of business without the private corporation having any control of their investment.

The government uses PANL as the path of least resistance knowing full well this is not would not be acceptable to any other corporation the government does business with.

When the government used Danny's old law firm to participate in the lawsuit against tobacco companies - the law society did not determine what the firm had to do the work for. Legal aid lawyers do not decide what hourly rate is charged by the law firm Minister Jerome Kennedy used to be a partner in. Tom Marshall did not allow government or a professional association to set his private legal rates.

Their law firms are not FORCED to do legal work for government at whatever rate of pay the government deems fit.

This is a pure deception - and the larger chain drugstores and mass retailers who have the individual ear of government when they employ lobbyists are happy enough to let their competition be slaughtered by government policy - when they publicly state they will be there to pick up the scripts when the more "vulnerable" independents fail. As for rural areas? They would be happy enough to mail the drugs if the local pharmacy disappears. Who cares about urgency, snowstorms, equal access, and rural communities? Good question.

The bottom line is government chooses it's people to sit at a table and then proceeds to dictate who sits on the other side. This is deception. This is dealing in bad faith with the corporations they want to do business with. Most importantly they are placing in jeopardy the equitable delivery of necessary medications to the most vulnerable in our society.

Prestigious National Award for NL Business Owners

CICPO Wins Prestigious National Lifetime Achievement Award

Celebrating Newfoundland and Labrador professionals and business owners on the National Level.
Read the full story: PRESS HERE

Good Morning MHA's - NEW POLL HEALTH - NL Dead Last

Good Morning to our MHA's - and after another long night of debate let me give you some Carnation Breakfast to wake you up.

Secondly - I better get this information out before Steve Kent shuts down the House or perhaps all documents are barred by Bill 29.

So Vickie Kaminski is headlined in the Telegram today "Best way to gain confidence is performing well".

Read this NEWS

Star exclusive poll shows Saskatchewan most satisfied with health care, Newfoundland the least

If you live in Saskatchewan, chances are you’re pretty satisfied with health care. In Newfoundland — not so much.

And in Ontario, you’re happy with family doctors, but much like the other provinces, you feel emergency services could use some work.

A new poll exclusive to the Star shows wide-ranging satisfaction with health care across the provinces, with Saskatchewan, Manitoba and New Brunswick scoring highest, and Nova Scotia and Newfoundland falling behind.

In Saskatchewan, 26 per cent of respondents were “very satisfied” with health care, and in Manitoba and New Brunswick it was 25 per cent.

In Newfoundland, only 10 per cent were very satisfied, followed by 13 per cent in Nova Scotia.
“Saskatchewan, which is sort of the birth place of medicare, has the highest satisfaction ratings with health care,” said Lorne Bozinoff, president of Forum Research, which conducted the poll.

“Then it varies considerably across the country.”

Bozinoff attributed the low overall score in Newfoundland to a shortage of specialists, such as cardiologists and pediatricians, and poor ratings for laboratories, possibly due to lack of access.
“That’s probably driving the dissatisfaction, the low satisfaction numbers, in Newfoundland overall,” he said.

A total of 75 per cent of respondents in Manitoba, 72 per cent in New Brunswick and 71 per cent in Saskatchewan were either very satisfied or satisfied with health care. In Ontario it was 66 per cent.
The survey found Ontario is above average for satisfaction with family doctors, specialists, diagnostic labs and hospitals, but fell behind the average on pharmacists and dentists.

The most highly rated health-care service in the survey was pharmacists, with an average of 63 per cent of respondents saying they were “very satisfied.” In Quebec, it’s 71 per cent, but in Ontario it’s 58 per cent.

The lowest satisfaction ratings went to walk-in clinics and emergency room services, which scored a national average of 21 per cent and 14 per cent, respectively.

Emergency services were the poorest received across the country. In Ontario 17 per cent of respondents were very satisfied with the emergency room, while Saskatchewan was the only province to top one-fifth of respondents. Newfoundland, Quebec and Manitoba ranked lowest at 9 per cent.
Hospitals scored highest in Prince Edward Island at 31 per cent, followed by Ontario and Saskatchewan with 26 per cent each. Newfoundland was last at 8 per cent.

Satisfaction with walk-in clinics was also highest in P.E.I. at 28 per cent, followed by Nova Scotia and New Brunswick at 24 per cent.

Family doctors were best received in Ontario and Saskatchewan, with 40 per cent of respondents very satisfied. The lowest scores go to P.E.I. at 29 per cent, and Newfoundland and Alberta at 32 per cent each.

In general, the survey found Canadians over 65 were more satisfied with hospital services, walk-in clinics, family doctors, pharmacy services, dentists and emergency services.

The poll results are based on an interactive voice response telephone survey of 3,932 randomly selected residents aged 18 or older across Canada. It was conducted on May 30-31st, 2012.

Results based on the total sample are considered accurate, plus or minus 1.56 percentage points, 19 times out of 20.

CICPO and Blue Cross Reach New Agreement

Continuing to build on a good partnership - promoting best health outcomes resulting in controlled costs the Council of Independent Community Pharmacy Owners and Medavie Blue Cross have reached a new agreement.

This agreement comes at a time when independent pharmacy revenues are being eroded by changes to generic drug pricing at the governmental level. “We are pleased to see Medavie Blue Cross participate in a process of real negotiation and meaningful recognition of independent pharmacy in Newfoundland and Labrador,” says Director of Third Party Relations CICPO, Phil O’Keefe.

To read complete release PRESS HERE

This type of industrial cooperation will achieve the best results both from a fiscal and health perspective. Positive negotiations that recognize the needs of and objectives of both sides - prove consultation and collaboration work in an arena of respect.

Will Dunderdale, Ball, or Michael investigate? $$$$ LOST!

We have now entered a time-frame industry people like to call the Patent Cliff.

Over the next 5 years residents of Newfoundland and Labrador as with all other jurisdictions in Canada and the USA should experience an extreme reduction in the price of essential commonly prescribed medications.

As these new generics enter the marketplace - our government should act immediately to replace the brand drugs on our formulary. This will save us tens of millions of dollars.

Unfortunately we still have a secret committee determining when our tax dollars will be used wisely.

If you can buy the drug in New Brunswick, Alberta, or Ontario - why not here in our province?

Why are our hospitals permitted to dispense drugs that our retail pharmacies cannot?

Why does our government pay brand prices when savings of 40 per cent and more are available?

Sue's Blog will layout some of the financial losses our government has allowed of our essential health care dollars.

We also need to discuss and understand if there are any potential conflicts within the secret committee that answers only to the Minister - and NOT the House of Assembly. We need to know if any member of the committee has any dealings with the drug companies - outside of the committee - and whether those dealings are commercial in nature.

Is it possible that any committee members - who have the power of recommendation to the Minister of Health - could use that power in commercial dealings?

Do the Brand Drug Houses lobby any of the committee members - in any way whatsoever?

You see something is not right here. We are losing tens of millions of dollars and nothing is being done about it. Sound Familiar?

Open and Transparent - right? Public Accounts - spending our money wisely right?

Where is the investigative journalism? Where are the NDP members on this - they are the champions of health care right?

Loss of Millions $$$ from Health Care - Secret Committee

Do you want to witness wastage of our health care dollars?

An open request to the Auditor General: Please review the workings, processes, and results of the interchangeable drug review advisory committee.

This committee consists of individuals appointed by the Minister of Health and must comprise of 2 pharmacists, 2 physicians, the Deputy Minister, and other persons the Minister may wish to appoint.

When a drug comes off patent and generic equivalents are made available - this committee reviews submissions by generic drug companies to have their products listed on our formulary. These drugs which range between 50-60% of brand price have the potential to save tens of millions of dollars a year.

First you must understand that in order for a generic to be permitted for use in Canada - Health Canada reviews the scientific data and confirms that the generic is safe. Once that has occurred any pharmacy in Canada can purchase the drug and dispense it under various private insurance plans and cash paying customers. In fact these new generic equivalents are almost immediately available in our hospitals - and quite often are dispensed to a patient when in hospital - only to be unavailable at a retail pharmacy when they are released.

Newfoundland and Labrador is notoriously slow to list many of these generic equivalents as they become available. This money is wasted and over the years the tens of millions could be hundreds of millions. In some cases one month delay equals over $100,000 loss of health care dollars.

So how is it that other provinces in Canada are dispensing a generic equivalent under publicly funded drug cards and hospitals in our province are dispensing this same drug - but this "committee" has not cleared it for retail pharmacies - costing us tens of millions of dollars?

The review committee sits in private and the deliberations are secret. The minutes are not available to the public.

Will the media attempt to find the answers to this gross wastage of health care dollars? Will the Auditor General review this situation and report to the House of Assembly what is going on?

Will the Opposition parties step to the plate?

This is a serious and ongoing issue - that is being kept from public scrutiny.

Pharmacists' Awareness Week 2012

Please visit the Newfoundland and Labrador Pharmacy Blog as the Council of Independent Community Pharmacy Owners recognize their valued employees during Pharmacists' Awareness Week.

Press HERE

Talk Newfoundland and Labrador - A show with Purpose for People not Politicians

Please join Shannon Reardon and I tonight on Talk Newfoundland and Labrador. Press HERE

Tonight we talk about pharmacy.

Available during the program is Todd Squires Pharmacist and owner of St. Mary's Pharmacy.

Topics to be covered:

1. What's happening with Pharmacy in Newfoundland and Labrador and Canada.
2. Medication and disease management.
3. CETA
4. Generic versus Brand
5. What is CICPO
6. Collaborative Care
7. Wastage in the Newfoundland and Labrador system.
8. Conflicts in the system.
9. Rural and inner-city pharmacy.
10. Your questions - your concerns - your points.

Press HERE to join the show at 8 pm tonight.

"Talk with Sue and Shannon" takes on Pharmacy Issue this Sunday

Listen to "Talk with Sue and Shannon" Newfoundland and Labrador's newest talk-show this Sunday evening at 8 pm NL time as we explore the pharmacy issue.

There will also be a pharmacist/owner on hand to answer questions about the independent pharmacy model, medication and disease management (diabetes, cardiac, asthma, and other chronic disease), pharmacy services, the court challenge, other provinces, generic drugs versus brand name, saving money for government and patients/customers and the role of pharmacy in the future.

Find out where there are inefficiencies in the government system that are wasting tens of millions of taxpayer dollars.

Please take the time to listen in and become involved in this area of front-line health that affects you, your family, and community.

To take in the show please PRESS HERE

Canada taking Notice of Pharmacy Lawsuit by CICPO in Newfoundland and Labrador

The latest edition of the Canadian Pharmacists Journal has extensive story on the Council of Independent Community Pharmacy Owners and it`s lawsuit against the government.

Please read the full article PRESS HERE