By Ben Dishman, PharmD
SAN DIEGO — A mildly demented and slightly disheveled gray-haired man comes to the window and says “I need to fill this prescription.” His mentally ill girlfriend blurts out he just had a heart attack and needs his blood pressure medicine filled. I overhear the technician at the window explaining to them that he does not have any type of health insurance to cover the cost of the medication. He asks the cost and is told it $48 for a one-month supply of his potentially life-preserving drug (and this is at a community healthcare facility for the poor and indigent).
He reaches into his tattered wallet and says, “I guess I will have to wait on getting it.” His girlfriend again blurts out he needs his heart medicine. As they start to leave the pharmacy I walk over to them and tell them that if they go to Walmart they can pick up the same medication for $4. After I explain where the nearest Walmart is, they thank me and leave.
I am a retired pharmacist who occasionally works at a community health center in its pharmacy. This scenario plays out day after day in one of the richest counties in America. Although the health care center can provide physician visits and decide upon an appropriate healthcare plan, it does not have the ability to pay for the medications needed to keep that patient healthy.
My wife is a Nurse Care Manager at a local hospital that deals mainly with an indigent population. I have provided her with the Walmart list of medications available for $4 and she has educated others at the hospital about what I consider a service Wamart provides to the less fortunate in our society.
The pharmacies within Target used to also offer the $4 prescriptions, but the pharmacies now run by CVS have elected to stop this program. I am not judging CVS. Perhaps its management realized CVS was losing profits by continuing the program (but here we are equating healthcare with profits).
I spent over 30 years working for the Veterans Administration (VA) as a Psychiatric Clinical Specialist in the field of pharmaceutical science, and taught nursing, medical and pharmacy students and residents.
Over the years working at the VA, I came to the realization that the majority of patients I treated could not afford the medications the VA provided if they had to purchase them on their own. I sat many times in my office with a depressed patient explaining to me that a spouse who is ineligible for VA benefits was in pain and suffering because they could not afford to visit a doctor or pay for the prescribed medications.
Many patients shared their medications with others who needed a little Motrin for their arthritis. The patients were made aware that this practice is illegal and that they would not be provided extra medications if they ran out early.
I could tell from their expressions that they would ignore my advice.
Whatever else might be said about Walmart, in the field of pharmacy this company is providing a service to the community. Thanks to Walmart, those in need do not have to chose between eating and taking a life-preserving medication. In its own way, Walmart is practicing tikkun olam.
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Ben Dishman is a retired pharmacist residing in San Diego.