Rural hospitals are the front line of care for millions of Americans who canít travel to big cities for medical treatment. Most are small, less than 25 beds, and many struggle to keep their doors open in the face of rising costs. A little-known prescription drug program called 340B helps these providers stay in business ó and extend vital services to needy patients.
Millions of Americans receive care thanks to the program, but it has powerful enemies in Washington, D.C. The pharmaceutical industry wants Congress to restrict or kill 340B, even though it helps make medications more accessible to the poorest and most vulnerable among us.
Itís important to remember that Congress created the 340B drug discount program in 1992 with bipartisan support to help community-based clinics and hospitals serving high numbers of economically vulnerable people. In 2010, Congress expanded the program to rural hospitals to help them in their efforts to treat uninsured, under-insured and other patients who have difficulty getting access to care. Under the program, eligible clinics and hospitals receive outpatient pharmaceuticals at discounted prices from drug companies. These savings are often passed on directly to uninsured and under-insured patients. In addition, health care providers also use the savings to fund dialysis, cancer and AIDS clinics, as well as other services.
The positive impact of the program is tangible in small towns and rural communities across America.
ē In Centerville, Tenn., St. Thomas Hickman Hospital reaches out to patients without cars, picks them up from home and brings them in for lunch and medical treatment. The hospital also provides free medications on a regular basis to outpatients who canít afford them.
ē Cass County Memorial Hospital in Atlantic, Iowa, provides qualified outpatients a full year of medications for free. And it gives its emergency room doctors vouchers to supply medicines at no cost to patients, based on need.
ē At Regional Health System in the Black Hills of South Dakota, 340B savings fund patient treatment in a local detoxification clinic and a short-term crisis center.
The benefits of 340B flow far beyond the needy patients treated at Americaís rural hospitals. Because savings are often passed on in low-cost or free prescriptions, people take their medications and return less often to the hospital emergency room. That translates into lower costs for Medicare and Medicaid ó saving a bundle of taxpayer dollars.
If Big Pharma persuades Congress to limit or end the program, hardworking Americans in the heartland of the country will lose as hospitals cut back on prescription discounts, treatment and services. Many of our hospitals and clinics would have to close altogether.
That would be a travesty we canít let happen.
Raymond G. Christensen, M.D., is president of the National Rural Health Association.
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