If you read the blog, “Say What? What Opponents say about Patient Choice” you heard all the “facts” and arguments presented by the PBMs, health plans and insurance companies why Patient Choice legislation is a bad idea. This included quotes from studies, government reports and surveys providing “evidence” that patient choice legislation increases health care costs, undercuts patient safety, and that “all patient choice laws are a bad idea from a public policy perspective.” What can you say and do to convince legislators to support your bill?
In preparation for testimony before a legislative committee, one tries to anticipate what the opposition will say and do, and while you don’t know the exact content, a strategy must be in place to convince legislators that the bill should pass, no matter what is said by the opposition.
How do you do this? You use the power of the story. For those of you who have a little silver in your hair, you may remember a radio broadcaster by the name of Paul Harvey. He broadcast the news from the 1950’s through the 1990s on 1200 radio stations and 300 newspapers. In the latter half of his career he became well known for the radio series “The Rest of the Story.” He would present either a news or historical event and then, using the power of the story, present a completely different perspective on the topic that most listeners had not even considered.
The power of the story was used to pass Patient Choice Legislation through the Colorado House of Representatives. Testimony in support of the bill was not provided by lawyers and lobbyists as the opposition had done, but by pharmacists and their customers.
The pharmacists shared their experiences and consumers provided real life examples of the challenges of dealing with PBMs, and without citing a single statistic, debunked many of the claims made by the PBMs and insurance companies during their testimony.
The pharmacists provided examples how PBMs affected their business, their patients/customers and the impact of no longer having the ability to fill the maintenance medications for their customers.
It was the testimony from the customers/consumers that was the most powerful. They told their stories of how they had signed up for a health plan that told them they could use the pharmacy of their choice and then discovered that this only applied to their acute medication prescriptions and that they had to use mail order for all their maintenance medications. They told stories of their insulin being delivered by mail, left on their fence post at the entrance to their ranch and how the package sat in the sun for an entire summer day. They told stories of spending 35 minutes to call in their medications for a refill and getting to talk to a pharmacist about a concern they had. They told stories of how, as an AIDs patient, mail order presented all sorts of concerns of confidentiality and privacy when living in an apartment and having their medications being left at their door or manager’s office. Doesn’t it make sense for them to go to their local pharmacy and get the care, attention and privacy they need? What if the medications were stolen from the front door? They were told once the delivery was made it was their responsibility.
The customers/consumers were so eloquent, with statements such as
We like using local businesses to support our local economy. We want someone locally that we know and trust for our medical questions and we prefer having our medical records all in one place.
If this bill doesn’t pass it will put small pharmacies out of business. We won’t have local pharmacies because they can’t survive on filling prescriptions just for acute medications.
We feel our pharmacist has blessed us and our community.
So how powerful is the power of the story? The Patient Choice bill wasn’t given much of a chance of passing even the first committee hearing, not to mention, the entire House of Representatives and the first committee hearing in the Senate. You couldn’t turn the corner in any part of the Capitol without bumping into one of the many lobbyists from the PBMs, health plans or insurance companies, yet the power of the story was like the rock used by David against Goliath. Even the legislators who voted no on this bill felt compelled to qualify their no vote with comments during the voting in committee with comments such as “I will be a soft no”, “a very respectful no,” and “respectfully for now, no.” These are comments that you just don’t hear every day at the Capitol.