However the ACCC did have to step in and force Colesworth to slash the fuel discount. Who remembers the days of getting 24c / L discount?
In the short term the consumer may win from getting much cheaper fuel but the ACCC looks at the longer term and knows what will happen once other players are forced out.
This is classic monopolist strategy: use your monopoly in one area to gain a monopoly in another area.
For all that though, late last year, Woolworths sold all its petrol stations. Limited to a 4c discount it didnât play out the way Woolworths wanted it.
Colesworthâs basic problem many years ago was that with a monopoly on groceries there wasnât much growth to be had. They could cut margins to the bone and fight each other for tiny exchanges of market share in groceries - or they could expand horizontally into fuel, hardware (Bunnings, sort of, and now separated from Coles again, and the Masters debacle), liquor (where almost all the store brand names are âfakeâ, designed to give the illusion of choice), poker machines, office equipment (Officeworks). I donât blame them for eyeing off pharmacy as another area to expand into - thatâs companies doing what companies do - but I am happy they were blocked.
Indeed. There is nothing good about market concentration in private hands from a consumer point of view. Would opening up pharmacy ownership produce more concentration or less? Would the consequences be worse than the present artificial rules?
Sounds as if Woolies and Coles would if they stepped into pharmacy apply the same pressure to pharmaceutical suppliers as they do to their current producers.
Of course that would only affect prescription and regulated medicines. Everything else pharmacies sell are already in the local super market.
If there is a consumer fear to be held, is it that by adding to the turnover potential of a mini Woolies or Coles, they can press into smaller communities as the sole supplier, of alcohol, groceries, take away food, banking, poker machines, and pharmacy?
They are not quite there yet.
The alternate view point might be that for many smaller communities, a single integrated business perhaps is the only viable way forward. Iâve seen some rural small township IGA stores diversify as far as possible to maximise their potential to stay in business?
Many small enclaves in the regions already live in that business model. A servo that is also a general store with some liquor, food, and clothing, as well as being the local take-away and cafe. But not yet the pharmacy which can be a long drive or mail order.
They do exist in a way. Until a pharmacy opened in the nearby village the doctorsâ surgery dispensed prescription medicine and the newsagent sold the non-prescription medicine, equipment and accessories usually found at a pharmacy.
I canât see prescription meds becoming available at the local servo/general store/cafe. There is a real need for pharmacists to consider all the ramifications of the drugs each patient is taking and to give advice on how and when to take, possible side effects, decide on substitutions etc. Just because some fail in this duty doesnât mean it has no place. This is not to say the dispenser/adviser has to be the owner.
Iâve found, for example, that the supermarket might have the product but in only one pack size whereas the pharmacy has several pack sizes; or the pharmacy has a bigger range of products generally (for medical or pharmaceutical products that can legally be sold in the supermarket).
An interesting growing(?) area is pharmaceuticals that are not prescription-only but which are restricted in some way (e.g. not directly available on the shelves and you have to ask for it). This doesnât really suit the supermarket model (although they could hide these pharmaceuticals with the tobacco products if they wanted to). I assume that these restrictions are coming from government. Perhaps thatâs what you meant by âregulatedâ.
And Iâm quite sure that the profits the drug stores in the U.S make selling medicines is greater than our pharmacies make selling them for PBS prices
The pharmacy still get the ârealâ price of PBS articles, the difference is that the Govt make up the difference between the PBS cost and the real cost and reimburse that to the pharmacy when records are lodged. On most PBS medications they show the real cost normally in the bottom right hand corner of the script label. A chemist can actually make more on some PBS articles if they choose to add the allowed mark-up if the item/s is/are priced below the co-payment of the patient:
From the PBS site (http://www.pbs.gov.au/info/about-the-pbs#What_are_the_current_patient_fees_and_charges)
" Items that are priced below the general patient co-payment
For general patients, an allowable additional patient charge can apply. The allowable additional patient charge is a discretionary charge to general patients if a pharmaceutical item has a dispensed price for maximum quantity less than the general patient co-payment. The pharmacist may charge general patients the allowable additional fee but the fee cannot take the cost of the prescription above the general patient co-payment for the medicine.
The fee is currently $4.53 and is adjusted on 1 January each year. This fee does not count towards your Safety Net threshold."
They are also allowed to charge a Safety Net Recording fee:
" Additional fee for ready prepared items
In addition, if a medicine has a âdispensed price for maximum quantityâ less than the general co-payment a Safety Net recording fee may be charged by your pharmacist. This fee may not take the cost of your script above the co-payment.
Concessional patients do not pay this fee.
This fee is currently $1.23. The amount of this fee does count towards your Safety Net threshold."
To see a more comprehensive list of fees, Co-payments and Thresholds and to see some examples of subsidies the Govt pays see:
You might be surprised, but some of our (low cost) medicines are sometimes cheaper buying them non-PBS! Of course that doesnât count toward the safety net, but.
Walmart is apparently struggling and the âdrug storeâ industry is consolidating in multiple ways. With US economies of scale, lack of worker protections for the most part, and some ideologists in Australia lusting after the US economic model for everything whether potentially applicable, good, bad, or indifferent; there could be a reasonable argument for artificially protecting chemists; I am not taking sides although I have my preferences, but note which related staff are being âreducedâ at Walmart as an example of how it inevitably goes.
In many business/government services it is common to try to âloseâ senior staff because they cost more in salary and sick leave as they age. The accountants in charge equate a new hire straight out of school as equally skilled and better for their ledgers with a staff who has decades of experience and a top track record.
As the first world transforms from a production to a service model an honest question is whether that might require inefficiencies, eg more artificial protections and more services with more fees to any given activity as part of the overall employment picture. As production has become more and more mechanised the balance between producers and workers/consumers has shifted. A never ending question is what and where are the jobs? Will related inefficiencies through protections of some businesses such as chemists be a necessary component? One of the examples of questionably necessary added services might be the myriad booking sites that once served major concerts, but now are into adding fees tor dinner bookings.
An article regarding the pharmacists taking offence to the AMAâs response to tthe Terry White Chemmart proposal to seize business from the doctors so as to furter enrich themselves.
Perhaps the AMA should petition the Federal Government to allow GPâs to own and operate pharmacies.
This highly selective protection of the Pharmacy Guild by the Federal Government is akin to the Federal Government announcing that the only private schools which will receive government funding in future will be the elite Anglican schools.
I come back to my original comment: Everything is always about greed and vested interests.
The AMA looks after its members and protects its turf the same as anything else.
In some sense it is questionable as to whether they would be âseizing business from doctorsâ. The assumption is that the person would otherwise have had the same checks done but done at a doctor. Many slackos just wouldnât have had those checks done at all. Where that is the case this may be an overall win for health outcomes in Australia even if the AMA doesnât like it.
If the check is one that can be done by the person himself / herself at home, I donât see a problem with choosing to pay money to have a pharmacy do it.
However we should be completely clear-eyed as to the motivation of Terry White and BUPA. They want to increase profits.
In the best case scenario, BUPA increases profits by having a healthier cohort of insured customers and that could be a slippery slope towards managed health. However at this stage I donât suppose it is mandatory to have that package of checks and equivalently I suppose that there is no financial penalty in the cost of your health insurance with BUPA if you donât have that package of checks.
The bottom line is that if you expect someone else to pay your health costs (whether it is the government or an insurer), you give up a certain level of control.
Getting a renewed prescription is not about wasting everyoneâs time. Your doctor needs to see how well you are doing in general and specifically, any side-effects of the medicine and if the medicine is still appropriate. If the visit coincides with the annual influenza shot, it is time well spent.
Thatâs how it is supposed to work. What about when you are in the door, the script is printed off and you are out in a couple of minutes and the system is charged a short consultation. Or you donât see the doctor at all. It is common in my area to ring up and arrange to have it at the receptionistâs counter, this saves the face-to-face renewal farce but they still charge $10 to print it.
I understand the theory of what you are saying but for a person who really is on something for life and has been on it for X years without side-effect, commonsense might say that you would rely on the patient to take the initiative if the medicine ceases to be effective or a side-effect emerges.
A doctor could always argue âbut what if?â, and I get that (there may even be liability considerations for the doctor) but the established practice fails a cost/benefit analysis i.e. waste a lot of taxpayer money and a lot of time on the 99% of patients who are going well without a followup consultation (and who know that!), while picking up the 1% who are not going well and who have not noticed it themselves.
Depending how the numbers work out, a new prescription may be required more frequently than annually, particularly if the medicine does not have a long shelf-life i.e. one dispense of the prescription cannot be a lot of medicine (or for unrelated commercial reasons of the manufacturer).
On the other hand, if the prescription renewal really is annual and nicely aligns with a flu shot then the doctor is still going to have to rely on the patient taking the initiative if a problem doesnât conveniently align with the flu shot.
