In most families, moms are the caregivers. They know the right cough medicine, the right dosages, the difference between aspirin and Tylenol, and what to do for their child’s allergies. Most moms have a box or tray with all kinds of cures for their children. Mom’s “medicine box” is there to fix middle-of-the-night pains and fevers. God bless moms.
Relief may range from chicken noodle soup to special itch-soothing creams. Moms handle most issues with love and with the right choice of home remedies and over-the-counter (OTC) medications. If it’s not in “the box,” a quick trip to a local 24-hour pharmacy will secure the needed treatment. If mom’s self-care and time doesn’t make the hurt go away, a doctor’s visit may be in order, with a prescription to be filled at the local pharmacy. But in most situations, a caring mom, Mother Nature, and over-the-counter medications will allow us to avoid unnecessary expenses and doctor visits.
For years, consumers have been encouraged to use lower cost generics and even less expensive OTC medications. In the past five years, more than 20 million Americans have purchased account-based health insurance in the form of health savings accounts (HSAs) and health reimbursement arrangements (HRAs). Millions more use flexible spending accounts (FSAs). Many use a plan-provided debit card to pay for medications. As part of their insurance plans, families can use these accounts to purchase OTC medications such as prenatal vitamins, antacids, allergy medicines, pain relievers, and cold medicines.
So, what changes under ObamaCare? Read for yourself. Section 9003 of ObamaCare states: “A drug is a prescribed drug determined without regard to whether such drug is available without a prescription.” What??? Translation from government-speak: Effective January 1, 2011, an OTC medication needs a doctor’s prescription to be defined as a qualified medical expense, even if it is otherwise available without a prescription! Only in the world of government control and bureaucracy would it make sense to require a mom, who is treating a sick child at 3am, to get a prescription for an OTC medication. That trip to the 24-hour pharmacy just got “government complicated.”
In the government world of economics, the new provision for OTC medications was estimated to save more than $5 billion dollars. Why? Because they assumed that moms will just pay cash and not get it covered by insurance reimbursable under tax-advantaged HSA, HRA, or FSA accounts. But here’s what is likely to happen in the real world:
- Moms, pharmacists, doctors, and children will be confused and outraged by the new restrictive rules. They won’t understand why they need a “prescription for non-prescription medications.”
- Pharmacists and checkout clerks will only be able to shrug their shoulders and state during the cash register denial, “That’s ObamaCare. Here’s your change.”
- Moms will need to take children to the doctor’s office to get a prescription for any OTC medication.
- Doctors will be baffled by the illogic of a request for a prescription for a non-prescription medication. Of course, with new exposure to liability, they will need to see the patient before prescribing anything. This produces an office visit charge, maybe a follow up visit, and makes access to care harder for others in real need of physician attention.
- To avoid calls, confusion, and assure insurance coverage, physicians are likely to start prescribing stronger “real” prescription drugs. That will add costs and increase the risk that patients will have adverse reactions to prescription drugs in situations where a simple OTC medication would suffice.
- After spending millions to accommodate consumer’s needs, drug card vendors will spend millions changing their cards to deny coverage for OTC medications.
OTC medications may not be the biggest problem with ObamaCare, but it is a simple example of how the regulations in ObamaCare will inconvenience millions of Americans. A mom doesn’t have to be an economist to see that this one item in ObamaCare will increase costs, decrease access to care, and lower the quality of that care. None of it helps her child. Only in Washington and Alice’s Wonderland does this change “save money.”
In the United Kingdom and Germany, patients must follow similar government mandates in order to get medications. Using those countries as examples, the Foundation for HealthSMART Consumers estimated that the cost increase of using more expensive prescription medications, more office visits, and added pharmacy expenses will total at least $10 billion. Of course, in Washington D.C., the difference between “saving” $5 billion and costing $10 billion is just a rounding error.
ObamaCare is so complicated that few understand all of its details and implications. Certainly the politicians who supported it did not think through its unintended consequences. They didn’t consider or care about the unnecessary hurt and delays that it would cause children. By not reading the bill, they dismissed mom and her medicine box cures. Common sense has taken leave. In November, mom may just tell some of the politicians who supported Obamacare to take leave.
Ronald E. Bachman FSA, MAAA, president & CEO of Healthcare Visions. He is a Senior Fellow at the Center for Health Transformation, an organization founded by former U.S. House Speaker Newt Gingrich, a Senior Fellow at the Georgia Public Policy Foundation, an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. He is also and a Senior Fellow at the National Center for Policy Analysis (NCPA). To better understand health reform and the new preventive care guidelines, go to www.healthreformnavigator.net.