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Let’s keep bad players from ruining good program


There’s an old story about a town that had a mouse problem. The town officials offered its residents 5 cents for every mouse tail they brought in as a way to incentivize the townspeople in the battle against infestation. Though many residents were bringing several bushels of mouse tails to city hall and collecting payment, the mice population unfortunately did not reduce.  That is because some residents took advantage of the program, and actually started to breed mice to create more opportunities for themselves. It just goes to show you that government programs with even the best intentions will always have bad players, and it is no different today with the 340B program.

The 340B Drug Pricing Program was created in 1992. Government officials wisely saw that there was too great of a burden put on health care providers who served the uninsured and low-income patients. The 340B program would ensure that these patients would get their medications at a reduced cost, which would help both the patient with their out-of-pocket costs and the health care provider (like a community health center) to be able to continue to serve these needy populations. The program was actually a large success for nearly two decades, especially for facilities that treat cancer, hemophilia, HIV/AIDS, and other diseases.

navarreteIn 2010 though, the bad players started to take advantage.  Starting then, those facilities eligible to receive 340B discounted medications were no longer limited to small, independent, or rural health care providers.  It would now be available to large disproportionate share hospitals that provide care to not only the needy populations that the original 340B program was designed for, but also affluent people who do not need the added support.  We all know which are these hospitals – they are the ones that are building $100 million-dollar facilities and bidding on stadium naming rights.  

Now there is a movement to fix the 340B program, both from our representatives in Congress and the smaller centers getting squeezed out as large hospitals continue to enlarge their footprint at the cost of patients who are the most vulnerable. When it comes to fixing 340B, there are various proposals floating out there.  

As a member of the Arizona Legislature serving on the Health & Human Services Committee, I have always looked to ensure that whatever solution is created is one that puts patients first.  Congress should do the same and adopt a model where anyone participating in the 340B program is transparent in the ways they help patients who have no insurance or are below the federal poverty line. This would root out the “good players” of the program and the “bad players” of the program. It would also help direct funds where they need to go instead of where they are simply qualified to go.

We cannot let a well-intentioned program fall by the wayside. Now is the time for our representatives in Congress to ensure that a program that can and should work for Arizona’s poor and uninsured isn’t ruined by a few scrupulous townspeople.  

Sen. Tony Navarrete, D-Phoenix, serves Legislative District 30 and is the deputy director of Promise Arizona.


  1. Thank you for addressing this Tony

  2. Your point is well taken, Tony, and applies to myriad government programs that have been exploited by people and institutions seeking to game the system for private gain. The total distortion of agricultural support programs by agribusiness and government agencies comes to mind–but not much to presidential candidates (with one exception) so far. The current political environment is largely immune to the fact that tracking performance and fine-tuning performance is an essential ingredient in any continuing or long term program.

    How can I help with your initiative to fix at least this one?

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