Guest Commentary
By Ben Shah
San Diego’s working families and small businesses are getting crushed by a healthcare system that puts profits over people. State Senator Scott Wiener’s SB41, marketed as a drug price fix, is a bureaucratic bulldozer that will flatten local pharmacies, jack up costs, and gut access for our most vulnerable communities. As a San Diego business leader who has seen government overreach choke local economies, I am calling this bill what it is: a Sacramento power play that betrays the neighborhoods it claims to help while giving big pharma a handout.
Pharmacy Benefit Managers (PBMs) negotiate prices for insurers, employers, and Medicare, saving 1040 dollars per person annually. In Georgia, balanced PBM oversight since 2022 has preserved pharmacy networks, saving small businesses 1.8 billion dollars in 2023. SB41, by contrast, could saddle California employers with 1.7 billion dollars in higher premiums, hitting San Diego’s 32000 small businesses.
Wiener’s bill demands PBMs ditch rebates, promising lower pharmacy costs. That is a flat out lie. Stripping PBMs’ leverage could spike drug prices 12 percent, hammering San Diego’s Latino and immigrant communities, where 27 percent already lack adequate insurance. Florida’s 2022 PBM reforms which mandated rebate passthrough still resulted in drug costs climbing 9 percent by 2024. California’s 11 percent pharmaceutical spending surge in 2023 points to the real culprit: drugmakers’ 18 percent price hikes in 2024.
SB41’s crackdown on pharmacy networks and mail order delivery is a dagger to access. A 2024 Journal of Managed Care and Specialty Pharmacy study shows mail order saves 15 percent on chronic drugs, vital for San Diego’s 120000 seniors. SB41 could shutter 200 San Diego pharmacies according to a 2024 estimate by the California Pharmacists Association, potentially devastating neighborhoods like Barrio Logan and City Heights where low income families rely on local drugstores.
The bill’s bureaucratic bloat is a nightmare. SB41 piles on to California’s overspending problem with oversight boards and rigid rules, mirroring the Affordable Care Act’s exchanges, where costs rose 15 percent by 2023 according to CMS data. Oklahoma’s 2021 PBM laws jacked up administrative costs 10 percent, and SB41’s state mandates could snarl federal Medicare contracts, delaying care per a 2022 GAO report. San Diego’s small pharmacies cannot afford this red tape.
Wiener dodges the real enemy: drugmakers. Their 18 percent price hikes in 2024 dwarf PBM profits, yet SB41 lets them slide. Generics saved 373 billion dollars nationwide in 2023 but California’s generic uptake lags Minnesota’s by 5 percent. Why not cap drugmaker prices as Maryland did in 2023, cutting high cost drugs by 7 percent? SB41 is a hollow gesture torching PBMs while San Diego’s communities suffer.
Sacramento is doing big pharma’s bidding and our neighborhoods deserve better than this self interested meddling. Reform must empower families with access and affordability: transparency, generics, no rebate hoarding, not a wrecking ball like SB41. Lawmakers must ditch this bill and protect San Diego’s pharmacies.
Shah is a San Diego Real Estate Investor & Economic Stakeholder