For more than 100 years the town of Lubec has had a community pharmacy to serve the health needs of its residents and those of the surrounding communities – a heritage that will end if Gov. John Baldacci’s administrative rulemaking proposal to reduce the Medicaid (MaineCare) dispensing fee is implemented.

The demise of independent community pharmacy practice, including Lubec Apothecary, is not a priority or even a consideration, as the Baldacci administration acts to offset a budget shortfall in the Department of Human Services resulting from incompetence and gross mismanagement. Baldacci, Trish Riley, his top aide on health care issues, and the leadership of DHS in an information and intelligence are making decisions vacuum.

Policies are being implemented that adversely affect the health and welfare of MaineCare patients and reimbursement MaineCare providers receive for their services. On Oct. 1, 2003, DHS implemented a program to provide diabetic supplies to MaineCare patients. DHS had previously, without consulting Maine pharmacists and other suppliers, signed a contract with a single-source supplier of diabetic products.

If a pharmacy wanted to continue to provide diabetic supplies to its MaineCare patients the pharmacy had to sign a purchase agreement with the single-source supplier, who, in many instances, did not have the lowest price available for a particular diabetic supply. If the pharmacy refused to sign the purchase agreement it would no longer be an authorized Durable Medical Equipment (DME) supplier, and could not supply diabetic or other DME products to its MaineCare patients. When most of Maine’s pharmacy chains and independent pharmacies refused to participate in this ill-conceived program the program was drastically altered.

Recently, the Bureau of Medical Services of the DHS proposed emergency litigation to allow pharmacies to provide asthma-related supplies to MaineCare patients. These supplies were previously only provided by those pharmacies that signed the single-source purchase agreement and were designated authorized DME providers. More than half of the prescriptions filled by Lubec Apothecary are for MaineCare patients. If the proposed reduction in the MaineCare pharmacy dispensing fee is implemented my pharmacy will experience a reduction in income it cannot sustain, which will leave me with two unacceptable choices. If I refuse to continue as a MaineCare provider I will be forced to close my pharmacy within two months, and if I continue in the MaineCare program I will be able to keep my pharmacy open several additional months. Which option is acceptable? A Catch-22.

When Gov. Baldacci was involved in the campaign for the office of governor he frequently cited the need to improve the economy of eastern and northern Maine. Apparently this was nothing more than a campaign issue designed to garner votes from the voters of eastern and northern Maine. In every rural community in eastern and northern Maine where a pharmacy is located, chain or independent, it is one of the keystones of the economy of the community. If you remove that keystone the economy of the community will begin to crumble. Nationwide there is a shortage of pharmacists, and in the states of California and Maine the shortage is acute.

If a community loses its pharmacy it will be a long time before it is replaced. Apparently this is a message that has been lost by the administration in Augusta, and the Legislature as well.

Donald E. De Golyer, R. Ph. is president of Lubec Apothecary .