Greg I think that the term ‘monopolistic racket’ does a substantial disservice to this (and many health professionals) and in this case their professional efforts with nursing homes, individual deliveries, dose packing, counselling, vaccinations etc i.e. including to the vulnerable and isolated that you may not see over and above the dispensing in front of you.
Costs of running a pharmacy in major urban and shopping centres and carrying hundreds of thousands of medicinal stock etc are significant. Being a small business shopping centre rents are increased based on turnover, rather than margins or profitability, so the dollars may come in but profits are reduced. These businesses have the entitlement to dispense (but so do some other health professionals) but also they have year-on-year increased restrictions on practise and also what they can ethically advertise or sell.
In terms of costs of the current set-up, the Commonwealth spends over $100b per year on health, the entire PBS is a bit more than $10b with dispensing fees being a small part of that, and not substantially increasing, but other areas of health are. For instance what the states and Commonwealth spend on hospitals and medical services are vastly above this and attempts to moderate the MBS growth via individual items have been much harder for the government to undertake as it is less of a broad ‘stroke of a pen’ by a Minister or senior public servant, though they have tried for many years.
But it is also not a ‘monopoly’, about 30000 pharmacists and 5400 pharmacies, largely individually owned and competing on many things, and competition has increased with supermarkets supplying many lines of treatment that were once the preserve of pharmacies.
By using this terminology about this health profession, a natural extension is to say there are monopolistic rackets by optometrists, dentists, physios, speech therapists, occupational therapies, Dr surgeries, surgical colleges etc. i.e all the professions regulated by AHPRA. What happens when oversight and restrictions are less? The current review of restrictions on cosmetic surgeons are a response to some rampant open marketing and reports on 60minutes etc.
I also dare say pharmacy would also be a welcome addition to our current supermarket duopoly (and we currently observe their record profit margins, price inflation and reduced checkout staff). Already we have lost diversity and service from their competing small businesses such as fruit shops, bakeries and newsagents etc., never to return. I don’t know of pharmacists living in mansions and I dare say there will not be tailoring of community services for individual health needs from a large chain, when management reports to shareholders.
