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By Pat Person
California Pharmacists Association

It is both ironic and tragic that while every politician, from president to city council, is focused on job creation and our economy, the state and federal governments have made a joint decision that will cost California jobs right now, when we can least afford to lose them.

Because of the decision made by the governor and the state Legislature, and approved by the federal Centers for Medicare & Medicaid Services, to yet again cut back reimbursement rates in Medi-Cal by 10 percent, physicians, dentists, optometrists and pharmacists throughout our state will have no choice but to stop participating in the health care coverage program. Worse, many clinics and pharmacies servicing rural communities will have to close their doors altogether.

The reason for that is simple: after years of reductions in the reimbursement rates the state pays to medical providers through Medi-Cal, it's no longer economically feasible to continue treating Medi-Cal patients.

The Sacramento Bee reported recently on just one example where jobs will be lost -- the Mayers Memorial Hospital District in Shasta County, where the health care industry is the top private-sector employer. At Mayers' skilled-nursing facility, 97 percent of patients are Medi-Cal enrollees, and administrators there are already contemplating what would happen if they had to shut down.

Similar problems are facing the Central Valley. The chief financial officer of the Kaweah Delta Health Care District, which operates two skilled-nursing facilities in Visalia and one of the three hospitals in Tulare County, told The Bee, "The natural thing is to close but where do we put the patients then?" The closest hospital-run nursing facilities are several communities and miles away from each other.

That would mean the loss of jobs, and there are similar stories at rural hospitals all through the state. The California Hospital Association conducted a survey last year when the cuts were being contemplated that showed that half of all the state's skilled-nursing units within hospitals would be forced to close, and an additional 35 percent of them would reduce their number of beds or stop treating Medi-Cal enrollees. That means tremendous numbers of job losses, not to mention skilled health care practitioners.

The economic tragedy would also strike small pharmacies in nearly every community. No one expects pharmacists to get rich from treating Californians insured by the state, but the reimbursements should at least cover the cost of the medications being dispensed. With this latest round of cuts, that's no longer the case. At Ming & H Drugs, we will be filling prescriptions and getting reimbursed below what it costs us to bring the medication into our store. We are being asked to, literally, pay out of our own pockets to provide services to Medi-Cal patients. This will force us to make decisions, not just about filling the prescriptions, but whether or not to continue to provide some of the services that we offer (free delivery, specialty prescription packaging), and these cuts may also result in employee hours being cut and/or layoffs.

As a result, our pharmacy may stop accepting new Medi-Cal patients and/or be forced to reduce staff. Unfortunately, some pharmacies serving Kern County Medi-Cal recipients may be forced to close down.

Paul Rohrer, president and chief executive officer of the Professional Pharmacy Alliance of California, recently stated that, "If the state action is granted, both rural and urban underserved communities across California will be adversely impacted as independent pharmacists are often the only access these Medi-Cal patients have to the medications they need and it will become too costly for many pharmacies to remain open."

Now that the state's action has been granted, we will unfortunately experience all too soon more closures affecting millions of Californians and costing us even more jobs.

There are more than 7.5 million Medi-Cal enrollees. That is equal to nearly 1 in 5 Californians. The program is therefore one of largest employers and economic drivers in our state. It is absurd to reduce its funding without considering the effect the cuts will have on job creation and our overall economy.

At a time of record-high unemployment, one would think that elected leaders would be scrambling to support good-paying, quality jobs in the health care profession, not cutting them.

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Pat Person, incoming president-elect of the California Pharmacists Association, is a registered pharmacist at Ming & H Drugs in Bakersfield. This article originally appeared in the Bakersfield Californian.