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Thank you, LachlanMinnesota. I really appreciate your encouragement this morning. Part of my job is explaining how health insurance works to businesspeople and while I’m fairly good at it, using only words to explain is far more difficult than explaining in person, with white boards and gestures and eye contact.

I didn’t realize until after the call the Rush thought that the Pharmacy Benefits Manager (PBM) is a person. In actuality the PBM is a company that acts as an information conduit between pharmacies and insurance companies. I wish I’d have realized that at the moment.

I also thought of a better way to illustrate how the “one bank account” impacts the purchase price of medication. Unfortunately I thought of it hours later. One can envision it as a spreadsheet with three columns. One column is Health Insurance Company dollars (out of pocket max, deductible, etc.) The next column is the Pharmacy Benefits Manager dollars (out of pocket max, deductible, etc.) The third column is the sum of the other two columns. Today, each column is summed up separately during the day and once each night, the insurance company and PBM trade information on each others’ column in order to calculate the third column amount.

When Obamacare kicks in, there won’t be an insurance company column and a PBM column. There will only be the third total column, and the PBM cannot talk to the insurance company at the very moment that a person gives a prescription to a pharmacist to determine the dollar amount of that third column at that very second.

Did you understand the explanation of how Obamacare is going to impact someone standing at the pharmacy counter waiting for a prescription during the call? Did it make sense?

Thanks again, LachlanMinnesota.