U.S. Rep. Derek Schmidt spent almost all of Thursday in Iola, visiting with people at their places of work.
On the list were Allen County Regional Hospital, the Allen County Sheriff’s Office, Iola Rotary Club, Allen Community College, Russell Stover, Peerless and The Iola Register.
SCHMIDT enjoyed a tour of the hospital and engaged in an extensive discussion about the pressures facing rural health care systems with administrator Pat Patton that touched on federal health policy, workforce shortages, pharmacy access, insurance reimbursement, and the future of rural hospitals in Southeast Kansas.
Patton discussed his 30-year involvement with the federal 340B Drug Pricing Program, a federal initiative that allows eligible hospitals and clinics serving a high percentage of low-income or uninsured patients to purchase prescription drugs at significantly reduced prices.
Hospitals are then allowed to use the savings to help offset uncompensated care costs, expand services, or support community health programs.
Patton said his experience with the program began when he helped establish the first Federally Qualified Health Center (FQHC) in Kansas in the early 1990s.
FQHCs are community-based health clinics that receive federal funding to provide primary care services in underserved areas, regardless of a patient’s ability to pay. They often serve as a critical access point for preventive and routine care in rural and low-income communities.
SCHMIDT ASKED Patton what aspects of the 340B program were most important to preserve or change.
Patton said that one of the biggest concerns is that pharmacy benefit managers, or PBMs, have gained increasing control over drug pricing and reimbursement.
PBMs are third-party companies that negotiate prices with drug manufacturers and pharmacies, determine which medications are covered, and set reimbursement rates for pharmacies. While originally intended to control costs, critics argue PBMs have become so powerful that they now drive independent pharmacies out of business.
“The really sad part about it is they’re pushing out these local pharmacies,” Patton said, explaining that PBMs can impose contracts so unfavorable that small pharmacies are forced to pay simply to participate.
Patton noted the issue is not only about hospitals but also about preserving access to pharmacy services in rural communities.
Schmidt said the discussion highlighted a fundamental reality of the American health care system.
“The way we pay for the delivery of health care services in our country is, at its core, not rational,” Schmidt said. “It is the result of lots of individual decisions over time that were designed to do one thing but are now doing something else instead.”
Schmidt cautioned that reform efforts must be undertaken carefully.
“As we try to fix some of it, we’ve got to be sure we don’t inadvertently undo something that is holding up a whole other pillar,” he said.
