Wednesday, March 9, 2011

Another Reason to Hate Obamacare

. . . as if we needed one. Obamacare's changed rules on over the counter medicine and flexible spending accounts is causing some patients to seek doctor's prescriptions for remedies such as Nyquil or ibuprofen. If you weren't aware, flexible spending accounts take pre-tax dollars out of your paycheck and allow you to spend them on qualified medical expenses, which avoids taxes on those dollars. The catch is that once you elect an amount to be deducted, any money not spent is lost at the end of the year. This leads people to stock up on over the counter medicine in December if they haven't spent their whole election. I have such an account, because my insurance doesn't cover vision and dental and I didn't like the price of buying supplemental to cover.

Today's WSJ discusses the law's unintended consequences. Patients are seeking prescriptions for over the counter because that makes those medicines eligible for reimbursement. Before the law, I could buy Aleve, for example, and be reimbursed. Because some patients are going to doctors for these prescriptions and because pharmacists must handle the prescriptions and label the bottles, it is significantly increasing the overall cost of health care. Remember how Obama's acolytes said that we couldn't trust the public to make their own decisions on health care? Guess they were right, but you can't trust the bureaucrats either. The obvious solution is to take away all consumer choice, eh comrade? The money quote from the article:
What the law's writers didn't anticipate was the determination of some people to squeeze every last drop of tax savings from their accounts.
Some other gems include this quote from a an economist who formerly advised HHS:
"The entire flexible-spending account thing is a waste of our taxpayer dollars," says Jonathan Gruber, . . .
A waste of taxpayer dollars? That's my f____ing money! Plus, if I buy an over-the-counter drug and don't get a prescription, I've lowered the cost to my insurance.

The over-the-counter provision isn't the only part of the health-care law that has defied expectations.

Health-policy experts predicted that new insurance pools for high-risk patients would attract so many expensive enrollees that funding would be quickly exhausted. In fact, enrollment is running at just 6% of expectations, partly because of high premiums.

A provision preventing insurers from denying coverage to children with pre-existing health conditions prompted insurers in dozens of states to stop selling child-only policies altogether.

And a piece of the law designed to centralize patient care by encouraging health-care providers to collaborate is running into antitrust concerns from regulators.

The hits just keep coming.


  1. "Remember how Obama's acolytes said that we couldn't trust the public to make their own decisions on health care?"

    No, I don't. Have any citations? What I do know, and see every day, is that most people do not understand the complexities of their own health care. Most people are not hyper-informed bloggers. Most people cannot remember the details of their own care. Just as an example, most of my patients who have had heart valves replaced do not remember which one they had replaced.

    The information asymmetry is huge. Add in the fact that many major decisions are made under stress and it becomes clear why markets are not very efficient in health care.

    So, we need to help people make the best decisions. We can do that with insurance purchases by requiring that insurance companies offer standardized products so that they compete on price and not obfuscation.


  2. Steve,
    "we need to help people make the best decisions." In a free market, that function is performed by the dissemination of product information and pricing. While I agree that health care has less transparency than some other products, the answer is more transparency and consumer choice, not less. Markets aren't perfect, they're just better than any other form of economic organization.