4 AM, Saturday morning. The pharmacist packs her car with vaccine supplies and documentation, then hits the road. It’s well before sunrise, but 5 hours and counting until the community clinic starts. Before the day ends, she’ll have administered more than 100 vaccines, with a 6-hour road trip bookending her day.

American healthcare is a disparate collection of incongruencies. Built on the fundamentals of capitalism yet segregated from the free market, the U.S. healthcare system has left a nation of disenfranchised providers attempting to care for bewildered patients who no longer know who to trust: their doctors and pharmacists? Or the health plans promising patient access and coverage of care while seemingly doing everything in their power to deny both?

If we’ve learned anything from the COVID pandemic, it’s this: community care providers get the job done. Quickly, efficiently, effectively. West Virginia, New York, and Louisiana are among the states whose governors wisely sought to include neighborhood pharmacists in the vaccine rollout. West Virginia became a case study.

But the perception that “bigger is better” still rules the day, and so giant, vertically-integrated corporations with their brick-and-mortar pharmacies-with-a-clinic snapped up government contracts to vaccinate vulnerable populations — and promptly stumbled in the process, sending mayday calls to local community providers because the truth is size does not equal capability.

Americans once again lost out on actual health care because of — and in spite of — the free market. And 3 months later Americans are still losing.

As she drives, the pharmacist considers the issues she sees every day: patients worried about prescription prices; endless cycles of prior authorizations and denied reimbursement claims; audits that feel predatory; PBMs helping themselves to her bank account in the name of CMS and other health plan payers. And now the opportunity to assist in vaccinating citizens of rural Belle Glade, Florida — nearly 3 months after the first vaccines debuted in the U.S. Because, in Florida, community pharmacies were among the last to receive vaccine shipments as part of the state’s COVID immunization program, with rural communities like Belle Glade left to figure out vaccine access for themselves.

Independent pharmacies are healthcare heroes whose “frontline warrior” attitude and optimism doesn’t ebb. It’s optimism and a genuine desire to provide personalized care that motivates pharmacists to become independent pharmacy owners. And whether it's kismet or kindred spirit, community pharmacies and their patients share a common belief: they understand that healthy communities prosper, and people who feel healthy are more likely to participate in the betterment of their communities.

Belle Glade is a small city in a rural part of West Palm Beach County that boasts a population of just under 20,000. Sometimes called “Muck City” because of the abundance of “muck” in which sugar cane grows, it is a community in which the median age is 33 and median household income just barely tops $25,500.

When Belle Glade appeared in a “60 Minutes” segment examining whether wealth and privilege had influenced vaccine distribution, an independent pharmacist jumped into action. Assuming the roles of healthcare provider, event coordinator, and patient advocate she called her fellow pharmacy owners, organized a pop-up COVID vaccine clinic in 48-hours, and brought positive press attention to a situation that just days before had been hailed as one of Governor Ron DeSantis’ biggest blunders.

Actions of this nature are not uncommon in independent pharmacy. Determination, drive, and swift flexibility allow community pharmacists to see the need and respond immediately. They are of the mindset that patients and communities are top priority — qualities rarely, if ever, seen in corporate healthcare conglomerates.

It’s an example of practice and outlook that truly does put the care back in healthcare.

PUTT is a nonprofit organization dedicated to advocating on behalf of independent pharmacy & fighting against PBM anti-competitive business tactics. TruthRx.org

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