You remember that new Medicare prescription drug plan that came into being this year? You know, the one that so confused all the senior citizens that it’s gained only very slow acceptance? Well, it’s causing yet more problems: it’s threatening to put pharmacists out of business entirely.

Some Texas pharmacists with close ties to President George W. Bush and his adviser Karl Rove visited the White House last week to express their concerns with the program.

Among their concerns were that the Medicare prescription drug benefit doesn’t always pay enough to cover the actual costs of the drugs, and that the program doesn’t pay pharmacists quickly enough, causing cash flow problems.

Bill C. Pittman, a former president of the Texas State Board of Pharmacy who is chairman of Pharmacists for Bush, a political fund-raising group, . . . told Mr. Rove and other officials: “If pharmacists don’t receive immediate relief, some will go broke. Others are hurting so bad that they will choose not to participate in Medicare and Medicaid.”

. . . [Richard E.] Beck, who is vice president of American Pharmacies, a purchasing co-op based in San Antonio, said the first six weeks of the new Medicare program had been “a total fiasco” for many pharmacists. “I have some members on the brink of going out of business,” he said. . . .

Pharmacists said that Medicare drug plans were paying them less than Medicaid and commercial insurers paid for the same services.

In an interview, Mr. Beck said: “Reimbursement by Medicare drug plans is very low and slow. Pharmacists are being asked to bankroll the program. Many have to dig into personal savings and take out loans to stay in business.”

Medicaid and commercial insurers pay pharmacies 7 to 15 days after a prescription is filled, but Medicare drug plans often take 30 days or more, Mr. Beck said. — New York Times

What happens when all the pharmacies go out of business, or to protect themselves, stop taking Medicare entirely?